ERU-27 The Fetal Heart and Chest

Question 1

At how many days gestation does the fetal heart begin to contract?
At what CRL should you see a fetal heart beat?
By what gestational age is the heart fully formed?

Answer 1

36-37 days
4-5mm
10 weeks

Question 2

Ductus venosus

Answer 2

A shunt from the unbiblical vein to the IVC

Question 3

Ductus arteriosus

Answer 3

A shunt from the right ventricle to the descending aorta

Question 4

Hypoplastic Left heart Syndrome

- Sonographic findings

Answer 4

1. Absent/small LV
2. No communication btw the L atrium and LV
3. Aortic atresia (possible)
4. Aortic stenosis (possible)
5. Coarctation of the aorta (possible)

Question 5

Hypoplastic Left heart Syndrome

• Associated diagnoses
• prognosis?

Answer 5

Turner syndrome and Tris 18

95% mortality in the first month unless surgery

Question 6

Hypoplastic Right Heart Syndrome

Answer 6

1. Absent or small right ventricle
2. Enlarged LV
3. Fetal hydrops (2/2 cardiac failure)
4. Narrowing of the pulmonary valve

Question 7

What is the most common form of cardiac defect?

Answer 7

VSD

Question 8

Atrioventricular Septal Defects are commonly associated with what diagnoses?

Answer 8

Aneuploidy, tris 21, and tris 18

Question 9

What is Ebstein anomaly?
What diagnoses are associated with this finding?
Prognosis

Answer 9

A cardiac defect in which the tricuspid valve is malformed or malpositioned resulting in the right ventricle continuous with the right atrium.
ASD, tetralogy of Fallot, transposition of the great vessels, and coarctation of the aorta.
80% die in the perinatal period.

Question 10

Sonographic findings of Ebstein Anomaly

Answer 10

1. malpositioned tricuspid valve
2. right and left atrial shunting
3. tricuspid regurg
4. enlarged RA
5. deviation of the atrial septum to the left
6. fetal hydrops 2/2 heart failure

Question 11

finding associated with Tetralogy of Fallot

Answer 11

1. Overriding aortic root
2. VSD
3. Pulmonary stenosis
4. Right ventricular hypertrophy

Question 12

What is the most common fetal cardiac tumor?

With what are these tumors associated?

Answer 12

Rhabdomyoma

Tuberous sclerosis

Question 13

Ectopic Cordis

Answer 13

Fetal heart located partially or completely outsice the chest

Question 14

With fetal lung maturity, the Lecitin to sphingomyelin ratio (increases / decreases).

Answer 14

increases; lecithin goes up

Question 15

What is the diagnosis associated with “bat-wing” sign?

Answer 15

Pleural effusion

Question 16

Cystic adenomatoid malformation

Answer 16

A mass consisting of abnormal bronchial and lung tissue.

Most are unilateral and resolve spontaneously.

Question 17

Pulmonary sequestration

Answer 17

A separate mass of nonfunctioning lung tissue with its own blood supply.
Triangular in shape, usually on the left side, with possible pleural effusion

Question 18

Bochdalek hernia

Answer 18

A left-sided (most common) diaphragmatic hernia

Question 19

Foramen of Bochdalek

Foramen of Morgagni

Answer 19

Located in the left posterior portion of the diaphragm

Located in the right anterolateralmedial diaphragm

Question 20

Pentalogy of Cantrell

Answer 20

Omphalocele
Ectopic cordis
Cleft sternum
Anterior diaphragmatic defect
Pericaridal defects

Question 21

Eventration of the diaphragm

Answer 21

A lack of muscle in the dome of the diaphragm