OSATS requirements for subspecialty training in maternal and fetal medicine
You have to be competent in:
Chorionic villus sampling
Items under observation:
- Appropriate pre-test counselling
- Appropriate choice of procedure
- Explanation of procedure
- Appropriate choice of position
- Local anaesthesia
- Placement of needle
- Aspiration of sample
- Assessment of sample
- Handling of sample, including labelling
- Rapport with patient during procedure
- Ultrasound check post-procedure
- Checking of blood group
- Post-procedure counselling
- Arrangement for results
Fetal echocardiography
Items under observation:
- Review indication for scan and establish rapport
- Determine cardiac situs and axis
- Determine cardiac size
- Obtain a good four-chamber view*
- Display left ventricular outflow tract and aortic valve
- Examine integrity of ventricular septum
- Display right ventricular outflow tract and pulmonary valve, and show relationship with left
- Demonstrate aortic and pulmonary arches**
- Demonstrate inferior vena cava and superior vena cava
- Perform M-mode echocardiography
- Show how colour flow and power Doppler are used in cardiac scanning
- Explain findings to woman and partner
*An adequate four-chamber view should allow the trainee to point out two atria (with the foramen ovale and flap) and two ventricles (the right with the moderator band) and to discuss the relative sizes of the chambers. The septae should be considered and the movement of the atrioventricular valves noted. Offsetting of the tricuspid valve should be demonstrated and drainage of at least two of the pulmonary valves into the left atrium.
**The arches should be delineated separately with their identifying features pointed out by the trainee; e.g. head and neck vessels arising from the aortic arch.
Amniocentesis
Items under observation:
- Appropriate pre-test counselling
- Appropriate choice of procedure
- Explanation of procedure
- Appropriate aseptic technique
- Appropriate choice of site for needle insertion
- Placement and visualisation of needle whilst within amniotic sac
- Aspiration of sample
- Assessment of sample
- Handling of sample, including labelling
- Rapport with patient during procedure
- Ultrasound check post-procedure
- Checking of blood group
- Post-procedure counselling
- Arrangement for results
- Appropriate record of procedure and results