2nd and 3rd Trimester OB Exams (14 weeks 0 days and greater)

Indications	Vaginal bleeding Abdominal or pelvic pain Pelvic mass Ectopic pregnancy Placental abruption Premature rupture of membranes Fetal demise
Prep	None
Transabdominal Imaging	Sagittal and transverse images of the placenta. Document "anterior," "posterior," "previa," etc. Sagittal and transverse images of the adnexa. Qualitative amniotic fluid. Document "WNL," "poly" or "oligo." No AFI measurements will be taken. Obtain FHR using M-mode. Cine loop to document the activity or lack of activity of the fetal heart. Image of presentation of fetus i.e. breech vs. cephalic vs. transverse. No measurements of the fetus will be taken. The general radiology based Ultrasound Department does not perform fetal surveys. Only limited studies are performed. If there is a question about whether the calculation package for CRL. Measure the fetus from the top of the head to a point on the body that equals 13w 6d. If the measurement fails to reach the rump of the fetus then the fetus is greater than 13w 6d. If the fetus is greater than 13w 6d store the single image with measurement to document the fetus is in the 2nd trimester. The calculation package should be used to store measurements (i.e., FHR). The worksheet image with measurements should be stored as the last image of the exam.

Clinical