Important 2nd Trimester US findings

Question 1

What is the definition of Mild Cerebral Ventriculomegaly?

Answer 1

Atrium 10 - 15 mm

Question 2

How much does cerebral ventriculomegaly increase the risk of down syndrome?

Answer 2

25 fold

Question 3

What other conditions are associated with Cerebral Ventriculomegaly?

Answer 3

CMV

Question 4

What is the strongest predictive ultrasound marker for Down syndrome?

Answer 4

Atrioventricular septal defects

Question 5

In a fetus with a AVSD what is the down syndrome risk?

Answer 5

> 80%

Question 6

What percentage of babies with DS with have an AVSD?

Answer 6

25%

Question 7

What percentage of fetuses with duodenal atresia will have down syndrome

Answer 7

1/3

Question 8

What is the differential diagnosis of Duodenal Atresia

Answer 8

Duodenal webb, annular pancreas

Question 9

What findings are typically associated with Duodenal Atresia?

Answer 9

Polyhydramnios

Question 10

Omphalocele is most associated with what Trisomy?

Answer 10

Trisomy 18

Question 11

True or False: With Gastroschisis, the defect occurs slightly to the right of the umbilical insertion

Answer 11

True

Question 12

What is the most reliable soft marker for downs syndrome?

Answer 12

Thickened nuchal skin fold

Question 13

What is the definition of thickened nuchal skin fold?

Answer 13

> 6 mm at < 20 weeks

Question 14

What is the increased risk of Down Syndrome with a thickened nuchal skin fold?

Answer 14

10 - 20 fold increase of DS

Question 15

What are the soft markers associated with down syndrome?

Answer 15

echogenic intracardiac focus, Choriod plexus cyst, bilateral pyelectasis, short femur or humerus, echogenic bowel

Question 16

Which soft markers require a third trimester US?

Answer 16

Bilateral pyelectasis, short femur or humerus, echogenic bowel

Question 17

When echogenic bowel is found, what other condition should you assess for?

Answer 17

CMV

Question 18

What are the classic karyotype findings associated with Down Syndrome

Answer 18

Ventriculomegaly, EIF, AVSD, Duodenal Atresia, Short HL, FL, echogenic bowel, pyelectasis, Sandal sign

Question 19

What are the classic Karyotype findings associated with Tri 18?

Answer 19

Choriod plexus Cyst, Posterior fossa abnormalities, Omphalocele, Club feet, Clenched hands, rockerbottom feet

Question 20

What are the classic Karyotype findings associated with Tri 13?

Answer 20

Midline craniofascial abnormalities (Holoprosencephaly, Cyclopia, Midline defects), Cardiac defects, NTDs, Severe FGR

Question 21

What cranial ultrasound findings area associated with spinda bifida?

Answer 21

Banana sign (herniated cerebellum), Lemon sign, Ventriculomegaly

Question 22

What spinal ultrasound findings area associated with spinda bifida?

Answer 22

Spinal defect, Meningomyelocele