Background:  There is a high incidence of work related injuries for sonologists with 93% affected. Injuries are most commonly sustained by the twisting of the neck and trunk, a static posture and the downward application of transducer pressure. Performing ultrasound on a bariatric pregnant patient greatly increases the risk of musculoskeletal disorders.(MSD)

Workplace injuries have a large financial and service provision impact within the hospital. An effective bariatric ultrasound protocol has been developed at RBWH to improve the service to patients with increased BMI and minimise work injuries to staff.

Ultrasound imaging is used to monitor the pregnancy, identify fetal structural anomalies and screen for chromosomal abnormalities. Maternal obesity can limit the accuracy and effectiveness of antenatal ultrasound examinations of the fetus and therefore increase the likelihood of failing to detect a fetal structural abnormality. Performing  ultrasound on a bariatric pregnant patient with a Body Mass Index (BMI) >40 is a difficult task due to the impaired acoustic window.

Outcome:  It is hoped that by altering the imaging pathway for bariatric pregnant women that workplace injuries may be reduced and the health of medical professionals performing diagnostic ultrasound will improve.