Limited sonography in collaborative midwifery practice

In 1996, the American College of Nurse Midwives published guidelines for mi dwives who wish to incorporate limited third trimester sonography into thei r practices. First, however, certain didactic and clinical content needs to be disseminated through basic and continuing midwifery education. To assis t the busy practitioner, information is offered related to recommended meth ods of obtaining learning validation and continuing competency in limited s onography. This article discusses various clinical situations in which the assessment and management of a patient's condition might be improved by having ultraso nographic information immediately available. In addition, selected data obt ained by limited sonography that may necessitate physician collaboration ar e described through clinical case presentations. The pitfalls of limited sonography are also discussed by use of case descri ptions detailing some of the risks inherent in performing a limited ultraso nogram. The recommendation of performing a complete uterine survey with eac h limited ultrasonogram is emphasized. Finally, some of the controversies surrounding routine sonography in pregna ncy and sonograms fur entertainment are addressed. (C) 2000 by the American College of Nurse-Midwives.