Obs-&-Fetus online reporting

Gestational Sac — Ultrasound Reporting (3-line chart)

Name

Age / Sex

Referring Doctor

Date of Exam

Pregnancy status Normal Subchorionic hemorrhage Anembryonic pregnancy Organ-wise Findings Uterus: The uterus anteverted, normal size for parity; myometrium unremarkable. Endometrium: Single intrauterine gestational sac identified. Adnexa: Both adnexa appear unremarkable. No complex adnexal mass identified. Free fluid: None identified in the pouch of Douglas. Intrauterine pregnancy: Gestational sac: visualized. Yolk sac: visualized. Fetal pole / embryo: Not visualized. Number of sacs/embryos: singleton

Measurements & Dating

LMP

MSD (mm)

CGA (e.g. 5w + 6d)

EDD

5th mean 95th Pointer = dashed line · Measured = black dot