Clinical obesity is defined as a body mass index (BMI)>35. Obstetric ultrasound scanning of patients with a high BMI may increase the likelihood of sonographers developing muscular-skeletal disorders (MSD). In order to reduce the likelihood GG&C sonographers should follow these guidelines.

• Do not apply any extra pressure and stop scanning if you experience any pain.
• Do not use a two handed technique as this will rotate the spine, shoulder muscles and ligaments increasing the risk of MSD. Use alternative techniques to improve resolution e.g. patient supporting any excess tissue, bladder filling/emptying, sending patient for a walk, re-adjust patient position.
• All efforts will be made to ensure ultrasound rooms are equipped with suitable ergonomic equipment.
• Sonographers should optimise image resolution by making full use of machine settings.
• Consider using a trans vaginal method to improve image resolution where appropriate.
• If there is inadequate visualisation at a routine Fetal Anomaly Scan due to a high BMI one further appointment may be given at 22 weeks.
• Where an examination has been limited due to maternal BMI, document this in the ultrasound report.