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Exam Requirements: Obstetrical Ultrasound (Revised 8-23-2024)


The Obstetrical module includes accreditation for any one trimester, any combination of two trimesters, or all three trimesters:

  • All three trimesters: One exam for each trimester is required. 

  • Trimester Specific: Your site will only be accredited in the specific trimester(s) you select. Required exams for trimester specific obstetrical are as follows: 

    • One trimester only (1st, 2nd, or 3rd):  Two exams (if 1st trimester, both must be transvaginal) 

    • Any combination of two trimesters: One exam of each trimester (if 1st trimester is selected, exam must be transvaginal) 

When submitting obstetrical images, choose examinations of a gestational age that allow all anatomy to be well demonstrated, as directed by the dating guidelines in the trimester specific Exam Requirements. 


Please see the article on Modalities with Low Volume or Emergency Use as needed. 



Complete documentation/survey means a series of several images throughout the entire organ in two planes. For example, from one side of the organ to the other in the longitudinal plane and from superior to inferior in the transverse plane. 


Anatomy should be intentionally imaged in an organized fashion and correctly labeled for clarity. 


Exam Requirements: Obstetrical Ultrasound Accreditation

1st Trimester Transvaginal (Must be between 6-12 weeks)

All requirements MUST be imaged transvaginally. Only transvaginal images will be reviewed. 

  • MUST include an embryo/fetus with cardiac activity

  • Documentation of the gestational sac

  • Documentation of the yolk sac

  • Documentation of the embryo/fetus without measurement

  • CRL measurement

  • Cardiac motion with M-mode

  • Uterus

  • Complete documentation in longitudinal 

    • At least three gray scale images to include right lateral, mid without measurement, left lateral

  • Complete documentation in transverse 

    • At least three gray scale images to include lower uterine segment, body without measurement, fundus

  • Cervix - longitudinal and transverse

  • Ovaries

  • Complete documentation of both ovaries in longitudinal

    • At least two distinctly different gray scale images of each ovary without measurements or color/spectral Doppler

  • Complete documentation of both ovaries in transverse

    • At least two distinctly different gray scale images of each ovary without measurements or color/spectral Doppler

  • Size-length, height (AP), width

OR

  • Longitudinal gray scale cine clip from medial to lateral throughout both ovaries

  • Transverse gray scale cine clip from superior to inferior throughout both ovaries

  • At least one static longitudinal gray scale image of each ovary without measurements or color/spectral Doppler

  • At least one static transverse gray scale image of each ovary without measurements or color/spectral Doppler

  • Size - length, height (AP), width

      2nd Trimester (MUST be between 18 and 26 weeks)

  • Fetal presentation/position

  • Amniotic fluid documentation

  • Placental location

  • Placental relation to the internal cervical os

  • Fetal measurements

    • Biparietal diameter

    • Head circumference

    • Abdominal circumference

    • Femur length

  • 4 chamber view of heart

  • Cardiac motion with M-mode

  • Right ventricular outflow tract (RVOT) - static image OR cine clip

  • Left ventricular outflow tract (LVOT) - static image OR cine clip

  • Cerebral ventricles

  • Cerebellum

  • Cisterna magna

  • Nose/lips

  • Stomach

  • Kidneys

  • Urinary bladder

  • Umbilical cord insertion into fetal abdomen

  • Umbilical cord vessel number

  • Spine in longitudinal and transverse

    • Cervical

    • Thoracic

    • Lumbar

    • Sacral

  • All 4 extremities

  • Maternal anatomy

    • Cervix with measurement

    • Uterus

    • Adnexa

3rd Trimester (MUST be greater than 26 weeks)

  • Fetal presentation/position

  • Amniotic fluid measurement (AFI or MVP)

  • Placental location

  • Placental relation to the internal cervical os

  • Fetal measurements

    • Biparietal diameter

    • Head circumference

    • Abdominal circumference

    • Femur length

  • 4 chamber view of heart

  • Cardiac motion with M-mode

  • Stomach

  • Kidneys

  • Urinary bladder



Revision History for this Article

Date

Section

Description of Revision(s)

12-12-19

All

Article created; FAQs incorporated; No criteria changes

12-17-19

1st Trimester

Added "including size-length, AP, width" to the complete documentation of both ovaries in longitudinal and transverse

12-17-19

2nd Trimester and 3rd Trimester

Added cardiac motion with M-mode

1-27-2020

1st Trimester

Clarified 1st bullet and included "Must" be between 6-12 weeks.

6-2-2020


Added complete documentation description

8-3-2020


Added further description of complete documentation for 1st trimester Endovaginal study

2-19-2021

1st Trimester Endovaginal

Added requirements for submissions after March 1, 2021

2-24-2021

Requirements for submissions after March 1, 2021

Edited complete documentation of uterus

1-21-2022

1st Trimester, 2nd Trimester and 3rd Trimester

Updated exam requirements

2-4-2022

2nd and 3rd Trimester

Added missing requirements from last update

5-10-2022

1st Trimester Endovaginal

Moved "Size-length, height (AP), width bullet to align with complete documentation

11-10-2022

1st Trimester Transvaginal

Changed endovaginal to transvaginal

7-17-2023

1st Trimester Transvaginal 

Added cervix to uterus requirements

8-23-2024


Added link to the Modalities with Low Volume or Emergency Use article


1st Trimester Transvaginal

Removed effective date for cervix



Previous: Clinical Image Testing: UltrasoundNext: Exam Requirements: Gynecological Ultrasound

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