Contents (Topic-wise)
Routine examination checklist
Typical items: maternal details, fetal biometry (BPD/HC/AC/FL), fetal lie and presentation, amniotic fluid assessment, placental location, basic fetal anatomy screen (head, face, spine, thorax, abdomen, limbs), Doppler if indicated.
Full-Text___________ ↑ Top
TIFA examination checklist
Targeted Imaging for Fetal Anomalies (TIFA): extended anatomic survey with dedicated views for heart (4-chamber, outflow tracts), brain (neurosonography), face, kidneys, limbs, and placenta; include measurements, Doppler, and photographic documentation.
Full-Text___________ ↑ Top
BPP & NST examination checklist
Biophysical profile (BPP): fetal tone, movement, breathing, amniotic fluid volume, and NST. Non-stress test (NST): fetal heart rate acceleration pattern; record baseline, variability, accelerations, decelerations.
Full-Text___________ ↑ Top
RMT assessment
Risk-modifying tests (RMT) / risk management triage: review maternal risk factors (hypertension, diabetes, infections), prior scans, and decide follow-up frequency; include targeted Doppler, growth charts, and referral to fetal medicine if needed.
Full-Text___________ ↑ Top
Cervix
Assess cervical length, funneling, and competence on transvaginal or transabdominal scan when indicated; note cerclage or morphological abnormalities.
Full-Text___________ ↑ Top
Placenta
Document location (anterior/posterior/fundal), grade, thickness, lacunae, signs of abruption, previa, succenturiate lobes, and cord insertion site (marginal, velamentous).
Full-Text___________ ↑ Top
Umbilical cord
Assess number of vessels (3 vs 2), insertion point, visible knots, coiling, and any cysts or masses; perform cord Doppler (AVA flow) if indicated.
Full-Text___________ ↑ Top
Amniotic fluid
Measure AFI or deepest vertical pocket, comment on oligohydramnios or polyhydramnios, and correlate with fetal swallowing and renal anatomy.
Full-Text___________ ↑ Top
Fetal Position and presentation
Document fetal lie (longitudinal/transverse/oblique), presentation (cephalic/breech/shoulder), and engagement; note station if relevant for late pregnancy.
Full-Text___________ ↑ Top
Sonographic anatomy of fetal head & Spine
Examine skull vault, midline falx, lateral ventricles, cavum septi pellucidi, thalami, cerebellum, cisterna magna, corpus callosum (when feasible), and vertebral alignment in sagittal/coronal planes.
Full-Text___________ ↑ Top
Measurable component in Fetal head
Common measures: biparietal diameter (BPD), head circumference (HC), occipito-frontal diameter (OFD), transcerebellar diameter (TCD), ventricular atrial width.
Full-Text___________ ↑ Top
Fetal skull shape
Assess skull contour for dolichocephaly, brachycephaly, plagiocephaly, craniosynostosis signs, and asymmetry; include 3D if needed.
Full-Text___________ ↑ Top
Cephalic Index (CI)
CI = (BPD / OFD) × 100. Document units and classification (dolichocephalic, mesocephalic, brachycephalic) and comment on clinical relevance.
Full-Text___________ ↑ Top
Fronto-Occipital Index (FOI)
FOI = (Fronto-occipital diameter / Maximum head breadth) × 100 (or other local definition) — used in some cranial assessments; specify formula used.
Full-Text___________ ↑ Top
Central Nervous System Anomaly
Screen for major CNS anomalies: anencephaly, holoprosencephaly, ventriculomegaly, Dandy-Walker malformation, agenesis of corpus callosum, etc.; document ventricles, midline, posterior fossa.
Full-Text___________ ↑ Top
Neural Tube Defects
Include open spina bifida (cranial signs: lemon/banana sign, ventriculomegaly), meningocele, encephalocele; examine spine continuity and overlying soft tissues.
Full-Text___________ ↑ Top
Sonographic anatomy of fetal face
Assess facial profile, forehead, nose, lips, palate (when possible), eyes, orbits, and maxillary/mandibular morphology in axial and sagittal planes.
Full-Text___________ ↑ Top
Measurable component in face
Key measures: nasal bone length (NBL), interorbital distance (IOD), binocular distance, mandibular length, inferior facial angle (IFA), fronto-maxillary facial (FMF) angle.
Full-Text___________ ↑ Top
Facial Ratios and Angles
Document ratios such as NB/mandible, philtrum-to-lip relationships, and angles (FMF, IFA) used for aneuploidy and craniofacial assessment.
Full-Text___________ ↑ Top
Fetal Facial Anomaly
Note cleft lip/palate, micrognathia, hypertelorism/hypotelorism, nasal bone abnormalities, and syndromic facial patterns; recommend genetic review if indicated.
Full-Text___________ ↑ Top
Sonographic anatomy of fetal neck
Assess nuchal thickness, cystic hygroma, lymphatic malformations, and neck mass lesions in sagittal and transverse planes.
Full-Text___________ ↑ Top
Measurable component in fetal neck
Include nuchal translucency (first trimester), nuchal fold (second trimester), neck circumference when required, and measurement of cystic components.
Full-Text___________ ↑ Top
Fetal neck anomaly
Identify cystic hygroma, teratoma, cervical meningocele, or lymphatic malformations and evaluate for hydrops and chromosomal associations.
Full-Text___________ ↑ Top
Sonographic anatomy of fetal thorax & heart
Perform standard four-chamber view, outflow tracts, three-vessel view, and axial/longitudinal thoracic assessment; evaluate lungs, pleura, diaphragm.
Full-Text___________ ↑ Top
Measurable component in fetal thorax & heart
Measurements: cardiac diameter (CD), thoracic diameter (TD), cardiac area (CA), thoracic area (TA), ventricular dimensions, trunk circumference when relevant.
Full-Text___________ ↑ Top
Fetal Cardiothoracic Ratio (CTR)
CTR (diameter-based) = CD / TD (expressed as ratio or percent). Normal ≈ 0.45–0.50; CTR ≥ 0.50 suggests cardiomegaly—recommend fetal echo and systemic evaluation.
Cardiac axis
Assess cardiac axis (normal leftward ~45°) in the thorax; deviations may suggest heterotaxy, congenital diaphragmatic hernia, or structural cardiac anomalies.
Full-Text___________ ↑ Top
Thoracic anomaly
Identify CPAM, diaphragmatic hernia, bronchopulmonary sequestration, pleural effusion, pulmonary hypoplasia, and mediastinal masses; correlate with lung-to-head ratio when applicable.
Full-Text___________ ↑ Top
Cardiac Anomaly
Document structural anomalies (septal defects, outflow tract abnormalities, valve lesions, complex congenital heart disease) and refer for fetal echocardiography.
Full-Text___________ ↑ Top
Upper limb sonographic anatomy
Examine clavicles, humerus, radius/ulna, hands, digits, limb movement, and symmetry; measure long bones (humerus) for growth.
Full-Text___________ ↑ Top
Lower limb sonographic anatomy
Assess femur, tibia/fibula, feet, toes, joint contractures, and limb lengths; note clubfoot, arthrogryposis, or limb reduction defects.
Full-Text___________ ↑ Top
Musculoskeletal anomaly
Recognize skeletal dysplasias, limb reduction defects, osteogenesis imperfecta signs, and anomalies of the chest wall or spine related to structural disorders.
Full-Text___________ ↑ Top
Hydrops fetalis diagnosis strategy
Definition: abnormal fluid accumulation in ≥2 fetal compartments (ascites, pleural effusion, pericardial effusion, skin edema). Evaluate for immune vs non-immune causes (alloimmunization, structural anomalies, infections, anemia).
Full-Text___________ ↑ Top
Associated anomaly
Search for cardiac failure, structural anomalies, chromosomal disorders, infections (parvovirus), tumors (chorioangioma), and twin complications (TTTS). Recommend targeted testing (PUBS, Doppler).
Full-Text___________ ↑ Top
Trisomy 21 (Down syndrome)
Ultrasound markers: shortened femur, nuchal fold, absent/short nasal bone, cardiac defects (AV septal defect), duodenal atresia, echogenic bowel, increased NT in 1st trimester.
Full-Text___________ ↑ Top
Trisomy 18 (Edwards syndrome)
Markers: choroid plexus cysts, overlapping fingers, micrognathia, omphalocele, cardiac defects, IUGR, and rocker-bottom feet.
Full-Text___________ ↑ Top
Trisomy 13 (Patau syndrome)
Markers: holoprosencephaly, cleft lip/palate, polydactyly, cardiac defects, severe CNS anomalies.
Full-Text___________ ↑ Top
Trisomy 8 mosaicism (Warkany syndrome)
Variable anomalies: skeletal and facial dysmorphism, deep furrowed palms, and other structural anomalies; ultrasound findings may be nonspecific—correlate with genetic testing.
Full-Text___________ ↑ Top
TORCH infections
Toxoplasma, Others (syphilis, varicella, parvovirus), Rubella, CMV, Herpes—look for growth restriction, ventriculomegaly, calcifications, hepatosplenomegaly, effusions.
Full-Text___________ ↑ Top
Syphilis (Treponema pallidum)
Findings: hepatosplenomegaly, hydrops, ascites, placental thickening; correlate with serology and maternal history.
Full-Text___________ ↑ Top
Varicella-zoster virus (VZV)
Possible limb hypoplasia, skin scarring, eye and CNS anomalies if maternal infection early in pregnancy; ultrasound findings are variable.
Full-Text___________ ↑ Top
Parvovirus B19
Associated with fetal anemia, hydrops fetalis, and high-output cardiac failure—monitor MCA Doppler, consider IUT if severe anemia.
Full-Text___________ ↑ Top
Human immunodeficiency virus (HIV)
Ultrasound findings nonspecific; correlate with maternal viral status and follow infectious disease guidance for management.
Full-Text___________ ↑ Top
Hepatitis B virus (HBV)
Ultrasound findings nonspecific; screen mother and manage per obstetric infectious disease protocols.
Full-Text___________ ↑ Top
Hepatitis C virus (HCV)
Ultrasound findings nonspecific; counsel and follow maternal management guidelines; consider targeted testing when indicated.
Full-Text___________ ↑ Top
Zika virus
Linked to microcephaly, brain calcifications, ventriculomegaly, cortical malformations—perform neurosonography and serial growth scans.
Full-Text___________ ↑ Top
Enteroviruses (Coxsackie, Echo)
May cause fetal myocarditis or hydrops; findings variable—correlate with maternal history and fetal status.
Full-Text___________ ↑ Top
Listeria monocytogenes
May present with fetal growth restriction, preterm labor, and non-specific ultrasound abnormalities; coordinate with maternal testing.
Full-Text___________ ↑ Top
Malaria (congenital)
Can cause fetal distress and growth restriction; ultrasound findings nonspecific—manage maternal infection promptly.
Full-Text___________ ↑ Top
Tuberculosis (congenital TB)
Rare; consider when maternal TB is present—findings variable and require multidisciplinary management.
Full-Text___________ ↑ Top
Fetal Doppler Studies
Include umbilical artery, middle cerebral artery (MCA), ductus venosus, uterine arteries; essential for growth restriction, anemia assessment, and fetal surveillance.
Full-Text___________ ↑ Top
Fetal Neurosonography
Dedicated brain protocol: coronal and sagittal planes, targeted assessment of ventricles, posterior fossa, cortical development, and midline structures.
Full-Text___________ ↑ Top
Fetal Echocardiography
Detailed cardiac anatomy and function study: 4-chamber, outflow tracts, three-vessel view, great vessel relationships, valve function, and fetal arrhythmia assessment.
Full-Text___________ ↑ Top
3D/4D Sonography
Useful for facial anomalies, skeletal dysplasia assessment, spatial relationships, and parental counselling; complements 2D imaging.
Full-Text___________ ↑ Top
Amniocentesis
Indications: genetic testing, infection studies, lung maturity (selected cases). Technique: ultrasound-guided transabdominal sampling, usually 15–20 weeks. Risks: small risk of miscarriage, leakage, infection.
Full-Text___________ ↑ Top
Chorionic Villus Sampling (CVS)
Indications: early genetic diagnosis. Technique: transabdominal or transcervical sampling at ~10–13 weeks under ultrasound guidance. Risks: miscarriage, confined placental mosaicism.
Full-Text___________ ↑ Top
Cordocentesis (Percutaneous Umbilical Blood Sampling, PUBS)
Indications: rapid karyotyping, fetal anemia assessment, infection testing. Technique: ultrasound-guided sampling of umbilical vein near insertion. Risks: fetal bradycardia, bleeding, preterm labor.
Full-Text___________ ↑ Top
Intrauterine Transfusion (IUT)
Indications: severe fetal anemia (alloimmunization, parvovirus). Technique: transfusion into umbilical vein under ultrasound guidance. Risks: preterm labor, fetal distress, infection.
Full-Text___________ ↑ Top
Amnioreduction
Indications: symptomatic polyhydramnios or to reduce uterine tension. Technique: ultrasound-guided removal of fluid; repeat as needed. Risks: ROM, infection, preterm labor.
Full-Text___________ ↑ Top
Amnioinfusion
Indications: oligohydramnios management in selected settings, relieve cord compression in labor. Technique: infusion of warmed saline under guidance; monitor uterine tone and fetal response.
Full-Text___________ ↑ Top
Fetal Paracentesis / Thoracocentesis
Indications: symptomatic ascites or large pleural effusion causing hydrops or lung compression. Technique: ultrasound-guided drainage; may require repeat drainage or shunt placement.
Full-Text___________ ↑ Top
Shunt Placements
Indications: obstructive uropathy (vesicoamniotic shunt), fetal hydrothorax (thoracoamniotic shunt). Technique: percutaneous ultrasound-guided placement; monitor for displacement and complications.
Full-Text___________ ↑ Top
Laser Therapy / Radiofrequency Ablation
Indications: TTTS, TRAP, selective reduction. Technique: fetoscopic laser coagulation of placental anastomoses or percutaneous RFA for specific lesions. Requires specialized centers.
Full-Text___________ ↑ Top
Fetoscopic Procedures
Indications: laser ablation for TTTS, selected fetal surgeries (spina bifida repair) in specialized centers. Technique: endoscopic instruments with ultrasound and endoscopic guidance; higher resource requirement.
Full-Text___________ ↑ Top
No comments:
Post a Comment