Ultrasound Nuchal Translucency ( NT / NB ) Obstetric Scan Report Template
Title
Default
Modality
Ultrasound
Part
Nuchal Translucency ( NT / NB ) Obstetric Scan
Technique
Ultrasound of foetus has been performed.
Findings
L.M.P: _____________ GA by LMP: __ weeks __ days EDD by LMP: _______________
Urinary bladder is well distended with smooth outlines.
Uterus is gravid and bulky showing a single gestation.
Forming placenta is posterior. No retro-chorionic haematoma is seen.
Internal OS is closed. Cervical length is __ cm.
A single, live, intra uterine fetus is seen.
Fetal cardiac activity well seen. Heart rate is ___ BPM.
Nuchal translucency is ___ mm (___st centile), which is normal for the gestational age.
Nasal bone ossification well seen.
CRL : ___ mm corresponding to __ weeks _ days.
CGA by USG : __ weeks __ days +/1 week
EDD by USG : __ __ __.
Right uterine artery PI measures 1.42. Left uterine artery PI measures 2.16. Mean uterine artery PI measures 1.79 (69th centile).
Ductus venosus shows no reversal of "A" wave. Ductus venosus PI measures 0.83.
Both ovaries are normal. Right ovary measures 2.7 x 1.3 cm and left ovary measures 4.1 x 2.4 cm. Corpus luteum in right ovary. No free fluid is seen in pouch of Douglas.
Impression
Single, live, intra uterine fetus of approximately __ weeks __ days +/- 1 week gestation.
Nuchal translucency is normal for the gestational age. Nasal bone ossification seen.
Suggest : Follow between ____ weeks for congenital anomaly scan.
I, Dr. ________________, declare that while conducting ultrasonography of Mrs. ____________, I have neither detected nor disclosed the sex of her fetus to anybody in any manner.