Exam Requirements: Obstetrical Ultrasound (Revised 5-13-2025)

Katie Albus

Modified on: Tue, 13 May, 2025 at 4:06 PM

Revision History

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

OR

Longitudinal gray scale cine from right to left throughout the uterus
At least one static longitudinal gray scale image of the uterus (mid uterus) without measurement
Complete documentation in transverse
At least three gray scale images to include lower uterine segment, body without measurement, fundus

OR

Transverse gray scale cine clip from superior to inferior throughout the uterus
At least one static transverse gray scale image of the uterus (mid uterus) without measurement
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
5-13-2025	1st Trimester Transvaginal	Updated complete documentation requirements

Previous: Clinical Image Testing: Ultrasound

Next: Exam Requirements: Gynecological Ultrasound

Revision History

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

OR

Longitudinal gray scale cine from right to left throughout the uterus

At least one static longitudinal gray scale image of the uterus (mid uterus) without measurement

Complete documentation in transverse

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

OR

Transverse gray scale cine clip from superior to inferior throughout the uterus

At least one static transverse gray scale image of the uterus (mid uterus) without measurement

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