Introduction: The 20-week morphology ultrasound is a critical milestone in antenatal care, combining diagnostic assessment with an opportunity for parental bonding. While often reassuring, it can also trigger significant maternal anxiety. Patient informedness, the extent to which women feel prepared and knowledgeable, may influence emotional responses, yet evidence in the Australian context remains limited. The aim is to examine the relationship between pre-scan informedness and anxiety. An exploratory analysis also considered differences in cost expectations between public and private patients.
Method: A prospective cross-sectional survey of 78 antenatal patients was conducted before the morphology scan. A 17-item questionnaire assessed informedness, anxiety, pregnancy factors, and cost expectations. Data were analysed using Spearman’s correlation, ordinal regression, and chi-square tests (Ethics Ref: 2025-45990-121310).
Results: Higher informedness was significantly associated with lower pre-scan anxiety (ρ = -0.26, p = 0.024). Regression confirmed informedness as an independent predictor of reduced anxiety (β = -0.30, p = 0.009), while pregnancy complications were linked to increased anxiety (p = 0.012). Private patients were more likely than public patients to anticipate out-of-pocket costs (χ²(1) = 14.82, p < 0.001).
Conclusion: Pre-scan informedness is a modifiable factor that reduces maternal anxiety at the 20-week morphology ultrasound. Structured pre-scan education and clear communication of financial expectations may optimise patient experience and reduce psychological distress. The findings underscore the role of imaging professionals in delivering patient-centred antenatal care.
Take-home message: Clear communication before the scan is as important as technical expertise during it.

Introduction: The myoadherent placenta (MAP), classified as Grade 1 of the placenta accreta spectrum, results from abnormal implantation into the uterine wall. Grades 2 and 3 involve myoinvasive disease, with Grade 2 extending to the serosal layer and Grade 3 invading adjacent organs such as the bladder or bowel. This abnormal implantation prevents normal placental separation post-delivery, leading to severe postpartum haemorrhage (PPH) due to extensive retroplacental vasculature. PPH often necessitates blood transfusions and may result in multi-organ failure or hysterectomy.
In Australia, PPH remains a leading cause of maternal death, with severe cases (≥1500 mL blood loss) occurring in 1.4% of births. The maternal mortality ratio was 4.8 deaths per 100,000 women giving birth in 2022, highlighting the need for early detection and multidisciplinary management.
Methods: Evidence-Based Case Study; A patient with significant PPH required blood transfusion and uterine balloon tamponade due to a myoadhesive placenta. This case underscores the importance of timely diagnosis and intervention.
Results: Optimal detection occurs between 28–32 weeks, coinciding with placental maturation, though high-risk patients (e.g., prior caesarean section with low anterior placenta or uterine surgery) warrant earlier evaluation at 11–16 weeks. Ultrasound remains the cornerstone for diagnosis, with hallmark features including: -Multiple vascular lacunae with a “moth-eaten” appearance and turbulent feeder vessels,-Loss or irregularity of the retroplacental clear zone,-Myometrial thinning (<1 mm) and placental bulge.
Conclusion: Improved detection enables critical planning, reducing maternal morbidity and mortality associated with post-partum haemorrhage.

Introduction: Sonographers are highly skilled to perform diagnostic imaging for obstetric and gynecological (O&G) examinations, fertility studies and Intrauterine Device insertions. Ultrasound guidance during O&G surgery is well documented for elective pregnancy termination, miscarriage, retained products of conception (RPOC), ectopic pregnancy, hysteroscopy, metroplasty or adhesiolysis. An opportune extension of existing sonographer clinical roles is guidance for O&G surgeries to optimise patient care and outcomes.
Methods: The authors performed a systematic literature review assessing the role of ultrasound guidance to reduce surgical complications, followed by retrospective cohort study documenting the sonographer's providing O&G guidance in a Sydney hospital. A further literature review was undertaken to investigate advanced practice characteristics, advanced skills, benefits, potential difficulties and training required for advanced sonographer roles.
Results: Ultrasound guidance reduces RPOC during uterine curettage(D&C). Sonographer continual guidance is recommended for patients with previous complications, later terminations or post-partum RPOC. Sonographers providing guidance require additional skills extending beyond basic competencies due to greater accountability, responsibility and autonomy required. Technical, communication, clinical judgement and interpersonal skills are crucial. Training is usually interprofessional without a formalised evidence-based education program.
Conclusion: Sonographer ultrasound guidance in theatre for obstetrics and gynaecology is increasingly an opportunity for advanced clinical practice. Further investigation of other applications requiring sonographer ultrasound guidance in theatres is warranted with future scope for more formalised training of sonographers in this challenging but rewarding role extension.
Take home message: Sonographers have the expertise and should be used in theatre to provide ultrasound guidance for O&G to improve patient outcomes.