Normal & abnormal 1st trimester images (WB & lecture)

Question 1

Subchorionic Hemorrhage

Question 2

impending abortion - abortion will happen very soon

8 week fetus - no heart beat, sac large for dates, cervical funneling, bleeding

Question 3

gestational trophoblastic disease (GTD)- proliferative disease that may present 3 ways

1. hydatidform mole- benign form
2. invasive mole - invasive form
3. chooriocarcinoma - slightly malignant form

Pt w/ Hx of trophoblastic disease have 20-40% increased risk for reoccurance

Answer 3

Question 4

extraovarian adnexal ring

Answer 4

adnexal echogenic ring

Question 5

sites of ectopic pregnancy

Answer 5

definitive ectopic

Question 6

Theca Lutein Cyst

Question 7

Invasive/Choriocarcinoma

Answer 7

Invasive/Choriocarcinoma

Question 8

hydatidiform mole w/ co- existing fetus

Answer 8

hydatidiform mole w/ co-existing fetus

Question 9

hydatidiform mole

w/ hydropic areas (hypoechoic cyst like)

Answer 9

hydatidiform mole

Question 10

hydatidiform mole

(starting to see cystic areas inside the placenta

Answer 10

hydatidiform mole

Question 11

viable ectopic

Answer 11

viable right adnexal ectopic

Question 12

ectopic c section scar

Answer 12

heterotopic pregnancy

Question 13

ectopic cervical pregnancy

Answer 13

interstitial pregnancy

Question 14

abdominal pregnancy (ectopic)

Answer 14

Treatment of Ectopic Pregnancy

• Microsurgery through laparoscope to maintain function of unruptured tube

• linear salpingostomy w/milking pregnancy out of distal ampulla

– Possible resection of segment of fallopian tube with gestation with or w/o reanastomosis

• Methotrexate injection - antimetabolite chemotherapeutic agent that interferes with DNA synthesis & disrupts cell multiplication.
– no morbidity frm surgery & general anesthesia
– Poten. less tubal damage, cost, & need for hospitalization
– Patient must be able to return for follow up
– Low success rate when ectopic w/ cardiac activity
• Surgery
– Live ectopic
– Large adnexal mass > 4cm
(Used very
early and
interferes with
DNA
synthesis)
(advantage)

Question 15

Anencephaly

Answer 15

Anencephaly

Question 16

ventriculomegaly

Question 17

cystic hygroma

lymphaniectasia

Answer 17

cystic hygroma

Question 18

diagram

Answer 18

Question 19

yolk sac

A- amnion

Answer 19

yolk sac

rhombencephalon -posterior aspect of embryo head- represents the developing 4th ventricle and posterior fossa

Question 20

rhombencephalon -posterior aspect of embryo head- represents the developing 4th ventricle and posterior fossa

Question 21

Answer 21

Question 22

Answer 22

Question 23

Answer 23

Question 24

Answer 24

Question 25

Answer 25

Question 26

Answer 26

Question 27

Answer 27

Question 28

Answer 28