Referral criteria for NT exam are as per PSBC Guidelines.

Number of available slots are limited. If the booking is declined, other sites offering NT exam can be found here 

Content

‎BCW OB ultrasound department is piloting a new early anatomical screening clinic for a subset of pregnant people with fetus  at risk for congenital differences and and for those with BMI>35. 

Endovaginal cervical length assessment is typically performed serially in "at risk patients" between 16 and 24+0 weeks GA. 

Frequency (usually every 1-2 weeks) depends on measurement obtained and the nature of risk factors

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Indications for endovaginal (EV) cervical length assessment include:

• Previous history of preterm birth <36 weeks GA
  
• Previous LEEP or cone biopsy 
  
• Follow up of EV cervix length <25mm in current pregnancy and gestational age < 24+6 weeks GA 
• Maternal history of connective tissue disease (eg Ehler Danlos)
  
• Maternal history of uterine malformation (eg unicornuate uterus)
  
• Cerclage placement confirmation:
  
• done once <24+6 weeks GA following procedure
  
• follow up EV ultrasound only if clinical concern of cerclage failure  
  

Referral for other indications (such as admission for signs/symptoms of preterm labour) are triaged at the discretion of the BCW ultrasound reporting physician

This assessment is performed between 20 and 24+0 weeks gestational age in singleton pregnancies meeting eligibility critria outlined in the risk assessment form as part of the MFM EMMA clinic referral.

All EMMA referrals are triaged by MFM. When deemed appropriate or when requested by careprovider, an ultrasound-based consult may be provided as part of the ultrasound report in lieu of a separate MFM clinic consult. 

When an ultrasound-based EMMA consult is requested:

1. Referral through MFM is required for booking the ultrasound examination

2. Recommendations are outlined in the ultrasound report following the ultrasound examination.

3. It is the responsibility of the referring care provider to review the content of the report with the patient.

4. When abnormal or unexpected findings are found at the time of ultrasound, the referring careprovider is notifified and the patient may be seen in consultation by MFM. 

‎Referral criteria for specialized heart exams are listed here.  Please specify indication on referral form.

Referrals for abnormality detected on a prenatal ultrasound exam are invited to an FDS clinic appointment. 

Referral criteria for the FDS clinic can be found here. 

Referral for abnormalities not listed under FDS clinic are triaged accordingt to the BCW Ultrasound triage guidelines.

BCW most recently updated umbilical artery Doppler protocol can be found here

Umbilical artery Doppler studies are routinely performed when:

• Fetal abdominal circumference measures less than the 10th percentile for gestational age in singleton or multiple pregnancies
  
• In pregnancies complicated by pre-eclampsia or gestational hypertension
• at MFM request (eg complex monochorionic twins)
• Other indications: are triaged and performed at the discretion of reporting MFM physician.
  

Middle cerebral artery Doppler (MCA) is routinely used for screening for severe anemia in the at risk fetus such as:

1. Kell alloimmunization (any antibody titer)

2. Anti-D or other significant antibodies alloimmunization, when critical titer is reached as per Canadian Blood services recommendations.

3. Fetal maternal hemorrhage documented by positive Kleihauer test.

4. As part of screening for TAPS in select cases of Monochorionic twins.

Women should be referred to the MFM clinic when the fetus is identified to be at risk for severe fetal anemia due to alloimmunization.

MCA Doppler studies may be performed for other indications, at the discretion of MFM.

All requests for Middle cerebral artery Doppler are triaged by the reporting MFM‎ physician.

BCW checklist for image acquisition and interpretation‎

BCW Umbilical artery Doppler Protocol update *2024*

Protocol and explanatory notes for BCW ultrasound examination schedule for monochorionic pregnancies‎

Follow up recommendations for PLSVC‎