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  • Template - If Different Lab - LMC

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    santhapriya767
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    1) The ultrasound was performed for a first trimester combined screening on a patient with a last period dating the pregnancy at weeks + days gestation. 2) Measurements taken included a crown-rump length of mm, biparietal diameter of mm, and nuchal translucency of mm. 3) Fetal anatomy scanned appeared normal and maternal structures were unremarkable.

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    template_-_if_different_lab_-_lmc

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    1) The ultrasound was performed for a first trimester combined screening on a patient with a last period dating the pregnancy at weeks + days gestation. 2) Measurements taken included a crown-rump length of mm, biparietal diameter of mm, and nuchal translucency of mm. 3) Fetal anatomy scanned appeared normal and maternal structures were unremarkable.

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    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
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    6 views2 pages

    Template - If Different Lab - LMC

    Uploaded by

    santhapriya767
    1) The ultrasound was performed for a first trimester combined screening on a patient with a last period dating the pregnancy at weeks + days gestation. 2) Measurements taken included a crown-rump length of mm, biparietal diameter of mm, and nuchal translucency of mm. 3) Fetal anatomy scanned appeared normal and maternal structures were unremarkable.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    ULTRASOUND REPORT TO LMC

    (if different reports are sent to the Laboratory and the LMC)

    Hospital No:
    Exam Date:

    Dear ……………….

    Thank you for referring your patient ………………………………………………………

    …………………………………………………………………………………………………

    INDICATION: Nuchal translucency scan. For first trimester combined screening.


    History:
    Maternal age:
    Last period:

    EDD by ultrasound: EDD by dates:


    Gestational age: weeks + day Gestational age by dates W+ D

    First Trimester Ultrasound:


    Transabdominal US with Voluson E8 Ultrasound view:
    Fetal heart action present Frequency bpm
    Crown-rump length (CRL) mm
    Biparietal diameter (BPD) mm
    Nuchal translucency (NT) mm

    Nasal bone (tick one or leave blank) Not looked for

    Present

    Absent

    Not able to be visualised for


    technical reasons

    Fetal anatomy:
    Skull/brain heart spine abdomen stomach
    bladder hands feet
    Placenta:
    Amniotic fluid:

    Maternal Structures:
    Right ovary:
    Left ovary:

    Summary:

    1
    Name of Specialist:
    Sonographer Initials:

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