Basic Ultrasound Training:

Lecture Outline
Simplifying the Approach
to Six Easy Steps •  ISUOG Basic US Training
•  Standardized 6 steps-approach to
basic ultrasound training
•  Application in low-resource
settings
Alfred Abuhamad, MD.
Eastern Virginia Medical School

Theoretical

•  Theoretical
•  Practical
•  Examination

Ultrasound Obstet Gynecol 2013

Ultrasound Obstet Gynecol 2013

Obstetrical Ultrasound Basic Ultrasound Training

Inherently Difficult

•  Operator dependent modality

•  Complex fetal organ anatomy Requires Simplification & Standardization of Approach
•  Fetal movements
•  Shadowing of target anatomic regions
•  Maternal body habitus
 Simplification & Standardization
Enhance Training

•  Minimizes ultrasound steps

•  Introduces consistency in image acquisition &
interpretation
•  Allows for efficient examination
•  Shortens learning curve
•  Provides path to automation

Am J Perinatol. 2016 Jan;33(1):90-8.

•  Determination of Fetal Presentation & Lie

•  Detection of Fetal Cardiac Activity
•  Identification of Number of Fetuses in Uterus
•  Determination of Location & Position of
Placenta
•  Estimation of Amniotic Fluid
•  Fetal Biometric Measurements
Am J Perinatol. 2016 Jan;33(1):90-8. Ultrasound Obstet Gynecol 2013

Implies Longitudinal Lie

Step 1: Fetal Presentation & Lie
Step 1: Fetal Presentation & Lie

Implies Transverse Lie 12

Am J Perinatol. 2016 Jan;33(1):90-8. Am J Perinatol. 2016 Jan;33(1):90-8.
 Step 2: Fetal Cardiac Activity Step 3: Number of Fetuses
Part 1

Am J Perinatol. 2016 Jan;33(1):90-8. Am J Perinatol. 2016 Jan;33(1):90-8.

Step 4: Location & Position of

Step 3: Number of Fetuses
Placenta
Part 2

Am J Perinatol. 2016 Jan;33(1):90-8. Am J Perinatol. 2016 Jan;33(1):90-8.

Step 5: Location & Position of Placenta

Step 5: Estimation of Amniotic Fluid

17
Abuhamad et al. American Journal of Perinatology - 2015 Am J Perinatol. 2016 Jan;33(1):90-8.
Step 4: Amniotic Fluid Volume Step 6: Fetal Biometric
Measurements
•  Biparietal Diameter
•  Head Circumference
•  Abdominal Circumference
•  Femur Length

19
Am J Perinatol. 2016 Jan;33(1):90-8. Am J Perinatol. 2016 Jan;33(1):90-8.

Biparietal Diameter Head Circumference

Abdominal Circumference Femur Length

Am J Perinatol. 2016 Jan;33(1):90-8. Am J Perinatol. 2016 Jan;33(1):90-8.

Impact of Ultrasound Conceptual Framework

Maternal Neonatal

Hemorrhage 27%

Hyp
erte
nsio
n 14
Abo

%
rtio
n8
%

49 % 69 %

ISUOG Outreach ISUOG Outreach

Haiti Program
January 2009 – May 2009 – January 2010 –

• ISUOG – education / training

What has been done? • GE – US equipment (10 machines)
• Partners in Health – local support
ISUOG Outreach
Haiti Program
May 2011 – January 2012
• ISUOG – education / training
• RAVA Foundation
• St Damien Hospital
• Operation Blessing International
• Medecins Sans Frontieres
ISUOG Outreach
Ghana Program
September 2010 – May 2011 – May 2012
• ISUOG – education / training
• Siemens– US equipment (3 machines)
• Physicians for Peace – international support
• Millennium Cities Initiative – local support
• Metro Health Disctrict – local support

ISUOG Outreach ISUOG Outreach

Somaliland Program Congo Program
September-2011, May 2012
January-2014
• ISUOG – education / training
• Sonosite– US equipment (4 machines) • ISUOG – education / training material
• Medecins Sans Frontieres • ISUOG members
• Edna Adan Hospital – local support • Medecins Sans Frontieres - local support

ISUOG Outreach
Mongolia Program
September-2012, 2013, 2014
• ISUOG – education / training ISUOG
• Samsung Medison– US equipment (4)
• South Korean Ultrasound Society
Outreach
• Central Government
Australia Program
October-2014
• ISUOG – education / training
• ASUM Volunteers
 Multi-Society Task Force

•  (American Institute of Ultrasound in Medicine [AIUM]

•  American College of Obstetricians and Gynecologists [ACOG]
•  American College of Osteopathic Obstetricians and

ISUOG - SANA Gynecologists [ACOOG]

•  Society of Maternal-Fetal Medicine [SMFM]

Outreach
•  American College of Radiology [ACR], Society of Radiologists in
Ultrasound [SRU]
•  International Society of Ultrasound in Obstetrics and
Lebanon Program Gynecology [ISUOG]).
May 2011 – Current
Lead by Dr. Reem Abu-Rustum

Multi-Society Task Force

Multi-Society Task Force

• Curriculum
• Competency Tools

Multi-Society Task Force Multi-Society Task Force

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