In this episode of The Seasoned Sonographer, we explore first trimester ultrasound essentials, including AIUM guidelines, image optimization tips, common early pregnancy pathology, and practical advice for overcoming scan challenges. Perfect for sonographers and providers looking to sharpen their early OB skills. © 2025 The Seasoned Sonographer, Lynn Flamm. All rights reserved.
In this episode of The Seasoned Sonographer, we’re diving deep into the foundational and fascinating world of first trimester ultrasound. Whether you’re confirming an intrauterine pregnancy or navigating a challenging early scan, this episode provides practical insights for sonographers and providers alike.
Join me as I break down the AIUM guidelines for what should be included in every first trimester scan—from evaluating gestational sacs and yolk sacs to measuring CRL and documenting cardiac activity. We’ll also walk through key image optimization techniques, including how to properly adjust depth, gain, and focus for clearer, more diagnostic images using both transabdominal and transvaginal approaches.
We’ll explore common early pregnancy pathology, like subchorionic hemorrhages, embryonic demise, molar pregnancy, and ectopic gestations, and I’ll share clinical tips for spotting red flags before they become emergencies. I also talk through some of the challenges we face in the field, such as patient body habitus, scan limitations, and how to sensitively manage tough conversations with patients when pregnancies are nonviable.
Whether you’re a new grad, a seasoned tech, or a provider looking to understand the sonographer’s perspective, this episode will help you scan smarter and with more confidence.