Pregnancy

What is a detailed extended obstetric ultrasound examination? The detailed extended obstetric ultrasound examination involves real-time US maternal evaluation plus detailed fetal anatomic examination. This is used when there is an increased risk of fetal abnormalities. The elements included in the detailed extended obstetric ultrasound examination are more detailed themselves in comparison to those of …

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What is a level II obstetric ultrasound examination, and what elements of fetal anatomy are included? A level II obstetric ultrasound examination is a comprehensive real-time ultrasonography (US) evaluation of fetal anatomy to detect fetal anomalies, whereas a level I obstetric ultrasound is a more general evaluation to detect obstetric problems. For the elements of …

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Soft ultrasound markers of potential fetal aneuploidy There are several markers of fetal aneuploidy that should be searched for and documented during routine second trimester US. These are considered “soft” because they are incidental, nonpathologic findings that may be seen in normal fetuses, but are associated with an increased incidence of chromosomal abnormalities, most commonly …

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What are the ultrasound features of a monochorionic diamniotic twin to twin transfusion syndrome (TTTS)? TTTS is a serious complication of monochorionic twins resulting from arteriovenous shunting of blood in a shared placenta. The recipient twin is large, polycythemic, and at risk for high-output cardiac failure which can manifest as hydrops and polyhydramnios. The donor …

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Complications that can be associated with a twin gestation Complications Associated with Twin Gestation TWIN TYPE COMPLICATION All twins PrematurityIUGR Monochorionicity (due to vascular anastomoses in a shared placenta) Twin-to-twin transfusion syndrome (TTTS)Twin embolization syndrome (TES)Twin reversed arterial perfusion (TRAP) sequence Monoamnionicity Conjoined twinsEntangled cords

Ultrasound features of fetal hydrops Fetal hydrops is excessive fluid accumulation in the fetal body cavities and soft tissues that results in pericardial and pleural effusions, ascites, skin thickening, placental thickening, and polyhydramnios. Causes of fetal hydrops are defined as either immune or nonimmune. Immune hydrops due to maternal and fetus blood group incompatibility is …

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When should the umbilical artery systolic to diastolic ratio be measured? In any setting of oligohydramnios with intact membranes or in any setting of IUGR, Doppler US imaging of the umbilical artery should be performed as a means to assess for placental insufficiency. Normally, the S/D ratio in the umbilical artery gradually decreases during pregnancy …

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