chapter 48 green boxes Flashcards
sonographic findings
<60 bpm
embryonic bradycardia
sonographic findings
>170 bpm
embryonic tachycardia
sonographic findings
empty uterus
no adenexal mass
no free fluid in pelvis
positive hCg levels with rapid decline
complete abortion
sonographic findings
variable findings:
intact gestational sac with nonviable embryo to collapsed sac
thickend endometrium > 8 mm
retained embryonic parts
incomplete abortion
sonographic findings
large (>18 mm) empty gestatoinal sac with failure to develope
no yolk sac amnion or embryo
anembryonic pregnancy
sonographic findings
uterus larger than dates
“snowstorm” of multiple tiny clusters of grapelike echoes within the uterine cavity
Theca lutei cysts may be present
Molar pregnancy
hyperemesis
increased hCG levels
bleeding
preeclampsia
abnormal uterine pregnancies
absence of cardiac motion in embryos 5mm or larger
absence of cardiac motoin after 6.5 menstrual weeks
embryo
abnormal uterine pregnancies
large yolk sac or amnion without a viable embryo
calcified yolk sac
yolk sac and amnion
abnormal uterine pregnancies
> 18 mm lacking a viable embryo
> 8 mm lacking a visible yolk sac
large gestational sac
abnormal uterine pregnancies
irregular or misshapen
shape
abnormal uterine pregnancies
conrnual, low or hour glassing through cervical os
position
abnormal uterine pregnancies
irregular
absent double decidual sac finding
thin trophoblastic reactoin < 2mm
intratrophoblastic venous flow
trophoblastic reaction
abnormal uterine pregnancies
gestational sac growth of <0.6mm per day
absent embryonic growth
growth
abnormal uterine pregnancies
discrepance in sac size with hCG levels
hCG correlation
first trimester pelvic mass
>5 mm in size
internal septations and debris (secondary to hemorrhage)
increased vascularity surrounding corpus luteum
corpus luteum syst
differentials
dermoid
ovarian cancer
first trimester pelvic mass
increased hormone stimulatoin growth
may compress gestational sac
various sonographic patterns, hypoechoic, echogenic, isoechoic when compared with myometrium
increased size causes uterine endometrial deformity
uterine leiomyoma
differentials
uterine contractions
dermoid
normal vs ectopic pregnancy
normal early intrauterine pregnancy (3-4 weeks)
recent spontaneous abortion
empty uterus
normal vs ectopic pregnancy
yolk sac present
burrowed gestational sac eccentrically postitioned in uterus (usually in fundus)
no internal echoes seen within the gestatoinal sac
peritrophoblastic flow around sac
low resistive flow pattern
normal itrauterine pregnancy
IUP
normal vs ectopic pregnancy
intrauterine saclike structure
yolk sac not present
pseudosac seen in central locatoin in uterus
homogenoeous echoes within pseudosac
no peritrophoblastic flow
high resistive patter
ectopic pregnancy with pseudogestational sac
differentials
intrauterine debris
incomplete spontaneous abortion
intrauterine blood
normal vs ectopic pregnancy
pseudogestational sac
extrauterine sac in adenexa with thickened echogenic ring
gestational sac or yolk sac
ectopic pregnancy
differentials
incomplete spontaneous abortion
intrauterine blood or fluid in the cul-de-sac
normal vs ectopic pregnancy
simultaneous intrauterine pregnancy and ectopic pregnancy
findings for both IUP and ectopic
heterotopic pregnancy
differentials
normal IUP and pelvic mass
normal vs ectopic pregnancy
found in segment of fallopian tube
rupture with hemorrhage
eccentric intrauterine gestational sac with incomplete myometrial mantel surrouding sac
interstitial pregnancy
differentials
ectopic pregnancy
pelvic mass
normal vs ectopic pregnancy
pseudogestational sac of ectopic pregnancy
nonviable intrauterine pregnancy
differentials
embryo, no cardiac motion/nonliving intrauterine pregnancy
embryo cardiac motoin/living intrauterine pregnancy
cranial anomalies
abnormal mineralization of bony structures (lack of echogenicity)
abnormal shaped “mickey mouse” head
acrania
cranial anomalies
absence of cranium superior to orbits with preservation of base of skull and face
brain may project from open cranium
anencephaly
cranial anomalies
midline cranial defect
herniation of brain and meninges
cephalocele
cranial anomalies
defect in occiput involving the foramen magnum
extreme retroflexion of spine
open spinal defect
iniencephaly
cranial anomalies
dilation of ventricular system without enlargement of cranium
compressed choroid plexus
lncreased cerbrospinal fluid
dangling choriod in dilated lateral ventricle
ventriculomegaly
cranial anomalies
failure of prosencephalon to differentiate into cerebral hemispheres and lateral ventrilces between 4th and 8th weeks
complete to partial failure of cleavage of prosencephalon
facila dysmorphism
remember brain appears to be single ventrilce until falx cerebri develope after 9 weeks
holoprosencephaly
cranial anomalies
6th -7th week of gestation
cystic dilatoin of 4th ventricle
dysgenesis or agenesis of cerebellar vermis and hydrocephaly
elevated tentrium
Dadny-Walker malformation
