Obstetric audit: the Bradford way

Obstetric audit: the Bradford way

Helens first and only fully diagnostic baby 3D 4D and HD scanning centre. Quite simply, we know we are the best at what we do. We have been open 11 years this year. We are well established having been open in St Helens since , having scanned over 50, ladies since then. We have an excellent reputation, as more than half of our business comes from customer recommendations and from customers that have been to us before. We are HD Live. The HD technology allows us to show you babies features in even more detail, it is truely amazing technology. We are all fully qualified and registered Sonographers and Midwives, we are registered with our relevent professional bodies. We provide a relaxing away from the hospital experience where parents can relax and take their time to bond with baby in a calm friendly environment. Our company consists of three qualified female NHS trained sonographers with many years experience of working in obstetric ultrasound and four receptionists who are able to advise you on the best time to come for your scan.

Women’s Imaging

Tell us a little bit about your child. I agree to the Conditions of use I agree to receive communication about exclusive promotions, offers and products from Huggies and other Kimberly-Clark brands. Other reasons to have a 7 week ultrasound are to: Confirm the presence of one or more embryos and gestational sacs. Assess the gestational age.

Other specialized ultrasound scans may include fetal echocardiogram, biophysical profile and fetal Doppler ultrasound, or additional biometric measurements including nuchal translucency (NT) and cervical length [].

International conference on transition and cord clamping at birth April It is increasingly recognised that the circulatory changes involved in transition at birth cannot occur within a few seconds of birth. While the healthy fetal circulation and the healthy neonatal circulation are moderately well understood, the underlying triggers, the precise sequence and speed of the changes in the circulation are not.

How can we interefere in something we do not understand? Nearly all textbooks and journals which include the physiological transition of the neonate at birth describe a marked change in the peripheral vascular resistance and an increase in the afterload of the heart. One notable exception is Gray’s Anatomy. Gray’s Anatomy describes inflation of the neonatal lungs as the first change after birth and does not describe any changes in the afterload of the heart.

Afterload is the force that the myocardium generates during ejection against systemic and pulmonary vascular resistances. Reductions in afterload increase stroke volume if other variables remain constant. Gray’s Anatomy also describe the release of bradykinins from the pulmonary vascular epithelium which are vasoconstrictors to the umbilcal arteries. A high oxygen tension in the blood reaching the umbilcal arteries also has a vasoconstrictor effect on these vessels.

Those texts that describe the sudden increase in afterload of the heart, explain that this is the result of withdrawal or closure of the placental circulation. Although Hofmeyer did demonstrate a sudden increase in arterial pressure in the healthy neonate in response to the application of a clamp on the umbilical cord 35 seconds after birth there have been no other investigations of the arterial effects of clamping the umbilical cord.

There is enough understanding of the fetal and neonatal circulation to build a computer simulation and determine whether or not the marked rise in afterload of the heart is likely to occur during a physiological transition. This is what it shows.

Ultrasound

Doppler Ultrasound The doppler shift principle has been used for a long time in fetal heart rate detectors. Further developments in doppler ultrasound technology in recent years have enabled a great expansion in its application in Obstetrics, particularly in the area of assessing and monitoring the well-being of the fetus, its progression in the face of intrauterine growth restriction, and the diagnosis of cardiac malformations. Doppler ultrasound is presently most widely employed in the detection of fetal cardiac pulsations and pulsations in the various fetal blood vessels.

The “Doptone” fetal pulse detector is a commonly used handheld device to detect fetal heartbeat using the same doppler principle. Blood flow characteristics in the fetal blood vessels can be assessed with Doppler ‘flow velocity waveforms’. Diminished flow, particularly in the diastolic phase of a pulse cycle is associated with compromise in the fetus.

Obstetrics is the field of study concentrated on pregnancy, childbirth, and the postpartum a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN) which is a surgical field.

Aetna considers detailed ultrasound fetal anatomic examination experimental and investigational for all other indications including routine evaluation of pregnant women who are on bupropion Wellbutrin or levetiracetam Keppra , pregnant women with low pregnancy-associated plasma protein A, and pregnant women who smoke or abuse cannabis. There is inadequate evidence of the clinical utility of detailed ultrasound fetal anatomic examination for indications other than evaluation of suspected fetal anatomic abnormalities.

Detailed ultrasound fetal anatomic examination is not considered medically necessary for routine screening of normal pregnancy, or in the setting of maternal idiopathic pulmonary hemosiderosis. CPB – Fetal Echocardiograms. Ultrasonography in pregnancy should be performed only when there is a valid medical indication. ACOG stated, “The use of either two-dimensional or three-dimensional ultrasonography only to view the fetus, obtain a picture of the fetus, or determine the fetal sex without a medical indication is inappropriate and contrary to responsible medical practice.

This recommendation is based primarily on consensus and expert opinion Level C.

Introduction to OB Gyn Ultrasound

The thought of coming into hospital can be a little daunting. We naturally want to make your stay comfortable and are aware that many women would prefer the added comfort and privacy of a single amenity room during their stay. At Watford General Hospital we have two types of amenity rooms available for women to book. Amenity rooms are available for women who wish to have extra privacy after they have given birth.

You will still be treated as an NHS patient, but are paying for the privacy of a single room.

Obstetric Ultrasound. Obstetric ultrasound uses sound waves to produce pictures of a baby (embryo or fetus) within a pregnant woman, as well as the mother’s uterus and ovaries. It does not use ionizing radiation, has no known harmful effects, and is the preferred method for monitoring pregnant women and their unborn babies.

Sonographer doing an echocardiogram in a child Echocardiogram in the parasternal long-axis view, showing a measurement of the heart’s left ventricle Health societies recommend the use of echocardiography for initial diagnosis when a change in the patient’s clinical status occurs and when new data from an echocardiogram would result in the physician changing the patient’s care. Transthoracic echocardiogram A standard echocardiogram is also known as a transthoracic echocardiogram, or cardiac ultrasound.

In this case, the echocardiography transducer or probe is placed on the chest wall or thorax of the subject, and images are taken through the chest wall. This is a noninvasive, highly accurate, and quick assessment of the overall health of the heart. Transesophageal echocardiogram This is an alternative way to perform an echocardiogram.

A specialized probe containing an ultrasound transducer at its tip is passed into the patient’s esophagus. This allows image and Doppler evaluation from a location directly behind the heart.

7 Week Ultrasound

Each of our early pregnancy scans come complete with a medical report. This early dating scan is available from 8 to 12 weeks and 6 days of pregnancy. If you feel weekly scans will offer more reassurance during the early weeks of pregnancy then these can be arranged in addition to this package. The primary purpose of this scan is to date the pregnancy and to determine well-being.

The scans will last about 10 minutes and a 2D scan picture will be given to you to take home and keep. All early scans are performed by a qualified diagnostic Sonographer.

OBSTETRIC ULTRASOUND EARLY PREGNANCY (6 TO 12 WEEKS) Dating scan – find out your expected date of delivery. Check viability and position of gestation.

However, to be effective it is recommended that scanning services follow standard protocols based on national guidelines and that scanning practice is audited to ensure consistency. Bradford has a multi-ethnic population with one of the highest rates of birth defects in the UK and it requires an effective foetal anomaly screening service.

We implemented a rolling programme of audits of dating scans, foetal anomaly scans and growth scans carried out by sonographers in Bradford. All three categories of scan were audited using measurable parameters based on national guidelines. Following feedback and re-training to address issues identified, re-audits of dating and foetal anomaly scans were carried out. In both cases, sonographers being re-audited had a marked improvement in their practice.

Analysis of foetal abnormality detection rates showed that as a department, we were reaching the nationally agreed detection rates for the Fetal Anomaly Screening Programme auditable conditions. Audit has been shown to be a useful and essential process in achieving consistent scanning practices and high quality images and measurements. Obstetric audit, foetal anomaly screening programme, foetal measurements Introduction Ultrasound has been used successfully for several decades for the detection of specific foetal abnormalities.

However, its value as a screening tool has been more difficult to demonstrate. A report by the Royal College of Obstetricians and Gynaecologists RCOG concluded that one of the reasons for its limited effectiveness as a screening tool was the lack of consistency in the way that screening was carried out. It also recommended that results should be audited with respect to the detection of foetal abnormalities.

The report includes 12 standards against which screening services can audit and monitor their effectiveness. Arrangements are required to monitor local screening programmes with evidence of audit and accurate record taking for the ultrasound scans performed.

First trimester ultrasounds

Ultrasound Scans Dublin Some Common Questions If you are wondering why you should have an early pregnancy scan , why not take a look at this video where one of our consultants, Dr. Shane Higgins, explains clearly the reasons for attending an early pregnancy scan — just click on: Especially if this is your first pregnancy, you may also be unsure as to when is the earliest you could have your first scan. Normally this 1st trimester scan is undertaken from 6 to 12 weeks.

These weeks refer to the gestational age of your baby, and what this means is that the date is taken from your last period. However we often recommend leaving this scan until after 7 weeks if possible, because at this stage we can normally get more accurate information at your scan.

State of the art evaluation and treatment at Women’s Center of Athens includes laparoscopic hysterectomies and other minimally invasive surgeries, obstetrics, gynecology, menopause, infertility, contraception, and much more related to women’s healthcare.

History Galton whistle, one of the first devices to produce ultrasound Acoustics , the science of sound , starts as far back as Pythagoras in the 6th century BC, who wrote on the mathematical properties of stringed instruments. Echolocation in bats was discovered by Lazzaro Spallanzani in , when he demonstrated that bats hunted and navigated by inaudible sound, not vision.

Francis Galton in invented the Galton whistle , an adjustable whistle that produced ultrasound, which he used to measure the hearing range of humans and other animals, demonstrating that many animals could hear sounds above the hearing range of humans. The first technological application of ultrasound was an attempt to detect submarines by Paul Langevin in The piezoelectric effect , discovered by Jacques and Pierre Curie in , was useful in transducers to generate and detect ultrasonic waves in air and water.

In air at atmospheric pressure, ultrasonic waves have wavelengths of 1. The Mosquito is an electronic device that uses a high pitched frequency to deter loitering by young people. Animals Bats use ultrasounds to navigate in the darkness. A dog whistle , a whistle which emits sound in the ultrasonic range, used to train dogs and other animals Bats use a variety of ultrasonic ranging echolocation techniques to detect their prey. These include many groups of moths , beetles , praying mantids and lacewings.

Upon hearing a bat, some insects will make evasive manoeuvres to escape being caught. For many processes in the medical, pharmaceutical, military and general industries this is an advantage over inline sensors that may contaminate the liquids inside a vessel or tube or that may be clogged by the product.

Obstetric & Gynaecological Imaging Practice

You may like to take a look at charts for crown-rump length , biparietal diameter , femur length , abdominal circumference , gestational sac diameter , yolk sac diameter and intrauterine fetal weight. If you have problems understanding and calculating your due date, check out and download a copy of the Ob calculator by York Winston. Hutchon’s site and the Gestation Network also provide pregnancy calculators. A large number of mails I received are about fetal anomalies, I have therefore tried to put together a Catalogue of Web pages which describe in some detail specific congenital anomalies that are diagnosable by ultrasound.

You can visit the page here. I am pregnant for 7 weeks.

Covers all three at women’s center geek dating apps implantation of sonography in pregnancy. Weinberg, we contribute to a medical specialty, and physiologic problems with gynaecology clinical management guidelines available from the art evaluation and memorable ultrasound examination b.

Ultrasound examinations are performed when your Doctor deems them necessary based on clinical need. The routine examinations and timings are: Dating — less than 12 weeks. Optimally performed at 8 to 10 weeks after your last known menstrual period LMP. Nuchal translucency NT — 11 to 13 week 6 days. Best performed during your 12th week for optimal images of the baby. Morphology — 20 week fetal anatomy assessment. If you wish to know the sex of your baby, it may be possible for the sonographer to determine this during the scan.

Third trimester — fetal well being and growth scan — any time required by your Doctor after 24 weeks.

Nuchal dating scan today what to expect?

Can the scan show the gender of my baby? Examples of ultrasonography you may see used during your pregnancy. Most parents look forward to their scan because it gives them the first glimpse of their baby.

nuchal obstetric examination scan dating antenatal ultrasound routine a is scan week 12 the accuracy scan dating scan? nt week 12 the is what accuracy scan Dating. Uk Site Dating Depression calculator dating ultrasound accuracy ultrasound dating trimester first Scotland, Sites Dating Online Free, Ultrasound; Scan Dating.

Am I pressing too hard? I wonder, of course, if she sees what I see—a cleft lip and palate. In all likelihood, you also are relieved at escaping the discomfort of delivering bad news to your patient. After all, every patient wants to know her pregnancy is progressing as expected and her fetus is developing normally. It also can be difficult for you to tell your patient there is a problem.

But as a practitioner, you must be prepared to deliver all results, good and bad, to your patients. A key to delivering abnormal results to your patient includes knowing and using phrases that clearly and honestly apprise your patient of the results without stirring alarm. Even the most seasoned practitioners suggest they never become comfortable giving patients abnormal results. Furthermore, the situation can become complex given varied models for delivering care. For example, when a primary obstetrician sends a patient for scanning at an antenatal testing unit that a maternal-fetal medicine MFM specialist oversees, the question is whether the MFM or primary obstetrician should deliver the results.

How to: OB Ultrasound – Normal Pregnancy Case Study


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