Obstetric ultrasound and women with obesity: Do we need industry guidance?

Australia, like many developed countries is experiencing an obesity crisis, with maternal obesity associated with increased risks of fetal and maternal complications. For obstetric sonographers, there are technical challenges to exclude a fetal anomaly or pregnancy complication in a woman with obesity. Furthermore, scan times are often longer, greater probe pressure is needed and follow up scans are often undertaken to complete examinations. There are numerous studies reporting high rates of work-related musculoskeletal disorders (WRMSDs) amongst sonographers and papers that provide tips and tricks to improve imaging and ergonomics. However, there is no specific industry guidance by way of a guideline, consensus statement or position paper from our leading professional associations, on how we can address this complex issue obstetric sonographers encounter when scanning women with obesity, or our communication with women about the difficulties faced. Given the high and increasing rates of obesity, the high risk of pain and WRMSDs for sonographers and limitations associated with these examinations, this raises the question—is it time for our industry to discuss guidance and communication in obstetric ultrasound for women with obesity to mitigate sonographer risk of WRMSDs, while ensuring safe, high quality care for these women?.