Fetal face and neck Flashcards
The upper liip and the Nares are best seen in the __________ ________ with respect to the fetus
Coronal plane
True or False
You must have this image, including the upper lip and the two Nares
True
Why is it important to image the upper lip and the Nares?
To exclude the possibility of facial clefting (this part of the normal second trimester US)
In what planes can the feral eyes be imaged?
Coronally or tranversely
In times past, the inner orbital distances were used to evaluate the _______
Pregnancy
The inner orbital distances are really only used when trying to evaluated for other fetal cranial abnormalities like ___________
Holoprosencephaly
The presence of a nasal bone is _________ noted
Usually
Hypoplastic or absent nasal bones maybe associated with______________
Trisomy 21
Soft tissue in the neck are evaluated in the _____________ or ______________
Transverse or sagittal plane
The AP dimensions or thickness of the nuchal fold is evaluated in fetuses less than ___________
24 weeks
The measurement of the fetal neck should be taken from ______________to the ______________
Outer echogenic skull to the outer skin line
Fetal neck measurement should be
less than 6mm
When the neck measurement is greater than six, there is an association with
Trisomy 21
When should the neck measurement no longer be taken?
If the fetus is greater than 24 weeks
Marked thickening of the nuchal fold is also associated with
Turner’s syndrome, called a cystic hygroma
Decreased intraorbital distance
Hypotelorism
Hypotelorism is associated with
Syndromes and holoprosencephaly
Increased intraorbital distance
Hypertelorism
Hypertelorism is associated with
Anterior Cephalocele and many syndromes
The most common congenital facial abnormality
Facial clefting
_________% cleft lip only
25
________% cleft lip and palate
50
_______% cleft palate only
25
The ultrasound diagnosis relies on the presence of a _________ ______ to recognize the abnormality
Cleft lip
What will cleft lip look like on ultrasound?
An interruption in the upper lip
this is why it is necessary to view the entire lip and Nares
Don’t mistake a cleft lip for a
Normal philtrum (dip in the skin above the lip)
It is extremely difficult to recognize an ___________ ____________ __________ on ultrasound
isolated cleft palate
Sagittal image of the midline of the face
Profile
What are the two things that the profile image is used for finding
- Micrognathia
2. Frontal bossing
an abnormally small jaw, associated with syndromes especially Trisomy 18
Micrognathia
A prominent forehead due to an absent nasal bridge, associated with syndromes and skeletal dysplasia
Frontal bossing
Facial masses
- Epignathus
- Cervical teratoma
- Cystic hygroma
Are facial masses common or uncommon
uncommon
A rare pharyngeal teratoma which protude from the fetal mouth
- looks like a large complex cystic and solid mass
Epignathus
Epignathus is associated with ______________ because of ineffective fetal swallowing
Polyhydramnios
May occur anywhere on or around the neck. It also appears as a complex solid or cystic mass near the fetal neck
Cervical teratoma
A benign developmental anomaly of the lympthatic system in which single or multiple cystic areas are present around the neck
Cystic hygroma
Cystic hygroma has a high association with
Chromosomal abnormalities especially Turner’s syndrome and downs syndrome
Large hygromas are often associated with
fetal hydrops
What are the ultrasound findings with Cystic hygromas
- thin walled, multi septated mass at the posterior aspect of the neck
- may see nuchal ligament extending posteriorly associated with hydrops fetalis which shows fetal ascites, body wall edema, pleural effusions
