OC10.05: The “Valensise Radar” to understand the maternal hemodynamic status

Abstract

Objectives: To provide a structured and logical method of examining the mid-trimester fetus by performing an anatomical review within the framework of the planes used for fetal biometry, and thereby excluding 50 fetal common abnormalities. Methods: The ISUOG Education Committee recommendations for Basic Training in obstetric and gynecological ultrasound and three sets of ISUOG Practice Guidelines were used to select the number and type of anatomical planes required for performing fetal biometry and assessment of mid-trimester fetal anatomy. Once the planes were identified, the structures requiring examination, measurement, or both, within each plane were described. The planes were grouped into anatomical areas. Members of the ISUOG Basic Training Committee then used these data to agree i) criteria for referral and ii) a list of abnormal appearances and/or structural abnormalities that this approach, when correctly followed, should exclude. The resulting 20+2 planes approach to assess the mid-trimester fetus was then produced as an instructive Powerpoint presentation for incorporation into the ISUOG Basic Training programme. Results: A total of 20 static fetal planes, divided into seven anatomical areas, were identified. Two realtime sweeps of the fetus were also included, comprising an initial longitudinal sweep and a concluding transverse sweep. Referral criteria included five biometric criteria and any anatomical appearance that was not normal. A total of 50 common abnormal fetal appearances were defined that this approach, when correctly followed, should exclude. The 22 slide Powerpoint presentation was delivered for the first time at the BT Precourse Congress in 2017 and has been incorporated into the ongoing BT training programme. Conclusions: A structured and logical method of examining the mid trimester fetal anatomy has been designed, providing a teaching resource for ISUOG Basic Training, and other similar programmes, that is appropriate and deliverable.