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OBSTETRICS > 1M - Fetal Imaging > Flashcards

1M - Fetal Imaging Flashcards

1
Q

Upon ultrasound, the results show an 80mm fetus with identifiable features and internal organs. What trimester is the fetus in?

A

1st trimester

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2
Q

What is the first sign of early pregnancy on ultrasound?

A

Gestational sac

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3
Q

When can we first see the gestational sac?

A

3-5 weeks gestation

The mean sac diameter is 2-3mm

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4
Q

Where can we see the true gestational sac and the pseudo gestational sac?

A

True gestational sac can be seen in the eccentrically in the endometrium while the pseudo gestational sac can be seen centrally within the uterine cavity

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5
Q

at 4.5-5 weeks, what is most helpful sign of pregnancy sonographically?

A

Double decidual sign

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6
Q

What is the possible hcg levels within the first 5 weeks of pregnancy that coincides with the presence of gestational sac?

A

1000-2000 IU/L

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7
Q

A sonographic
measurement of the gestational sac which is usually
first seen at around 3 weeks after conception (5 weeks
after the last menstrual period), when it measures 2-3
mm

A

Mean sac diameter

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8
Q

What measurement of MSD with absent fetal pole is indicative of pregnancy failure or missed miscarriage?

A

> 25mm

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9
Q

What measurement of MSD is suspicious of pregnancy failure if an embryo is not found?

A

16-24mm

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10
Q

What measure of MSD should yolk sac be already visible?

A

8mm

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11
Q

First anatomical structure identified within the gestational sac?

A

Yolk sac

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12
Q

This structure play a critical role in embryonal development by providing nutrients and serving as the site of initial hematopoiesis?

A

Yolk sac

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13
Q

This is characterized a a structure with a round bright ring measuring <6mm sonographically

A

Yolk sac

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14
Q

When does the yolk sac involute?

A

At 11 weeks

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15
Q

When does the yolk sac become unidentfiable?

A

at 14-20 weeks

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16
Q

Appears as a circular thick-walled echogenic structure

with an anechoic center within the gestational sac, but outside the amniotic membrane

A

Yolk sac

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17
Q

This is the first direct imaging manifestation of the fetus? Seen as a thickening on the margin of the yolk sac
during early pregnancy. It is often used
synonymously with the term “embryo”.

A

Fetal pole

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18
Q

When can we first identify the fetal pole?

A

6.5 weeks with TAS

6 weeks with TVS

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19
Q

Upon TVS what is the MSD if the fetal pole already present?

A

> or = 16mm

TAS - > or = 25mm

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20
Q

When a fetal pole measures > or = 5mm what what other thing should be detected?

A

fetal heartbeat

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21
Q

it is the length of the
embryo or fetus from the top of its head to bottom of
torso?

A

Crown rump length

the largest dimension of the embryo excluding the yolk sac and extremities

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22
Q

It is the most accurate estimation of gestational age in early pregnancy?

A

Crown rump length

This is due to the small biological variability

23
Q

This is the primary measure of gestational age from 7-13 weeks?

A

Crown rump length

accurate to within 5-7 days

24
Q

What measure of CRL should cardiac activity be present?

A

7mm

25
Q

What is the definitive sign of intrauterine pregnancy at 5 weeks?

A

Gestational sac and yolk sac

26
Q

if the yolk sac or embryo is not yet visualized, what can be an alternative sign of intrauterine pregnancy?

A

Double decidual sign

27
Q

What are the outer and inner parts of the double decidual sign?

A

Outer - decidua
Inner - chorion

seen as round oval fluid filled collection surrounded by 2 echogenic rings

28
Q

Visualization of a gestational sac containing a yolk
sac and amniotic sac giving an appearance of two
small bubbles where the embryonic disc is located between the 2 bubbles?

A

Double bleb sign

29
Q

How many days of gestation should we first see intradecidual sign and when is the last discriminatory day of gestation should it start be seen to confirm intrauterine pregnancy?

A

Should be seen at 24 days (threshold level) but not later than 47 days (discriminatory level) to confirm intrauterine pregnancy

30
Q

This is a frequent cause of first and second trimester hemorrhage caused by blood collecting between the uterine wall and the chorionic membrane

A

sub chorionic hemorrhage

31
Q

This is the normal fluid-filled
subcutaneous space identified at the back of the
fetal neck during the late first trimester and early
second trimester (11 weeks 3 days to 13 weeks 6
days).

A

Nuchal transluency

nuchal fold - seen at second trimester

32
Q

What does increase in nuchal translucency indicate?

A

dilated lymphatic vessels and fetal abnormalities

33
Q

When do we check for nuchal translucency?

A

11-13 weeks

34
Q

What are the 3 factors used to calculate for risk of trisomies?

A

Nuchal translucency
Crown rump length
fetal heart rate

35
Q

Most accurately reflects gestational age, with a

variation of 7 to 10 days in the second trimester

A

bi parietal diameter

measurement of the shape of the fetal head

36
Q

What view is needed to see the biparietal diameter?

A

Axial view at the level of the thalamus

37
Q

How to measure biparietal diameter?

A

From the outer edge of the near cranium to the inner edge of the far cranium

38
Q

What is the condition if BPD is high for gestational age?

A

Brachycephaly

39
Q

What is the condition if BPD is low for gestational age?

A

dolicocephaly

40
Q

To correctly measure the head circumference and biparietal diameter, what structures must be included?

A

cavum septum pellucidum, thalamus, and choroid plexus in the atrium of the lateral ventricles

41
Q

What measurements reflects growth of the fetal brain?

A

Head circumference and biparietal diameter

42
Q

This is a perimeter measurement of the fetal cranium excluding subcutaneous soft tissues.

A

Head circumference

43
Q

This measurement reflects the growth of intraabdominal organs and fetal weight and sized? It is the peripheral measurement of the fetal abdomen including the subcutaneous tissue

A

Abdominal circumference

44
Q

What are the landmarks in measuring the abdominal circumference?

A

Portal section of the UV
Stomach
Spine

45
Q

Serves to monitor growth of long bones?

A

Femur length

46
Q

The normal growth and development of the fetus are dependent upon the normal function and integrity of this structure?

A

Placenta

47
Q

When can the placenta be first visualized sonographically by TVS

A

8 weeks

as a focal thickening along the periphery of the gestational sac

evident by 12 weeks

48
Q

This protects the fetus from injury and allows growth and fetal movement. This is also essential for lung maturation.

A

Amniotic fluid

49
Q

This measure the vertical height of the deepest fluid pocket in 4 quadrants?

A

amniotic fluid index

50
Q

What is the normal range for amniotic fluid index?

A

5-20 cms

51
Q

If AFI is below 5 cms, what is the condition?

A

Oligohydramnios

52
Q

What are the causes of oligohydramnios?

A

Post term
PROM
IUGR
urinary tract abnormalities

53
Q

If AFI is more than 20 cms, what is the condition?

A

polyhydramnios

54
Q

What are the causes of polyhydramnios?

A

Gestational diabetes - most common
GI and CNS abnormalities
lethal skeletal dysplasia
chromosomal abnormalities

OBSTETRICS (36 decks)

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