Evaluation of fetal anatomy
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This document outlines guidelines for performing a midtrimester fetal survey ultrasound. It describes using a 2 sweep and 20 plane approach to systematically examine the fetus. This includes fetal biometric measurements and an anatomical survey to assess growth and exclude abnormalities. Each fetal structure is examined in multiple planes. Following this structured approach enables a thorough assessment of the fetus.
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8 fetal chest Dr Ahmed Esawy
8 fetal chest dr ahmed esawy
Fetal Chest Biometry
Lungs – Sonographic Appearance
Diaphragm – Sonographic
Appearance
Thymus – Sonographic
Appearance
Fetal cardio-thoracic (C/T) circumference ratio
CYSTIC THORACIC MASSES
• Diaphragmatic hernia (stomach adj
• CCAM, type 1,2
• Cysts: bronchogenic, enteric duplica
• cystic hygroma
SOLID (ECHOGENIC) MASSES
• Diaphragmatic hernia
• CCAM, type 3
• Pulmonary sequestration
• Tumors
• Teratoma
• Rhabdomyoma of the heart
• Pulmonary hypoplasia
1-Diaphragmatic hernia
• 2-Congenital cystic adenomatous malformations
• 3-Broncho-pulmonary sequastration
• 4-Pleural effusions
• 5-Pulmonary hypoplasia
• 6-Congenital hydro/chylo thorax
• 7-Pulmonary lymphangiectasia
• 8-Chondrodysplasia
• 9-Bronchogenic cysts and other tumours
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2nd trimester ultrasound..
The document provides details about performing and interpreting a fetal anatomy scan between 18-20 weeks of gestation. It describes assessing various fetal anatomical structures including the brain, skull, abdomen, lungs, heart, spine, and limbs. Key measurements and normal ranges are outlined. Common congenital anomalies that may be detected on the scan are also described for various structures. The purpose of the anatomy scan is to evaluate fetal anatomy and screen for potential fetal anomalies.
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This document discusses abnormal fetal positions and presentations that can occur during labor, including occiput posterior, face, brow, and shoulder presentations. It provides details on the diagnosis, mechanisms of labor, complications, and management for each presentation. The key points are:
1) Occiput posterior positions are usually diagnosed by vaginal exam and have higher risks of prolonged labor and operative delivery; manual rotation or vacuum extraction can be attempted for deep transverse arrest.
2) Face and brow presentations engage the pelvis with the chin/mentum and forehead, respectively, increasing risks; mentoanterior positions usually rotate anteriorly while mentoposterior often require c-section.
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8 fetal chest Dr Ahmed Esawy
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Fetal Chest Biometry
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Diaphragm – Sonographic
Appearance
Thymus – Sonographic
Appearance
Fetal cardio-thoracic (C/T) circumference ratio
CYSTIC THORACIC MASSES
• Diaphragmatic hernia (stomach adj
• CCAM, type 1,2
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• cystic hygroma
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• Diaphragmatic hernia
• CCAM, type 3
• Pulmonary sequestration
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• Rhabdomyoma of the heart
• Pulmonary hypoplasia
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• 2-Congenital cystic adenomatous malformations
• 3-Broncho-pulmonary sequastration
• 4-Pleural effusions
• 5-Pulmonary hypoplasia
• 6-Congenital hydro/chylo thorax
• 7-Pulmonary lymphangiectasia
• 8-Chondrodysplasia
• 9-Bronchogenic cysts and other tumours
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Umblical & uterine artery Doppler
This document discusses umbilical and uterine artery Doppler ultrasound. It notes that umbilical artery Doppler is useful for predicting abnormal fetal outcomes, with a resistance index above 0.72 outside normal limits after 26 weeks. Absent or reversed end diastolic flow in the umbilical artery indicates fetal distress and need for monitoring or delivery. Uterine artery Doppler has limited use in predicting fetal growth restriction but can suggest maternal versus fetal causes. An abnormal uterine Doppler with decreased diastolic flow or persistence of a diastolic notch after 24 weeks can help predict preeclampsia. Fortnightly umbilical artery Doppler scans are recommended when growth is not maintained or abdominal circumference is below the third percentile.
2nd trimester ultrasound..
The document provides details about performing and interpreting a fetal anatomy scan between 18-20 weeks of gestation. It describes assessing various fetal anatomical structures including the brain, skull, abdomen, lungs, heart, spine, and limbs. Key measurements and normal ranges are outlined. Common congenital anomalies that may be detected on the scan are also described for various structures. The purpose of the anatomy scan is to evaluate fetal anatomy and screen for potential fetal anomalies.
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1. The document discusses radiological imaging of placenta accreta, specifically focusing on ultrasound and MRI findings.
2. Key ultrasound findings that suggest placenta accreta include placental lacunae, disruption of normal color Doppler blood flow patterns in the myometrium, loss of the retroplacental clear space, and reduced myometrial thickness.
3. Important MRI findings include uterine bulging, heterogeneous placental signal intensity, and dark intraplacental bands on T2-weighted images. Visualization of direct placental invasion of the bladder is also suggestive of placenta percreta.
Colour doppler in iugr
This document discusses color Doppler ultrasound in the evaluation of intrauterine growth restriction (IUGR). It provides details on:
1. Changes seen in the fetal circulation in IUGR, including increased placental resistance seen on umbilical artery Doppler leading to absent or reversed end diastolic flow in severe cases.
2. Brain sparing effect seen on middle cerebral artery Doppler in IUGR fetuses, shown as increased diastolic flow.
3. Changes in the ductus venosus Doppler waveform seen in IUGR, from decreased forward flow to eventual reversal, indicating worsening fetal hypoxia and myocardial dysfunction.
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The document discusses several congenital heart defects including atrial septal defects, ventricular septal defects, atrioventricular septal defects, Ebstein's anomaly, hypoplastic left heart syndrome, tetralogy of Fallot, double outlet right ventricle, transposition of the great arteries, and coarctation of the aorta. It provides details on the incidence, types, sonographic criteria for diagnosis, and prognosis for each condition.
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obstetrics- malpositions and malpresentations
This document discusses abnormal fetal positions and presentations that can occur during labor, including occiput posterior, face, brow, and shoulder presentations. It provides details on the diagnosis, mechanisms of labor, complications, and management for each presentation. The key points are:
1) Occiput posterior positions are usually diagnosed by vaginal exam and have higher risks of prolonged labor and operative delivery; manual rotation or vacuum extraction can be attempted for deep transverse arrest.
2) Face and brow presentations engage the pelvis with the chin/mentum and forehead, respectively, increasing risks; mentoanterior positions usually rotate anteriorly while mentoposterior often require c-section.
3) Shoulder presentations have no mechanism of
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The fetal heart
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1 ultrasound diagnosis of fetal anomalies
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You can find the full article here:
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This document discusses color Doppler ultrasound techniques for fetal surveillance. It describes the anatomy of fetal and placental circulation and examines the uterine, umbilical and middle cerebral arteries. Waveform analysis using indices like S/D ratio, resistance index and pulsatility index is discussed. Normal and abnormal Doppler findings are presented along with their clinical significance and management. Precise techniques for imaging and interpreting various fetal blood vessels are provided.
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Placenta ultrasound
This document discusses various ultrasound findings related to the placenta:
- Images show a normal placenta that is relatively homogeneous in texture with a hypoechoic retroplacental clear space.
- Other findings discussed include subchorionic cysts, velamentous cord insertion, vesicular mole, placental calcification, grading of the placenta, chorioangioma, succenturiate placenta, circumvallate placenta, venous lakes, and placenta previa. These images provide examples of ultrasound appearances of various normal and abnormal placental conditions.
Doppler interpretation in pregnancy
This document discusses the interpretation of various types of Doppler ultrasound during pregnancy. It describes:
1. Umbilical artery Doppler which can detect placental hypoxia and increased resistance, predicting abnormal outcomes. Abnormal readings include increased resistance index and absent/reversed end diastolic flow.
2. Middle cerebral artery Doppler which can detect fetal anemia by increased blood flow to the brain. It is also used to time delivery of growth restricted infants.
3. Ductus venosus Doppler which has moderate predictive value for growth restriction in preterm infants.
4. Uterine artery Doppler has limited use in predicting fetal growth restriction but can identify maternal causes by abnormal readings.
Mullerian anomalies
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The document discusses the evaluation and management of non-immune hydrops fetalis (NIHF). It begins by defining NIHF and listing common ultrasound findings. It then discusses evaluating the fetus for various potential causes of NIHF, including chromosomal abnormalities, anemia, twin-twin transfusion syndrome, cardiovascular defects, infections, and tumors. A thorough clinical evaluation of the mother and fetus is recommended to identify treatable conditions. Counseling should explain available options which may include termination of pregnancy for untreatable cases or antenatal management and treatment when possible. A step-wise investigation is outlined including detailed ultrasound, Doppler, fetal echocardiogram, and maternal/fetal testing to identify the underlying cause.
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11-Fetal skeletal system part 1 Dr Ahmed Esawy
11 fetal skeletal system part 1 dr ahmed esawy
FETAL SKELETAL SYSTEM .
normal,basic paramters
and algorithms
fetal Skeletal Dysplasia
Thanatophoric Dwarfism
• Achondroplastic Dysplasia
• Osteogenesis Imperfecta
• Trisomy 18
• Meckel- Gruber Syndrome
• Down Syndrome
Fetal foot length
clavicular aplasia, hypoplasia
Hypoplastic thorax
•thanatophoric dysplasia,
•achondrogenesis,
•hypophosphotasia,
•camptomelic dysplasia,
•chondroectodermal dysplasia,
•osteogenesis imperfecta,
•short-rib polydactyly
•lead to pulmonary hypoplasia,.
Hypoplastic scapula
Platyspondyly
Jarcho-Levin syndrome
Hemivertebra and block vertebra
OI fetus
Chest hypoplasia
micrognathia,
•short upper lip,
•abnormally shaped ears,
•frontal bossing,
•cloverleaf skull.
•brachycephaly (anteroposterior shortening of the head),
•scapocephaly (lateral flattening of the head), and
craniosynostoses (premature fusion of the sutures),
hypertelorism
micropathia
Clover leaf skull
Thanatophoric Dysplasia
Osteogenesis Imperfecta
Chondrodysplasia Punctata
Diastrophic Dysplasia
Achondrogenesis
Achondroplastic Dysplasia
Achondroplasia
Acrocephalopolysyndactyly
Amyoplasia
Atelosteogenesis
micrognathia
ASPHYXIATING THORACIC DYSTROPHY
Campomelic dysplasia
Seckel Syndrome
Cleidocranial dysostosls
ARTHROGRYPOSIS
Clubfoot
Straight knee joints
FETAL AKINESIA DEFORMATION
SEQUENCE (FADS)
• Hypophosphatasia
Short-Rib Polydactyly Syndrome
Mimics of Skeletal Dysplasias
Chronic Intervillous Histiocytosis
Focal anomalies upper limb
Shortened fetal humerus
Aneuopliody syndromic
• Down syndrome:
• Non-aneuopliody syndromic
• Fetal skeletal dysplasia
• non syndromic
• IUGR
Clinodactyly
Syndactyly
Clenched Hand
A fetal akinesia sequence (FAS)
Camptodactyly
•
Fetal club hand deformity
pre-axial polydactyly:
post-axial polydactyly:
central polydactyly
Ectrodactyly
Ectrodactyly (split hands or feet).
Lobster claw
Congenital constriction band
Sequence
Isolated limb deficiency.
SHORT fetal FEMUR
The Hitchhiker's Thumb
Mesomelia
rockerbottom foot
Amputations
Early amnion rupture sequence
Hypoplasia of the foot
Ultrasonography of the ovary
Ultrasonography is useful for evaluating the normal ovary and detecting abnormalities. A normal ovary appears hypoechoic and contains multiple small follicles. During ovulation, a corpus luteum forms which appears as a solid or cystic structure. Polycystic ovary syndrome is diagnosed based on the number of follicles present. Ultrasonography can also detect cysts, masses, ectopic pregnancies and other ovarian pathologies. It is an important tool for assessing ovarian function and guiding fertility treatments.
evaluation of fetal anatomy in 1st trimester.pptx
EVALUATION OF FETAL ANATOMY IN FIRST TRIMESTER .
FETAL DEVELOPMENT IN FIRST YAER.
NORMAL ULTRASOUND FINDINGS IN THE FIRST TRIMESTER.Evaluation of fetal anatomy, including a detailed fetal cardiac examination, is possible in the late first trimester.
Many anatomic abnormalities can be detected in the first trimester, giving families time to make important decisions regarding pregnancy management and the opportunity for early termination of pregnancy to reduce maternal morbidity risks.Week 6: By the 6th week, the limb buds begin to differentiate into upper and lower limbs with large hand plates, which develop primordial digits. The lower extremities lag behind the upper limbs by approximately 4 to 5 days. The primordial ear develops and the eyes become obvious as the retina becomes pigmented. The fetal liver occupies the majority of the abdominal cavity at the 6th week. As the rapid growth of the intestines exceeds the growth of the abdominal cavity the physiologic herniation of the intestines into the umbilical cord occurs. Spontaneous twitching movements and reflex responses to touch begin to take place.
Congenital lateral ventriculomegaly.
This document discusses fetal lateral ventriculomegaly seen on prenatal sonograms. It defines mild ventriculomegaly as lateral ventricle width of 10-15mm and overt or frank hydrocephalus as over 15mm. For mild cases, further evaluation with fetal MRI, ECG, karyotyping and corpus callosum assessment is recommended. Unilateral ventriculomegaly is usually benign while bilateral may be associated with neural tube defects or midline anomalies. Signs like dangling choroid plexus or anomalies of the posterior fossa/central canal can also be seen.
Fetal Neurosonogram
This document discusses fetal neurosonography and the sonographic appearance of fetal brain structures throughout gestation. It begins with an overview of embryonic brain development and the division of the brain into sections. It then examines how the appearance of specific structures changes with gestational age, including the posterior fossa, lateral ventricles, and cerebellum. Serial images demonstrate the maturation and relationships between structures over time. The role of 3D imaging in examining the posterior fossa is also mentioned.
Obstetrics doppler ultrasound
Doppler ultrasound uses sound waves to evaluate blood flow and was first used in 1977 to study umbilical artery flow. It measures the Doppler shift in echoes from moving blood cells to determine flow velocity. Fetal vessels commonly assessed include the umbilical artery, which provides information on placental perfusion, and the middle cerebral artery, which indicates fetal oxygenation status. Doppler ultrasound can detect signs of fetal hypoxia like increased end-diastolic flow in the MCA, and meta-analyses found it reduces perinatal deaths and inductions when used for monitoring high-risk pregnancies.
Hình ảnh siêu âm cơ bản thai nhi quý 1 2 3 AIUM 2019
This document provides an overview of ultrasound examinations in the first, second, and third trimesters of pregnancy. It describes the key anatomical structures that should be imaged and evaluated during each trimester exam, including the gestational sac, yolk sac, fetal heart rate, measurements, and anatomy. Potential abnormalities that may be observed are also outlined. Guidelines are provided for documenting examination findings.
Ultrasound evaluation of fetal thorax
1) The document discusses various fetal lung abnormalities that can be evaluated by ultrasound such as pulmonary hypoplasia, congenital pulmonary airway malformation, bronchial atresia, and congenital lobar emphysema.
2) It describes the sonographic findings, differential diagnosis, and management considerations for each condition.
3) Factors that influence prognosis are discussed such as lesion size and presence of complications like hydrops or mediastinal shift. Prenatal counseling is important as some conditions can lead to high mortality.
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This document provides guidance on performing an ultrasound examination of the fetus in the second and third trimesters of pregnancy. It details the standard views and measurements that should be obtained, including images of the head, heart, abdomen, limbs and other structures. Potential abnormalities are also listed for each structure. Fetal echocardiography is important for detecting congenital cardiac defects, which occur in 2-6.5% of live births and can have serious consequences if not identified prenatally.
The fetal heart
Generally occurs secondary to pulmonary atresia with intact IVS .
Pathophysiology- it develops because of a reduction in the blood flow secondary to inflow impedence from tricuspid atresia or outflow impedence from pulmonary arterial atresia .
Typical findings- a small , hypertrophic RV and a small or absent pulmonary artery
1 ultrasound diagnosis of fetal anomalies
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Accompanying slides for the Ultrasound in Obstetrics and Gynecology article 'How to measure cervical length' by K. O. Kagan and J. Sonek
You can find the full article here:
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Internal iliac artery ligation (IIAL) is a technique to control pelvic hemorrhage by ligating the internal iliac arteries. It preserves fertility and can be life-saving when other options risk compromising the patient. IIAL works by reducing blood flow and pressure in the pelvis, allowing clots to form and stop bleeding. The pelvis has extensive collateral circulation, so ligation does not cause ischemia. IIAL is effective for prophylactic or therapeutic control of hemorrhage from the uterus, cervix, or broad ligament. It carries risks if not performed carefully to avoid injuring nearby structures like veins and ureters.
Antenatal doppler
This document discusses color Doppler ultrasound techniques for fetal surveillance. It describes the anatomy of fetal and placental circulation and examines the uterine, umbilical and middle cerebral arteries. Waveform analysis using indices like S/D ratio, resistance index and pulsatility index is discussed. Normal and abnormal Doppler findings are presented along with their clinical significance and management. Precise techniques for imaging and interpreting various fetal blood vessels are provided.
Ultrasonography of twin pregnancy SOGC GUIDELINE
This document discusses the clinical uses of ultrasonography in twin pregnancies. It covers determining chorionicity and amnioticity, gestational age, screening for anomalies, preterm labor, assessing fetal growth, wellbeing, amniotic fluid, and complications unique to twins such as twin-to-twin transfusion syndrome. Ultrasonography is useful for monitoring growth, detecting anomalies and complications, and guiding management of high-risk twin pregnancies.
Placenta ultrasound
This document discusses various ultrasound findings related to the placenta:
- Images show a normal placenta that is relatively homogeneous in texture with a hypoechoic retroplacental clear space.
- Other findings discussed include subchorionic cysts, velamentous cord insertion, vesicular mole, placental calcification, grading of the placenta, chorioangioma, succenturiate placenta, circumvallate placenta, venous lakes, and placenta previa. These images provide examples of ultrasound appearances of various normal and abnormal placental conditions.
Doppler interpretation in pregnancy
This document discusses the interpretation of various types of Doppler ultrasound during pregnancy. It describes:
1. Umbilical artery Doppler which can detect placental hypoxia and increased resistance, predicting abnormal outcomes. Abnormal readings include increased resistance index and absent/reversed end diastolic flow.
2. Middle cerebral artery Doppler which can detect fetal anemia by increased blood flow to the brain. It is also used to time delivery of growth restricted infants.
3. Ductus venosus Doppler which has moderate predictive value for growth restriction in preterm infants.
4. Uterine artery Doppler has limited use in predicting fetal growth restriction but can identify maternal causes by abnormal readings.
Mullerian anomalies
Mullerian duct anomalies occur due to abnormal development of the paired mullerian ducts in females during embryological development. The three main phases of mullerian duct development are organogenesis, fusion, and septal resorption. When one or more of these phases are disrupted, it can lead to mullerian duct anomalies such as a bicornuate or septate uterus. Mullerian duct anomalies are diagnosed using imaging modalities like ultrasound, MRI, and hysterosalpingography which allow visualization of the uterine cavity and identification of the specific anomaly present. The most common anomalies include septate uterus, bicornuate uterus, and arcuate uterus.
Fetal brain usg 1
Embryonic development of the CNS
in relation to sonographic findings
Standard Sonographic Examination of the CNS
DEB BISWAS MDRD Doppler in pregnancy
This document provides an overview of Doppler ultrasound in the assessment of fetal and placental blood flow during the second trimester of pregnancy. It discusses the history and development of Doppler ultrasound techniques. It then covers the basic principles of Doppler ultrasound and details the specific vessels that should be examined, including the umbilical artery, middle cerebral artery, uterine artery, thoracic aorta, inferior vena cava, ductus venosus, and umbilical vein. Normal and abnormal waveforms are presented for each vessel. The uses and clinical significance of Doppler assessments are described.
Managing Nonimmune hydrops fetalis
The document discusses the evaluation and management of non-immune hydrops fetalis (NIHF). It begins by defining NIHF and listing common ultrasound findings. It then discusses evaluating the fetus for various potential causes of NIHF, including chromosomal abnormalities, anemia, twin-twin transfusion syndrome, cardiovascular defects, infections, and tumors. A thorough clinical evaluation of the mother and fetus is recommended to identify treatable conditions. Counseling should explain available options which may include termination of pregnancy for untreatable cases or antenatal management and treatment when possible. A step-wise investigation is outlined including detailed ultrasound, Doppler, fetal echocardiogram, and maternal/fetal testing to identify the underlying cause.
Obstetric ultrasound
Obstetric ultrasonography, or prenatal ultrasound, is the use of medical ultrasonography in pregnancy, in which sound waves are used to create real-time visual images of the developing embryo or fetus in the uterus.
11-Fetal skeletal system part 1 Dr Ahmed Esawy
11 fetal skeletal system part 1 dr ahmed esawy
FETAL SKELETAL SYSTEM .
normal,basic paramters
and algorithms
fetal Skeletal Dysplasia
Thanatophoric Dwarfism
• Achondroplastic Dysplasia
• Osteogenesis Imperfecta
• Trisomy 18
• Meckel- Gruber Syndrome
• Down Syndrome
Fetal foot length
clavicular aplasia, hypoplasia
Hypoplastic thorax
•thanatophoric dysplasia,
•achondrogenesis,
•hypophosphotasia,
•camptomelic dysplasia,
•chondroectodermal dysplasia,
•osteogenesis imperfecta,
•short-rib polydactyly
•lead to pulmonary hypoplasia,.
Hypoplastic scapula
Platyspondyly
Jarcho-Levin syndrome
Hemivertebra and block vertebra
OI fetus
Chest hypoplasia
micrognathia,
•short upper lip,
•abnormally shaped ears,
•frontal bossing,
•cloverleaf skull.
•brachycephaly (anteroposterior shortening of the head),
•scapocephaly (lateral flattening of the head), and
craniosynostoses (premature fusion of the sutures),
hypertelorism
micropathia
Clover leaf skull
Thanatophoric Dysplasia
Osteogenesis Imperfecta
Chondrodysplasia Punctata
Diastrophic Dysplasia
Achondrogenesis
Achondroplastic Dysplasia
Achondroplasia
Acrocephalopolysyndactyly
Amyoplasia
Atelosteogenesis
micrognathia
ASPHYXIATING THORACIC DYSTROPHY
Campomelic dysplasia
Seckel Syndrome
Cleidocranial dysostosls
ARTHROGRYPOSIS
Clubfoot
Straight knee joints
FETAL AKINESIA DEFORMATION
SEQUENCE (FADS)
• Hypophosphatasia
Short-Rib Polydactyly Syndrome
Mimics of Skeletal Dysplasias
Chronic Intervillous Histiocytosis
Focal anomalies upper limb
Shortened fetal humerus
Aneuopliody syndromic
• Down syndrome:
• Non-aneuopliody syndromic
• Fetal skeletal dysplasia
• non syndromic
• IUGR
Clinodactyly
Syndactyly
Clenched Hand
A fetal akinesia sequence (FAS)
Camptodactyly
•
Fetal club hand deformity
pre-axial polydactyly:
post-axial polydactyly:
central polydactyly
Ectrodactyly
Ectrodactyly (split hands or feet).
Lobster claw
Congenital constriction band
Sequence
Isolated limb deficiency.
SHORT fetal FEMUR
The Hitchhiker's Thumb
Mesomelia
rockerbottom foot
Amputations
Early amnion rupture sequence
Hypoplasia of the foot
Ultrasonography of the ovary
Ultrasonography is useful for evaluating the normal ovary and detecting abnormalities. A normal ovary appears hypoechoic and contains multiple small follicles. During ovulation, a corpus luteum forms which appears as a solid or cystic structure. Polycystic ovary syndrome is diagnosed based on the number of follicles present. Ultrasonography can also detect cysts, masses, ectopic pregnancies and other ovarian pathologies. It is an important tool for assessing ovarian function and guiding fertility treatments.
evaluation of fetal anatomy in 1st trimester.pptx
EVALUATION OF FETAL ANATOMY IN FIRST TRIMESTER .
FETAL DEVELOPMENT IN FIRST YAER.
NORMAL ULTRASOUND FINDINGS IN THE FIRST TRIMESTER.Evaluation of fetal anatomy, including a detailed fetal cardiac examination, is possible in the late first trimester.
Many anatomic abnormalities can be detected in the first trimester, giving families time to make important decisions regarding pregnancy management and the opportunity for early termination of pregnancy to reduce maternal morbidity risks.Week 6: By the 6th week, the limb buds begin to differentiate into upper and lower limbs with large hand plates, which develop primordial digits. The lower extremities lag behind the upper limbs by approximately 4 to 5 days. The primordial ear develops and the eyes become obvious as the retina becomes pigmented. The fetal liver occupies the majority of the abdominal cavity at the 6th week. As the rapid growth of the intestines exceeds the growth of the abdominal cavity the physiologic herniation of the intestines into the umbilical cord occurs. Spontaneous twitching movements and reflex responses to touch begin to take place.
Congenital lateral ventriculomegaly.
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Presentation1.pptx, ultrasound examination of the 2nd & 3rd trimester pregnancy.
Presentation1.pptx, ultrasound examination of the 2nd & 3rd trimester pregnancy.
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Hình ảnh siêu âm cơ bản thai nhi quý 1 2 3 AIUM 2019
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2) It describes the sonographic findings, differential diagnosis, and management considerations for each condition.
3) Factors that influence prognosis are discussed such as lesion size and presence of complications like hydrops or mediastinal shift. Prenatal counseling is important as some conditions can lead to high mortality.
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ultrasound in 1st TM.pdf
This document outlines key landmarks and assessments that can be made using ultrasound during the first trimester of pregnancy. Sonographic landmarks like the gestational sac, yolk sac, amnion, and embryo normally appear between 4-8 weeks and allow confirmation of intrauterine pregnancy and accurate dating. Major fetal anomalies affecting the head, chest, abdomen or extremities can sometimes be diagnosed as early as 11-13 weeks. Chorionicity and zygosity in multiple pregnancies influence placental structure and can be assessed after 8 weeks. Nuchal translucency measurement between 11-13 weeks, along with other markers, provides risk assessment for chromosomal abnormalities. Pregnancy failure can be diagnosed before symptoms via ultrasound if
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Biometria 11 14
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Obstetric ultrasound
This document discusses techniques for fetal age estimation using obstetric ultrasound. It begins with an introduction to obstetric ultrasound, describing its history and uses. It then covers ultrasound technology and transducer principles. The main uses of obstetric ultrasound are established as determining fetal number, position, growth and detecting abnormalities. Examination types like transabdominal and transvaginal ultrasound are described. The document outlines fetal assessment and measurements used in each trimester to estimate gestational age, including crown-rump length in the first trimester and biometric parameters like biparietal diameter in later stages. Fetal age estimation is emphasized as fundamental to obstetric care, with ultrasound providing a reliable method.
details of the Obstetrical Ultrasound.pptx
Obstetrical ultrasound uses sound waves to safely image the fetus without radiation. It can assess gestational age and fetal anatomy. The first trimester ultrasound screens for abnormalities and measures the fetal crown-rump length. The second trimester ultrasound performs a detailed fetal anatomy survey. Cardiac structures like the four chambers and blood flow are evaluated. Biometrics like the head circumference, abdominal circumference, femur length are measured for growth assessment. The placenta, amniotic fluid and cervix are also examined.
first trimester ultrasound and overview of obs imaging
Ultrasound is a safe, non-invasive imaging technique used to evaluate pregnancies. This document discusses the use of ultrasound in the first trimester to confirm intrauterine pregnancy location, estimate gestational age, diagnose ectopic pregnancies or multiples, and evaluate vaginal bleeding or pain. Normal ultrasound anatomy is shown for the gestational sac, embryo, and fetus. The second and third trimesters are used to further assess fetal growth and anatomy, amniotic fluid levels, placental location, and fetal well-being. Detailed guidelines are provided for assessing the fetal head, chest, abdomen, extremities, and gender.
first trimester ultrasound and overview of obs imaging
Ultrasound is a safe and non-invasive imaging technique used to examine the fetus and provide information about gestational age, fetal growth, anatomy and well-being. This document discusses the use of ultrasound in the first, second and third trimesters of pregnancy. In the first trimester, ultrasound is used to confirm intrauterine pregnancy, detect anomalies, and measure nuchal translucency. Standard views include measurements of the gestational sac, embryo and fetal heart. The second and third trimesters involve detailed anatomical surveys and measurements to assess fetal growth and anatomy. Key views include the brain, heart, abdomen and limbs. Ultrasound provides important information to guide management and care of the pregnant woman and fetus
Ultrasound screening in pregnancy
The document discusses ultrasound screening and testing during pregnancy in Hungary. It recommends five ultrasound examinations - one diagnostic and four screenings - according to guidelines from the Hungarian Society of Ultrasound in Obstetrics and Gynecology (MSZNUT). The screenings have defined protocols and occur at 11-13, 18-20, 30-31, and 36-37 weeks gestation. Different healthcare levels are required depending on the exam, and MSZNUT ensures regular training to meet proficiency standards. Fetal well-being testing like non-stress tests and biophysical profiles may also be used for high-risk pregnancies starting at 32 weeks.
Ultrasonography in pregnancy, acoh 2011.
This document provides guidelines for performing obstetric ultrasounds, including indications, imaging parameters, and types of examinations. It recommends using real-time ultrasound with transducers of 3-5 MHz for standard second and third trimester exams to evaluate fetal anatomy, growth, and well-being. First trimester ultrasounds should use transvaginal or transabdominal ultrasound to assess gestational age, viability, and risk of aneuploidy by measuring the nuchal translucency. Limited and specialized ultrasounds are also described for targeted evaluations.
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This document provides an overview of obstetric ultrasound procedures and measurements. It discusses estimating gestational age using biometric measurements like crown-rump length, biparietal diameter, abdominal circumference, and femur length in each trimester. It also covers assessing fetal number, position, growth, amniotic fluid, and potential complications like placenta previa or abruption. Key ultrasound goals are determining gestational age, fetal well-being, and detecting any anomalies or complications.
2nd trimester scan
The document discusses the key aspects of a 2nd trimester fetal anatomy scan, including using biometric measurements like BPD, HC, FL to determine gestational age and assess growth. It describes evaluating the placenta's location, amniotic fluid volume, fetal anatomy of the brain, heart, abdomen, and sex. Specific abnormalities that can be detected on the scan are outlined. The purpose is to confirm dating, check for fetal abnormalities, and locate the placenta.
FETAL ECHOCARDIOGRAPHY-006.pptx
Fetal echocardiography is an ultrasound used during pregnancy to evaluate the structure and function of the fetus's heart. It can be indicated for fetal reasons like suspected cardiac abnormalities or arrhythmias, or maternal reasons like family history of heart disease or exposure to teratogens. The exam involves a sequential analysis of the situs, atria, ventricles, and great arteries using both grayscale and Doppler ultrasound. Standard views include the four-chamber, outflow tracts, and measurements of cardiac structures are taken. Documentation includes still frames and video clips of the key views and flows within the heart.
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Evaluation of fetal anatomy
- 1. Midtrimesterfetalsurvey DR.NIRANJAN PATIL PROFESSOR DR.D.Y.PATIL MEDICAL COLLEGE AND HOSPITAL
- 2. OBJECTIVES To provide accurate diagnostic information so as to optimise antenatal care This determines gestational age ,growth patterns and detection of congenital abnormalities This is practiced by following guidelines instituted by ISUOG/AIUM Local guidelines can be followed keeping local conditions in mind
- 3. GUIDELINES WHENTO DO?-Ideally 18-22 weeks Equipment-real time gray scale ,3-5 MHz transducer ,having facility to adjust acoustic power output (ALARA-AS LOW AS REASONABLYACHIEVABLE) DOCUMENTATION: it is essential to document the findings in the report format along with the appropriate images
- 4. Approach Systemised 2 sweeps and 20 plane approach
- 5. Whatisthis2sweep and20plane approach? Provides structured and logical method of examining the mid trimester fetus It includes MEASUREMENTS Assessing fetal size : Bi-parietal diameter Head circumference Abdominal circumference Femur length ANATOMICAL SURVEY to exclude more than 50 fetal abnormal appearances This is ISUOG basic Training recommendations
- 6. 20planes Each fetal structure has multiple planes Measurements are included in the plane Each plane has number of structures to be evaluated This approach enables identification of 50 abnormal appearances
- 7. 2overviews +20 planes It’s a combination of 2 overview sweeps & 20 planes covering 7 anatomical areas 2 over views- one at the beginning and one at the end of the exam survey sweep Review sweep
- 12. • One need to be opportunistic while evaluating mid trimester fetus • Evaluation of fetal face and fetal heart should be completed whenever the fetus is in optimal position • Similarly fetal stomach and urinary bladder should be looked for • Whenever possible fingers should be seen
- 13. Sweep1 Determination of fetal presentation and lie Viability –detection of fetal cardiac activity Identification of number of fetuses Determination of location and position of placenta Estimation of amniotic fluid Fetal biometric measurements Based on these 6steps in sweep 1 we move on to 20 planes
- 14. Fetalspine Sagittal Coronal Axial or transverse section of vertebral body
- 15. Sagittalsection Coronal section Curvature abnormalities like scoliosis and kyphosis can be identified Vertebral body abnormalities Widening of spinal cord and intra spinal lesions Sacrum should be seen extending beyond the iliac wings There will be tapering at sacro-coccygeal junction Axial /transverse section The three ossification centres form an equilateral triangle through out the length of the spine Intact skin cover the spine • Fetus is in prone position • Intact skin line should be demonstrated all along the spine from cervical region to sacrum • CSF should be seen along the dorsal aspect of spine • Film terminals should be identified
- 17. Fetalhead • Trans ventricular • Trans thalamic • Trans cerebellar
- 18. Transventricular Frontal horns Cavum septum pellucidi Posterior horns Choroid plexus Ventricular measurement at parieto-occipital sulcus
- 19. Transthalamicview Inter hemispheric fissure Frontal horns Cavum septum pellucidi Thalami Third ventricle Choroid plexus +posterior horn Sylvian fissure Measurement of BPD,HC &OFD
- 20. TRANSCEREBELLARPLANE Frontal horn Cavum septum pellucidi Thalami Cerebellum Vermis Blake’s pouch Cisterna magna Nuchal pad thickness Trans cerebellar distance Depth of cisterna magna
- 21. Midsagittalplane Corpus callosum Cavum septum pellucidi Brain stem Vermis pons
- 23. Thefetalchestand heart Presence of cardiac activity Establishing situs Real time exam-cine loops Four chambers- size, morphology, inflow tracts LVOT &RVOT Sagittal section of thorax-both hemi- diaphragms Lung echogenicity Mediastinal shift
- 24. Fetalsitus Presentation of the fetus Iie of the fetus Relationship of the fetal spine to maternal spine
- 27. Fourchamberview
- 31. Three vessels and trachea view (3VT)
- 32. Aorticarch
- 33. Ductalarch
- 35. Fetalface Coronal plane of nose ,upper lip, lower lip and chin Both orbits Both lenses Median facial profile
- 39. Abdominalplanes
- 40. Abdomenandpelvis Stomach Direction of Porto umbilical junction Bowel loops Kidneys Presence of bladder and skirting supra-vesical arteries Cord insertion
- 42. Longboneplanes Femur length 3 bones of both legs, both feet and their relation ship to legs 3 bones of both upper limbs ,both hands and their relationship to arms
- 50. Summary! 2 sweeps and 20 planes approach provides a logical and time efficient examination of whole fetus Correct evaluation of fetal anatomy is more important following the order of examination Detecting normal variations and abnormal appearances helps in diagnosing the condition Lesions which cannot be confirmed in the basic examination need to be referred to an expert for advanced examination