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OSATS, maternal and fetal medicine

This page sets out the 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

External cephalic version

Itemw under observation:

  • Ensuring appropriate selection of patient*
  • Appropriate place of procedure
  • Appropriate communication with team
  • Appropriate counselling and consent
  • Use of tocolysis, if appropriate
  • Appropriate preparation, including pre-procedure CTG
  • Careful ultrasound assessment of fetal and placental position, liquor and identification of body parts
  • Safe and systematic movement of fetus
  • Regular assessment of fetal wellbeing during procedure
  • Ensuring no excessive maternal discomfort
  • Ensuring fetal monitoring post-procedure
  • Checking appropriate follow up arrangements such as:
    • Check of rhesus status and give Anti-D as appropriate
    • Delivery plan

*This should include assessment of fetal size and absence of contraindications to the procedure.

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.

Rotational instrumental delivery

Items under observation:

  • Ensuring appropriate selection of patient*
  • Appropriate place of delivery
  • Appropriate communication with team
  • Appropriate counselling and consent
  • Appropriate preparation, including analgesia and bladder care
  • Selection of appropriate instrument
  • Safe application of instrument
  • Successful rotation
  • Appropriate traction and safe delivery of head
  • Safe completion of delivery
  • Perineal repair
  • Appropriate abandoning of procedure
  • Section following failed trial
  • Appropriate debrief and counselling

*This should include assessment of fetal size and wellbeing, amount of head palpable abdominally, station and position of vertex, and size of pelvis.

Elsewhere on the site

OSATS
An explanation of OSATS: what they are and how they are used within O&G training
Resources for trainees
Resources to support specialty trainees in O&G