Imaging in obstetrics
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Imaging in obstetrics

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Imaging in obstetrics Presentation Transcript

  • 1. Imaging in Obstetrics
  • 2. Objectives• State the imaging modalities used in obstetrics - Ultrasound scanning - MRI• Describe the role of imaging in obstetrics - Diagnosis and assessment of early pregnancy - Determination of gestational age - Assessment of fetal growth & well being - To detect congenital anomalies
  • 3. Confirmation of Pregnancy IUP Blighted Ovum
  • 4. Detection of IUP on ImagingBy Trans vaginal scan Gestational sac - 4 weeks Yolk sac, Fetal pole ( somite state) - 5 weeks Fetal cardiac pulsations - 5 weeks
  • 5. Gestation - Intra / extra uterine ? Either un ruptured or ruptured Early detection, by awareness, wide use of US
  • 6. IUP / Hydatidiform mole( H Mole) ?• Unusually large uterus for POG• Small cystic spaces in endometrial cavity• Types - complete / partial / choriocarcinoma Complete H mole Partial mole
  • 7. Early pregnancy on Ultrasound Gestational sac, Yolk sac, fetal pole at 6 weeks at 7 weeks
  • 8. Fetus & yolk sac, 8 weeks
  • 9. Identification of Multiple Gestations Twins Triplets
  • 10. Measurement of gestational age • The Crown-rump length (CRL) - measurement made between 7 to 13 weeks - accurate estimation of gestational age in 1st TM • The Biparietal diameter (BPD) - diameter between the 2 parietal bones - measured after 13 weeks, in 2nd TM - dating in the later part of pregnancy unreliable • The Femur length (FL) - measures the longest bone in the body - reflects the longitudinal growth of the fetus, in 3rd TM • The Abdominal circumference (AC) - circumference at the level of umbilical vein - gives an indication of liver size, 2nd & 3rd TM
  • 11. Measurement of gestational age • 1st TM GS - Gestational sac diameter CRL - Crown rump length • 2nd & 3rd TM BPD – Biparietal diameter AC – Abdominal circumference FL – Femoral length
  • 12. 1st TM measurements Average of 3 measurements / widest dimension6 – 9 weeks – fetal length GS CRL After 9 weeks
  • 13. 2 nd TM measurements AC BPD, HC FL
  • 14. Congenital anomalies Normal fetal brain Hydrocephalus
  • 15. Anencephaly
  • 16. Encephalocoele
  • 17. Congenital anomalies What is this abnormality ?
  • 18. Nuchal translucency More than 3 mm nuchal translucency at any gestational age indicates chromosomal abnormality
  • 19. Omphalocoele
  • 20. Placental assessment • Site – placenta preavia • Size • Maturity • Abnormalities
  • 21. Placental attachment site Types of placenta preavia
  • 22. Amniotic fluid – AFI• Oligohydramnios - AFI < 6 in 3rd TM - IUGR( intra uterine growth retardation)• Polyhydramnios - AFI > 20 - diabetes, congenital anomalies
  • 23. Doppler Ultrasound in Pregnancy • Umbilical artery • Uterine artery • Ductus venosus
  • 24. Umbilical artery Doppler Normal spectral flow with high diastolic flow
  • 25. Umbilical artery Doppler Normal flow Absent diastolic flow Reversed diastolic flowReduced or reversed diastolic flow indicates poor fetal outcome
  • 26. MRI in ObstetricsMRI may aid in the detection of1 . life-threatening complications of pregnancy - placenta accreta2. Confirmation of major congenital anomalies Placenta accreta
  • 27. MRI in Obstetrics – congenital anomalies Oesophageal atresia Normal oesophagus
  • 28. MRI - Congenital Brain abnormalities What is the diagnosis ?