Patient name Age/Sex

Patient ID Visit No

Referred By Visit Date

LMP Date: POG : EDD :

USG POG CEDD:

OB-2/3 Trimester Scan Report

Real time B-mode ultrasonography of gravid uterus done.
Route:Transabdominal
Single intrauterine gestation
Maternal:
Cervix measured cm in length.
Internal os closed.

Fetus:
Survey
Presentation:
Placenta-
Liquor- Single pocket- Amniotic fluid index-
Umbilical cord-Two arteries and one vein
No loop of cord is seen around the fetus neck.
Fetal activity present.
Cardiac activity present.
Fetal heart rate- bpm
Biophysical profile score-
BPD-
HC-
AC-
FL
EFW-
Fetal Doppler
Umbilical ArteryPI:
S/D:

Impression:
 Single live intrauterine gestation corresponding to a gestational age of weeks days.
 Menstrual age 35 weeks 5 days
 Estimated fetal weight :
 Normal study of umbilical artery Doppler.
 AFI-

Declaraion of doctor:I Dr.Afshan Anjum declare that while conducting ultrasonography on this patient,I have neither detected nor disclosed the sex of the fetus to anybody in any manner.Furthermore it must be
understood that not all congenital anomalies can be detected with USG.

Sonologist