- Cervix – assess if closed and measure length between internal and external os
- Assess placental location and distance from internal os.
- Check for retroplacental haemorrhages, placental masses etc
- Maternal adnexae (if indicated, also maternal kidneys)
Confirm heart beat & rate
Foetal lie: ( eg cephalic, spine to maternal left) If breech, describe the ‘type’ of breech.
- Cavum septum pellucidum
- Heart~ rate (check for arrhythmia) position & orientation (4 chambers, outflow tracts)
- Lungs (homogenous & echogenic relative to liver)
- anterior abdo wall & cord insertion
- 12 long bones
- Position of hands/feet
- Movement & tone
- Spine: Symmetry from C spine to the sacral taper and an intact posterior skin edge
- Cervical length
- Placenta to internal Os distance(>3cm)
- Biparietal diameter(BPD)
- head circumference(HC)
- Abdominal circumference(AC)
- femur length(FL)
- Foetal heart rate (FHR)
- Amniotic fluid index (AFI)
- Umbilical artery: resistive index (UA RI)
- If UA RI is abnormal.Check the Ductus venosus and Middle cerebral artery: pulsatility index(MCA PI)
BIOPHYSICAL PROFILE ASSESSMENT
(For utero-placental vascular insufficiency)
- Look for foetal movements such as leg, hand flexing and diaphragmatic movements.
- Assess foetal tone and posture.
Biophysical Score is a combination of the following assessments giving them a mark out of 8 in total.
- Foetal breathing 2/2
- Foetal limb/body movements 2/2
- Foetal posture 2/2
- AFI 2/2
If the score is below 7 then this is a concern which will need close follow up. The assessment must span a minimum of a 30minute period before a negative report is suggested.