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IN THE NAME OF GOD. 3 RD TRIMESTER SONOGRAPHY. Historical Ultrasound. 1876 : 1st used dog 1880 discovery of piezoelectric effect 1940 Ultrasonic energy was 1st applied in human body for medical purpose. 1954 Medical application of ultrasound. How to work Ultrasound ?. Air 331 m/s
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IN THE NAME OF GOD 3RD TRIMESTER SONOGRAPHY
Historical Ultrasound • 1876 : 1st used dog • 1880 discovery of piezoelectric effect • 1940 Ultrasonic energy was 1st applied in human body for medical purpose. • 1954 Medical application of ultrasound.
How to work Ultrasound ? • Air 331 m/s • Water 1340 m/s • Soft tissue 1450 m/s • Bone 1540 m/s
How to work Ultrasound ? • Tranceducer • According to wavelength and speed and density tissue reflect to oscillator • Display to monitor • A-Mode, B-Mode , M-Mode • 2 D , 3D ,4D
Safety Ultrasound • Ti:up to 1 degree Celsius • Tis: Soft tissue • TiC: Cranium • TiB: Bone • Routine 2D may be safe • 3D & 4D unsafe or hasard
Routine prenatal sonography as a screening tool • CDC reported 67% routine sonography • Support the use of ultrasound when there is a specific medical indication • ACOG • AIUM • ACR • RCOG
Using ultrasound in OBs • Confirm date of delivery ( EDC) • Diagnosis of abnormal pregnancy EP , Blighted ovum(1st Trimester) • Anomaly • Reduced diagnose of IUGR(RGF) ,Postdatisem Prevent abuse tocolytic (date )
3rd Trimester • Abnormal Placenta Location • IUGR(RGF) • Maturity :osification proximal femur 32 distal tibia ,humerus 35 w • BPD,FL,HC,AC,CI (2-3 w error ) • Amniotic fluid volum • BPP,MBPP, Cervical lenght
3rd TrimesterMultiple Markers • HC,FL equal to PD,FL,AC,HC • HC/AC • BPD/FL • FL/AC • Others: interaorbital,clavicle length Foot length….etc.
Ponderal Index • = birth weight(gr) x 100 crown-heel length(cm)
”در عشق همیشه قطره ای جنون هست و در جنون هم همیشه قطره ای عقل“ (فردریک نیچه) “Always there is a drop of madness in love, yet always there is a drop of reason in madness” (F. Nietzshe)