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Current Issues- updated after RUG meeting Oct 2011

This page aims to summarise the ongoing issues/agenda items for the West Midlands Regional Ultrasound Group.
The next RUG meeting will be held in May 2012.

See archive pages for older topics.

TOPIC + link
Cut-offs for CRL

BMUS has issued guidance re pregnancy dating for screened and unscreened pregnancies
Key message: Trusts responsible for implementing changes.

T21 Working standards consultation

The consultation on the Working Standards for Down's Syndrome Screening 2007 ends on 28/10/2011.
Key message: Trusts and individuals are encouraged to submit a response to the consultation

Fetal anomaly scan storage of cardiac images

It has been confirmed that there is no requirement within the National 18-20 week ultrasound Standards to store any cardiac images.

NICE guidelines Multiple Pregnancy These guidelines were launched in September 2011 and contain guidance for determining gestational age and chorionicity and monitoring for IUGR.
Key message: Trusts responsible for implementing changes.
Training for sonographers Fetal anomaly scan online resource
This resource supports the implementation of the 2010 standards for the fetal anomaly screening scan.
Key message
Sonographers are encouraged to complete the course.

Nuchal Transluscency training
The Fetal Medicine Foundation has a web-based system to register for NT accreditation, watch a video theoretical course, and upload images.
Key message: Sonographers are encouraged to register and complete the course.

  Fetal echocardiography training FMF-FASP internet course
This internet-based course in basic fetal echocardiography has been prepared in collaboration between the FMF and FASP.
Key message: Sonographers are encouraged to register and complete the course.
Pathway for raised NT >= 3.5mm

If referrals are made to fetal medicine and the pregnancy continues, women are recalled by fetal medicine for fetal cardiac assessment at 16 and 20 weeks.

Ultrasound before TOP

The RUG recommended that routine use of ultrasound prior to abortion should be undertaken to:
- date the pregnancy in order to give accurate information to the patient regarding the best method to be used and the possible complications, which are gestation dependant.
- ensure that the termination complies with the law relating to the 24 weeks of gestation limit.
- ensure that ectopic and molar pregnancies are identified.
- identify and allow different management in cases of failed intrauterine pregnancy.

GROW accreditation for junior doctors

NEW workshops have been designed for junior medical staff. They will be held twice annually, the first date is 1st Nov 2011.
Key message: Check WMPI diary for dates.

RUG Subgroup early onset IUGR

A RUG subgroup on pregnancies with early onset IUGR will be set up Ellen Knox will Lead.
Key message: Interested parties to contact Ann Tonks.

Prenatal detection rates FASP auditable condition

The regional anomaly register produce regional and local prenatal detection rates for the 11 FASP auditable conditions.
Key message: Units will be asked to review cases without prenatal notifications to confirm if cases were suspected antenatally or did not have ultrasound screening (e.g. late bookers). Units have already received lists of trisomy 18 and 13 cases.

Basic ultrasound training for junior doctors

Geraldine Masson is the Regional Ultrasound Tutor. An annual 1 day theory course has been established, trainees are receiving initial clinical training on a simulator with the practical training to be delivered locally. The next annual training day is to be held on 11th October.

3rd trimester EFW survey

All but one West Midlands unit use radiology information systems to record information on routine scans; the majority were using CRIS. 82% had access to PACS for image storage. All units who calculated EFW used the Hadlock formula recommend by RUG. One unit used abdominal circumference to assess growth in the 3rd trimester. Three units reported that they did not scan in the third trimester to assess growth after 37/38 weeks gestation.

BCU Focussed courses

All five BCU focussed courses, including those for midwives in dating and third trimester ultrasound, have been accredited by CASE.

West Midlands Soft Marker Policy

This policy, implemented in 2002 is being withdrawn by April 2011. It has been superseded by the FASP programme statement on normal variant screening in pregnancy.
Key message: Trusts responsible for implementing changes.

Hands on Cardiac Training

All West Midlands units have received practical training in fetal cardiology.

GROW accreditation for sonographers

An evening workshop for sonographers, midwife sonographers, and student sonographers will be held twice annually in September and March.
Key message: Sonographers interested in attending should complete a registration form. Click on link.

Placenta praevia after CS

A new care bundle has been launched. The ultrasound implications of implementing the care bundle are detailed in point 4.1.
Key message: Units implementing the care bundle will need to modify the routine imaging of the placenta within the fetal anomaly scan for women who have had a previous caesarean section.


Abbreviations used:


Birmingham City University

BPD Biparietal Diameter
CASE Consortium for the Accreditation of Sonographic Education
CRL Crown rump length
FASP Fetal Anomaly Screening Programme
HC Head Circumference
HPC Health Professions Council

National Institute for Health and Clinical Excellence


National Screening Committee


Picture Archiving & Communication System


Royal College of Obstetricians and Gynaecologists

RUG Regional Ultrasound Group

Strategic Health Authority

TBC To be confirmed

© Perinatal Institute 2011