Step by Step® ULTRASOUND IN OBSTETRICS
Step by Step® ULTRASOUND IN OBSTETRICS
Third Edition
Editor-in-Chief
Narendra Malhotra MD FICMCH FICOG FRCOG FICS FMAS FIAP
President, INSARG, Past President, FOGSI/IFUMB/ISPAT/ISAR Vice President, WAPM/SAFOG Managing Director, Global Rainbow Health Care & MNMH(P) Ltd Agra, Uttar Pradesh, India Professor, Sarajevo School of Science and Technology, Croatia
Associate Editors
Nidhi Gupta MS FICMCH FICOG
Past President, Agra Obstetrical & Gynecological Society Professor, Department of Obstetrics and Gynecology SN Medical College, Agra, Uttar Pradesh, India
Neharika Malhotra MD (Gold Medalist) DRM (Germany) FICMCH Fellow ICOG (Rep Med) ICOG (USG)
Joint Secretary, FOGSI, Chair YTP Committee, FOGSI Director and Consultant, Global Rainbow IVF & MNMH(P) Ltd Agra, Uttar Pradesh, India
Jaideep Malhotra MD FICMCH FICOG FRCOG FRCPI FMAS
President, SAFOM/ISPAT Past President, IMS/ISAR/FOGSI/ASPIRE Managing Director, ART—Global Rainbow IVF & MNMH(P) Ltd Agra, Uttar Pradesh, India
Kuldeep Singh MBBS FAUI FICMCH
Consultant Ultrasonologist Dr Kuldeep's Ultrasound and Color Doppler Clinic New Delhi, India
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Step by Step® Ultrasound in Obstetrics
First Edition: 2004
Second Edition: 2008
Third Edition: 2021
9789352709045
Printed at
All the ultrasound lovers
“Use sound to see better
Turn on the color to improve your image
Shift to the 3rd and 4th dimension
Heal with sound”
Ultrasonography has become a very important diagnostic tool in obstetrics and is now used extensively to determine anatomic parameters, such as location of the placenta, fetal presentation and lie and biometric measurements of the fetus to date the gestation.
It is also used to assess fetal growth and to diagnose congenital anomalies. In fact, the indications of ultrasound in obstetrics have become so numerous, information obtained so valuable that, ultrasonography equipment has moved from the radiology department to the labor room and obstetrician's office.
After a great enthusiasm shown to our earlier editions, by all the readers we have come out with a new edition adding chapters—basics in ultrasonography, training and syllabus for FOGSI-ICOG certificate courses in ultrasound medicine, a detail account of filling up form, PCPNDT Act, Ergonomics in reducing injury risk in sonography has been described in detail. The book is well illustrated with recent ultrasound images for the busy practitioners as ready reference.
Almost 50 tables and flowcharts have been incorporated in the book to act as a ready reckoner for the busy obstetrician.
We hope the readers will be benefited by this book.
Narendra Malhotra
Nidhi Gupta
Neharika Malhotra
Jaideep Malhotra
Kuldeep Singh
Preface to the First Edition
Today ultrasound is the mainstay investigation in all fields of medicine. The widespread use of ultrasound has brought this wonderful technology to the consulting rooms of the practising gynecologists. It is now impossible to even conceive a modern obstetric care unit without ultrasound and it is impossible to practise infertility and gynecology without a transvaginal probe which has added the dimension of imaging with palpation.
The law in India mandates that each machine and the sonologist be licensed to practise ultrasound under the PNDT Act for which training and updating is required.
There are numerous textbooks and reference books on ultrasound but our aim to bring out this handy series of Step by Step Ultrasound in Obstetrics is to simplify the indications, steps and the interpretations of this wonderful technology.
We hope the readers will be benefited by this book.
Kuldeep Singh
Narendra Malhotra
Acknowledgments
Our heartiest thanks to our parents, elders, teachers, spouses, siblings, our sons, daughters and our friends who have helped us step by step at every step of our ambitious project of step by step series.
We were introduced to interventional sonography by Ananda Kumar (Singapore), Rajat Goswamy (UK), Asim Kurjak and Sanja Kupesic (Croatia), Prof Alfred Kratrochwil (Austria), Ashok Khurana, Ambarish Dalal, Pratap Kumar, Bhupendra Ahuja, Dr PK Shah, Jatin P Shah and Pranay Shah and many others who taught us small tricks of the trade at each step of our life.
We are indebted to Prof Struat Campbell and Prof Asim Kurjak for teaching us imaging and grateful to Ian Donald School, India and INSUOG.
Special thanks to Dr Rahul Gupta and Nitin Agarwal of Rainbow 4D imaging center for all the images.
Editor-in-Chief
Narendra Malhotra