Ultrasound Course: Long Term Fellowship Program

Curriculum for observership in Ultrasound in Obstetric & Gynaecology- 1

• Know your scanner & adjusting the correct setting
  • Doppler
  • Knobology
  • Settings
• Safety of ultrasound

Gynaec Scans

• Systematic transvaginal scans
• Various manuals for transvaginal scan & their indications

Congenital Uterine Anomalies

Different classification systems –

• Diagnosis
• Clinical relevance

Acquired Uterine Anomalies

• Endometrial pathologies
  • Polyp
  • Hyperplasia
  • Synachiea
  • Blood

• Myometrial pathologies
  • Fibroids
  • Adenomyoma
• Ultrasound diagnosis & clinical relevance

Adnexal lesions – Differential diagnosis

• Different morphologies
• Doppler characteristics
• Role of dynamic assessment

Gynecological Malignancies: Ultrasound diagnostic criteria in malignancies of

• Endometrium
• Myometrium
• Ovaries

Ultrasound in Infertility:

• Ultrasound Diagnosis of PCO – relevance to endocrinology
• Cycle monitoring for infertility
• Tubal assessment

Obstetric

• Scanning Early Pregnancy
  • Signs of abnormal pregnancy
  • Prognosticating pregnancy
  • Nuchal scan
    • Method
    • Guidelines
    • Risk assessment
    • Further management

• Second trimester – target scan
  • Biometry- methodology – relevance
  • Common congenital fetal anomalies
  • Markers for chromosomal abnormalities
• Basics fetal echocardiography
• Detailed fetal neurosonography
• Rh isoimmunisation

Diagnosis of Growth Restriction

• Prediction & diagnosis of vascular insufficiency
• Doppler based management of pregnancies with IUGR

Doppler, it’s role in Obstetric Scans

• Changing trends in circulation in different vessels – related physiology
• Understanding placental physiology
• Abnormalities of placenta- morphology, size, adherence, position.
• Cord morphology, abnormalities, attachments, number of vessels
• Cord coiling physiology – related abnormalities
• Knot, cord round neck
• How often to scan
• Repeating of obstetric scans
• Documentation of obstetric scans
• Documentation of gynaec scans
• Repeating of gynaec scans

Multiple Pregnancies

• Complication
• Reporting

Pregnancies with Medical Disorders

• Thyroid
• Prolactin
• Hypertension
• D.M.
• Anemia

3D – 4D US basics

• Application of 3D – 4D in obstetric scans
• Application of 3D-4D in gynaec scans
• Infertility application of 3D 4D

Invasive US guideline procedures in Gynaecology

• Ovum pickup
• Embryo transfer
• Sonohysterography
• Sonosalpingography

Know your scanner & adjusting the correct setting

• • Doppler
  • Physics
  • Knobology
  • Settings
• What is the optimum image quality
• How to achieve the best results
• Safety of ultrasound

Gynaec Scans

• Systematic transvaginal scans
  • Patient counseling & tips for better scan

• Various maneuvers for transvaginal scan & their indications
• Congenital uterine anomalies
  • Different classification systems -comparison
  • Diagnosis
  • Clinical relevance

• Acquired uterine anomalies
  • Endometrial pathologies
    • Polyp
    • Hyperplasia
    • Synachiea
    • Blood

• Myometrial pathologies
  • Adenomyosis
  • Fibroids
  • Adenomyoma
• Ultrasound diagnosis & clinical relevance

Adnexal lesions – Differential diagnosis

• Different morphologies
• Doppler characteristics
• Role of dynamic assessment
• Longitudinal assessment

Gynaecological Malignancies

• Ultrasound diagnostic criteria
  • Endometrium
  • Myometrium
  • Ovaries
  • Tubes
  • Clinical relevance

Ultrasound in Infertility

• Ultrasound Diagnosis of PCO – relevance to endocrinology
• Sonoendocrinology
• Cycle monitoring for infertility
• Tubal assessment- Saline infusion salpingography, HyCosy, Role of 3D, Comparision with other techniques
• Different consensus for uterine pathologies and ultrasound- MUSA, IETA, for ovarian pathologies- IOTA, for ednometriosis IEDA

Obstetric

• Scanning Early Pregnancy
  • Signs of abnormal pregnancy
  • Prognosticating pregnancy
  • 11-14 weeks scan
    • Method
    • Guidelines
    • Physiology of Ductus venosus
    • Physiology of tricuspid flow
    • Risk assessment
    • Counseling
    • Further management
    • Anatomical assessment

• Second trimester – target scan
  • Biometry- methodology – relevance
  • Common congenital fetal anomalies
  • Markers for chromosomal abnormalities

• Basics and detailed fetal echocardiography- b mode, color doppler, pulsed wave doppler, m mode, embryological and genetic relevance, intrauterine management, post-delivery prognosis.
• Detailed fetal neurosonography
• Genitourinary and gastrointestinal disorders
• Fetal tumors
• Rh isoimmunisation

Diagnosis of Growth Restriction

• Prediction & diagnosis of vascular insufficiency
• Doppler based management of pregnancies with IUGR, Doppler & its role in obstetric scans
  • Changing trends in circulation in different vessels – related physiology
  • How often to scan
  • Repeating of obstetric scans
  • Genetic relevance of congenital anomalies
  • Genetic testing in obstetric patients and counseling
  • When is pregnancy termination indicated
  • Multiple pregnancies
    • Complication
    • Reporting

• Pregnancies with medical disorders
  • Thyroid
  • Prolactin
  • Hypertension
  • D.M.
  • Anemia

Placenta and Umbilical Cord:

• Understanding placental physiology
• Abnormalities of placenta- morphology, size, adherence, position.
• Cord morphology, abnormalities, attachments, number of vessels
• Cord coiling physiology – related abnormalities
• Knot, cord around the neck

3D – 4D US Basics

• Calculation in 3D US
• Application of 3D – 4D in obstetric scans
• Application of 3D-4D in gynaec scans
• Application of 3D – 4D in Infertility

Invasive US guideline procedures in Gynaecology

• Ovum pickup
• Embryo transfer
• Cyst aspiration
• Fetal reduction
• Sonohysterography
• Sonosalpingography

Invasive US guidelines in Obstetric

• Amnioinfusion.
• Amniocentesis
• CVS
• Cordocentesis
• Fetal biopsies
• Laser ablation in TTTS

Therapeutic uses of US

• HIFU
• Ultrasound-guided vascular procedures

Documentation and Data Analysis:

• Documentation of Obstetric Scans
• Documentation of Gynaec Scans
• Reporting of Gynaec Scans
• Data Keeping
• Basic Statistics

This course includes the hands-on training and publication of at least one paper is mandatory for this course.