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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5786_Библиотеки_им_академика_М_И_Перельмана.pdf
✩ ✩✩✩✩✩✩✩✩✩✩✩
ANSWERS
Chapter 2:
1 c; 2 a; 3 d; 4 a; 5 d.
Chapter 3:
1 a; 2 g; 3 c; 4 b; 5 c.
Chapter 4:
1 b; 2 c; 3 a, c; 4 a, b, d; 5 b.
Chapter 5:
1 c; 2 d; 3 e; 4 b.
Chapter 6:
1 c; 2 a; 3 a; 4 c.
Chapter 7:
1 c; 2 e; 3 d; 4 e; 5 a
Ultrasound in obstetrics and gynaecology
Chapter 8:
1 d; 2 b; 3 b; 4 a; 5 c.
Chapter 9:
1 b; 2 b; 3 a; 4 c; 5 c.
Chapter 10:
1 b; 2 c; 3 c; 4 b; 5 c.
Chapter 11:
1 d; 2 c; 3 c; 4 a; 5 e; 6 d.
Chapter 12:
1 b; 2 c; 3 a; 4 d.
Chapter 13:
1 b; 2 b; 3 a; 4 c; 5 a.
Chapter 14:
1 a+d; 2 b; 3 a; 4 b; 5 c.
Chapter 15:
1 a; 2 b; 3 b; 4 d; 5 d.
Chapter 16:
1 c; 2 e; 3 a; 4 d; 5 e.
Chapter 17:
1 a; 2 a; 3 c.
368
Chapter 18:
1 c; 2 c; 3 c
Chapter 19:
1 d; 2 b.
Chapter 20:
1 b; 2 b, c; 3 d; 4 d; 5 b.
Chapter 21:
1 d; 2 b; 3 e.
✩✩✩✩✩✩✩✩✩✩✩ ✩
Test yourself – questions and answers
369
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Index
Note: Page numbers in italics refer to figures and page numbers in bold refer
to tables.
A
abdomen
cysts, 190 (see also specific anatomical region)
gestational age estimation/prediction, 147,
147–8
normal fetal anatomy at 18–22 weeks, 81,
95–7, 95–7
abdominal circumference (AC), embryo/fetus
first trimester, 64–5, 65
gestational age estimation/prediction, 147,
147–8
macrosomia, 154
second trimester, 95, 95, 96
abdominal wall
anterior, normal fetal anatomy at 18–22
weeks, 97–8
fetal anomalies, 185–90
abortion
spontaneous, 69
threatened, 69
see also miscarriage
abscesses
adnexal, 50
tubo-ovarian, 326
absent end-diastolic flow (AEDF), umbilical
artery, 215–17, 216
achondrogenesis, 195
achondroplasia, 195
acidaemia, fetal, 220
acoustic absorption coefficient of tissue, 24
acoustic energy, 22
acoustic output, 22–3, 23
acoustic power, 22
acoustic streaming, 21, 27
adenoma, fetal hepatic, 197
adenomatous hyperplasia, 49
adenomyosis, 47, 307, 307–8
adnexal masses, 49–50
differential diagnosis, 314
Doppler studies, 329–30
echogenicity, 316
malignant, 314
see also ovarian cysts; ovarian tumours
adnexal torsion, 53, 323
adrenal glands, normal fetal anatomy at 18–22
weeks, 101
ADR linear scanner, 7, 10
alcohol, effect on fetal movements, 281
alloimmune thrombocytopenia, fetal, 238
American Fertility Society classification of
congenital uterine anomalies,
300, 302
amniocentesis (AC), 229, 234–5
approach, 234–5
early, 234
multiple pregnancies, 235, 252
safety, 235
timing, 234
amnion, 110
amnionicity determination, 68, 69, 250,
250–1
amniotic cavity diameter, 57, 67, 67, 68, 70
amniotic fluid, 109–14
fetal urinary production, 110
flow across the chorionic plate, 110
lung fluid, 110
physiology, 110
volume, 111–13
abnormal, 112–13
assessment methods, 111, 112
normal, 112
quantitation of, 45
amniotic fluid depth (AFI), 45
amniotic fluid index technique, 111, 112
A-mode, 6, 8, 23
amputation, congenital, 196
anaemia, fetal
blood transfusion, 238
middle cerebral artery Doppler, 217,
218–19, 220
371
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372
anencephaly, 161–2
diagnosis, 161–2
effect on fetal movements, 278–9
incidence, 161
prognosis, 162
Index
aneuploidy, 233–4
angiomyxoma, umbilical cord, 130, 130
anhydramnios, 112, 190
anophthalmia, 168–9
anorectal atresia, 188
anterior abdominal wall, normal fetal anatomy
at 18–22 weeks, 97–8
antiarrhythmic drugs, fetal cardiac
dysrhythmias, 181
anti-La antibodies, 181
anti-Ro antibodies, 181
aorta, 93, 93, 94
aortic arch, 94, 94
coarctation, 173–4
interruption, 173–4
tubular hypoplasia, 173–4
aortic stenosis, 173
appropriate for gestational age (AGA), 152
arcuate uterus, 300, 301, 302
Arnold–Chiari malformation, 84
artery-to-artery anastomosis, 224
artifacts, 17–19
attenuation shadows, 17–18
edge shadows, 17, 18
enhancement, 18, 18
reverberation, 19, 19
ascites, hydrops fetalis, 199
asepsis, invasive obstetric procedures, 232
Asherman syndrome, 49
asphyxiating thoracic dysplasia, 196
asplenia, 95, 171–2
atria, normal fetal anatomy at 18–22 weeks, 90
atrial fibrillation, 181
atrial flutter, 180–1
atrial septum
defects, 170–1
normal fetal anatomy at 18–22 weeks, 90
atrioventricular block, 181–2
atrioventricular malformations, ductus venosus
blood flow, 222
atrioventricular septal defect, 169, 170–1
atrioventricular valve
ductus venosus blood flow, 223
normal fetal anatomy at 18–22 weeks, 90
regurgitation, 221
attenuation shadows, 17–18
audible sound, 2
autonomy, 342, 343, 348, 349
autosomal dominant cystic kidneys, 192
autosomal mutations, 159
autosomal recessive cystic kidneys, 191–2
axial plane, 14, 15
axial resolution, 14–15, 15
azimuth plane, 16
B
banana sign, 161, 162
beam see ultrasound beam
Beckwith–Wiedemann syndrome, 185
Beemer–Langer syndrome, 196
behavioural states, fetal, 276–8, 277
beneficence, 340–2, 343, 349
b-human chorionic gonadotropin (b-hCG),
hydatidiform mole, 72
betametasone, effect on fetal movements, 281
b2-microglobulin, obstructive uropathies, 239
b-mimetics, atrioventricular block, 182
bicornuate uterus, 300, 302
bilateral uterine artery notch, 212
bimanual pelvic examination prior to
scanning, 36–7
binocular diameter (BOD), 86, 149
biological effects and safety aspects of
ultrasound, 21–31
acoustic output of diagnostic ultrasound
scanners, 22–3, 23
evidence from epidemiology, 27–8
management of safety, 28–9
manufacturers’ obligations, 29
non-thermal mechanisms and their safety
implications, 26–7
safety practice, 29–31
tissue warming by diagnostic ultrasound,
23–6, 25
user’s responsibility, 28–9
biophysical profile testing, 44–5
biparietal diameter (BPD)
first trimester, 63, 65
gestational age estimation, 144, 146–7
macrosomia, 154
second trimester, 80
birthweight and ultrasound, 27
bladder
empty or full when scanning, 34, 34–5
exstrophy, 186–7
mass, 51
normal fetal anatomy at 18–22 weeks, 99, 101
polyps, 52
scanning routine, 51–2, 52
shunting, 241
stones, 52
bleeding
irregular uterine, 49
vaginal see vaginal bleeding
blood flow
fetal and uroplacental, 209–24, 277
normal fetal anatomy at 18–22 weeks, 91, 92
blood perfusion rate of tissue, 24
blood transfusion, fetal, 199, 237–8
complications, 238
indications, 238
technique, 237–8
volumes, 238
B-mode, 7, 9
spatial-peak temporal-average intensity,
23, 23
uterine abnormalities, 300
uterine fibroids, 305
body movements, fetal, 274–5, 275
body stalk anomaly, 186
bones
heating of, 24, 25
normal fetal anatomy at 18–22 weeks,
102–4, 102–5
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bowel
echogenic, 189
hyperechogenic, 204
normal fetal anatomy at 18–22 weeks, 97
perforation, 189
brain
cavities, embryo/fetus, 60
lesions, effect on fetal movements, 278
normal fetal anatomy at 18–22 weeks,
80–5, 81
transcerebellar view, 83, 84–5
transthalamic view, 80–2, 82
transventricular view, 82–4, 83
brain-sparing effect, 216, 218
Braxton Hicks contractions
differentiating from the placenta, 117
fetal behavioural states, 277
breathing movements, fetal, 273, 276
C
caffeine, effect on fetal movements, 281
calculi, bladder, 52
calvarium, normal fetal anatomy at 18–22
weeks, 80–5, 81
transcerebellar view, 83, 84–5
transthalamic view, 80–2, 82
transventricular view, 82–4, 83
cardiac anomalies, fetal, 169, 169–82, 170
see also specific anomaly
cardiac apex, 89
cardiac dysrhythmias, 180–2
cardiac failure, 178
cardiomegaly, 221
cardiosplenic syndrome, 171–2
cardiovascular system, 3D/4D imaging, 268
cavum septum pellucidum (CSP), 80–1, 82
cavum vergae, 80–1
central nervous system, fetal anomalies, 160–6
see also specific anomaly
cephalic index (CI), 147
cerclage, cervical, 137, 137–9
cerebellum
agenesis, 84
hemispheres, embryo/fetus, 61, 83, 83, 84
normal fetal anatomy at 18–22 weeks, 84
cerebral anomalies, fetal, 160–6
see also specific anomaly
cerebral lesions, destructive, 165–6
cerebral ventricles, 60, 61, 83, 84
cerebroplacental ratio (CPR), 218
cervical pregnancy, 46, 73
cervical teratoma, fetal, 197
cervix
fibroids, 45–6
funnelling, 134–5, 135
incompetence, 137, 137–9
length
and cervical incompetence, 137
and preterm delivery, 134, 135–6, 136
measurement technique, 136, 136
normal ultrasound morphology, 286, 286
scanning orientation, 41, 41
scanning routine, 45–6
transvaginal ultrasound examination, 46,
133–9
cervical incompetence treatment, 137, 137–9
clinical judgement of preterm labour, 136–7
follow-up, 138–9
measurement technique, 136, 136
preterm birth prediction, 134–6
prophylactic cerclage, 138–9
childhood malignancies and ultrasound, 27
choledocal cysts, 190
chondroectodermal dysplasia, 196
chorioangiomas, 121, 124, 124–5
choriocarcinoma, 72–3
chorion frondosum, 114, 114, 115
chorionic cavity see gestational sac
chorionicity determination, 68, 69, 249,
250, 250–1
chorion laeve, 114, 115
chorion villus sampling (CVS), 229, 232–4
approach, 233,
multiple pregnancies, 233–4, 251–2
safety, 234
timing, 232
choroid plexus cyst, 84, 166, 204
choroid plexuses, 60, 61, 82–3
chromosomal anomalies, fetal, 159, 199–204,
200–1
effect on fetal movements, 278–282
individual risk assessment using midtrimester
ultrasound, 201–4
maternal age risk, 202–3, 203
maternal autonomy, 348
in oesophageal atresia, 187
in omphalocele, 185
ultrasound findings with chromosomal
aberrations, 199–201
circle of Willis, 217
circummarginate placentation, 122
circumvallate placentation, 122–3
cisterna magna (CM), 83, 84–5
absent, 161, 162
large, 161
mega, 164
normal, 161
clavicles
gestational age estimation/prediction, 149
normal fetal anatomy at 18–22 weeks,
104–5
cleft lip/palate, 85–6, 166–8, 167
cloacal exstrophy, 186–7
coarctation of the aortic arch, 173–4
coefficients of correlation, 143
colour Doppler, 52–3
adnexal masses, 330
aortic stenosis, 173
atrioventricular septal defects, 171
in gynaecology, 329
in vitro fertilization, 331
spatial-peak temporal-average intensity,
23, 23
tetralogy of Fallot, 178
uterine artery, 212
ventricular septum, 91, 91
competence, 347
complete atrioventricular block, 181–2
complete transposition, 176–7
confidentiality, 349
233
Index
373
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374
congenital amputation, 196
congenital anomalies
fetal, 157–60
causative factors, 158–9
Index
classification, 158
effect on fetal movements, 278–9
incidence, 158
morbidity, 159–60
mortality, 159
prevalence, 158
uterine, 299–303, 301, 302, 302
see also specific anomaly
conjoined twins, 68, 247, 256
conotruncal malformations, 176–9
presentation, 176
prevalence, 176
prognosis, 176
contractions
Braxton Hicks see Braxton Hicks
contractions
uterine see uterine contractions
cord see umbilical cord
cordocentesis see fetal blood sampling (FBS)
corpus callosum, 81–2, 82
agenesis of, 160, 164
corpus luteum, 53, 288, 289, 291, 291–2
cysts, 318, 319
corrected transposition, 176–7
corticosteroids, effect on fetal movements, 281
cotyledons, placental anatomy, 115
counselling, genetic, 230
coupling gel, 38–9
cranial vault absence see anencephaly
craniofacial anomalies, fetal, 166–9
see also specific anomaly
cross-sectional studies, fetal biometry, 142
crown–rump length (CRL)
comparing with amniotic cavity, 70
first trimester, 57, 58–61, 59–63, 63
gestational age estimation/prediction, 146
multiple pregnancies, 248
crux of the heart, 90
curvilinear regression analysis, 143
cystadenocarcinoma, 321
cystic adenomatoid malformation of the
lungs, 182
cystic dysplasia of the kidneys, 191
cystic fibrosis, 189
cystic lungs, 182–3
cysts
abdominal, 190
choledocal, 190
choroid plexus, 84, 166, 204
corpus luteum, 318, 319
dermoid, 323
follicle, 318
hepatic, 190
inclusion, 289, 290
kidneys, 191–2
mesenteric, 190
omental, 190
ovarian see ovarian cysts
placental, 118
theca-lutein, 125, 318
vestigial, 130
D
Dandy–Walker complex, 161, 164–5
Dandy–Walker malformation, 84, 85, 164, 165
Dandy–Walker variant, 164
dating see gestational age estimation/prediction
decidua basalis, 114, 114
decidua capsularis, 114, 114
decidua parietalis, 114
dermoid cysts, 323
destructive cerebral lesions, 165–6
diabetes, maternal, effect on fetal movements,
280
diamniotic (DA) twins, 68, 248
diaphragmatic hernia, 183–4
dichorionic (DC) twins, 68, 248
dominant autosomal mutations, 159
Donald, Ian, 3
Doppler effect, 2
Doppler indices, 210–12, 211
see also specific index
Doppler ultrasound
colour see colour Doppler
ductus venosus, 219–23
Ebstein’s anomaly, 179
endometrium, 310
fetal and uroplacental blood flow, 209–24
fetal growth restriction outcomes, 222
in gynaecology, 329–31
indications in pregnancy, 210
middle cerebral artery, 217–19, 219, 220
normal uterine and ovarian vascularization,
291, 291–2
pulsed see pulsed Doppler
spectral, 23, 23
truncus arteriosus, 179
in twin pregnancies, 223–4
umbilical artery, 214–17, 216
umbilical vein, 223
uterine artery, 209–10, 212–14, 213, 214
uterine sarcoma, 306
in vitro fertilization, 331
double bubble sign, 96, 188
double-outlet right ventricle (DORV), 177
drugs, effect on fetal movements, 281–2
ductus venosus, 219–23, 221, 222
duodenum
atresia, 187–8
normal fetal anatomy at 18–22 weeks, 96
dwarfism, short-limbed, 154
dynamic focusing, 14
E
ears, normal fetal anatomy at 18–22 weeks,
86–7
Ebstein’s anomaly, 179–80, 221
echocardiography
Ebstein’s anomaly, 179
fetal cardiac assessment, 169
tetralogy of Fallot, 178
truncus arteriosus, 179
echogenic bowel, 189
echogenic foci, heart, 180, 204
echogenic intracardiac focus/chorda
tendinae, 91
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ectopic heartbeats, 180
ectopic pregnancy
cervical, 46, 73
early pregnancy failure, 73–4, 74
identification, 73
prevalence, 73
scanning with full bladder, 35
tubal, 324–5
edge shadows, 17, 18
elevation plane, 14, 15
Ellis–Va Creveld syndrome, 196
embryo
early anomalies, 74–5
head width, 57, 60
measurements, 63–6, 63–7
placental localization, 114, 114–15
sensitivity to thermal effects, 25
sonoanatomic development, 58–61, 59–62
see also fetus
embryo-fetoscopy, 242
embryonic pole, 58
encephalocele, 161
diagnosis, 162
incidence, 161
prognosis, 162–3
endometrioma, 316, 317
endometriosis, 319, 320
endometrium
hyperplasia, 309–10
malignancy, 49, 309–10, 310
measuring the thickness of, 47, 47–8
menstrual cycle changes, 286–7, 287
ovulation, 48
polyps, 49, 308–9, 309, 310, 310
scanning routine, 47–9
thickness measurement, 286, 309
enhancement, 18, 18
epignathus, 197
epithelial ovarian tumours, 319–21
equipment, 37–9
see also specific item
ethics, 339–49
autonomy, 342, 343
beneficence, 340–2, 343
competence, 347
confidentiality, 349
disclosure of results, 348–9
fetus as a patient, 343–6
referral, 347
routine screening of pregnant women, 347–8
euryopia, 168
examination table, 36, 37
exomphalos, 185
extraembryonic structures, 67, 67–8
extremities
gestational age estimation/prediction, 148,
148–9
normal fetal anatomy at 18–22 weeks, 81,
102–4, 102–5
eye movements, fetal, 272, 276, 277
F
face, normal fetal anatomy at 18–22 weeks, 81,
85–7, 85–7
facial clefts, 85–6, 166–8, 167
fallopian tubes, 292, 292, 293
carcinoma, 325
ectopic pregnancy, 324–5
hydrosalpinx, 325, 325
infectious diseases, 326–7
non-infectious diseases, 324–5
visualization, 323–4, 324
febrile patients, obstetric scanning on, 31
feet
gestational age estimation/prediction, 150
normal fetal anatomy at 18–22 weeks,
103, 104
femur
gestational age estimation/prediction,
148, 148
normal fetal anatomy at 18–22 weeks, 102,
102, 103
short, 204
fertile women, normal ultrasound morphology
ovaries, 288, 289
uterus, 286–8
fetal akinesia deformation sequence (FADS),
196, 279
fetal anomalies, 157–206
abdominal wall, 185–90
cardiac, 169–82
central nervous system, 160–6
chromosomal defects see chromosomal
anomalies, fetal
congenital, 157–60
craniofacial, 166–9
effect on fetal movements, 278–9
gastrointestinal tract, 185–90
hydrops fetalis, 198–9
maternal autonomy, 348
multiple pregnancies, 253
renal, 190–4
selective fetocide for, 244
skeletal, 194–7
thoracic, 182–4
tumours, 197–8
ultrasound accuracy in detecting, 204–6, 205
urinary tract, 190–4
see also specific anomaly
fetal biometry, 141–54
aims of, 141
anomalies and syndromes, 154
biometric parameters, 146–50
abdominal size, 147, 147–8
crown–rump length, 146
data report, 150
gestational sac, 146
head measures, 146–7
limbs, 148, 148–9
other measurements and dating, 149,
149–50
biometric ratios, 151
coefficients of correlation, 143
confidence limits, 144
curvilinear regression analysis, 143
dating see gestational age
3D/4D imaging, 268–9
displaying data and curve fitting, 142–3
fetal growth evaluation see fetal growth
evaluation
Index
375
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376
fetal biometry—(Continued)
fetal weight estimation, 150–1
F test, 143
linear regression analysis, 143
longitudinal and cross-sectional studies, 142
Index
multiple pregnancies, 252
other parameters, 151
patient selection and study design, 142
prediction of date and size, 143–4
principles of, 141–4
reference values, 142
sample size, 142
fetal blood sampling (FBS), 229, 235–7
complications, 237
technique, 236, 236–7
fetal growth evaluation, 151–4
definition, 151–2
fetal growth restriction see fetal growth
restriction (FGR)
macrosomia see macrosomia
screening and diagnostic strategies, 153
unsolved problems, 152
fetal growth restriction (FGR), 152, 153
ductus venosus flow, 220–2
fetal movements in, 279, 279–80
middle cerebral artery Doppler, 217, 218
multiple pregnancies, 247, 252
outcome parameters according to Doppler
assessment, 222
prediction in twin pregnancies, 224
single umbilical artery (SUA) syndrome, 129
third trimester, 217, 218
umbilical artery Doppler, 215, 216
umbilical vein Doppler, 223
uterine artery flow, 212, 214
fetal heart rate (FHR), 57
abnormalities, middle cerebral artery velocity,
218
behavioural states, 276, 277
first trimester, 57, 59, 59, 61, 65–6, 66, 71
second trimester to term, 89
fetal hydrops see hydrops fetalis
fetal movements, 271–82
abnormal conditions affecting, 278,
278–82
altered brain or muscular development,
278–9
drugs, medication, stress and fetal
stimulation, 281–2
intrauterine growth retardation, 279,
279–80
maternal diabetes, 280
preterm contractions and/or rupture of
membranes, 280, 280
behavioural states, 276–8, 277
body movements in normal pregnancy,
274–5, 275
breathing in normal pregnancy, 273, 276
emergence of patterns, 272–4, 273, 274
methodology, 272
fetal shunts, 238–42
complications, 241
delivery and shunt removal, 241
indications, 239
instrumentation, 240, 240
outcome, 242
techniques, 239–41
fetocide, selective for fetal abnormality, 244
fetoscopy, diagnostic and operative, 242
fetus
acidaemia, 220
age see gestational age estimation/prediction
anaemia see anaemia, fetal
anatomical survey see second trimester,
normal fetal anatomy
behavioural states, 276–8, 277
blood flow evaluation, 209–24
blood transfusion see blood transfusion, fetal
brain, scanning orientation, 41, 42
breathing movements, 44
dating see gestational age estimation/
prediction
early anomalies, 74–5
ethics, 343–6
exam, 43–4, 115–16 see also (obstetric
scanning)
gender disclosure, 348
growth evaluation
growth restriction see fetal growth restriction
(FGR)
head width, 57, 60
karyotyping, 201–2, 229–30 see also
amniocentesis (AC); chorion villus
sampling (CVS)
lung fluid, 110
measurements, 63–6, 63–7
micturition, 277
moral status, 344–5
movements, 44
multiple pregnancies monitoring, 252
normal anatomy at 18–22 weeks see second
trimester, normal fetal anatomy
as a patient, 343–6
previability, 346
scanning see obstetric scanning
sensitivity to thermal effects, 25
sonoanatomic development, 58–61, 59–62
stimulation, effect on fetal movements, 281–2
tissue warming, 24, 25
tone, 44
tumours, 197–8
urinary production, 110
viability, 345–6
weight estimation, 150–1
fever, obstetric scanning on patients with, 31
fibroblast growth factor receptor type 3
(FGFR3) gene, 195
fibroid polyps, 305, 308
fibroids
cervical, 45–6
uterine see uterine fibroids
fibromas, ovarian, 321–2, 322
fibrothecomas, ovarian, 321–2
fibula
gestational age estimation/prediction, 148
normal fetal anatomy at 18–22 weeks, 103–4
first trimester, 57–77
bleeding, 69
description of the sonoanatomic
development, 58–62, 59–62
see fetal growth evaluation
✩✩✩✩✩✩✩✩✩✩✩ ✩
diagnostic ultrasound during, 29–30
evaluation of early pregnancy failure, 69–75
early anomalies, 74–5
early pregnancy loss, 69–71, 71, 71–3, 72
ectopic pregnancy, 73–4, 74
extraembryonic structures, 67, 67–8
fetal movements, 273–4, 274
measurement of the embryo/early fetus,
63–6, 63–7
multiple pregnancy, 68, 69
placental location, 116
scanning routine, 43–4
standardisation of transvaginal and
transabdominal imaging in gynaecology,
75–7, 76
ultrasound, multiple pregnancies, 248–52,
249, 250
umbilical vein Doppler imaging, 223
uterine artery Doppler, 214
flow velocities, 52
focal trophoblastic hyperplasia, 126
focusing, beam, 12–14, 13
follicles, 288, 289, 291–2
cysts, 318
follicle-stimulating hormone (FSH), 318
Fontan procedure, 173
forebrain cleavage see holoprosencephaly
four-dimensional (4D) ultrasound, 259–69
glass body mode rendering, 268, 269
inversion mode rendering, 267, 267–8
maximum mode rendering, 265, 266
minimum mode rendering, 266, 267
real-time, 260
single plane of choice, multiplanar orthogonal
planes or multiple tomographic parallel
slices, 261–4, 262–4
spatial and temporal image correlation, 260–1
surface mode rendering, 264–5, 265
volume acquisition, 260–1
volume calculation, 268–9
volume data display, 261–9
free pelvic fluid, 51
frequency levels, 2, 4, 5
frontal bone scalloping, 162
F test, 143
funipuncture see fetal blood sampling (FBS)
G
gallbladder, normal fetal anatomy at 18–22
weeks, 96, 97
gas body activation, 26
gas body effects of diagnostic ultrasound, 26
gas bubble contrast agents, 26
gastrointestinal tract anomalies, fetal, 185–90
gastroschisis, 185–6
genetic counselling, 230
genitalia, normal fetal anatomy at 18–22 weeks,
81, 101, 102
germ cell ovarian tumours, 323
gestational age estimation/prediction, 143–4,
144–6
accuracy, 145–6
biometric parameters, 146–50
conceptual age, 145
errors of measurements, 145
menstrual age, 145
multiple pregnancies, 248
gestational sac
definition, 122
detection, 122
early pregnancy evaluation, 63, 67, 67, 69, 70
gestational age estimation/prediction, 146
gestational trophoblastic disease (GTD), 71–3,
124, 125, 125–6
see also choriocarcinoma; hydatidiform
mole; placental tumours; gestational
trophoblastic
gloves, 38
Goldenhar syndrome, 168
Graafian follicles see follicles
Grannum placental classification, 119
gut herniation, embryo/fetus, 60, 61, 62, 66
gynaecological anatomy, 285–96
gynaecological pathology
ovaries, 313–23
tubes, 323–7
uterus, 299–310
see also specific pathology
gynaecological scanning
orientation, 39
routine, 45–9, 46–8
see also specific anatomical area
H
habituation, 281–2
haemangioma
fetal hepatic, 197
placental, 124, 124–5
umbilical cord, 130
haematoma
intrauterine, 70, 71, 121
placental, 127, 128
umbilical cord, 130–1
haematometra, 49
hamartoma, fetal
mesenchymal, 197
renal, 198
handedness and ultrasound, 27
hands, normal fetal anatomy at 18–22 weeks,
103, 104
head circumference (HC), embryo/fetus, 64,
80, 147
head width, embryo/fetus, 57, 60, 63, 64, 64,
65, 146–7
heart
defects, 169, 169–82, 170 (see also specific
defect)
echogenic foci, 180, 204
normal fetal anatomy at 18–22 weeks, 81,
88–94, 90–4
univentricular, 172–3
ventricles, normal fetal anatomy at 18–22
weeks, 90, 92
see also entries beginning cardiac
heart rate, fetal see fetal heart rate (FHR)
hepatoblastoma, fetal, 197
hernia, diaphragmatic, 183–4
heterotaxy, 95, 171–2
hiccups, fetal, 273–4
history taking, 38
Index
377
✩ ✩✩✩✩✩✩✩✩✩✩✩
378
holoprosencephaly, 160, 163–4
alobar, 163
lobar, 163–4
semilobar, 164
human chorionic gonadotropin (hCG), 318
Index
beta, 72
ectopic pregnancy, 73
maternal serum, 125–6
humerus
gestational age estimation/prediction, 148
normal fetal anatomy at 18–22 weeks,
102, 102
hydatidiform mole, 71–3, 72, 121
complete, 71, 72, 72, 125–6
invasive, 71, 72
partial, 71, 72, 125, 126
hydranencephaly, 165–6
hydrocephalus, 82
hydrometra, 49
hydronephrosis, 192–3, 204
hydrops fetalis, 198–9
and chorioangiomas, 124
ductus venosus blood flow, 222
pleural effusions, 183
hydrosalpinx, 325, 325
hydrosonography see saline infusion sonography
hydroureteronephrosis, 193
hyperechogenic bowel, 204
hyperechogenic lungs, 182–3
hyperreactio luteinalis, 125, 318
hypertelorism, 168
hypoplastic left heart syndrome, 174–5
hypotelorism, 168
hystero-contrast salpingosonography (HyCoSy),
285, 293–6, 295
procedure, 293–5
prophylactic antibiotics, 295
timing of examination, 293
uterus abnormalities, 300
hysteroscopy, uterine fibroids, 305
I
iliac bone, gestational age estimation/prediction,
150
imaging in medicine, 75–7, 76
inclusion cysts, 289, 290
infantile polycystic kidneys, 191–2
infarcts, placental, 121, 126–7
inferior vena cava, 92–3
infertility
intramural uterine fibroids, 306
submucosal uterine fibroids, 306
informed consent, 347–8
infrasound, 2
instrumentation see physics and
instrumentation; specific instrument
intensity, sound waves, 4
interocular diameter (IOD), 86
interruption of the aortic arch, 173–4
interstitial pregnancy, 73
interventricular septum, 90
intestinal obstruction, 188–9
intracranial tumours, fetal, 197
intrauterine fetal blood transfusion see blood
transfusion, fetal
intrauterine growth retardation (IUGR) see fetal
growth restriction (FGR)
intrauterine haematoma, 70, 71, 121
invasive procedures in obstetrics, 229–44
asepsis, 232
counselling, 230
multiple pregnancies, 251–2
procedures, 232–44
training, 230–2, 231
see also specific procedure
in vitro fertilization, 331
irregular uterine bleeding, 49
isomerism, 171–2
J
Jeune syndrome, 196
K
karyotyping, fetal, 201–2, 229–30
see also amniocentesis (AC); chorion villus
sampling (CVS); fetal blood sampling (FBS)
kidneys
cystic, 191–2
fetal anomalies, 190, 190–2
normal fetal anatomy at 18–22 weeks, 98–9,
99, 100
see also entries beginning renal
L
labia, normal fetal anatomy at 18–22 weeks,
101, 102
lambda sign, 68, 250, 250
large bowel, normal fetal anatomy at 18–22
weeks, 97
large for gestational age (LGA), 152
last menstrual period (LMP), gestational age
estimation/prediction, 145
lateral plane, 14, 15
lateral resolution, 16
latex allergy, 38
left isomerism, 171–2
legal claims see medico-legal implications of
ultrasound
leiomyomata see uterine fibroids
lemon sign, 162
limb deficiency, 196
limbs see extremities
linear regression analysis, 143
litigation see medico-legal implications of
ultrasound
liver
cysts, 190
normal fetal anatomy at 18–22 weeks, 96,
97, 97
tumours, fetal, 197
loculated pelvic fluid, 51
longitudinal sound waves, 3–4
longitudinal studies, fetal biometry, 142
lung fluid, fetal, 110
lungs
cystic, 182–3
hyperechogenic, 182–3
normal fetal anatomy at 18–22 weeks, 81, 94–5
luteinizing hormone (LH), 318