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hello I might even on a GP from Lisbon and I'm here with my colleague dr. Karen McMullen radiologist and we're going to talk today about ultrasound scans in pregnancy so carries starting with the very first of the sins that we might order dating viability in skinny with a question mark about a topic pregnancies Kenny please talk us through what are the important points you'd like us and your son ographers would like us to know well first of all a good quality examination at this stage should always include an n-terminal skin so very important to let the patient know that this is a stain seizure and it's actually more comfortable for a patient than having a wall bladder and it will give us a better technical quality in what accurate dates so every set center ideally should be doing transportation skinny generally speaking by seven weeks of gestation we will see a good fetal ball at a quarter fetal heartbeat so we would prefer to see the baby somewhere between seven and eight weeks we will be most accurate with their dates unfortunately some patients water rushing quickly and can't wait to see their baby if they come with their only five weeks to six weeks we may be ever seen enjoy your pregnancy but sometimes at the stretch we won't have a fetal pole yet and we won't be able to confirm viability if however you've got a different clinical scenario of patient with a bit of pain had a previous ectopic your little bit uncertain they want to know whether this pregnancy we can see a gestational sac definitely from a biro city level of 1000 we can always see a fetal heartbeat from a being HCG level of 10,000 so that that guide you but if we can't see gestational sac in that early stages and there's a concern of an ectopic we would recommend the correlation to the serial order to be less than G of a 48-hour period it should double every 48 hours up until eight weeks of pregnancy if it is doubling normally it's likely that it's a normal pregnancy but it's just too early and we'd get them back in the same ten days if it's not doubling normally we start to get more concerned about than ectopic if they've got panic or symptoms were not necessarily wait 10 days we and see what's happened in that 48 hour period okay so in summary with early scanning in pregnancy there is such a thing as too early not really any point getting a scan done in the first five weeks five to six weeks is a bit iffy for the very anxious woman waiting to she's hit at least a thousand with her bigger HCG if you want to see the interview during say if you want to be confident about the fetal heart every woman I know wants to see that little heartbeat as well as that...