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Fetal Face

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Fetal Face

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    1. 12/14/2011 L.Zanin - MS213 - Fetal Face 1 Fetal Face

    2. 12/14/2011 L.Zanin - MS213 - Fetal Face 2

    3. 12/14/2011 L.Zanin - MS213 - Fetal Face 3 Fetal Face at 13 weeks A wide open mouth, notice the nasal bones between the orbits

    4. 12/14/2011 L.Zanin - MS213 - Fetal Face 4 Fetal Face A targeted exam of the face may be useful if the pregnancy is complicated by: polyhydramnios maternal history of teratogen exposure family history of previous craniofacial malformatoin (cleft lip)

    5. 12/14/2011 L.Zanin - MS213 - Fetal Face 5 Viewing the Fetal Face The following views can be obtained to view the facial features of the fetus: Transverse of the orbits, nose, lips and anterior palate Coronal view through the orbits, nose and lips View of the ears

    6. 12/14/2011 L.Zanin - MS213 - Fetal Face 6 Orbit Measurement Documentation of the presence and size of two eyes and of the distance between them provides the most useful diagnostic information You can obtain this image by starting with the normal BPD image and angling caudal at the anterior aspect of skull until orbits are imaged

    7. 12/14/2011 L.Zanin - MS213 - Fetal Face 7 Fetal Face Coronal view showing fetal eye, eye lids, lens, lips, & nose.

    8. 12/14/2011 L.Zanin - MS213 - Fetal Face 8 Fetal Face Coronal view showing fetal eye, eye lids, lens lips, & nose.

    9. 12/14/2011 L.Zanin - MS213 - Fetal Face 9 FETAL FACE

    10. 12/14/2011 L.Zanin - MS213 - Fetal Face 10 Eyes Hypertelorism Eyes are set far apart May be isolated or secondary as part of multiple syndromes, especially chromosomal abnormalities or teratogen exposure, & cephaloceles Most are found with anterior or frontal cephaloceles Hypotelorism Eyes are set close together Most commonly associated with holoprosencephaly

    11. 12/14/2011 L.Zanin - MS213 - Fetal Face 11 Hypertelorism

    12. 12/14/2011 L.Zanin - MS213 - Fetal Face 12 Hypertelorism

    13. 12/14/2011 L.Zanin - MS213 - Fetal Face 13 Hypotelorism

    14. 12/14/2011 L.Zanin - MS213 - Fetal Face 14 Hypotelorism

    15. 12/14/2011 L.Zanin - MS213 - Fetal Face 15 Hypotelorism

    16. 12/14/2011 L.Zanin - MS213 - Fetal Face 16 Hypotelorism Associated with Holoprosencephaly is a complex spectrum of intracranial abnormalities resulting from absent or incomplete development and includes: Cyclopia, cleft lip and palate Hypotelorism Cebocephaly - proboscis, hypotelorism Ethmocephaly - marked hypotelorism absent nose with proboscis

    17. 12/14/2011 L.Zanin - MS213 - Fetal Face 17 Ethmocephaly - marked hypotelorism absent nose with proboscis

    18. 12/14/2011 L.Zanin - MS213 - Fetal Face 18 Proboscis cebocephaly - proboscis, hypotelorism

    19. 12/14/2011 L.Zanin - MS213 - Fetal Face 19 Proboscis & Fused Orbits

    20. 12/14/2011 L.Zanin - MS213 - Fetal Face 20 Hypertelorism with Encephalocele

    21. 12/14/2011 L.Zanin - MS213 - Fetal Face 21 Lips, Mouth, Tongue: Coronal The coronal view provides useful information regarding cleft lips which are often seen with polyhydramnios, family history, or an unusually shaped mouth Things to look for: Is the upper lip cleft Is the tongue protuberant Macroglossia – enlarged tongue (associated with Beckwith-Wiedemann Syndrome) Is the mouth open wide or fixed in position

    22. 12/14/2011 L.Zanin - MS213 - Fetal Face 22 Cleft Lip & Cleft Palate Most common facial deformity Two major groups of cleft lip and palate Upper lip and anterior maxilla with or without involvement of the soft and hard palates Clefts involving the hard and soft palates May be an isolated finding (rare) Also associated with chromosomal disorders and amniotic band syndromes Associated with a number of syndromes, holoprosencephaly, trisomy 13, 18 and triploidy

    23. 12/14/2011 L.Zanin - MS213 - Fetal Face 23 Cleft Lip & Cleft Palate Sonographic appearance of cleft lip Anechoic region in the upper lip, lateral to the midline extending to the nostrils Sonographic appearance of cleft palate Difficult to diagnose sonographically due to facial bone shadowing Visualized by obtaining coronal frontal scans angled posteriorly

    24. 12/14/2011 L.Zanin - MS213 - Fetal Face 24 Normal Lip & Palate

    25. 12/14/2011 L.Zanin - MS213 - Fetal Face 25 Fetal Lips & Nose Coronal view of the lower face showing the normal appearance of the upper lip and nose

    26. 12/14/2011 L.Zanin - MS213 - Fetal Face 26 Fetal Lips & Nose

    27. 12/14/2011 L.Zanin - MS213 - Fetal Face 27 Lips and Nose

    28. 12/14/2011 L.Zanin - MS213 - Fetal Face 28 Fetal Nose & Lips Axial view through the upper and lower lip, the mouth is slightly open. This view would rule out cleft lip.

    29. 12/14/2011 L.Zanin - MS213 - Fetal Face 29 Fetal Nose & Lips Axial view through the upper and lower lip, the mouth is slightly open. This view would rule out cleft lip.

    30. 12/14/2011 L.Zanin - MS213 - Fetal Face 30 Lips & Nose Another image shows the face of the same fetus with the nose and lips no longer pressed against the uterine wall and thus no cleft.

    31. 12/14/2011 L.Zanin - MS213 - Fetal Face 31 Lips & Nose Pseudocleft. The lips and nose are pressed against the uterine wall

    32. 12/14/2011 L.Zanin - MS213 - Fetal Face 32 Cleft Lip

    33. 12/14/2011 L.Zanin - MS213 - Fetal Face 33 Cleft Lip & Cleft Palate

    34. 12/14/2011 L.Zanin - MS213 - Fetal Face 34 Unilateral Cleft Lip

    35. 12/14/2011 L.Zanin - MS213 - Fetal Face 35 Unilateral Cleft Lip

    36. 12/14/2011 L.Zanin - MS213 - Fetal Face 36 3D image of Unilateral Cleft Lip

    37. 12/14/2011 L.Zanin - MS213 - Fetal Face 37 Unilateral Cleft Lip

    38. 12/14/2011 L.Zanin - MS213 - Fetal Face 38 Unilateral Cleft Lip

    39. 12/14/2011 L.Zanin - MS213 - Fetal Face 39 Unilateral Cleft Lip Facial cleft. Shows the gap in the upper lip.

    40. 12/14/2011 L.Zanin - MS213 - Fetal Face 40 Unilateral Cleft Lip

    41. 12/14/2011 L.Zanin - MS213 - Fetal Face 41 Unilateral Cleft Lip

    42. 12/14/2011 L.Zanin - MS213 - Fetal Face 42 Unilateral Cleft Lip

    43. 12/14/2011 L.Zanin - MS213 - Fetal Face 43 Bilateral Cleft Lip & Cleft Palate

    44. 12/14/2011 L.Zanin - MS213 - Fetal Face 44 Bilateral cleft lip

    45. 12/14/2011 L.Zanin - MS213 - Fetal Face 45 Cleft lip and cleft palate

    46. 12/14/2011 L.Zanin - MS213 - Fetal Face 46 Bilateral Cleft Lip

    47. 12/14/2011 L.Zanin - MS213 - Fetal Face 47 Cleft Palate

    48. 12/14/2011 L.Zanin - MS213 - Fetal Face 48 Beckwith-Wiedemann Syndrome Sonographic detection of an enlarged and protuberant tongue (Macroglossia) especially when associated with large for dates, polyhydramnios or omphalocele Fetal profile evaluation is very important especially if there is a positive family history

    49. 12/14/2011 L.Zanin - MS213 - Fetal Face 49 Beckwith-Wiedemann Syndrome

    50. 12/14/2011 L.Zanin - MS213 - Fetal Face 50 Beckwith-Wiedemann Syndrome

    51. 12/14/2011 L.Zanin - MS213 - Fetal Face 51 Beckwith-Wiedemann Syndrome

    52. 12/14/2011 L.Zanin - MS213 - Fetal Face 52 Facial Profile View The fetal profile is optimally demonstrated with the mid sagittal view of the face Ask yourself the following questions: Is the nose flattened Is the chin abnormally small Is an abnormal mass present This view may reveal large facial or neck masses as well as more subtle abnormalities including abnormal or absent nose or an enlarged tongue

    53. 12/14/2011 L.Zanin - MS213 - Fetal Face 53 Fetal Profile The contour of the face in profile. Notice the smooth surface of the frontal bone, the appearance of the nose and upper and lower lips

    54. 12/14/2011 L.Zanin - MS213 - Fetal Face 54 Fetal Profile Tongue in mouth

    55. 12/14/2011 L.Zanin - MS213 - Fetal Face 55 FETAL LENSES

    56. 12/14/2011 L.Zanin - MS213 - Fetal Face 56 FETAL LENS

    57. 12/14/2011 L.Zanin - MS213 - Fetal Face 57 FETAL PROFILE

    58. 12/14/2011 L.Zanin - MS213 - Fetal Face 58 FETAL FACE/PROFILE

    59. 12/14/2011 L.Zanin - MS213 - Fetal Face 59 FETAL FACE

    60. 12/14/2011 L.Zanin - MS213 - Fetal Face 60 Fetal Profile

    61. 12/14/2011 L.Zanin - MS213 - Fetal Face 61 Fetal Profile Micrognathia (small chin) associated with trisomy 13

    62. 12/14/2011 L.Zanin - MS213 - Fetal Face 62 Micrognathia

    63. 12/14/2011 L.Zanin - MS213 - Fetal Face 63 Micrognathia vs severe micrognathia

    64. 12/14/2011 L.Zanin - MS213 - Fetal Face 64 Fetal Profile Cloverleaf skull

    65. 12/14/2011 L.Zanin - MS213 - Fetal Face 65 Fetal Profile Fetus with anencephaly Note the fetal orbits are the highest structures of the fetal head

    66. 12/14/2011 L.Zanin - MS213 - Fetal Face 66 Fetal Ears Routine sonographic exams of the fetal external ears rarely provides any useful information in the absence of other abnormalities Low set ears and malformations occur in 85 different syndromes Look for the following: Are the ears obviously deformed Are the ears low set or abnormal in size

    67. 12/14/2011 L.Zanin - MS213 - Fetal Face 67 Fetal Ear

    68. 12/14/2011 L.Zanin - MS213 - Fetal Face 68 Ear

    69. 12/14/2011 L.Zanin - MS213 - Fetal Face 69 Low Set Ear

    70. 12/14/2011 L.Zanin - MS213 - Fetal Face 70 Dorsal Pseudomembrane or Nuchal Translucency Thin echogenic line that parallels the posterior occiput & cervical spine Must be less than 2.8 - 3.0 mm Seen between 10-14 weeks Disappears by 18 weeks If it measures greater than 3.0 mm is is strongly associated with chromosomal abnormalities such as trisomies 13, 18 & 21

    71. 12/14/2011 L.Zanin - MS213 - Fetal Face 71 Dorsal Pseudomembrane

    72. 12/14/2011 L.Zanin - MS213 - Fetal Face 72 Nuchal Translucency

    73. 12/14/2011 L.Zanin - MS213 - Fetal Face 73 Nuchal Translucency

    74. 12/14/2011 L.Zanin - MS213 - Fetal Face 74 Nuchal Translucency

    75. 12/14/2011 L.Zanin - MS213 - Fetal Face 75 Nuchal Translucency

    76. 12/14/2011 L.Zanin - MS213 - Fetal Face 76 Nuchal Translucency

    77. 12/14/2011 L.Zanin - MS213 - Fetal Face 77 Nuchal Translucency

    78. 12/14/2011 L.Zanin - MS213 - Fetal Face 78 Nuchal Translucency

    79. 12/14/2011 L.Zanin - MS213 - Fetal Face 79 Nuchal Translucency

    80. 12/14/2011 L.Zanin - MS213 - Fetal Face 80 Nuchal Translucency

    81. 12/14/2011 L.Zanin - MS213 - Fetal Face 81 Nuchal Translucency

    82. 12/14/2011 L.Zanin - MS213 - Fetal Face 82 Nuchal Fold

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