Point-of-care ultrasound (POCUS) is increasingly used by midwives, physicians, nurse practitioners, physician assistants, and nurses to evaluate fetal well-being and guide clinical decisions in the third trimester. Third-trimester assessments focus on growth, placental health, amniotic fluid volume, and fetal presentation—all of which can impact birth planning and outcomes. At Ultrasound Trainings, we teach providers how to use POCUS effectively and safely to enhance prenatal care.
Key Third-Trimester Assessments with POCUS
1. Fetal Growth Monitoring
- Biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) are measured to estimate fetal weight and growth trajectory.
- Tracking growth helps identify intrauterine growth restriction (IUGR) or macrosomia, guiding interventions and timing of delivery.
2. Placental Evaluation
- Ultrasound determines placental position, ensuring there is no placenta previa or abnormal attachment.
- Monitoring placental maturity and morphology can provide insight into potential complications.
3. Amniotic Fluid Assessment
- Oligohydramnios (low fluid) and polyhydramnios (excess fluid) can be identified using amniotic fluid index (AFI) or single deepest pocket (SDP) measurements.
- Abnormal fluid levels guide clinical monitoring, potential interventions, and labor planning.
4. Fetal Presentation
- Determining whether the fetus is cephalic, breech, or transverse is crucial for delivery planning.
- POCUS provides real-time confirmation of presentation near term, allowing for timely interventions if needed.
5. Umbilical and Fetal Doppler (when available)
- Evaluates blood flow in the umbilical artery or other key vessels to assess fetal well-being, especially in growth-restricted pregnancies.
Advantages of POCUS in the Third Trimester
- Rapid, bedside evaluation without the need for referral to a radiology suite.
- Immediate clinical decision-making, particularly in urgent or resource-limited settings.
- Supports informed counseling, giving families up-to-date information about fetal health and birth planning.
- Enhances safety by identifying complications early, allowing timely intervention.
Best Practices for Providers
- Standardize measurement techniques to ensure accuracy and reproducibility.
- Document findings carefully, including gestational age, estimated fetal weight, and placental location.
- Correlate ultrasound data with maternal history and physical exam for comprehensive assessment.
- Seek additional imaging or specialist consultation if abnormalities are detected or uncertain.
At Ultrasound Trainings, we provide hands-on workshops and practical guidance for performing third-trimester POCUS assessments, emphasizing accuracy, safety, and clinical integration.
Third-trimester POCUS is a valuable tool for monitoring fetal growth, fluid levels, placental health, and presentation. By incorporating POCUS into routine prenatal care, providers can enhance safety, support informed decision-making, and improve outcomes for both mother and baby.
Expand your expertise with Ultrasound Trainings courses designed to teach practical, real-world third-trimester ultrasound assessments for every prenatal provider.
