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Ultrasonography of Congenital fetal Defects

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Ultrasonography of Congenital fetal Defects

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Ultrasonography of Congenital fetal Defects

  1. 1. Ultrasonography of Congenital fetal Defects Prof Aboubakr Elnashar Benha university. Egypt Aboubakr Elnashar
  2. 2. 1. Introduction Incidence 2.5% of total births 1/3: NTD 1/3: congenital heart 1/3: other anomalies 20% of S.B Aboubakr Elnashar
  3. 3. Importance of diagnosis 1. Terminate pregnancy or not. 2. Fetal therapy Aboubakr Elnashar
  4. 4. 2. Indications for targeted U/S  In the past I. From history 1. Maternal age >35 years 2. Previous child with structural or chromosomal. anomalies. 3. Family history 4. Exposure to irradiation or teratogen 5. IDDM 6. Repeated pregnancy loss Aboubakr Elnashar
  5. 5. II. From examination 1. Ab. MSAFP 2. Multiple pregnancy 3. Severe poly. or oligohydramnios. 4. Suspicious finding on routine U/S. 5. IUGR 6. Ab. Placenta (thick, cystic, hydropic) 7. Abnormal Doppler velocimetry of umbilical cord  Today: Routine mid-trimester fetal ultrasound scan (ISUOG, FMF, RCOG, SMFM) Aboubakr Elnashar
  6. 6. 3. Role of Ultrasonography 1. Direct visualization of the defect Anencephaly. 2. Visualization of the pathology due to the defect Dilated stomach and duodenum {duod. Atrsia}. Increased nuchal folds & short femurs {Down syndrome} 3. Ultrasonic markers of chromosomal abnormalities. 4. Guide to obtain fetal tissue Amniocentesis Fetoscopy Chorionic villous biopsy Cordocentesis. Aboubakr Elnashar
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  8. 8. CVB amnicentesis Aboubakr Elnashar
  9. 9. Cordocentesis Aboubakr Elnashar
  10. 10. 7. Anomaly scan Indication All pregnant women NICE All pregnant women should be offered 2 scans in pregnancy : - 1st : 11-13 w - 2nd : around 20 w Aboubakr Elnashar
  11. 11. Mid-trimester fetal ultrasound scan  Objective 1. Congenital malformations 2. Gestational age. 3. Fetal measurements for the timely detection of growth abnormalities later in pregnancy. 4. Multiple pregnancies. Aboubakr Elnashar
  12. 12. When: between 18 and 22 w. Sonographer: well-trained US machine:  Real time, gray-scale  TA transducers (3–5-MHz range)  adjustable acoustic power output controls with output display standards  freeze frame capabilities  electronic calipers  capacity to print/store images  regular maintenance and servicing Chick list Aboubakr Elnashar
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  14. 14. RCOG, 2000: anomaly scan Aboubakr Elnashar
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  43. 43. 3 vessel – tracheal view P A SV C Aboubakr Elnashar
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  57. 57. 3 vessel Umb A Aboubakr Elnashar
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  67. 67. First Trimester Ultrasound Scan Objective 1. Towards the end of the first trimester, gross fetal abnormalities. 2. aneuploidy screening 3. viability 4. gestational age accurately 5. number of fetuses 6. Assess chorionicity and amnionicity. Aboubakr Elnashar
  68. 68. When:  between 11 and 13+6 w.  Any time if there clinical concerns, pathological symptoms or specific indications. Aboubakr Elnashar
  69. 69. Aboubakr Elnashar You can get this lecture from: 1.My scientific page on Face book: Aboubakr Elnashar Lectures. https://www.facebook.com/groups/2277 44884091351/ 2.Slide share web site 3.elnashar53@hotmail.com 4.My clinic: Elthwara St. Mansura

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