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ULTRASOUND FIRST TRIMESTER OVERVIEW
OVARIAN  PERIOD   ( WEEK 1 - 2 ) <ul><li>Ovarian follicle matures </li></ul><ul><li>Ovulation </li></ul><ul><li>Corpus leu...
CONCEPTUS PERIOD   ( WEEK  3 - 5 ) <ul><li>Fertilization </li></ul><ul><li>Morula </li></ul><ul><li>Blastocyst </li></ul><...
EMBRYONIC PERIOD   ( WEEK 6 – 10 ) <ul><li>C – shaped embryo </li></ul><ul><li>Major organs develop </li></ul><ul><li>Yolk...
FETAL PERIOD   ( WEEK 11 –12 ) <ul><li>Fetal growth </li></ul><ul><li>Amniotic & Chorionic membranes approach each other <...
OVERVIEW
AIUM GUIDLINES <ul><li>Gestational sac: </li></ul><ul><ul><ul><ul><li>Location </li></ul></ul></ul></ul><ul><ul><ul><ul><l...
SONOGRAPHIC FINDINGS <ul><li>Threshold level : </li></ul><ul><li>The size at which a finding  may be  seen </li></ul><ul><...
PREGNANCY DATING <ul><li>MSD  =  </li></ul><ul><li>MA ( days )  =  MSD( mm )  + 30 </li></ul><ul><li>MA ( Weeks)  =  CRL (...
PREGNANCY DATING 5mm CRL 2mm  CRL  Heartbeat TV -  18mm TA -  25mm TV  -  8mm Embryo  TV -  10mm  TA -  20mm TV  -  4mm Yo...
DISCRIMINATORS <ul><li>MSD  > 10 mm  must  have a yolk sac </li></ul><ul><li>MSD  > 18 mm  must  have an embryo </li></ul>...
CARDIAC ACTIVITY <ul><li>Must be present with CRL  > 5mm </li></ul><ul><li>5 - 6 weeks  100 -  110 bpm </li></ul><ul><li>8...
ABNORMAL FIRST TRIMESTER <ul><li>Embryonic demise </li></ul><ul><li>Bradycardia </li></ul><ul><li>Anembryonic pregnancy </...
ANEMBRYONIC PREGNANCY   <ul><li>MSD > 10mm without yolk sac </li></ul><ul><li>MSD > 18mm without fetal pole </li></ul><ul>...
YOLK SAC   <ul><li>First landmark in gestational sac  </li></ul><ul><li>In the chorionic cavity  </li></ul><ul><li>Abnorma...
GROWTH   <ul><li>Normal growth rate 1 mm per day  </li></ul><ul><li>MSD - CRL < 5 mm poor prognosis  (first trimester olig...
SONOEMBRYOLOGY <ul><li>6 Wks  ---  Neural tube complete </li></ul><ul><li>8 Wks  ---  Spine ,  Limb buds </li></ul><ul><li...
 
 
 
 
 
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First Trimester over view

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Its a presentation made by Dr. Rubina Mushtaq on the first trimester of pregnancy.

Published in: Health & Medicine
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First Trimester over view

  1. 1. ULTRASOUND FIRST TRIMESTER OVERVIEW
  2. 2. OVARIAN PERIOD ( WEEK 1 - 2 ) <ul><li>Ovarian follicle matures </li></ul><ul><li>Ovulation </li></ul><ul><li>Corpus leuteum formation </li></ul>
  3. 3. CONCEPTUS PERIOD ( WEEK 3 - 5 ) <ul><li>Fertilization </li></ul><ul><li>Morula </li></ul><ul><li>Blastocyst </li></ul><ul><li>Trilaminar embryo </li></ul>
  4. 4. EMBRYONIC PERIOD ( WEEK 6 – 10 ) <ul><li>C – shaped embryo </li></ul><ul><li>Major organs develop </li></ul><ul><li>Yolk sac detaches </li></ul>
  5. 5. FETAL PERIOD ( WEEK 11 –12 ) <ul><li>Fetal growth </li></ul><ul><li>Amniotic & Chorionic membranes approach each other </li></ul>
  6. 6. OVERVIEW
  7. 7. AIUM GUIDLINES <ul><li>Gestational sac: </li></ul><ul><ul><ul><ul><li>Location </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Measure MSD in absence of embryo </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Measure CRL in prsence of embryo </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Document yolk sac </li></ul></ul></ul></ul><ul><li>Cardiac activity </li></ul><ul><li>Fetal number </li></ul><ul><li>Uterus, Adenexa, & cul – de-sac </li></ul>
  8. 8. SONOGRAPHIC FINDINGS <ul><li>Threshold level : </li></ul><ul><li>The size at which a finding may be seen </li></ul><ul><li>Discriminatory level: </li></ul><ul><li>The size at which a finding must be seen </li></ul>
  9. 9. PREGNANCY DATING <ul><li>MSD = </li></ul><ul><li>MA ( days ) = MSD( mm ) + 30 </li></ul><ul><li>MA ( Weeks) = CRL (mm ) + 6.5 </li></ul>L + W + D 3
  10. 10. PREGNANCY DATING 5mm CRL 2mm CRL Heartbeat TV - 18mm TA - 25mm TV - 8mm Embryo TV - 10mm TA - 20mm TV - 4mm Yolk Sac 5mm 2mm Gestational Sac Discriminatory Level - MSD Threshold Level MSD
  11. 11. DISCRIMINATORS <ul><li>MSD > 10 mm must have a yolk sac </li></ul><ul><li>MSD > 18 mm must have an embryo </li></ul><ul><li>CRL > 5 mm must have a heartbeat </li></ul>
  12. 12. CARDIAC ACTIVITY <ul><li>Must be present with CRL > 5mm </li></ul><ul><li>5 - 6 weeks 100 - 110 bpm </li></ul><ul><li>8 - 9 weeks 150 - 170 bpm </li></ul>
  13. 13. ABNORMAL FIRST TRIMESTER <ul><li>Embryonic demise </li></ul><ul><li>Bradycardia </li></ul><ul><li>Anembryonic pregnancy </li></ul><ul><li>Perigestational haemorrhage </li></ul><ul><li>Abnormal yolk sac </li></ul><ul><li>Poor growth </li></ul>
  14. 14. ANEMBRYONIC PREGNANCY <ul><li>MSD > 10mm without yolk sac </li></ul><ul><li>MSD > 18mm without fetal pole </li></ul><ul><li>Weak decidual reaction </li></ul><ul><li>Abnormal shape or location </li></ul><ul><li>Empty Amnion </li></ul>
  15. 15. YOLK SAC <ul><li>First landmark in gestational sac </li></ul><ul><li>In the chorionic cavity </li></ul><ul><li>Abnormal findings: </li></ul><ul><ul><ul><li>>6mm </li></ul></ul></ul><ul><ul><ul><li>irregular shape </li></ul></ul></ul><ul><ul><ul><li>calcifications </li></ul></ul></ul><ul><ul><ul><li>multiple yolk sacs </li></ul></ul></ul>
  16. 16. GROWTH <ul><li>Normal growth rate 1 mm per day </li></ul><ul><li>MSD - CRL < 5 mm poor prognosis (first trimester oligohydramnios) </li></ul>
  17. 17. SONOEMBRYOLOGY <ul><li>6 Wks --- Neural tube complete </li></ul><ul><li>8 Wks --- Spine , Limb buds </li></ul><ul><li>10Wks --- Ossification of vertebra </li></ul><ul><li>& skull bones </li></ul><ul><li>10Wks --- Face , Liver, Bladder </li></ul><ul><li>11Wks --- Fingers / Toes </li></ul><ul><li>12Wks --- Heart , Stomach </li></ul><ul><li>13Wks --- Kindeys </li></ul>

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