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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 99
Fig. 4.83: Color flow mapping for assessing flow
through and distal to the atrioventricular valves
Fig. 4.84: Color flow mapping for assessing flow
through and distal to the semilunar valves
100 Step by Step Ultrasound in Obstetrics
Fig. 4.85: Doppler gate for sampling for arterial flow
velocities across the atrioventricular valves for peak
flow velocities and volume flow across these valves for
delineation of stenosis or regurgitation
Fig. 4.86: Cardiomegaly with the cardio-thoracic
ratio in this case as 80%
Second Trimester 101
Fig. 4.88: Four chamber view with a perimembranous
ventricular septal defect (arrow labelled)
Fig. 4.87: Four chamber view with a large ventricular septal
defect (solid line) and an atrial septal defect (dashed line)
102 Step by Step Ultrasound in Obstetrics
Fig. 4.89: Four chamber view with a large ventricular
septal defect (solid line) and an atrial septal defect
(dashed line)
Fig. 4.90: Cardiac rhabdomyoma (dashed line) with
a diffuse thickening of the myocardium (solid lines)
Second Trimester 103
Fig. 4.91: Diffuse thickening of the myocardium with
increased echogenecity in a case of cardiomyopathy
Fig. 4.92: Focal increase in echogenecity at the left
atrio-ventricular junction with no myocardial thickening
104 Step by Step Ultrasound in Obstetrics
Fig. 4.93: Pericardial effusion (solid line) seen
enveloping the fetal heart
Fig. 4.94: Pseudoascites (arrowheads) is the hypo-
echoic area seen only along the anterior and lateral
aspects on the periphery commonly seen in a
transverse section
Second Trimester 105
Fig. 4.95: Fluid filled structures, stomach (S) and
urinary bladder (UB) seen in the fetal abdomen
Fig. 4.96: Normal colonic echoes (hypoechoic) seen
at the periphery of the fetal abdomen (solid line)
106 Step by Step Ultrasound in Obstetrics
Fig. 4.97: Esophageal atresia as diagnosed by demon-
stration of polyhydramnios (right side) with an inability
to visualise the stomach bubble (left side)
Fig. 4.98: Double bubble sign seen as a distended
stomach (S) and an enlarged duodenal bulb (star)
Second Trimester 107
Fig. 4.99: Small bowel obstruction seen as multiple
interconnecting, overdistended bowel loops more than
07 mm in diameter. Take care that you do not confuse
the same picture with a multicystic dysplastic kidney or
a dilated tortuous ureter
Fig. 4.100: Echogenic bowel (solid lines) which can
be normally seen in a normal fetus at term with hyper-
echoic colonic meconium or hyperechoic bowel con-
tents in the fetus who has swallowed intra-amniotic
blood
108 Step by Step Ultrasound in Obstetrics
Fig. 4.101: Dilated large bowel segments (arrow) seen
near the periphery in a case of anorectal malformation
Fig. 4.102: Dilated large bowel segments (stars)
seen in a case of meconium plug syndrome
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