Dear all. I want to share the information about level scanning skill. I recieved a forward letter from my friend Dr.Anandakumar who is a Vice President of Asia-Oceania Federation of Obstetry and Gynecology. He will come to Bali being a lecturer in our workshop ultrasound update in 20th-21st December 2008.The level scanning skill are divided by 4 level such as:
Level I; A)First and second trimester Dating Scan(CRL,BPD,HC and FL0B)Growth scan HC,AC,FL.C)localization of placenta.D)assessment of Amniotic Fluid.E)Number of Fetus.F)Fetal Position.G)Fetal Viability.H)Uterine and adnexal masses.I)FetalAbnormalities;Anencephaly,Spina bifida,Ompalocoele,Gastroschisis,Severe Dwarfs.Time frame 6months.
Level 2;A)Level I and.B)Fetal well being assessment with biophysical profile and uterine and fetal Doppler.C)Fetal anatomical survailance including 4 chamber view of the heart.E)Nuchal Translucancy assessment.F)Transvaginal Cervical assessment.G)Straight foreward Amniocentesis at 16 weeks and above.H)Grey scale assessment of Gynaecological masses.Time frame;18 months.
Level 3;Level1,2 and,A)Advanced Doppler(Cardiac,Arterial and Venous) to monitor very high risk fetuses(eg;Twin to twin Transfusion syndrome).B)Detail Fetal Echocardiography with Colour doppler and pulsed cardiac doppler.C)Facial malformation(Eg cleft Lips,Palates).D)Chorionic Villous Sampling.E)Assessment of pelvic masses with Colour flow imaging and Doppler studies.F)Hysterosonography.G)Ultrasound guided aspiration of cysts and follicles.H)Basic 3D/4D in O&G.Time frame.6months after completing level2.
Level4;Level1,2,3, and,A)Early prenatal diagnosis including fetal echocardiography at 13 to 14 weeks.B)Genetic ultrasound.C)Ultrasound in Gynaeurology and pelvic floor assessment.D)Advanced 3D/4D in O&G.E)Fetal Blood SamplingF)Intrauterine Fetal Therapy.Time frame 6 months after completing level 3.
From start of level one to end of level 4 will take around 36 months( around 3 years).What you should do is make it compulsory for all O&G residence to achieve level 2 skills when they complete their residency and senior residency program.Those who want to go into fetal medicine or full time O&G ultrasound should then go on to level 3 and level 4 training.
