Ovarian and Foetal Imaging

Question 1

Dating of ultrasound scans in pregnancy is done using the LMP/Date of conception

Answer 1

LMP

Question 2

Week __ of a pregnancy scan will correlate with conception/ovulation

Answer 2

2

Question 3

By week 6-7 of pregnancy scanning what structures are you expecting to see?

Answer 3

• Gestation sac
• Yolk sac
• Embryo

Question 4

A normal gestation sac should lie just under the ___ and be positioned slightly ___

Answer 4

Endometrium

Eccentric

Question 5

If the developing baby hasn’t doubled in size by weeks ___ the pregnancy is considered failed

Answer 5

6-7

Question 6

What is a threatened abortion?

Answer 6

bBeeding and cramping in the first 20 weeks of a pregnancy

Question 7

If there foetal cardiac activity is absent by a CRL of > __mm this is considered pathologic

Answer 7

7

Question 8

If the embryo is absent by a MSD (mean sac diameter) of ___mm this is considered pathologic

Answer 8

25

Question 9

What is a normal embryonic heart rate?

Answer 9

140-150 bpm

Question 10

What is the prognosis for a subchorionic bleed?

Answer 10

Unlikely to be problematic because is not where the embryo is developing

Question 11

The yolk sac normally measures __mm

Answer 11

4

Question 12

How should you refer to an anembryonic pregnancy in clinical practice?

Answer 12

An empty sac

Question 13

Why is free-floating amnion before 12 weeks of scanning not necessarily indicative of a miscarraige?

Answer 13

Amnion does not stick to the chorion until around 12 weeks

Question 14

Which condition causes a marked increase in likelihood of ectopic pregnancy?

Answer 14

Pelvic inflammatory disease

Question 15

Should you only scan the uterus for an IVF pregnancy?

Answer 15

No - higher chance of ectopic pregnancy, need to scan outside the uterus

Question 16

Is fluid around the uterus more indicative of an ectopic or ovulation?

Answer 16

Ecotopic

Question 17

Which drug is used in the termination of pregnancy?

Answer 17

Methotrexate

Question 18

Where does fluid due to ovulation tend to collect?

Answer 18

The pouch of Douglas

Question 19

Ovaries are normally ___ cm in size

Answer 19

2.5-3cm

Question 20

Ovarian follicles may rupture between ___mm

Answer 20

16-25

Question 21

What are the ddx for fluid in the pouch of douglas and pelvic pain?

Answer 21

• Ectopic pregnancy
• Ovulation
• Menstruation (blood)
• PID (pus)

Question 22

What causes a haemorrhagic corpus luteum?

Answer 22

Rupture of blood vessels on the ovary post-ovulation

Question 23

Corpus luteum is responsible for hormonal control of pregnancy until ___ weeks

Answer 23

10-12

Question 24

What is a common presentation of patients with gestational trophoblastic disease?

Answer 24

Severe sickness - excessive vomiting to the point of being unable to keep up with fluids

Question 25

From Week 4-8 BHCG ___ every 2-3 days

Answer 25

Doubles

Question 26

At what level of bHCG would you expect to see foetal cardiac activity?

Answer 26

20,000

Question 27

At what level of bHCG would you expect to see a gestation sac?

Answer 27

> 2000

Question 28

The accuracy of scanning in predicting EDD is
+/- ___ in the 1st trimester
+/- ____ 2nd trimester
+/- ____ 3rd trimester

Answer 28

+/- 5 days in the 1st trimester
+/- 10 days 2nd trimester
+/- 3 weeks 3rd trimester

Question 29

Why do monochorionic pregnancies need to be monitored closely?

Answer 29

Risk of twin to twin transfusion

Question 30

All of the embryology has formed by___ weeks. You are not altering develop at ~ 20 weeks

Answer 30

12

Question 31

Why can bHCG not be used for dating?

Answer 31

To variable between patients

Question 32

The patient’s LMP was only 3 weeks ago. Why should I do an ultrasound scan when an ectopic pregnancy does not manifest until 5 weeks after the LMP?

Answer 32

• Cannot assume this was actually her LMP

- Need to do a pregnancy test