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A short history of the development of ultrasound in pregnancy can be found in the History pages.Ultrasound scan is currently considered to be a safe, non-invasive, accurate and cost-effective investigation in the fetus. The gestational sac can be visualized as early as four and a half weeks of gestation and the yolk sac at about five weeks.Fetal body measurements reflect the gestational age of the fetus. In patients with uncertain last menstrual periods, such measurements must be made as early as possible in pregnancy to arrive at a correct dating for the patient. In the latter part of pregnancy measuring body parameters will allow assessment of the size and growth of the fetus and will greatly assist in the diagnosis and management of intrauterine growth retardation (IUGR).a) The Crown-rump length (CRL) This measurement can be made between 7 to 13 weeks and gives very accurate estimation of the gestational age.If this is observed, the probability of a continued pregnancy is better than 95 percent.Missed abortions and blighted ovum will usually give typical pictures of a deformed gestational sac and absence of fetal poles or heart beat.A positive pregnancy test 3 weeks previously for example, would indicate a gestational age of at least 7 weeks.Such information would be useful against the interpretation of the scans. In the presence of first trimester bleeding, ultrasonography is also indispensible in the early diagnosis of ectopic pregnancies and molar pregnancies. Determination of gestational age and assessment of fetal size.

Normal heart rate at 6 weeks is around 90-110 beats per minute (bpm) and at 9 weeks is 140-170 bpm.It has progressively become an indispensible obstetric tool and plays an important role in the care of every pregnant woman. The embryo can be observed and measured by about five and a half weeks. The viability of the fetus can be documented in the presence of vaginal bleeding in early pregnancy.Ultrasound can also very importantly confirm the site of the pregnancy is within the cavity of the uterus. A visible heartbeat could be seen and detectable by pulsed doppler ultrasound by about 6 weeks and is usually clearly depictable by 7 weeks.Dating with the CRL can be within 3-4 days of the last menstrual period.(Table) An important point to note is that when the due date has been set by an accurately measured CRL, it should not be changed by a subsequent scan.

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