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overveiw OB imaging
LLU sonography
| Question | Answer |
|---|---|
| What is considered adequate training for ultrasound personnel? | hands on experience, registered, Recommended traing is Credentialed |
| Who should perform an ultrasound exam? | qualified and knowlegable physicians and/or sonographer. |
| What is included in guidelines for a general survey of first trimester ultrasound? | 1. uterus including the cervix, adnexa, and cul-de-sac for the presence of a gestational sac. 2. presence or absence of cardiac activity 3. fetal number 4. fetal/embryo anatomy appropriate for 1st trimester. 5. apperance of the nuchal region of fetus. |
| Is Ultrasound Safe? | there have been no apparent side effect of sonography with correct use. it should be prefomed when there is a valid medical reason at the lowest exposure to gain the nessisary info. |
| 12 indications 1st trimester: | 1.To confirm the presence of an intrauterine pregnancy.2.To evaluate a suspected ectopic pregnancy.3. To define the cause of vaginal bleeding. 4.To evaluate pelvic pain. 5.To estimate gestational (menstrual3) age.6.To diagnose or evaluate multiple gesta |
| 27 indications 2nd,3rd trimester: | 1.Estimation of gestational (menstrual) age. 2.Evaluation of fetal growth. 3.aginal bleeding. 4.Abdominal or pelvic pain. 5.Cervical insufficiency. 6.Determination of fetal presentation. 7.Suspected multiple gestation. 8.Adjunct to amniocent |
| What patient clinical history should be obtained prior to an OB exam | LMP or expected date of confinement) any previous sonographic examinations, latex allergies, currently taking any medications, or experienced any clinical problems with the pregnancy( bleeding, decreased fetal movement or pelvic pain |
| List 5 maternal risk factors for an abnormal fetus | Increased maternal age, abnormal triple screen biochemistry values, maternal disease(diabetes, lupus), exposure to chemicals, a pregnant uterine cavity that is too large or small for the due date, and a previous child born with abnormalities. |
| How are the mean sac diameter MSD measured | measure across the sac to the interface of the chorionic villi and chorionic fluid. Measuring from three dimentions (length, width, and depth) |
| how is the crown rump length measured | measurment from the top of head to the rump,The maxium length measurement of at least 3 good images averaged. |
| when is NT measured | is measured in the 11-14th week gestation |
| What information can NT measurment provide | This can provide information on trisomy 18, 21, or other chromosomal defects, congenital heart defects, and cystic hygroma |
| Describe the terminology Level I Level II ultrasound examinations | LEVEL 1- standard/routine exam LEVEL 2- high risk specialized/detailed exam |
| What is included in AIUM guidelines for survey of 2nd, 3rd trimester ultrasound? | fetal presentation, amniotic fluid volume, cardiac activity, placental position, fetal biometry(bpd,hc,ac,fl), and fetal number, # of vessels in cord,plus an anatomic survey. The maternal cervix and adnexa.surveys should be done 16-22 weeks(20-22 optimal) |
| Discuss how BPD and head circumference is measured | measured from 13-14 weeks.Fetal head should be imaged in a transverse axial section. Measured perpendicular to the fetal skull at the level of the thalamus and the cavum septi pellucidi. Measure from leading side to leading side of the skull. |
| What structures should be visualized on these views? | falx cerebri anteriorly and posetriorly, cavum septi pellucidi anteriorly in the midline, and the coroid plexus in the atrium of each lateral ventricle. |
| Discuss cephalic index (CI) formula, and its role in assessing dolichocephaly and brachycephaly | CI=BPD/OFD x 100.(normal is 75-85%) This formula is used to determine normality of the fetal head shape so there is no over or underestimation of gestational age. |
| Discuss and describe how to accurately measure the femur. Briefly what is involved in sonographic evaluation of the extremities? | Measured from the greater trochanter to the external condyles.Epiphyseal cartilages (curved ends)should'nt be included in the FL measurement nor should the distal femoral point be included.Shortened femur length could indicate trisomy or dwarfism |
Created by:
katw1967
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