Table 1 Training requirements for PURE pregnancy screening and obstetrics ultrasound course completion

● Received 30 h of theoretical teaching covering the following topics

○ Ultrasound physics, technology

○ Estimation of gestation age: crown–rump length, femur length, biparietal diameter, abdominal circumference, head circumference

○ Multiple gestation

○ Fetal presentation and lie

○ Normal fetal anatomy

○ Placenta location, identification of placenta previa

○ Amniotic fluid index

○ Focused assessment for free fluid (FAFF) in the peritoneum

○ Ultrasound program administration and quality assessment and control

○ Ultrasound safety, machine maintenance, infection control

● Performed a minimum of 75 obstetric ultrasound exams under supervision

● Performed satisfactory (minimum 75% correct) on a written exam covering the theoretical knowledge listed above

● Performed satisfactory (minimum 85% correct) on a practical skills assessment of the following

○ Performs a systematic pelvic ultrasound exam

○ Optimizes and correctly orientates ultrasound images

○ Correctly identifies an intrauterine pregnancy

○ Can identify fetal number

○ Can recognize fetal presentation and lie

○ Can identify placental location

○ Can determine fetal heart rate and identifies fetal distress

○ Obtains accurate measurements of the fetal biparietal diameter, head circumference, abdominal circumference, and femur length

○ Fetal dating and/or weight estimation

○ Amniotic fluid index and recognition of polyhydramnios and oligohydramnios

○ Identifies common obstetric abnormalities such as molar pregnancy, placenta previa, and intrauterine fetal demise and has knowledge of their management

○ Performs a focused assessment for free fluid in the correct clinical context