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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 89
Fig. 4.65: Narrow fetal thorax (solid white line) in com-
parison with the fetal abdomen (dashed black line)
Fig. 4.66: Large pleural effusion (star) taking on the
shape of the chest wall, diaphragm and mediastinal
contour
90 Step by Step Ultrasound in Obstetrics
Fig. 4.67: Unilateral pleural effusion (star) taking the
shape of the chest wall and mediastinum
Fig. 4.68: Bilateral pleural effusion (stars) with the
lungs pushed posteriorly (L)
Second Trimester 91
Fig. 4.69: Bilateral pleural effusion (solid line) as a part
of generalised hydrops. Note the cutaneous hydrops
over the abdominal wall (arrowhead) and ascites
(arrowhead)
Fig. 4.70: Cystic adenomatoid malformation of the right
lung (solid line). Because of distal acoustic enhance-
ment from very small cysts the lesion appears as a
solid mass. Note the difference in echo pattern from
the left lung (arrow head)
92 Step by Step Ultrasound in Obstetrics
Fig. 4.71: Fetal stomach (S) seen in the retrocardiac
area with the diaphragm seen (arrowheads)
Fig. 4.72: Right sided diaphragmatic hernia. The mass
(solid line) is almost isoechoic with the lung. The venous
vascularity of this mass (arrowheads) is seen superior
and inferior to the diaphragm and drains into the inferior
vena cava inferiorly
Second Trimester 93
4.9 FETAL HEART (Figs 4.73 to 4.93)
1. Situs
2
. Size
3. Rate
4. Rhythm
5. Configuration
6. Connections
7. Fetal circulation
4.10 FETAL ABDOMEN (Figs 4.94 to 4.123)
1. Gastro-intestinal
a
. Stomach
b. Duodenum
c. Small Bowel
d. Large Bowel
e. Omentum
f. Mesentery
2. Hepatobiliary
a. Liver
b. Gallbladder
3. Genitourinary
a. Kidneys
b. Ureters
c. Urinary bladder
4. Pancreas
5. Spleen
94 Step by Step Ultrasound in Obstetrics
Fig. 4.74: Aorto-septal continuity (arrowheads) seen in
the long axis view. The left ventricle (LV), right ventricle
(RV) and left atrium (LA) are also labelled
Fig. 4.73: Moderator band (solid line) seen
in the right ventricle at the apex
Second Trimester 95
Fig. 4.75: Aorto-septal continuity (arrowheads)
seen in the long axis view
Fig. 4.76: Right ventricle (RV), pulmonary valve (arrow-
head) and pulmonary artery (solid line) seen as the
right ventricular outflow tract
96 Step by Step Ultrasound in Obstetrics
Fig. 4.77: Right ventricular outflow tract with the
pulmonary artery (solid line) from the right ventricle
going into the ductus arteriosus and descending aorta
(arrowhead)
Fig. 4.78: Left ventricular outflow tract with aorto-septal
continuity (left side) and right ventricular outflow tract
with the pulmonary artery (right side) shown
Second Trimester 97
Fig. 4.79: Aortic arch seen from the fetal heart and its
branches in the neck
Fig. 4.80: Right atrium (RA), right ventricle (RV) and
pulmonary artery (arrowhead) seen in the short axis
view encircling the aorta (solid line)
98 Step by Step Ultrasound in Obstetrics
Fig. 4.81: M-mode tracings to check for pericardial
effusion, chamber size and wall thickness
Fig. 4.82: M-mode tracings with the cursor through
the right ventricle, left ventricle and left atrium
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