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2002-02-11-15 Ultrasound examination in the second and third trimester © Novakov www.thefetus.net/


Ultrasound examination in the second & third trimester

Aleksandra Mikic Novakov, MD, PhD

Novi Sad, Yugoslavia

Normal fetal morphology

Transverse section of the skull at the biparietal diameter level

  • complete ossification of the skull

  • choroid plexuses fill the anterior and posterior horns of the lateral ventricles

  • anterior and posterior horns less than 10 mm (Va/Hem ratio less than 0.5)

Biometry of the skull and brain at the biparietal diameter level

  • measurement of biparietal diameter (BPD), occipitofrontal diameter (OFD), head circumference (HC),

  • anterior horn of the lateral ventricle (Va), posterior horn of the lateral ventricle (Vp) and hemisphere (Hem)

Transverse section of the skull at the level of the posterior fossa

  • cerebellum exists, normal shape
  • vermis seen in whole
  • cisterna magna bigger than 3.5 mm
  • nuchal fold less than 5 mm. 

Biometry of the skull and brain at the level of the posterior fossa

Measurement of : 
  • transcerebellar diameter (TCD)
  • cisterna magna (CM)
  • nuchal fold (NF)

Transverse section of the head at the level of the orbits

          
  • orbits of the same size

  • normal interorbital diameter

  • lenses visible  

  • measurement of IOD

Hard palate

 
  • continuity of the hard palate

Coronal section of the face

 

  • continuity of the upper and lower lip

  • normal shape of the nostril  

  • the tip of the nose and the chin seen at the same time

     

Fetal profile

 

  • nasal bone seen

  • normal size and shape of the chin, nose and forehead

     

Neck

 
  • continuity of the cervical spine and the skin that covers it  

Chest

  • lungs of normal echogenicity, homogenous

  • apex of the heart points to the front and left

  • right chamber closer to the thorax, seems shorter and coarser than the right one

  • both ventricles of the same size

  • both atria of the same size

  • continuity of the interventricular septum

  • continuity of the interatrial septum  

 

Heart - left ventricle outflow tract 

 
  • continuity of the interventricular septum and front wall of the aorta  

Heart - great vessels

 

  • longitudinal section of the pulmonary artery

  • transverse section of the aorta

     

Heart - longitudinal section of the aortic arch

 
  • aortic arch with the branches for head and neck (t. brachiocephalicus, a. carotis communis sin, a. subclavia sin)  

Longitudinal section of the fetus - chest and abdomen

 

  • diaphragm completely divides thorax from the abdomen

  • stomach in the abdomen only

  • thorax of the normal size compared to the abdom en

     

Abdomen - measurement of abdominal circumference

 
  • continuity of the ribs
  • stomach at the left, normal size and shape  
  • measurement of the abdominal circumference

           

Abdomen - umbilical cord insertion 

 
  • complete continuity of the abdominal wall
  • normal cord insertion   

Kidneys 

 

  • normal echogenicity of the parenchyma

  • anteroposterior diameter of the pelvis 5 mm and less  

     

Bladder

 
  • normal size and shape of the bladder  

Fetal sex- female / male

Arm and hands

  • both hands seen at the same time or enough away from each other to be sure that they both exist

  • all phalanx seen  

  • extension of all the fingers on both hands 

  • normal length and form of all the long bones

  • movements seen in all the joints

            

Leg and foot

  • both feet seen

  • five toes, normal position of the big toe

  • normal position of the foot, shin and thigh 

  • normal length and form of all the long bones

  • movements seen in all the joints

                         

Spine - longitudinal section

 
  • continuity of the spine and the skin above it  

Spine - transverse section

 

  • three ossification centres form closed circle

  • continuity of the skin above the spine  

     

Spine - coronal section

 
  • three parallel lines

Umbilical cord

 
  • three vessels in the umbilical cord - one vein and two arteries

Uterine cervix

 
  • measure the length of the cervix
  • check whether there is funneling


 

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