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Normal fetal anatomy. Anatomy Scan. Indications Identify fetal abnormalities Identify IUGR Dating Placental localisation Timing 16-20 weeks 22-24 weeks Machine Good quality machine TGC sliders Record images High quality curvelinear probe Problems Incorrect dates Poor views
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Anatomy Scan • Indications • Identify fetal abnormalities • Identify IUGR • Dating • Placental localisation • Timing • 16-20 weeks • 22-24 weeks • Machine • Good quality machine • TGC sliders • Record images • High quality curvelinear probe • Problems • Incorrect dates • Poor views • Fetal position
Routine • History and consent from patient • Previous child with abnormality • Family history of abnormality • Exposure to teratogens eg drugs, infections • Explain limitations • Growth scan • Placental localisation • Anatomy
Fetal head and face • BPD and HC • Cerebellar view • TCD = gestation • Foramen magna < 10mm • Nuchal fold < 6mm • Lateral ventricles • Posterior aspect ventricle, Perpendicular to falx • <12mm normal, 12-15mm moderate, >15mm severe • Orbits • Inner to inner border, 1/3 ratio of eyes and bridge of nose • Lips and nose • Exclude cleft lip • Profile • Micrognathia, proboscis
Fetal head and face • BPD and HC • Cerebellar view • TCD = gestation • Foramen magna < 10mm • Nuchal fold < 6mm • Lateral ventricles • Posterior aspect ventricle, Perpendicular to falx • <12mm normal, 12-15mm moderate, >15mm severe • Orbits • Inner to inner border, 1/3 ratio of eyes and bridge of nose • Lips and nose • Exclude cleft lip • Profile • Micrognathia, proboscis
Fetal trunk • Coronal section • Heart, stomach, diaphragm and bladder • Sagittal section of anterior abdominal wall • Kidneys • Coronal • Transverse • Diaphragms sagittal view • Umbilical cord insertion • Two umbilical arteries
Fetal trunk • Coronal section • Heart, stomach, diaphragm and bladder • Sagittal section of anterior abdominal wall • Kidneys • Coronal • Transverse • Diaphragms sagittal view • Umbilical cord insertion • Two umbilical arteries
Fetal heart • Reduce gain • Situs • 4 Chamber view • FHR and rhythm • Interventricular septum • LVOT • RVOT • (Aortic arch) • (Ductal arch)
Fetal heart • Situs • 4 Chamber view • FHR and rhythm • Interventricular septum • LVOT • RVOT • (Aortic arch) • (Ductal arch)
Fetal Spine and limbs • Spine- reduce total gain • Sagittal with skinline in view • Coronal • Transverse- 3 ossification centres ‘tight’, not splayed • Follow limb from trunk noting side • Full length all 12 bones • Exclude club foot • Feet- plantar view and count toes • Hands- open if possible and count fingers and thumb