Obstatric

Goals :
1.

Ultrasound in first trimester

Visualization of G.S.: A- seen :(age): -single or multiple (number of membranes and placentas) -alive: * normal . *abnormal (anomaly) -dead or blighted ovum B- Not seen: - decid.reaction - normal endometrial thickness. Localization of G.S : A- Intrauterine ( normal place or aborted). B- Ectopic .

2.

G.Sac:

5th week : G.S. seen 6th week: fetus seen 7th week: heart beats seen. 7-12th weeks calculated by C.R.L Multiple G.S diagnose multiple pregnancies.

Ultrasound in 2nd and 3rd trimesters

B.P.D (best at 18-20 w., not after 24-26 w. where FL or HC are better) - measure the ventricles to exclude hydrocephalus . and exclude other fetal anomalies. - sex also seen. - placenta ( 11th week): * placenta previa (0.5%) N.B. 1/3-1/2 of placentas in lower segment .then most of placentas migrate up.(sure diagnosis at 36th w)

* Large

for dates uterus

1. mistake in calculation ( usually). 2. multiparity.( early more than G.S. and later more than fetal bodies) 3.Vesicular mole and choriocarcinoma.( no D.D.) 4. ovarian or uterine tumours 5.polyhydramnios : - maternal D.M . - neural tube defect. - duodenal and esophageal atresia .

Small for dates uterus :

1. mistake in calculation. 2. intrauterine growth retard. 3. perinatal death. 4.oligohydramnios

Fetal anomalies

neural tube defects(the commonest) particularly spina bifida and unencephaly ( elevate alpha feto prot.) - hydrocephalus(16th w), and unencephaly(12th w). - spina bifida.+/- meningiocele - tumours (sacral teratoma) -congenital diaphragmatic hernia - some cong. Heart diseases - A-V canal defec , and fallot tertralogy.

HEAD

SPINE

CHEST

G.I.T - duodenal atresia, omphalocele and gastroschisis. - esophageal atresia indirectly diagnosed by polyhydramnios. URINARY TRACT ( usually with oligohydamnios) - hydronephrosis and multicystic kidney usually unilateral . - post.urethral valve. SKELETON - short limbs