2.5% of total births
1/3: congenital heart
1/3: other anomalies
20% of S.B
Importance of diagnosis
1. Terminate pregnancy or not.
2. Fetal therapy
2. Indications for targeted U/S
In the past
I. From history
1. Maternal age >35 years
2. Previous child with structural or
3. Family history
4. Exposure to irradiation or teratogen
6. Repeated pregnancy loss
II. From examination
1. Ab. MSAFP
2. Multiple pregnancy
3. Severe poly. or oligohydramnios.
4. Suspicious finding on routine U/S.
6. Ab. Placenta (thick, cystic, hydropic)
7. Abnormal Doppler velocimetry of umbilical cord
Routine mid-trimester fetal ultrasound scan
(ISUOG, FMF, RCOG, SMFM)
3. Role of Ultrasonography
1. Direct visualization of the defect
2. Visualization of the pathology due to the defect
Dilated stomach and duodenum
Increased nuchal folds & short femurs
3. Ultrasonic markers of chromosomal abnormalities.
4. Guide to obtain fetal tissue
Chorionic villous biopsy
Cordocentesis. Aboubakr Elnashar
7. Anomaly scan
All pregnant women
All pregnant women should be offered 2 scans in
- 1st : 11-13 w
- 2nd : around 20 w
Mid-trimester fetal ultrasound scan
1. Congenital malformations
2. Gestational age.
3. Fetal measurements for the timely detection of growth
abnormalities later in pregnancy.
4. Multiple pregnancies.
between 18 and 22 w.
Real time, gray-scale
TA transducers (3–5-MHz range)
adjustable acoustic power output controls with output display
freeze frame capabilities
capacity to print/store images
regular maintenance and servicing
Chick list Aboubakr Elnashar
First Trimester Ultrasound Scan
1. Towards the end of the first trimester, gross fetal
2. aneuploidy screening
4. gestational age accurately
5. number of fetuses
6. Assess chorionicity and amnionicity.
between 11 and 13+6 w.
Any time if there clinical concerns, pathological
symptoms or specific indications.
You can get this lecture from:
1.My scientific page on Face book:
Aboubakr Elnashar Lectures.
2.Slide share web site
4.My clinic: Elthwara St. Mansura