DMS 114 - Advanced OB/GYN Sonography

1. Demonstrate knowledge of anatomy and sonographic appearances for the 2nd and 3rd trimester placenta.
   1. Identify the chorionic plate, substance and basal layers
   2. Discuss transducer and equipment requirements
   3. Discuss normal sonographic appearance and the grading system
2. Demonstrate knowledge of pathology of the 2nd and 3rd trimester placenta.
   1. Describe the sonographic findings and patient clinical history for:
      1. Placenta previa
      2. Placenta abruption
      3. Succenturiate lobe and variations
      4. Abnormal adherence
      5. Trophoblastic disease
3. Demonstrate knowledge of normal and abnormal fetal growth patterns and pregnancy dating.
   1. Define gestational age
   2. Discuss measurements used to evaluate fetal growth
   3. Explain the difference between asymmetric and symmetric IUGR
   4. Discuss morbidity and mortality related to large and small for dates fetuses
   5. Explain the effect of IUGR on amniotic fluid volume
   6. Describe placental grade in relation to IUGR
4. Demonstrate knowledge of the fetal biophysical profile scoring method.
   1. List the parameters of a BPP
   2. Explain the scoring method for BPP
   3. Correlate BPP score with clinical results
5. Demonstrate knowledge of amniotic fluid volume in 2nd and 3rd trimester pregnancy.
   1. Describe the method for evaluating amniotic fluid
   2. Correlate AFI with gestational parameters and clinical outcome
   3. Correlate AFI with BPP score
6. Demonstrate knowledge of umbilical cord Doppler.
   1. Describe how an umbilical cord Doppler is obtained
   2. List indications for doing a cord Doppler
   3. Correlate umbilical cord Doppler with clinical outcome
7. Demonstrate a knowledge of 2nd and 3rd trimester pregnancy complications.
   1. Describe the sonographic features and clinical outcomes for the following:
      1. Incompetent cervix
      2. Fetal hydrops
      3. Diabetic patient
      4. Pregnancy induced hypertension
      5. Preeclampsia and eclampsia
      6. PROM
      7. Maternal infections
      8. Pre-term labor
8. Demonstrate a knowledge of 2nd and 3rd trimester multiple gestation pregnancies.
   1. Differentiate between monozygotic and dizygotic pregnancies
   2. Differentiate between monochorionic and dichorionic pregnancies
   3. Differentiate between monoamniotic and diamniotic pregnancies
   4. Discuss complication rates and implications of multigestation pregnancies
   5. Describe a protocol for multigestation pregnancy
   6. Discuss the following multigestation complications:
      1. Twin-twin transfusion
      2. Stuck-twin syndrome
      3. Twin embolization syndrome
      4. Conjoined twins
9. Demonstrate a knowledge of 2nd and 3rd trimester head pathology and its correlation to sonographic appearance.
   1. Describe the sonographic findings and patient outcomes for the following:
      1. Ventriculomegaly / hydrocephalus
      2. Dandy-Walker syndrome
      3. Holoprosencephaly
      4. Agenesis of the corpus callosum
      5. Choroid plexus cysts
      6. Correlation head shape to anomlies
      7. Anencephaly, acrania, exencephaly
      8. Encephalocele
      9. Hyrancephaly 
      10. Microcephaly
      11. Other brain variants
10. Demonstrate a knowledge of 2nd and 3rd trimester spine pathology and its correlation to sonographic appearance.
    1. Describe the sonographic findings and patient outcomes for the following:
       1. Spina bifida
       2. Meningocele / myelomeningocele
       3. Arnold chiari malformation
       4. Caudal regression
       5. Sacral-coccygeal teratoma
11. Demonstrate a knowledge of 2nd and 3rd trimester GU pathology and its correlation to sonographic appearance.
    1. Describe the sonographic findings and patient outcomes for the following:
       1. Relationship between urinary anomalies and AFI
       2. VACTERL syndrome
       3. Renal agenesis / Potter's syndrome
       4. Fetal urinary obstruction
       5. Prune belly syndrome
       6. Meckel-Gruber syndrome
       7. Mesoblastic nephromas
       8. Renal cystic disease
       9. Bladder extrophy
       10. Ambigusous genetalia
12. Demonstrate a knowledge of 2nd and 3rd trimester abdominal wall pathology and its correlation to sonographic appearance.
    1. Describe the sonographic findings and patient outcomes for the following:
       1. Omphalocele
       2. Gastroschisis
       3. Limb/body wall complex
       4. Amniotic band syndrome
       5. Pentalogy of Cantrell
    2. Explain fetal embryogenesis in relationship to abdominal wall abnormalities
13. Demonstrate knowledge of 2nd and 3rd trimester abdominal/thorax pathology and its correlation to sonographic appearance.
    1. Describe the sonographic findings and patient outcomes for the following:
       1. CAM
       2. Pulmonary sequestration
       3. Pleural effusions
       4. Pulmonary hypoplasia
       5. Stomach / GB / adrenal glands
       6. Duodenal atresia
       7. Echogenic bowel
14. Demonstrate understanding of the role of the sonographer in evaluating scanning protocol modifications based on the sonographic findings and differential diagnosis.
    1. Recognizes indications and contraindications for the exam and exam modification
    2. Demonstrate ability to correlate patient history with sonographic findings and make exam modifications as necessary
    3. Demonstrate ability to correlate exam findings with patient history to produce a differential list
15. Demonstrates understanding of the role of the sonographer in patient  management.
    1. Demonstrates the ability to take a complete patient history according to the exam ordered
    2.  Demonstrates the ability to correlate patient history with related imaging, other testing and lab procedures and outcomes