What are the common contraindications for performing an ultrasound scan in a primary care setting?

In a primary care setting, common contraindications for performing an ultrasound scan include:

• Patient factors making the scan unacceptable or intolerable: For example, if a transvaginal ultrasound scan is unacceptable to the woman, it should not be performed and an alternative such as a transabdominal scan should be offered instead, with explanation of its limitations ¹.
• Clinical situations requiring specialist assessment: Women presenting with symptoms or signs of early pregnancy complications such as pain, bleeding with pregnancy of 6 weeks or more, or uncertain gestation should be referred to an early pregnancy assessment service or gynaecology service rather than scanned in primary care ¹.
• Need for appropriately trained personnel: Ultrasound scans, especially transvaginal scans for early pregnancy assessment, should be performed or directly supervised by healthcare professionals with appropriate training and experience in diagnosing conditions like ectopic pregnancy ¹.
• Urgent clinical conditions: Presence of signs suggesting haemoperitoneum or ectopic pregnancy require urgent referral and specialist imaging rather than routine primary care ultrasound ¹.

Therefore, contraindications in primary care are mainly related to patient acceptability, clinical urgency, and the need for specialist expertise rather than absolute medical contraindications to ultrasound itself.