Course Number and Title:
DMS 114 Obstetrical Sonography
Prerequisites
Prerequisite: DMS 113
Course Credits and Hours
2 credit(s)
2 lecture hours/week
1 lab hours/week
Course Description
This course is a study of the reproductive organs of the female in the gravid state. Topics include the role of diagnostic medical sonography in the determination of fetal age, growth, and well-being; the detection of anomalies; and obstetrical management.
Additional Materials
None
Core Course Performance Objectives (CCPOs)
- Explain the principles of scanning techniques in obstetric and gynecologic ultrasound. (CCC 1, 2, 3, 4, 5, 6; PGC 1, 2, 3, 4)
- Examine the anatomy, anatomic variants, & sonographic appearances of normal maternal, embryonic, and fetal anatomic structures during the developing trimesters. (CCC 1, 2, 3, 4, 5, 6; PGC 1, 2, 3, 4)
- Explain the techniques and criteria used in the assessment of fetal age and size. (CCC 1, 2, 3, 4, 5, 6; PGC 1, 2, 3, 4)
- Explain the sonographic appearance of structures in an abnormal state to include measurements and doppler analysis when applicable. (CCC 1, 2, 3, 4, 5, 6; PGC 1, 2, 3, 4)
- Explain the significance of multiple gestations. (CCC 1, 2, 3, 4, 5, 6; PGC 1, 2, 3, 4)
- Explain the use of Doppler ultrasound in the assessment of fetal well-being. (CCC 1, 2, 5, 6; PGC 1, 2, 3, 4)
- Explain the methodology of various invasive and non-invasive techniques in the assessment of the fetus. (CCC 1, 2, 3, 4, 5, 6; PGC 1, 2, 3, 4)
- Explain the effects of maternal disease on pregnancy. (CCC 1, 2, 3, 4, 5, 6; PGC 1, 2, 3, 4)
- Explain the controversies in obstetric and gynecologic ultrasound. (CCC 1, 2, 3, 4, 5, 6; PGC 2, 3)
- Perform with competency fetal evaluation in the first, second, and third trimesters in a simulated environment. (CCC 1, 2, 3, 4, 5, 6; PGC 1, 2, 3, 4)
See Core Curriculum Competencies and Program Graduate Competencies at the end of the syllabus. CCPOs are linked to every competency they develop.
Measurable Performance Objectives (MPOs)
Upon completion of this course, the student will:
- Explain the principles of scanning techniques in obstetric and gynecologic ultrasound.
- Discuss the importance and benefit of using proper transducer selection and technique in sonographic ob-gyn examinations.
- Describe the accepted guidelines and scanning protocols for antepartum obstetrical and gynecological examinations.
- Discuss the professional responsibilities of the sonographer.
- Describe the process of patient preparation in the gynecological and obstetric examination, including the importance of obtaining the patient's medical history.
- Examine the principles of safety of ultrasound and the findings of various agencies relating to mammalian bio-effects.
- Examine the anatomy, anatomic variants, & sonographic appearances of normal maternal, embryonic, and fetal anatomic structures during the first, second, and third trimesters.
- Examine the sonographic appearance of the gravid uterus during the first-trimester to include: gestational sac, embryonic plate, yolk sac, early placenta, fetal cardiac activity, uterus, cervix, adnexa, pelvic spaces, & multiple gestations.
- Examine the sonographic appearance of the gravid uterus during the second- and third-trimester to include: intracranial anatomy, face, thoracic cavity, heart (position and size, four-chamber view, LVOT and RVOT views, three-vessel and three-vessel trachael views), abdomen and pelvis, abdominal wall, spine, extremities, external genitalia, amniotic fluid, placenta, umbilical cord, fetal cardiac activity, maternal cervix, maternal adnexa, and multiple gestations.
- Examine the importance of a technical systematic approach in examining normal morphological structures of the fetus.
- Explain the techniques and criteria used in the assessment of fetal age and size.
- Discuss general scanning methodology with respect to accuracy and the value of multiple fetal measurement parameters.
- Describe measurement techniques in the first trimester:
- Gestational sac diameter (GSD)
- Crown-rump length (CRL)
- Fetal heart rate (FHR)
- Yolk sac
- Describe measurement techniques in the second and third trimesters:
- Biparietal diameter (BPD)
- Head circumference (HC)
- Cephalic index (CI)
- Abdominal circumference (AC)
- Femoral length ( FL)
- Estimated fetal weight (EFW)
- Fetal heart rate (FHR)
- Explain the sonographic appearance of structures in an abnormal state to include measurements and doppler analysis when applicable.
- Examine the abnormal clinical indications leading to serial examinations of the first trimester pregnancy.
- Define the parameters used in the diagnosis and continuing assessment of intrauterine growth retardation (IUGR).
- Discuss the incidence, range, and sequelae of gestational trophoblastic disease.
- Discuss abnormalities of the placenta and umbilical cord and their sonographic appearance.
- Describe the fetal head shape and intra-cranial structures and anomalies associated with the fetal neural axis.
- Describe fetal thoracic abnormalities, including the lungs and diaphragm.
- Discuss fetal anterior abdominal wall abnormalities, differentiating among an omphalocele, gastroschisis, and umbilical hernia.
- List the abnormalities of the gastrointestinal tract and their sonographic findings.
- Describe situs inversus and its implications on fetal well-being.
- Describe basic embryology of the developing fetus and the sonographic appearance of malformations in detecting fetal anomalies/genetic syndromes.
- Detail the development of the urogenital system and congenital malformations.
- Describe potential fetal malformations associated with maternal drug or chemical use.
- Describe the variety of musculoskeletal anomalies that can occur in the fetus, differentiating sonographically among the most common skeletal dysplasias.
- Discuss the advantages and disadvantages of sonographic 3-D and 4-D evaluation of fetal anomalies.
- Explain the significance of multiple gestations.
- Describe the incidence, major types, specific protocols, and increased risks relating to multiple gestations.
- Describe basic concepts of fertility management.
- Discuss technical pitfalls and determination of accurate fetal number.
- Discuss the importance of chorionicity and amnionicity in relation to pregnancy management and fetal well-being.
- Explain the use of Doppler ultrasound in the assessment of fetal well-being.
- Discuss the development and current data of bio-effects of Doppler ultrasound technique.
- Discuss wave form analysis of the Doppler signal.
- Contrast quantitative and qualitative Doppler indices.
- Discuss the Doppler clinical applications in obstetrical ultrasound.
- Discuss the efficacy of Doppler ultrasound during clinical application.
- Explain the methodology of various invasive and non-invasive techniques in the assessment of the fetus.
- Explain interventional/invasive ultrasound procedures to include: amniocentesis, chorionic villus sampling, & fetal therapy.
- Examine the clinical significance of the criteria developed as an assessment tool in the fetal biophysical profile.
- Explain the changes in fetal movement over the duration of pregnancy.
- Discuss the relationship of the biophysical profile score to fetal well-being.
- Explain the effects of maternal disease on pregnancy.
- Discuss the role of sonography in evaluating pregnancies complicated by maternal disease.
- Discuss the indications and clinical considerations for examination of the patient with a pelvic mass.
- Discuss the various entities and conditions that may be associated with pregnancy and post-partum.
- Explain the controversies in obstetric and gynecologic ultrasound.
- Discuss routine versus selective scanning in terms of ultrasound.
- Discuss the ethical issues associated with obstetrical and gynecological ultrasound.
- Discuss education and competency in the delivery of diagnostic medical sonography.
- Perform with competency fetal evaluation in the first, second, and third trimesters in a simulated environment.
- Evaluate scanning protocol and modifications based on the sonographic findings and the differential diagnoses.
- Indications and contraindications
- History and physical examination
- Related imaging, laboratory, and functional testing procedures
- Clinical differential diagnosis
- Role of sonography in patient management
- Demonstrate professional behavior and appropriate communication skills.
- Demonstrate basic knowledge of instrumentation and appropriate transducer selection.
- Perform at a supervised, dependent level the requisite skills necessary to obtain required anatomical images and anatomical planes for measurement in the first trimester of CRL, gestational sac, fetal heart rate, nuchal translucency, nasal bones, uterus and ovarian size, and right and left adnexa.
- Perform at a supervised, dependent level the requisite skill necessary to obtain required anatomical images and anatomical planes for measurement in the second and third trimester, including but not limited to: BPD, HC, AC, femur length, choroid plexus, lateral ventricle, cavum septum pellucidum, cerebellum, nuchal fold, cisterna magna, midline falx, fetal lie, placenta location and grading, cervical length, fetal heart rate, 4-chamber heart, umbilical cord insertion, 3-vessel cord, fetal spine, fetal kidneys, AFI, fetal extremities, fetal diaphragm, fetal stomach, fetal bladder, and fetal gender.
- Recognize the required criteria for biophysical profile that is visible sonographically, including fetal breathing movement, fetal movement, fetal tone, and appropriate amniotic fluid levels.
- Produce written reports of findings using sonographic terminology.
Evaluation Criteria/Policies
The grade will be determined using the Delaware Tech grading system:
| 90-100 |
= |
A |
| 80-89 |
= |
B |
| 70-79 |
= |
C |
| 0-69 |
= |
F |
Students should refer to the
Catalog/Student Handbook for information on the Academic Standing Policy, the Academic Integrity Policy, Student Rights and Responsibilities, and other policies relevant to their academic progress.
Final Course Grade
Calculated using the following weighted average
|
Evaluation Measure
|
Percentage of final grade
|
|
Tests (5) (Equally Weighted) (summative)
|
50%
|
|
Final Comprehensive Exam (summative)
|
20%
|
|
3 Lab Competencies (Equally Weighted) (summative)
|
15%
|
|
Simulator & Classroom/Workbook Assignments (formative)
|
10%
|
|
Professional Behavior
|
5%
|
|
TOTAL
|
100%
|
Program Graduate Competencies (PGCs are the competencies every graduate will develop specific to his or her major)
AHTAASDMO
- Graduates will demonstrate clinical competence by performing a full range of diagnostic medical sonography procedures on all patient populations pertaining to their learning concentration.
- Graduates will professionally utilize verbal, nonverbal, and written communication skills in patient care, procedure intervention, and professional relationships.
- Graduates will demonstrate professional growth and development by acting in a professional and ethical manner and comply with the professional scope of practice.
- Graduates will integrate critical thinking and problem solving skills as expected of a healthcare professional.
AHTAASDMS
- Perform competently a full range of diagnostic medical sonographic procedures pertaining to their learning concentration.
- Utilize professional verbal, nonverbal, and written communication skills in patient care, procedure intervention, and professional relationships.
- Act in a professional and ethical manner and comply with professional scope of practice.
- Integrate critical thinking and problem solving skills as expected of a healthcare professional.
Core Curriculum Competencies (CCCs are the competencies every graduate will develop)
- Apply clear and effective communication skills.
- Use critical thinking to solve problems.
- Collaborate to achieve a common goal.
- Demonstrate professional and ethical conduct.
- Use information literacy for effective vocational and/or academic research.
- Apply quantitative reasoning and/or scientific inquiry to solve practical problems.
Students in Need of Accommodations Due to a Disability
We value all individuals and provide an inclusive environment that fosters equity and student success. The College is committed to providing reasonable accommodations for students with disabilities. Students are encouraged to schedule an appointment with the campus Disabilities Support Counselor to request an accommodation needed due to a disability. The College's policy on accommodations for persons with disabilities can be found in the College's Guide to Requesting Academic Accommodations and/or Auxiliary Aids Students may also access the Guide and contact information for Disabilities Support Counselors through the Student Resources web page under Disabilities Support Services, or visit the campus Advising Center.