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65 Cards in this Set
- Front
- Back
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first trimester bleeding
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normal IUP (implantation)
abortion (impending, in progress, incomplete) ectopic pregnancy GTD subchorionic hemorrhage unrelated to pregnancy (rare) polyp cancer vaginal ulcers |
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empty sac
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normal early iup
blighted ovum (anembryonic gestation) ectopic pregnancy (pseudogestational sac) |
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echogenic central cavity
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normal pregnancy
decidua in early, not visible IUP hemorrhage ectopic pregnancy decidual reaction abortion retained products after an incomplete abortion |
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complex intrauterine mass
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missed abortion with placental hydropic degeneration
fetal demise with retained tissue molar pregnancy degenerated uterine fibroid endometrial carcinoma |
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elevated msAFP
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fetal abnormalities 60%
NTD abdominal wall defects cystic hygroma gastrointestinal obstruction, atresia liver disease-hepatitis renal disease-congenital nehprosis incorrect dates 20% multiple gestation 15% fetal demise 5% low birth weight placental abnormalities |
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low msAFP
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down syndrome
trisomy 18 incorrect dates |
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predictors of poor outcome
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fetal heartbeat not seen with CRL of >5mm
MSD >=8mm and no yolk sac on (TVS) MSD >=16mm and no fetal pole (TVS) bHCG > 1000 mIU/mL and no gestational sac bHCG > 3600 and no yolk sac heart rate < 90 bpm MSD-CRL < 5mm irregular gestational sac abnormal yolk sac (>6mm, calcified, irregular) absent double decidual sign with MSD > 10mm empty sac, large sac large subchorionic hematoma <2mm choriodecidual reaction |
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diffusely enlarged placenta in 2nd/3rd trimester
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diffusely enlarged placenta (>4cm thick)
hydrops fetalis maternal diabetes maternal anemia TORCH intraplacental hematoma |
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small placenta (hypoperfusion) in 2nd/3rd trimester
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maternal hypertension
toxemia severe diabetes IUGR |
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abnormal placental echotexture
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partial mole
hydropic placenta hemorrhage or abruption common but insignificant findings (venous lakes, fibrin, intervillous thrombosis, septal cysts, infarcts) |
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solitary umbilical artery
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trisomy 13, 18
structural abnormalities |
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enlargement of umbilical cord
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edema
hematoma cysts (allantoic, omphalomesenteric) mucoid degeneration of wharton's jelly |
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other umbilical cord abnormalities
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knots
varices |
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risk factors for preterm delivery
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prior preterm delivery
multiple gestations uterine anomaly 25% DES exposure of mother in utero 25% incompetent cervix 25% large fibroid 20% polyhydramnios 20% |
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abnormal lower uterine segment
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prolapse of cord (emergency, place patient in trendelenburg position and call obstretician)
incopentent cervic placenta previa cerclage low fibroid |
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third trimester bleeding
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placenta previa 10%
abruptio placentae cervical lesions idiopathic (occult abruptio) |
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uterine masses in pregnancy
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fibroid
focal myometrial contractions GTD hemorrhage |
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adnexal masses in pregnancy
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corpus luteum cyst
dermoid theca lutein cysts other ovarian neoplasms |
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other masses during pregnancy
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PID
other organs-appendiceal abscess, diverticulitis |
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frequently missed lesions
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NTD
facial anomalies head anomalies in near field heart defects limb anomalies difficulties with imaging in oligohydramnios |
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fetal death
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no fetal heart beat
absent fetal movement occasional findings overlapping skull bones (spaldings sign) gross distortion of fetal anatomy (maceration) soft tissue edema-skin > 5 mm uncommon findings thrombus in fetal heart gas in fetal heart |
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cystic cns structures
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supratentorial
choroid plexus cysts ventriculomegaly, hydrocephalus hydranencephaly porencephaly holoprosencephaly arachnoid cyst teratoma posterior foss DW complex arachnoid cyst mega cisterna magna midline cysts cavum septum pellucidum dorsal cyst in ACC vein of galen AVM |
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noncommunicating hydrocephalus
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NTD-chiari II, meningocele, meningomyelocele, encephalocele, spina bifida
dandy-walker complex aqueduct stenosis agenesis of corpus callosum |
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communicating hydrocephalus (rare prenatally)
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hemorrhage
infection |
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cystic head and/or neck masses
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cystic hygroma
encephalocele (bone calvarial defect) hemangioma teratoma (solid elements) branchial cleft cyst (anterolateral) or thyroglossal (midline) duct cyst umbilical cord tangled around neck |
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cystic back masses
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ntd
cystic teratoma |
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hyperechoic brain mass
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hemorrhage
teratoma lipoma of corpus callosum |
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incomplete mineralization of skull
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osteogenesis imperfect
achondrogensis type 1 hypophosphatasia |
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skull deformities
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lemon sign
myelomeningocele encephalocele cloverleaf skull craniosynostosis thanatophoric dwarfism other rare skeletal dysplasias |
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kyphoscoliosis
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isolated finding-hemivertebra, butterfly vertebra
complex anomalies VACTERL limb-body wall any skeletal dysplasia |
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cystic thoracic masses
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diaphragmatic hernia
ccam type 1 and 2 cysts-bronchogenic, enteric duplication, pericardial cystic hygroma |
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solid echogenic masses
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diaphragmatic hernia
ccam type 3 pulmonary sequestration tumors teratoma rhabdomyoma of heart |
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unilateral pleural effusion
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usually due to lung masses
CHD sequestration CCAM |
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bilateral pleural effusion
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fetal hydrops (any cause)
pulmonary lymphangiectasia (rare) |
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unilateral or bilateral pleural effusion
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idiopathic
infection chromosomal anomalies |
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absent stomach bubble
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oligohydramnios
swallowing abnormality (CNS defect) esophageal atresia CDH situs abnormality risk of chromosomal abnormalities (trisomy 18) |
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double bubble
LADS |
associated with polyhydramnios
Ladds bands annular pancreas duodenal atresia stenosis of duodenum |
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dilated bowel
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atresia
stenosis volvulus meconium ileus enteric duplication hirschsprungs disease proximal obstructions usually associated with polyhydramnios distal obstructions are usually associated with normal amniotic fluid volume |
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echogenic bowel content
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bowel as bright as iliac bone
normal variant during 2nd ti cystic fibrosis down syndrome IUGR CMV infection |
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abdominal calcification
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bowel related (usually occurs with obstruction)
meconium peritonitis (most common) meconium ileus atresias volvulus related to other organs renal liver (torch) neuroblastoma teratoma fetal gallstones |
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hydronephrosis
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most common causes
upj obstruction uvj obstruction (primary megaureter) duplicated collecting system with obstruction of upper pole bladder outlet obstruction male PUV, thick bladder wall prune belly syndrome, normal bladder wall females and males caudal regression syndrome megacystitis microcolon intestinal hypoperistalsis ureteral agenesis maternal drugs ectopic ureterocele |
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common renal anomalies
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agenesis
ectopic kidney hydronephrosis cystic disease ARPCKD, enlarged hyperechoic kidneys MCDK, large noncommunicating hypoechoic cysts |
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cystic abdominal structures
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hydronephrosis, bladder outlet obstruction
fluid-filled dilated bowel ascites meconium pseudocyst fetus in fetu cysts mesenteric cysts urachal cysts duplication cysts ovarian cysts choledochal cysts |
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hepatic calcifications
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infection-torch
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hepatic cysts
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simple cyst
polycystic disease choledochal cyst, carolis disease hamartoma |
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hepatic masses
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teratoma
hepatoblastoma hemangioma, hemangioendothelioma hamartom |
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splenomegaly
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rh immune hydrops
premature rupture of membranes TORCH |
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ascites
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hydrops (any cause)
urine ascites meconium peritonitis infection pseudoascites |
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midline abdominal wall defect
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omphalocele
pentalogy of cantrell |
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lateral abdominal wall defect
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gastroschisis
limb-body wall complex amniotic band syndrome |
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hydronephrosis
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most common causes
upj obstruction uvj obstruction (primary megaureter) duplicated collecting system with obstruction of upper pole bladder outlet obstruction male PUV, thick bladder wall prune belly syndrome, normal bladder wall females and males caudal regression syndrome megacystitis microcolon intestinal hypoperistalsis ureteral agenesis maternal drugs ectopic ureterocele |
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common renal anomalies
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agenesis
ectopic kidney hydronephrosis cystic disease ARPCKD, enlarged hyperechoic kidneys MCDK, large noncommunicating hypoechoic cysts |
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cystic abdominal structures
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hydronephrosis, bladder outlet obstruction
fluid-filled dilated bowel ascites meconium pseudocyst fetus in fetu cysts mesenteric cysts urachal cysts duplication cysts ovarian cysts choledochal cysts |
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hepatic calcifications
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infection-torch
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hepatic cysts
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simple cyst
polycystic disease choledochal cyst, carolis disease hamartoma |
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hepatic masses
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teratoma
hepatoblastoma hemangioma, hemangioendothelioma hamartom |
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splenomegaly
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rh immune hydrops
premature rupture of membranes TORCH |
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ascites
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hydrops (any cause)
urine ascites meconium peritonitis infection pseudoascites |
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midline abdominal wall defect
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omphalocele
pentalogy of cantrell |
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lateral abdominal wall defect
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gastroschisis
limb-body wall complex amniotic band syndrome |
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infraumbilical abdominal wall defect
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bladder or cloacal exstrophy
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anomalies in sarcral region
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teratoma
meningocele (anterior or posterior) caudal regression syndrome (sacral agenesis, sirenomelia) |
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fractures of extremities
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osteogenesis imperfecta
hypophosphatasia |
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polydactyly
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familial
trisomy 18, 13 meckel-gruber syndrome jeune's syndrome short-rib polydactyly sydromes |
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IUGR
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<10th percentil (lmp%)
low AFI look at doppler s/d ratio to determine if need to deliver right now if abnormal, deliver sd ratios of the UA and MCA, UA as far from fetus as possible normal UA-low resistance and s/d< 3 after 30 weeks MCA-high resistance and should be higher than UA |
