An Absent Right Umbilical Artery Versus Absent Lt and the Prognostic Implications for the Fetus

Jennifer Durant, BS, RDMS, RDCS, RVT, Douglas Helm, MD,  
Karen Having, MS ED, RT(R), RDMS,  2
and Joy Guthrie, PhD, RDMS, RDCS, RVT, RCS, RCCS, RVS, FSDMS 3



A single umbilical artery (SUA) is one of the most common malformations in a fetus, with approximately a 1% occurrence rate. A retrospective study of 108 fetuses with a SUA was done to determine if the laterality of the SUA made a difference in fetal prognosis. An absent right umbilical artery was found in 42 (38.9%) of cases and an absent left umbilical artery in 66 (61.1%) cases. When correlated with fetal outcome, there was a closer association between an absent right umbilical artery with genitourinary anomalies, cardiac defects, and chromosomal abnormalities. There was a nine times greater likelihood (95% confidence interval of a 3 to 27 times greater probability) of a fetal anomaly with an absent right umbilical artery than with an absent left umbilical artery. 

                                            To download and read full article, click Download PDF


Sonographers, what are you measuring?

M-Mode is the modality we use to obtain a fetal heart rate, but few and far between sonographers even know what they are really measuring. Unfortunately, sonography schools, though they teach the many facets of OB sonography, are not teaching how to correctly perform, interpret or measure M-mode. This is truly astounding. Why don’t we know this?!! It could make a big difference in a baby’s prognosis and treatment.

When measuring the heart rate, many sonographers are measuring the most pronounced thing they visualize, which is usually the motion of a heart valve. This is NOT the fetal heart rate, and you might be missing a significant heart dysrhythmia. 

                                                   To learn more, download the free PDF.


The Big No-No That You May Not Know for Transcranial Doppler Imaging (TCDI)


Transcranial Doppler imaging can be a challenging exam for the sonographer to perform on the stoke inpatient. Small rooms, lots of equipment, lots of “lines” and often patient bandages. Many of these factors we have no control over, and we have to adjust our scanning accordingly. But the one no-no you may not know is not to move the bed or the patient. It could be catastrophic and life threatening for the patient. Why? Let me explain….

Some background first:
Approximately 30,000 hemorrhagic strokes occur annual, with over 50% of those patients not making it to the hospital and dying within just minutes. If the patient does make it to the hospital, obtains the needed CTA/MRA for diagnosis and is able to tolerate the coiling of the aneurysm, they still have a 50-70% chance of intracranial vessel vasospasm1 which carries with it a 15-20% risk of another stroke or even death. Though the patient may seem to be doing better after the coiling, it is not until day 3-14 where the manifestations of vasospasm may occur. That is why a baseline (day after coiling) is so important to obtain, as the effects (vasospasms) caused by blood extravasation have not yet occurred. This baseline will aide in later detection of the severity of vasospasm and treatment. Why vasospasms and why that late?                 

                                                            To learn more, download the free PDF.




Knowing the basic principles of flow is essential to understanding vascular physics and its related pathophysiology. If sonographers will understand these principles, the complicated will make sense.


See practical applications of flow in your everyday life. The same principles apply to vessels. ....


                                                 To learn more, download the free PDF.



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Beautiful african woman happy and excite
  • Be Confident in What you Know!

  • When you sit down for the test, go through instructions on test. After instructions, click to start test, then STOP!!! Don't look at any questions yet. On the white board you are given, write down the things you are worried about forgetting: i.e. Lab QA, formulas, draw out anatomy, Laws/Equations,....

  • Now start the test.

  • TAKE YOUR TIME!!! You have plenty of time to go slow.

  • Answer EVERY question the first time, do not skip a question. If you skip questions, it will add significantly to your anxiety in the middle of the test.

  • If you don't know an answer, choose what you think is the best answer. Your first instinct is almost always correct. If you absolutely don't have a clue, choose C, it is often the correct answer.

  • Put a check mark for those questions you really didn't know. The answer may be given later on in the test within a different question.

  • DO NOT go back and change ANY answers unless  you are 100% sure you now know the correct answer. ***changing answers is the #1 reason sonographers fail any test***

  • If your mind goes blank, pause for a minute, take a deep breath, say a prayer to calm you down, and continue when your mind is relaxed. YOU HAVE PLENTY OF TIME!

  • You can do this!!! If you put the time in to study, you will succeed!