Ovarian and fetal imaging

Question 1

What happens during the growth of a baby at each week?

Answer 1

LMP
Week 1 -
Week 2 - ovulation and conception
Week 3 - implantation
Week 4 - gestational sac
Week 5 - gestational sac + yolk sac
Week 6-7 - gestation sac + yolk sac + embryo
Week 6-10 - embryo
Week 11-40 fetus

Question 2

When and how is it most accurate to date the embryo?

Answer 2

Within the first 12 weeks before any interperson variation in development can occur.
Date using length from the crown to rump.

4 mm at 6 weeks
8 mm at 7 weeks
15 mm at 8 weeks
22 mm at 9 weeks

Question 3

What would constitute an abnormal first trimester ultrasound?

Answer 3

Bleeding and cramping in the first 20 weeks is a threatened abortion.
- lack of a yolk sac
lac of the double decidual reaction
lack of embryo

CRL > 7 mm with no heart beat
MSD >25 mm with no embryo

Question 4

Whyat happens to betaBCG in the first few days in a normal and eptopic pregnancy?

Answer 4

Should double within the every 2-3 days. but this won’t happen in an ectopic. It will pleateau.

Question 5

When is a subchorionic bleed a threatened pregnancy?

Answer 5

When the bleed is on the side of the embryo. Between the chorion and the uterus.

Question 6

What is an anembroyonic pregnancy?

Answer 6

When the gestation sac does not develop an embryo.

Question 7

What is fetal demise?

Answer 7

When the fetus has no heart rate

Question 8

What so you detect in an ectopic?

Answer 8

Positive pregnancy test - empty uterus
betaHCG abnormal
Fluid in ectopic places (POD).

Question 9

When does the corpus leuteum stop functioning?

Answer 9

6-7 weeks it stars to shrink and ceases to function at 10 weeks.

Question 10

What is gestational trophoblastic disease (molar pregnancy)?

Answer 10

Proliferation of trophoblast tissue.
Can fill the whole uterus.
Very high beta HCG

Question 11

What are the normal levels of beta HCG?

Answer 11

Week 4-8 beta HCG doubles every 2-3 days (otherwise eptopic)

Question 12

When should you do a scan?

Answer 12

For estimated date of delivery:
12 weeks for the nuchal translucency scan. Estimate the risk of down syndrome. also look at beta HCG and PAPP-A levels. Confirm down syndrome with amniocentesis.
20 weeks - routine anatomy scan - assessing anomaly
Growth scan in third trimeter.

Question 13

When will an ectopic pregnancy manifest?

Answer 13

At 5 weeks of LMP

Question 14

When can you see the fetus?

Answer 14

8 Weeks

Head is the half size of embryo. Can only see limb buds. Cannot yet sex the baby.

Question 15

What is a molar pregnancy?

Answer 15

A non-cancerous tumour that develops in the uterus as a result of a non-viable pregnancy.