2nd & 3rd Tri Fetal Position & Gen Scanning Techniques Flashcards
What do you use for reference to determine the position of the fetus?
maternal side
Longitudinal
transverse
Oblique
vertex
breech
Vertex – Head position toward cervix or inferior
Breech – Head position toward fundus or superior
what cross section is taken?
where is the babies spine?
long fetal lie w/ cephalic (vertex) presentation.
tranverse cross section of baby.
what is this postion?
long fetal lie w/ breech position
tranverse cross section of both
what position is this?
transverse fetal lie w/ head on maternal left
fetal transverse cross-section
what position is this?
trans fetal lie w/ head on maternal rt
fetal trans cross section
what position? how can you tell?
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).
what position is this?
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.
what position is this?
breech.
front pic. notice vagina, internal cervix, anecoic amniotic fluid.
below. long midline. bladder as landmark. rump and spine anterior
position?
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
position?
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
paptient prep for 2nd/3rd tri
Bladder only needs to be filled enough to visualize cervix well
Usually only do TA, still can TV if necessary
what do you need to determine when scanning?
scan through before taking pictures
Fetal number
Fetal position – Heart beat? Fetal head
Placental position
Fetal survey & size – Done following the above
required documentation / protocol
Uterus
Adnexa
Fetal Position
Placenta
Amniotic Fluid
Fetal Survey & Size
braxton hicks
contractions in which uterus thicker in that area. common. changes coutour of uterus for 30-45 minutes
what do you need to check for in the uterus?
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)
when shoudl the corpus luteum regress and disappear?
by 16-18 weeks
below - adnexa
when should be able to get a good view of the placenta?
what else should you check at this time?
20 weeks
position, masses, bleeds, grade
placenta location and position
importance of scan plane documentation
where is this placenta located?
posterior
where is the placenta?
anterior
where is this placenta located?
lateral
what is this diagram showing?
placental grading
What are some good fetal imaging tips?
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
what is the AFI?
what is its echogenicity 1st vs 2nd/3rd tri?
amniotic fluid index
1st trimester is anechoic
2nd & 3rd trimester it has free-floating echoes called
vernix within the anechoic fluid
what do you note in a 2nd/3rd tri fetal survey?
Heart rate & 4 chamber heart
Stomach
Cord insertion
Kidneys & bladder
Spine
Head
All measurements
2nd/3rd tri protocol
BPD (Biparietal Diameter)
HC (Head Circumference)
AC (Abdomen Circumference)
FL (Femur Length)
AFI (Amniotic Fluid Index)
- What is this position called? 2. Where is fetal spine? 3. Which is the right & left side of fetus?
- Vertex 2. Anterior 3. Maternal right
side is fetal right side, maternal left is fetal left
- What is this position called?
- Where is fetal spine?
- Which is the right & left side of fetus?
- Where is placenta on this diagram?
- Breech
- Fetal spine on maternal left
- Fetus is lying on its’ right side so the left side is anterior
- It is a right/fundal placenta the placenta is in the RUQ
- Where is the fetal head?
- Where is fetal spine?
- Which is the right & left side of fetus?
- Where is placenta on this diagram?
- On maternal left
- Fetal spine is inferior toward cervix
- Fetal right side is posterior and fetal left side is anterior
- Placenta is fundal
- What is this position called?
- Where is fetal spine?
- Which is the right & left side of fetus?
- Vertex
- Midline on picture so, maternal right
- Fetal left side is anterior, right side is posterior. Therefore, the stomach is on the left side of fetus.
- Where is the fetal head?
- Where is fetal spine?
- Which is the right & left side of fetus?
- Where is placenta on this diagram?
- Head is on maternal right
- Spine is fundal or superior in uterus
- Fetus is lying on its’ right side so fetal left side is anterior
- Placenta is fundal
