This document provides information on transvaginal ultrasound (TVS) in the first trimester. It discusses the advantages of TVS including better image resolution from the shorter probe-target distance. Common indications for first trimester ultrasound are listed, along with normal ultrasound findings from 4-10 weeks of gestation. Guidelines for estimating gestational age using crown-rump length are provided. Diagnostic signs of early pregnancy failure and molar pregnancy are outlined. Biometric measurements used in obstetric ultrasounds after 13 weeks are also noted.