Fetal Imaging
Fetal Imaging
ISUOG
• The International Society of Ultrasound in
Obstetric and Gynecology
SECOND TRIMESTER ULTRASOUND
Mid trimester fetal ultrasound scan
• HEAD ULTRASOUND
The correct plane for the measurement of
thecorrect
The head circumference (HC) and bi-parietal
plane for the measurement of BPD: Measure outer table of the
diameter
the (BPD)must include
head circumference thebi-parietal
(HC) and cavum skullMeasure
BPD: to the inner table.
outer table of the
septum (BPD)must
diameter pellucidum,include
thalamus
the and choroid
cavum HC:to
skull Measure around
the inner table.the outer
BPD
• Estimating GA from
BPD
B. Head Circumference
B. Head Circumference
• Same view as BPD
• Outer to outer
• Superior to BPD for dating
HC = 1.62 × (BPD + OFD)
Fetal Measurements:
B. Head Circumference
DOLICHOcephaly BRACHYcephaly
– If the head shape is flattened – Head shape if rounded
Fetal Measurements
C. Abdominal circumference (AC)
–parameter with
the widest
variation of 2 to 3
weeks
–parameter most
affected by fetal
growth
• -
C. Abdominal circumference (AC)
Landmark features:
Circular section with ribs
One vertebra -triangle of 3
white spots
Umbilical vein (short) -
hockey stick
Stomach left abdomen
• Good for dating of
pregnancy
• Sensitive to growth
aberrations
• Fetal weight assessment
C. Abdominal circumference (AC)
AD and AC measurement
C. Abdominal circumference (AC)
AC = 1.57 × (anteroposterior AD +
transverse AD)
D. Femur Length
Fetal Measurements:
D. Femur Length
• Correlates well with
both BPD and
gestational age
• Has a variation of 7 to
11 days
• MEASURED WITH THE BEAM
PERPENDICULAR TO THE LONG
AXIS OF THE SHAFT EXCLUDING
THE EPHIPHYSIS
Femur Length
Femur Length
AMNIOTIC FLUID
AMNIOTIC FLUID
AMNIOTIC FLUID MEASUREMENT
LIQUOR
LIQUORand
andAFI
AFI
LIQUOR and AFI
Greater
Greaterthan
thanthe
the95th
95thcentile
centile Amniotic
AmnioticFluid
Fluidindex
index(AFI),
(AFI),Measure
Measurethethe
=Polyhydramnios.
=Polyhydramnios.Less
Lessthan
than deepest
deepestvertical
verticalpocket
pocket(with
(withno
nofetal
fetalcontent)
content)
FETAL ANATOMIC SURVEY
Craniospinal Abnormality
Craniospinal abnormality
ULTRASOUND 18-20 WEEKS - Normal
ULTRASOUND 18-20 WEEKS - Normal (MORPHOLOGY SCAN)
ULTRASOUND (MORPHOLOGY
HEAD ULTRASOUND
18-20 WEEKS - Normal SCAN)
(MORPHOLOGY SCAN)
HEAD ULTRASOUND
• HEAD ULTRASOUND
The correct plane for the measurement of
thecorrect
The head circumference (HC) and bi-parietal
plane for the measurement of BPD: Measure outer table of the
diameter
the (BPD)must include
head circumference thebi-parietal
(HC) and cavum skullMeasure
BPD: to the inner table.
outer table of the
septum (BPD)must
diameter pellucidum,include
thalamus
the and choroid
cavum HC:to
skull Measure around
the inner table.the outer
The cerebellar diameter should approximately
The cerebellar
equal the weeksdiameter should
of gestation. approximately
(EG
Transventricular view of the atrium, which is marked by calipers and
contains the echogenic choroid plexus (CH).
Transcerebellar view of the posterior fossa, demonstrating measurement
of the cerebellum (C) and cisterna magna (CM).
The LATERAL VENTRICLES should be less than
The LATERAL
10mm VENTRICLES
in diameter (best measured the than
atless
should be
occipital diameter
10mm inhorn). The CHOROID PLEXII at
(best measured the be
should
homogeneous. The CHOROID
occipital horn).Small, PLEXII should
and sometimes be
multiple,
NOSE & LIPS: From the 'face' image, rotate the
NOSE & LIPS: From the 'face' image, rotate the
probe to visualize the nose and lips front on.
FACE: Ensure there is symmetry with probe to visualize the nose and lips front on.
2 distinctly separate nodules and in intact
Fetal Anatomy Assessment
Fetal Anatomy Assessment
Fetal abdominal scan
ABDOMINAL ULTRASOUND
ABDOMINAL ULTRASOUND
ABDOMINAL ULTRASOUND
TheFemur
The Femurlength
lengthshould
shouldonly
onlybebemeasured
measuredwhen
when
Lower limbs
Confirm the presence and equal size The foot should be perpendicular
of the tibia and fibula bilaterally. to the tibia and fibula.
Fetal Anatomy Assessment
• Fetal sex:
Recognizable from 14 weeks
Placental Localization
The echogenic mucous plug is readily Uterine contraction
visible in the cervix. Measure the length
Beware of uterine contractions
Placenta Localization
PLACENTA
PLACENTA PLACENTA
B. Absence of end-diastolic
flow.
C. Reversed end-diastolic
flow.
FETAL VESSEL CLINICAL SIGNIFICANCE REMARKS