WAHT-KD-024
Radiology Key Documents
STANDARD OPERATING PROCEDURE (SOP) FOR Serial Scan Requests from
Consultant Antenatal Clinics IN TRUST IMAGING DEPARTMENTS
(RADIOLOGY)
DIRECTORATE: RADIOLOGY
This is the most up to date version and should be used until a revised document is in
place : 16th January 2020
AIM AND SCOPE OF PROCEDURE
This SOP aims to provide guidance on the appropriate booking of serial scan requests for
screening of women at risk of IUGR from Consultants in Antenatal Clinics across the Trust. It
provides Guidance on which maternal risk factors require serial scans and at which intervals
scans should be performed when attending the Antenatal clinic.
It is based on the RCOG/saving babies lives recommendations and also trust findings from
missed late IUGR. The main change is the timing of serial scans will now be 28, 34, 38 weeks
instead of the current 28, 32, 36 weeks to aid our diagnosis of late onset IUGR without
stretching our already limited scan capacity.
These guidelines have also been embedded into the Trust protocol WHAT-TP-094
Management of Intrauterine Growth Restriction IUGR.
KEY STAFF RESPONSABILITIES
Carolyn Stabler Lead Sonographer To ensure SOP is disseminated and
followed by staff
Caroline Fox Consultant Obstetrician. Contribution to document
REFERENCES:
WHAT-TP-094 Management of Intrauterine Growth Restriction
IUGR
DEFINITIONS:
IUGR – Intrauterine Growth Restriction
DESCRIBE SOP OR INSERT PROTOCOL / GUIDANCE / FLOWCHART
Date of Commencement 1.2.2018
Serial scan requests at the Consultant Antenatal Clinic – booking visit
Page 1 of 3
Please note that the key documents are not designed to be printed, but to be used on-line. This is to
ensure that the correct and most up-to-date version is being used. If, in exceptional circumstances,
you need to print a copy, please note that the information will only be valid for 24 hours and should be
read in conjunction with the key document supporting information and/or Key Document intranet
page, which will provide additional information including approval and review dates.
WAHT-KD-024
Radiology Key Documents
Indications for serial growth scans
Maternal risk factors:
Maternal age ≥ 40 years
Ongoing smoker > 10 per day (at booking)
Drug misuse
BMI>35
Previous obstetric history
Previous severe PET (needed delivery <34 weeks)
Previous SGA baby (<10th centile)
Previous stillbirth or abruption
Maternal medical history
Chronic hypertension
Epilepsy on medication
Diabetes (scans to remain at 28;32 and 36 weeks of gestation)
Renal impairment
Antiphospholipid syndrome
Hyperthyroidism, including women with previous treated Grave’s
who are now euthyroid or hypothyroid
Large fibroids
Epilepsy
Current Pregnancy complications
Early pregnancy
PAPP-A <0.4 MoM
Fetal echogenic bowel
Late pregnancy
Severe pregnancy induced hypertension (if diagnosed <36 weeks one scan is
indicated and if normal, does not need repeating)
Pre-eclampsia (PIH and proteinuria)
Unexplained antepartum haemorrhage
GDM
Page 2 of 3
Please note that the key documents are not designed to be printed, but to be used on-line. This is to
ensure that the correct and most up-to-date version is being used. If, in exceptional circumstances,
you need to print a copy, please note that the information will only be valid for 24 hours and should be
read in conjunction with the key document supporting information and/or Key Document intranet
page, which will provide additional information including approval and review dates.
WAHT-KD-024
Radiology Key Documents
If growth scan is required >38/40, or there is a need for further/other scans to
be performed – these need to be requested by a Consultant
Women who do not require serial scans:
Hypothyroidism
Recurrent miscarriage where all investigations normal
Previous pre-term delivery, but not SGA
Previous LSCS and not SGA
Fertility treatment (IVF/ICSI) and no other factors
If the request form is not completed appropriately (clinical indication for
scan/gestation/investigation required/name of requester), the patient may not
be able to be scanned so please ensure all requests are complete. It can waste
lots of time otherwise and may mean the patient does not get the appropriate
scan. Please ensure you state the actual BMI and age rather than “raised BMI”
etc
Page 3 of 3
Please note that the key documents are not designed to be printed, but to be used on-line. This is to
ensure that the correct and most up-to-date version is being used. If, in exceptional circumstances,
you need to print a copy, please note that the information will only be valid for 24 hours and should be
read in conjunction with the key document supporting information and/or Key Document intranet
page, which will provide additional information including approval and review dates.
