This document discusses obstetrical ultrasound, including its history, uses, techniques, and findings. Key points include:
- Ultrasound uses sound waves and real-time imaging to safely view the fetus without radiation. It is used to date pregnancies, screen for fetal anomalies, and monitor fetal growth.
- Techniques include measuring the crown-rump length in the first trimester and biometric measurements like head circumference later on. Nuchal translucency is measured in the first trimester screen.
- Anatomy that can be evaluated includes the fetal heart, brain, limbs, placenta, and amniotic fluid level. Abnormal findings may indicate conditions like growth issues or birth defects.
Obstetrical Ultrasound• Introduced in the late 1950’s ultrasonography is a safe, non- invasive, accurate and cost-effective means to investigate the fetus• Computer generated system that uses sound waves integrated through real time scanners placed in contact with a gel medium to the maternal abdomen• The information from different reflections are reconstructed to provide a continuous picture of the moving fetus on the monitor screen
Obstetric ultrasound uses sound waves to produce pictures of a baby (embryo or fetus) within a pregnant woman, as well as the mother's uterus and ovaries. It does not use ionizing radiation, has no known harmful effects, and is the preferred method for monitoring pregnant women and their unborn babies.
Obstetrical Ultrasound• Introduced in the late 1950’s ultrasonography is a safe, non- invasive, accurate and cost-effective means to investigate the fetus• Computer generated system that uses sound waves integrated through real time scanners placed in contact with a gel medium to the maternal abdomen• The information from different reflections are reconstructed to provide a continuous picture of the moving fetus on the monitor screen
Obstetric ultrasound uses sound waves to produce pictures of a baby (embryo or fetus) within a pregnant woman, as well as the mother's uterus and ovaries. It does not use ionizing radiation, has no known harmful effects, and is the preferred method for monitoring pregnant women and their unborn babies.
In this presentation we will discuss
First trimester US especially TVS is an integral part for confirmation of intrauterine pregnancy and to rule out ectopic pregnancy.
First trimester US helps us in suggesting conceptus viability.
First trimester US especially TVS is very efficient in approaching and evaluating the cause of vaginal bleeding.
Cervical incompetence is the inability for the cervix to retain an intra-uterine pregnancy till term as a result of structural and functional defects of the cervix
Help the medical students to know about the fetal clinical parameters. Very rarely material present in the books. I prepared this for the little bit help from my side.
The methods of pregnancy diagnosis in farm and pet animals are explained in this lecture. Useful for veterinary students, practitioners, and researchers.
In this presentation we will discuss
First trimester US especially TVS is an integral part for confirmation of intrauterine pregnancy and to rule out ectopic pregnancy.
First trimester US helps us in suggesting conceptus viability.
First trimester US especially TVS is very efficient in approaching and evaluating the cause of vaginal bleeding.
Cervical incompetence is the inability for the cervix to retain an intra-uterine pregnancy till term as a result of structural and functional defects of the cervix
Help the medical students to know about the fetal clinical parameters. Very rarely material present in the books. I prepared this for the little bit help from my side.
The methods of pregnancy diagnosis in farm and pet animals are explained in this lecture. Useful for veterinary students, practitioners, and researchers.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
2. Obstetrical Ultrasound
• Introduced in the late 1950’s
ultrasonography is a safe, non-
invasive, accurate and cost-effective
means to investigate the fetus
• Computer generated system that uses
sound waves integrated through real
time scanners placed in contact with a
gel medium to the maternal abdomen
• The information from different
reflections are reconstructed to
provide a continuous picture of the
moving fetus on the monitor screen
3. Obstetrical Ultrasound
• Indications:
• Unsure last menstrual period
• Vaginal bleeding during pregnancy
• Uterine size not equal to expected for dates
• Use of ovulation-inducing drugs confirm early pregnancy
• Obstetric complications in a prior pregnancy: ectopic, preterm
delivery
• Screen for fetal anomaly: abnormal serum screens, certain drug
exposure in early pregnancy, maternal diabetes.
Rhisoimmunization
• Postdate fetus
• Twins (monochorionic)
• Intrauterine growth restriction (IUGR)
RADIUS study (1993) did not support routine US screening
5. Obstetrical Ultrasound
• Pre and peri-ovulation (1-2 weeks): ovarian
follicle matures and ovulation
• Conceptus (3-5 weeks): Corpus
luteum, fertilization, morula, blastocyst, bila
minar embryo
• Embryonic (6-10 weeks): Trilaminar C-
shaped embryo
• Fetal Phase: (11-12 weeks):
6. Obstetrical Ultrasound
(TVU)
Gestational sac: seen at 4 weeks, fluid
filled with echogenic border, grow at least
0.6 mm daily.15
Yolk sac: 33 days (4.7 wk)
Embryonic echoes: 38 days (5.4 w) with
embryo at 6 wk
In a normal pregnancy, the embryo should
be visible if the gestational sac is 25 mm
or larger in diameter.
7. Obstetrical Ultrasound
• An intrauterine gestational sac should be visualized by
transvaginal ultrasound with β-hCG values between 1000
and 2000 IU and abdominal exam 5500-6500 IU
• Visible heart activity: 43 days (6.1w)
• Normal heart rate at 6 weeks: 90-110 bpm
• At 9 weeks:140-170 bpm.
• At 8-9 weeks if nl heartbeat: no bleeding 3%loss
bleeding 13% loss
• At 5-8 weeks a bradycardia (<90 bpm) is associated with a
high risk of miscarriage.
8. Obstetrical Ultrasound
• CRL(Crown Rump Length):
• Longest length excluding
limbs and yolk sac
• Made between 7 to 13 weeks
• 3 days: 7-10 weeks
• 5 days: 10-14 weeks
• Fetal CRL in centimeters plus
6.5 equals gestational age in
weeks
9. Obstetrical Ultrasound
• Ultrasound findings in a
pregnancy destined to abort
include:
• A poorly-defined, irregular
gestational sac
• A large yolk sac (6 mm or
greater in size)
• Low site of sac location in the
uterus
• Empty gestational sac at 8
weeks' gestational age (the
blighted ovum).
10. Obstetrical Ultrasound
• First Trimester Screening
• In 2007, the American College of Ob Gyn endorsed offering
aneuploidy screening to all gravidas
• Performed between 11 and 13 weeks 6 days (fetal crown–rump
length 42–79 mm).
• Fetal nuchal translucency and maternal blood, β-hCG and
pregnancy-associated plasma protein A (PAPP-A).
• This test can detect approximately 60-85% of fetuses with
Down syndrome, with a 5% false positive rate.2
• Abnormal screen can increase the risk of genetic, other
aneuploidiesand other cardiac anomalies
11. Obstetrical Ultrasound
• Nuchal translucency:
• Translucent space between the back of the
neck and the overlying skin
• The scan is obtained with the fetus in sagittal
section and a neutral position .
• The fetal head (neither hyperflexed nor
extended, either of which can influence the
nuchal translucency thickness).
• The fetal image is enlarged to fill 75% of the
screen, and the maximum thickness is
measured, from leading edge to leading edge.
(inner to inner measurement)
• It is important to distinguish the
nuchallucency from the underlying amnionic
membrane.
• > 6 mm considered abnormal
13. Obstetrical Ultrasound
• Cervical length
• Endovaginal probe, examine in dorsal lithotomy position
with empty bladder
• Normal cervix should have a length of 2.5cm or more from
10 weeks gestation until 36 week
• The width of the cervical canal at the level of the internal
os should be less than 4mm
• Document any evidence of funneling
• Optimal gestational age for cervical length assessment is
after 16 to 20 weeks gestation
• Assessment 20-24 weeks best time evaluation PTD
16. Obstetrical Ultrasound
• BPD:
• Greatest accuracy between 12-28 weeks
(better>14 wks.)
• The plane for measurement of head circumference
(HC) and bi-parietal diameter (BPD)must include:
• Cavum septum pellucidum
• Thalamus
• Choroid plexus in the atrium of the lateral
ventricles.
• Measure outer table of the proximal skull to the
inner table of the distal
• HC:
• Measure the longest AP length
• (BPD + OFD) X 1.62
17. Obstetrical Ultrasound
• Abdominalcircumference
• Determined on transverse view
atthe level of thejunction of the
umbilical vein, portal sinus,and
fetal stomach
• Measured from the outer
diameter to outer diameter
• Multiply mean diameter by 3.14
• Assessing fetal
weight/IUGR/macrosomia
18. Obstetrical Ultrasound
• Femur Length (FL):
• Aligning the transducer with the lower
end of the fetal spine and rotating
toward the ventral aspect of the fetus
• Can measure from 10 weeks onward
• Measurement origin to distal end of
shaft and shows two blunted ends
• Do not include femoral head or distal
epiphysis
• Femur image is at an angle of less than
30 degrees to the horizontal.
• It increases from about 1.5 cm at 14
weeks to about 7.8 cm at term.
• Humerus
• Measured similarly
19. Obstetrical Ultrasound
• Amnionitic Fluid
• AFI: measure four quadrants
of largest verticle pocket
• 5-20 cm. nl, 6-8 cm.
borderline,<5 cm
oligohydramnios
• Polyhydramnios is defined as
an amniotic fluid volume in
excess of 2000 mL. A single
pocket of fluid that is 8 cm or
larger
20. Obstetrical Ultrasound
• Placenta:
• Determining its upper and lower edges r/o
placenta previa
• With increasing gestational age, the placenta
increases in echogenicity because of increased
fibrosis and calcium content.
• This feature of placental maturation has led to a
grading of placentas from immature (grade 0) to
mature (grade 3).
• Placentolmegaly
Diabetes, fetal hydrops, Rhisoimmunization
• Small placenta:
• Severe IUGR (symmetrical/asymmetrical)
Grade 0
Grade 1
Grade 3
21. Obstetrical Ultrasound
• Abnormal placentas
• Placenta Previa
• found in approximately 5% of
second-trimester scans
• If detected at 15–19 weeks, it
persists in 12% of patients.
• If it is detected at 24–27
weeks, it may persist in up to
50%.
• VasaPrevia:membranous
insertion of cord where exposed
vessels cross internal os
22. Obstetrical Ultrasound
• Fetal anatomy:
• Head
• Atrium of lateral ventricles
• Choroid plexus assessment
• Cerebellum
• Cisterna magna
• Nuchal fold
23. Obstetrical Ultrasound
• The atrium of lateral
ventricles should be less
than 10mm in diameter
(best measured at the
occipital horn).
• The choroid plexii should
be homogenous.
• Small, and sometimes
multiple, choroid plexus
cysts are a common
finding on high resolution
equipment.
• They are of doubtful
significance as an isolated
finding.
24. Obstetrical Ultrasound
The cerebellar diameter should approximately equal the weeks of gestation.
(Ex: 19weeks=19mm)
Cisterna magna: < 10mm
Nuchal fold: (outer edge of occipital bone to skin surface )
<6mm (between 17-20weeks).
27. Obstetrical Ultrasound
• Fetal Circulation
• Blood from the placenta is carried to the fetus by the
umbilical vein
• About half of this enters the fetal ductusvenosus and is
carried to the inferior vena cava
• The other half enters the liver proper from the inferior
border of the liver.
• The branch of the umbilical vein that supplies the right
lobe of the liver first joins with the portal vein.
• The blood then moves to the right atrium of the heart.
• In the fetus, there is an opening between the right and
left atrium (the foramen ovale), and most of the blood
flows through this hole directly into the left atrium from
the right atrium, thus bypassing pulmonary circulation.
• The continuation of this blood flow is into the left
ventricle, and from there it is pumped through the aorta
into the body
28. Obstetrical Ultrasound
– Some of the blood entering the
right atrium does not pass
directly to the left atrium
through the foramen ovale, but
enters the right ventricle and is
pumped into the pulmonary
artery.
– In the fetus, there is a
connection between the
pulmonary artery and the
aorta, called the
ductusarteriosus, which directs
most of this blood away from
the lungs
29. Obstetrical Ultrasound
• Cardiac Anatomy
• Four-Chamber View of the Heart
• The ultrasound beam is directed
perpendicular to the midchest plane
at the level of the heart.
• These chambers consist of the right
and left atrial and both ventricular
chambers
• Corresponding valves between them
http://www.fetal.com/FetalEcho/04%20Standard.html
30. Obstetrical Ultrasound
• The heart is approximately one-third
the area of the chest, inclined to the
left 45 degrees to the midline.
• The AP midline passes through the
left atrium and the right ventricle
• The midline (AP) and the cardiac axis
(arrowhead on dashed line) intersect
and form the angle shown
• Look for asymmetry in chamber
size, defects in the septum or
displacement of the heart
• Detection rate 60-75% for anomalies
with 4 chamber view, higher with
outflow tracts
31. Obstetrical Ultrasound
• Sweep the transducer beam in a transverse plane from the level of
the four chamber view towards the fetal neck
• Right Outflow Tract
• Right outflow track comes
off right ventricle and bifurcates
continues into pulmonary artery
Left Outflow Tract
Comes off left ventricle
continues into aortic arch
and then to descending aorta
34. • Cord Insertion:
• Ensure the abdominal wall
around the cord insertion
is intact
• No bowel has herniated
into the cord.
• 3-vessel
35. Obstetrical Ultrasound
• Kidneys/Bladder
• Kidneys
• Confirm the presence
and position of both
kidneys.
• Look for the anechoic
renal pelvis.
• The renal pelvis TS
diameter should be
less than 5mm.
36. Obstetrical Ultrasound
• Abnormal
• Renal:
• urethral atresia: large fetal
bladder (bl), urinary
ascites (asc), and
hydronephrotic kidneys
• Posterior urethral valves
with keyhole bladder
41. Obstetrical Ultrasound
• Doppler Ultrasound
• Blood flow characteristics in the fetal blood vessels can be assessed
with Doppler 'flow velocity waveforms‘
• Diminished flow, particularly in the diastolic phase of a pulse cycle is
associated with compromise in the fetus.
• Various ratios of the systolic to diastolic flow are used as a measure of
this compromise.
• The blood vessels commonly interrogated include the umbilical
artery, the aorta, the middle cerebral artery, ductusvenosus (DV) and
umbilical vein (UV)
• Abnormal uterine artery Doppler velocimetry and pre-eclampsia, intra-
uterine growth retardation and adverse pregnancy outcomes.
42. Doppler Ultrasound
• Ductusvenosus leads directly into the vena cava to allows some blood
rich in oxygen and nutrients to be pumped out of the body without
passing through the capillary beds in the kidney.
• Abnormalwaveforms in the ductusvenosus may be key to predicting
right heart failure in the hypoxic fetus and an important indicator of
imminent fetal demise (Kiserud 1991).
• Reversed flow in the ductusvenosus is an ominous sign.
43. Doppler Ultrasound
• The umbilical artery is
evaluated measuring the
blood flow velocity at
peak systole (maximal
contraction of the heart)
and peak diastole
(maximal relaxation of
the heart)
• These values are
computed into different
ratios like S/D or RI
44. Doppler Ultrasound
• Predict fetuses at risk
for anemia or hydrops
especially
Rhalloimmunized
pregnancies
• >1.5 MOM or ratios
can be used
47. Obstetrical Ultrasound
• 4D Ultrasounds that adds the element of
time to the 3D process.
• Offers live images
• Fetal changes like movement, kicking, reach
with hands and facial expressions can be
seen