Patient Name Date

Age/ Sex Time

LMP Referred By Dr.Sandip Patil
EDD (by LMP) USG EDD
Indication Diagnosis and dating of pregnancy

Obstetrical Ultrasound Report

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

Fetal anatomy and structures

Fetal pole is seen.
Developing fetus is seen with head and back.
Cardiac activity is present 144bpm regular.
Crown rump length is cm and corresponds to w d
Placenta is developing and away from OS. No evidence of retro-placental collection.
Amniotic fluid appears normal for gestation age

Maternal structures:
Uterus appears normal. B/L ovaries appear normal.
Cervix is 3.cm. Internal OS closed. No e/o OS incompetency.

Impression: Single live intra-uterine fetus of wd

Advice: Clinical correlation needed. Follow up scan at 12 wks

Note: This document is not for the medico-legal purpose. This report is produced considering that the fetus is in normal situs.
All the anomalies cannot be visualised and detected 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.
This is a level I scanning, if clinically suspicious of any abnormality or anomaly the level III scanning by an expert is indicated
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 20100000638