2nd & 3rd Tri Fetal Position & Gen Scanning Techniques

Question 1

What do you use for reference to determine the position of the fetus?

Answer 1

maternal side

Longitudinal
transverse

Oblique

Question 2

vertex

breech

Answer 2

Vertex – Head position toward cervix or inferior

Breech – Head position toward fundus or superior

Question 3

what cross section is taken?

where is the babies spine?

Answer 3

long fetal lie w/ cephalic (vertex) presentation.

tranverse cross section of baby.

Question 4

what is this postion?

Answer 4

long fetal lie w/ breech position

tranverse cross section of both

Question 5

what position is this?

Answer 5

transverse fetal lie w/ head on maternal left

fetal transverse cross-section

Question 6

what position is this?

Answer 6

trans fetal lie w/ head on maternal rt

fetal trans cross section

Question 7

what position? how can you tell?

Answer 7

vertex. the bladder is sitting anterior to babies head. you can see hypechoic vagina, cervical bend adn endo cervical canal. they hyperechoic circle in the uterus is babies calvarian (head).

Question 8

what position is this?

Answer 8

vertex

1st pic (top ant bottom post) you can see the anechoic stomach, the hearts on the left – putting baby spine to maternal lt and heart to maternal posterior.

Question 9

what position is this?

Answer 9

breech.

front pic. notice vagina, internal cervix, anecoic amniotic fluid.

below. long midline. bladder as landmark. rump and spine anterior

Question 10

position?

Answer 10

breech

(long) front - ant post, sup, inf. spine ant.

below - trans - ant, post, rt, lt. spine ant, uterus ant. placenta post. baby head post/rt

Question 11

position?

Answer 11

transverse

front - trans on baby. bladder ant/lt of mom. belly of baby and placenta rt/post. cervix of mom posterior.

below (trans on baby -ant/post supe/inf). mom’s aorta and ivc posterior, placenta posterior

Question 12

paptient prep for 2nd/3rd tri

Answer 12

Bladder only needs to be filled enough to visualize cervix well

Usually only do TA, still can TV if necessary

Question 13

what do you need to determine when scanning?

Answer 13

scan through before taking pictures

Fetal number
Fetal position – Heart beat? Fetal head
Placental position
Fetal survey & size – Done following the above

Question 14

required documentation / protocol

Answer 14

Uterus
Adnexa
Fetal Position
Placenta
Amniotic Fluid
Fetal Survey & Size

Question 15

braxton hicks

Answer 15

contractions in which uterus thicker in that area. common. changes coutour of uterus for 30-45 minutes

Question 16

what do you need to check for in the uterus?

Answer 16

check for masses

subchorionic bleeds (if placenta not adhered)

cervical length (over distended bladder can falsely lengthen)

bulging membranes (internal or external os fills with fluid)

Question 17

when shoudl the corpus luteum regress and disappear?

Answer 17

by 16-18 weeks

below - adnexa

Question 18

when should be able to get a good view of the placenta?

what else should you check at this time?

Answer 18

20 weeks

position, masses, bleeds, grade

Question 19

placenta location and position

Answer 19

importance of scan plane documentation

Question 20

where is this placenta located?

Answer 20

posterior

Question 21

where is the placenta?

Answer 21

anterior

Question 22

where is this placenta located?

Answer 22

lateral

Question 23

what is this diagram showing?

Answer 23

placental grading

Question 24

What are some good fetal imaging tips?

Answer 24

Watch focal zones
Watch depth
Use a linear transducer
Have a routine, avoid skipping around on every exam
Not used for routine scanning but, when information needed out weighs the risk

Question 25

what is the AFI? what is its echogenicity 1st vs 2nd/3rd tri?

Answer 25

amniotic fluid index 1st trimester is anechoic 2nd & 3rd trimester it has free-floating echoes called vernix within the anechoic fluid

Question 26

what do you note in a 2nd/3rd tri fetal survey?

Answer 26

Heart rate & 4 chamber heart Stomach Cord insertion Kidneys & bladder Spine Head All measurements

Question 27

2nd/3rd tri protocol

Answer 27

BPD (Biparietal Diameter) HC (Head Circumference) AC (Abdomen Circumference) FL (Femur Length) AFI (Amniotic Fluid Index)

Question 28

1. What is this position called? 2. Where is fetal spine? 3. Which is the right & left side of fetus?

Answer 28

1. Vertex 2. Anterior 3. Maternal right side is fetal right side, maternal left is fetal left

Question 29

1. What is this position called? 2. Where is fetal spine? 3. Which is the right & left side of fetus? 4. Where is placenta on this diagram?

Answer 29

1. Breech 2. Fetal spine on maternal left 3. Fetus is lying on its’ right side so the left side is anterior 4. It is a right/fundal placenta the placenta is in the RUQ

Question 30

1. Where is the fetal head? 2. Where is fetal spine? 3. Which is the right & left side of fetus? 4. Where is placenta on this diagram?

Answer 30

1. On maternal left 2. Fetal spine is inferior toward cervix 3. Fetal right side is posterior and fetal left side is anterior 4. Placenta is fundal

Question 31

1. What is this position called? 2. Where is fetal spine? 3. Which is the right & left side of fetus?

Answer 31

1. Vertex 2. Midline on picture so, maternal right 3. Fetal left side is anterior, right side is posterior. Therefore, the stomach is on the left side of fetus.

Question 32

1. Where is the fetal head? 2. Where is fetal spine? 3. Which is the right & left side of fetus? 4. Where is placenta on this diagram?

Answer 32

1. Head is on maternal right 2. Spine is fundal or superior in uterus 3. Fetus is lying on its’ right side so fetal left side is anterior 4. Placenta is fundal