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INTRODUCTION: Inconsistent reporting practices in third trimester ultrasound, the choice of reference charts in particular, have the potential to misdiagnose abnormal fetal growth. But this may lead to unnecessary anxiety and confusion amongst patients and clinicians and ultimately influence clinical management. Therefore, we sought to determine the extent of variability in choice of fetal biometry and Doppler reference charts and reporting practices in Australia and New Zealand. METHODS: Clinicians performing and/or reporting obstetric ultrasound were invited to answer questions about fetal biometry and Doppler charts in a web‐based survey. RESULTS: At least four population‐based charts are in current use. The majority of respondents (78%) report the percentile for known gestational age (GA) alongside measurements and 63% using a cut‐off of estimated fetal weight (EFW) < 10(th) percentile when reporting small for gestational age (SGA) and/or fetal growth restriction (FGR). The thresholds for the use of fetal and maternal Doppler in third trimester ultrasound varied in terms of the GA, EFW cut‐off, and how measures were reported. The majority of respondents were not sure of which Doppler charts were used in their practice. CONCLUSION: This survey revealed inconsistencies in choice of reference chart and reporting practices. The potential for misdiagnosis of abnormal fetal growth remains a significant issue.

The purpose of this document is to guide ultrasound practitioners in providing accurate information on the assessment of gestational age, viability and fetal development in the first trimester. In the presence of twins and higher order multiple pregnancies, it is also intended to assess chorionicity and amnionicity which have implications for risk assessment and continuing antenatal care. This guideline has been adopted by the ASUM Council and is applicable to all ultrasound practitioners.

We report on the key sonographic feature of uterine cavernous haemangiomas in pregnancy, a rare condition with only 14 cases reported in the literature including this case. A key feature of our case is post‐partum follow‐up ultrasound investigation up to 6 months. This condition is associated with morbidity and mortality, correct identification can prevent catastrophic outcomes.

Fetal urinomas are a rare but important sonographic finding. Urinomas are peri‐renal collections of urine, formed after the rupture of the kidney secondary to an underlying urinary tract obstruction or trauma. Diagnosis antenatally is important for ongoing monitoring and postnatal follow up as their presence may indicate reduced or absent kidney function in the affected kidney.

Congenital High Airways Obstruction Syndrome (CHAOS) is a rare condition associated with high fetal or neonatal mortality. Prenatal diagnosis in the second trimester is made by the typical ultrasound features of large echogenic lungs, a flattened or inverted diaphragm, and fetal ascites or hydrops. We present two cases diagnosed at our institution; one in the second trimester, and a first trimester diagnosis. To the best of our knowledge, first trimester diagnosis of CHAOS has not been previously reported.

Objective: To develop a classification system for congenital spine anomalies detected by prenatal ultrasound. Methods: Data were collected from fetuses with spine abnormalities diagnosed in our institution over a five‐year period between June 2005 and June 2010. The ultrasound images were analysed to determine which features were associated with different congenital spine anomalies. Findings of the prenatal ultrasound images were correlated with other prenatal imaging, post mortem findings, post mortem imaging, neonatal imaging, karyotype, and other genetic workup. Data from published case reports of prenatal diagnosis of rare congenital spine anomalies were analysed to provide a comprehensive work. Results: During the study period, eighteen cases of spine abnormalities were diagnosed in 7819 women. The mean gestational age at diagnosis was 18.8w ± 2.2 SD. While most cases represented open NTD, a spectrum of vertebral abnormalities were diagnosed prenatally. These included hemivertebrae, block vertebrae, cleft or butterfly vertebrae, sacral agenesis, and a lipomeningocele. The most sensitive features for diagnosis of a spine abnormality included flaring of the vertebral arch ossification centres, abnormal spine curvature, and short spine length. While reported findings at the time of diagnosis were often conservative, retrospective analysis revealed good correlation with radiographic imaging. 3D imaging was found to be a valuable tool in many settings. Conclusions: Analysis of the study findings showed prenatal ultrasound allowed detection of disruption to the normal appearances of the fetal spine. Using the three features of flaring of the vertebral arch ossification centres, abnormal spine curvature, and short spine length, an algorithm was devised to aid with the diagnosis of spine anomalies for those who perform and report prenatal ultrasound.

Introduction In Australia, ultrasound assessment of pregnancy is not routine after 22 weeks gestation, however ultrasound for fetal growth forms a substantial part of the case load in a typical obstetric ultrasound practice. Aim To determine how many ultrasound assessments beyond 22 weeks gestation are performed in a typical obstetric ultrasound practice, the gestations they were performed, and the most common indications for referral. Methods A retrospective study was undertaken to evaluate occasions of service for fetal growth ultrasound beyond 22 weeks in 2016 in a private ultrasound practice dedicated to obstetrics and gynaecology in Canberra, ACT. Results Over one quarter of patients seen in 2016 were referred for ultrasound examinations beyond 22 weeks. Most ultrasounds (58%) were performed between 32 and 36 weeks, and for most (53%), this was the only growth scan performed. Common indications were for unspecified fetal growth concerns, maternal diabetes, and suspected placental abnormalities. Conclusion Many providers of obstetric care consider an ultrasound between 32 and 36 weeks part of clinical care, despite recommendations against routine third trimester.

Persistent left superior vena cava (LSVC) is the commonest congenital anomaly of the thoracic venous system. It is within the group of anomalous systemic venous return (ASVR) and the group is subdivided in cephalic, involving the superior vena cava (SVC) and caudal, involving the inferior vena cava (IVC) types. It is also important to recognise that there can be a persistent LSVC with or without a normal right superior vena cava (RSVC). In most cases, a persistent LSVC drains into the right atrium via the coronary sinus without any clinical symptoms. In this article we discuss embryology, diagnostic and further management approaches and a review of the literature related to persistent LSVC.

Spontaneous hemopertitoneum in pregnancy (SHiP) is a rare but potential catastrophic complication with high maternal and fetal mortality. The main cause of morbidity and mortality is delayed diagnosis and treatment. In this paper we will document the findings of an interesting case managed in our unit. We also discuss the etiology, diagnosis and management of this condition with high potential to lead to medico‐legal cases.

A congenital left ventricular diverticulum is a rare prenatal finding. The four‐chamber view of the heart is a standard part of the 18–20 week morphology scan, and evaluation of the heart with colour Doppler imaging has greatly enhanced the detection of rare and subtle cardiac anomalies.

Heterotopic pregnancy refers to the presence of simultaneous pregnancies in two different implantation sites, generally one intra-uterine pregnancy and one extra-uterine pregnancy (usually tubal). This is a rare case of a heterotopic pregnancy involving concurrent intra-uterine pregnancy and caesarean section scar pregnancy (CSEP). CSEPs are at a high risk of bleeding and uterine rupture, carrying with them significant maternal morbidity.