Recomendações e diretrizes na ultrassonografia obstétrica do terceiro trimestre

OBJECTIVES: This study aims to review and consolidate international recommendations and guidelines, especially those from ISUOG, related to the performance of third-trimester obstetric ultrasound, based on current scientific evidence. INTRODUCTION: Third-trimester ultrasound is an essential tool in fetal assessment, aiding in the identification of anomalies, growth monitoring, and placental evaluation. The adoption of standardized international guidelines ensures greater reliability and effectiveness in clinical practice, making it fundamental to be familiar with evidence-based recommendations for its performance. METHODS: A literature review was conducted on ISUOG guidelines and relevant scientific studies, focusing on recommendations regarding performance, clinical indications, assessment parameters, and interpretation of findings in third-trimester ultrasound. RESULTS: The recommendations highlight the importance of performing examinations that assess fetal presentation, growth, amniotic fluid volume, placenta, and fetal circulation by Doppler. Proper measurement techniques for head and abdominal circumferences, as well as the use of Doppler parameters, are essential for accurate assessment. The guidelines also provide direction for the investigation of placental abnormalities, such as placenta previa and placenta accreta. DISCUSSION: Evidence shows that, although they do not have a direct impact on perinatal mortality, third-trimester ultrasounds are valuable for the management of high-risk pregnancies, prevention of complications, and clinical decision-making. Moreover, adherence to international guidelines increases the accuracy and standardization of examinations in different clinical contexts. CONCLUSION: Compliance with international recommendations, particularly those from ISUOG, ensures more effective assessment in third-trimester ultrasound, promoting safer obstetric management based on evidence, even though it does not directly impact perinatal mortality.