Patient Name Date

Age/ Sex Time

LMP Referred By
EDD (by LMP) USG EDD
Indication

Obstetrical Ultrasound Report

Single Intra-uterine gestational sac is seen. Mean gestational sac diameter corresponds to
Yolk sac is seen.

Fetal anatomy and structures

Fetal pole is seen.
Developing fetus is seen with
Cardiac activity present
Crown rump length is mm and corresponds to
Bi-parietal diameter is mm corresponding to
Nasal bone seen
Nuchal translucency is mm
Placenta is and away from OS. No evidence of retro-placental collection
Amniotic fluid is adequate for gestational age. AFI is

Maternal structures:
B/L ovaries appear normal. Uterus is normal.
Cervix is cm. Internal OS closed.

Impression: Single live intra-uterine pregnancy of

Advice: Clinical correlation needed. Follow up scan

Note: This document is not for the legal purpose. This report is produced considering that the fetus is in normal situs.
All the anomalies cannot be visualised in the obstetrical ultrasound. The detection of anomalies is highly dependent on the
nature of anomaly, position of the fetus, period of gestation, amount of liquor, maternal built and maternal reproductive
anatomy.
I, Dr. Sandip G Patil, declare that, while conducting ultrasonography on this patient, I have neither detected nor disclosed the
sex of the fetus to any one in any manner.

Dr. Sandip Patil

MBBS, DGO