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Failure to identify fetal cardiac activity in a fetus whose overall length is greater than 4 mm is an ominous sign.
It can sometimes be difficult identifying a fetal heartbeat from the background movement and maternal pulsations.
After the uterus is evaluated by sweeping up and down and side to side, the ovaries are identified and evaluated.
Document important views and measurements on film or electronically.
Then document your findings in some written format.
Place a small amount of ultrasonic coupling gel on the tip of the transvaginal transducer. After lubricating the vaginal opening, gently insert the transducer into the vagina.
Visualize the longitudinal plane of the uterus (sagital section) and evaluate its' size.
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