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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5841_Библиотеки_им_академика_М_И_Перельмана
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Second Trimester 79
Fig. 4.46: Fetal orbits seen in the coronal view
to assess for hypo/hypertelorism
Fig. 4.45: Amniotic bands (arrow) can be
associated with a cleft lip or palate
80 Step by Step Ultrasound in Obstetrics
Fig. 4.48: Single nostril (solid line) seen in the case of
hypotelorism with semilobar holoprosencephaly
Fig. 4.47: Hypotelorism seen in a case of semilobar
holoprosencephaly. The ocular diamtere in this case
was 12 mm, the interocular distance was 08 mm and
the binocular distance was 32 mm
Second Trimester 81
Fig. 4.49: Three ossification centres seen in the transverse plane.
Two of these are posterior (solid line) and one is anterior (arrow
head). Transverse planes to delineate any minimal widening of
the inter-pedicular distance
Fig. 4.50: The cutaneous, subcutaneous and muscular
components seen posterior to the vertebral column all along the
cervical, dorsal, lumbar and sacrococcygeal vertebrae. The
longitudinal plane of the fetal spine delineating the soft tissues
posterior to the vertebral column and any dysraphic
disorganisation of the spine
82 Step by Step Ultrasound in Obstetrics
Fig. 4.51: Sagittal plane to delineate the spinal cord in
the lower cervical, dorsal and lumbar spine and to
delineate any osseous deformity
Fig. 4.52: Defect in the osseous component of the
vertebral column and disruption of cutaneous and
subcutaneous elements. Osseous disorganisation of
the fetal spine
Second Trimester 83
Fig. 4.53: Gross dysraphic disorganisation of the
entire spine
Fig. 4.54: Bulging membrane covering the vertebral
lesion (within circle)
84 Step by Step Ultrasound in Obstetrics
Fig. 4.55: Meningocele with anechoic contents
(within circle)
Fig. 4.56: Lumbosacral meningomyelocele
(within circle)
Second Trimester 85
Fig. 4.57: Diastematomyelic spur (solid line) with a
spina bifida
Fig. 4.58: Gross dysraphic disorganisation of the
entire fetal spine with a tethered spinal cord
86 Step by Step Ultrasound in Obstetrics
Fig. 4.59: Splitting of the spinal cord with a lumbo-
sacral meningomyelocele
Fig. 4.60: Mass (star) seen inferior to the sacrococcy-
geal area (solid line). Sacrococcygeal mass with a solid
cum cystic echo pattern
Second Trimester 87
Fig. 4.61: Longitudinal section through the fetal
thorax on both sides to assess the fetal lungs
Fig. 4.62: Longitudinal section through the fetal thorax
to assess the spine posteriorly (for osseous deformities,
meningoceles or meningomyeloceles, anterior or
posterior) and anterior thoracic wall anteriorly (for any
thinning or ectopia cordis)
88 Step by Step Ultrasound in Obstetrics
Fig. 4.63: Diffusely homogeneous fetal lung (LU) seen
as diffuse low level echoes in comparison with the fetal
liver (L). Diaphragm seen as arrow heads
Fig. 4.64: Absent anterior thoracic wall with the fetal
heart (solid line) seen outside the fetal thorax
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