[CG] Fetal gender determination and disclosure (ultrasound)

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There is no requirement to determine fetal gender within the Fetal Anomaly Screening programme; however disclosure of fetal sex upon request respects a woman’s rightful autonomy over personal health information.

If the Sonographer is able to determine fetal sex with certainty and the patient wishes this information to be divulged to her, the Sonographer should verbally advise the patient of their findings and document the gender in the ultrasound report.

Consent

The Sonographer should establish at the start of the examination whether the patient wishes to know the sex of the baby. If the patient indicates that they do wish to know – verbal consent should be obtained and recorded on the ultrasound report.

The Sonographer should advise the patient that it is not always possible to determine the sex of the baby, that it is not always 100% accurate and that the examination will not be extended to determine this.

There are occasions where the woman may not want to know the sex of the baby but Obstetric and Neonatal Medical Staff require this information for future management. In these circumstances the gender should be recorded on the ultrasound report and clearly stated that the patient does not want to be informed of the gender.

The Ultrasound examination

During the ultrasound examination, fetal gender should be ascertained under direct observation; views including transverse, sagittal and tangential sections of the fetal perineum should be examined.

The male gender should be determined by the clear visualisation of the penis and scrotum. Female gender should be determined by identification of the two or four parallel echogenic lines representing the labia folds.

An ultrasound image demonstrating the fetal genitalia should be recorded and retained in the patients notes. The Sonographer should document the gender in the ultrasound report.

If clear visualisation of the genitalia is not possible with the prescribed time limits, the examination should not be prolonged or repeated to determine the fetal gender. The Sonographer should document in the notes that they were unable to determine the fetal sex.

Informing the Patient

The Sonographer should verbally advise the patient of their findings. This information should not be shared with the patient’s friends or relatives.

References

Harrington, K, Armstrong, V, Freeman, J, Aquilina, J and Campbell, S. (1996), Fetal sexing by ultrasound in the second trimester; maternal preferences and professional ability. Ultrasound in Obstetrics and Gynaecology, (8), p318-321.

Fetal Anomaly and Down’s Syndrome Screening National protocols, Version 2.0 NHS Scotland Screening Programmes – Pregnancy and Newborn Screening, (2011).

Sale of images, determination of Fetal Gender and commercial aspects related to NHS Obstetric Ultrasound examinations. The Society and College of Radiographers, (2011).

Last reviewed: 01 November 2018

Next review: 01 November 2021

Author(s): Donna Bean, Lead Sonographer, Glasgow North

Approved By: Dr C Bain, Clinical Director