ultrasound in 1st, 2nd & 3rd trimester د.رامز الأسودي
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Obstatric
Ultrasound in first trimester Goals :
1. Visualization of G.S.:
A- seen :(age):-single or multiple (number of membranes and placentas)-alive: * normal .
*abnormal (anomaly)-dead or blighted ovum
B- Not seen:- decid.reaction- normal endometrial thickness.
2. Localization of G.S :A- Intrauterine ( normal place or aborted).B- Ectopic .
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5th
week : G.S. seen6 th week: fetus seen7 th week: heart beats seen.
7-12 th weeks calculated by C.R.LMultiple G.S diagnose multiplepregnancies.
G.Sac:
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Ultrasound in 2 nd and 3 rd trimesters
B.P.D (best at 18-20 w., not after 24-26 w.where FL or HC are better)
- measure the ventricles to excludehydrocephalus .and exclude other fetal anomalies.- sex also seen.- placenta ( 11 th week):
* placenta previa (0.5%)N.B. 1/3-1/2 of placentas in lower segment
.then mostof placentas migrate up.(sure diagnosis at
36 th w)
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* Large for dates uterus 1. mistake in calculation ( usually).2. multiparity.( early more than G.S. and later
more than fetal bodies)3.Vesicular mole and choriocarcinoma.( no D.D.)4. ovarian or uterine tumours5.polyhydramnios :
- maternal D.M .- neural tube defect.- duodenal and esophageal atresia .
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Small for dates uterus :1. mistake in calculation.
2. intrauterine growth retard.3. perinatal death.4.oligohydramnios
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Fetal anomalies
neural tube defects(the commonest)particularly spina bifida and unencephaly( elevate alpha feto prot.)
HEAD- hydrocephalus(16 th w), and
unencephaly(12 th w).SPINE
- spina bifida.+/- meningiocele
- tumours (sacral teratoma)CHEST-congenital diaphragmatic hernia- some cong. Heart diseases- A-V canal defec , and fallot tertralogy .
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G.I.T- duodenal atresia, omphalocele and
gastroschisis.- esophageal atresia indirectly diagnosed
by polyhydramnios.URINARY TRACT ( usually with
oligohydamnios)- hydronephrosis and multicystic kidney
usually unilateral .- post.urethral valve.SKELETON
- short limbs
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