ultrasonography of congenital fetal defects

Ultrasonography of

Congenital fetal

DefectsProf Aboubakr Elnashar

Benha university. Egypt

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1. Introduction

Incidence

2.5% of total births

1/3: NTD

1/3: congenital heart

1/3: other anomalies

20% of S.B

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Importance of diagnosis

1. Terminate pregnancy or not.

2. Fetal therapy

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2. Indications for targeted U/S

In the past

I. From history

1. Maternal age >35 years

2. Previous child with structural or

chromosomal. anomalies.

3. Family history

4. Exposure to irradiation or teratogen

5. IDDM

6. Repeated pregnancy loss

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II. From examination

1. Ab. MSAFP

2. Multiple pregnancy

3. Severe poly. or oligohydramnios.

4. Suspicious finding on routine U/S.

5. IUGR

6. Ab. Placenta (thick, cystic, hydropic)

7. Abnormal Doppler velocimetry of umbilical cord

Today:Routine mid-trimester fetal ultrasound scan(ISUOG, FMF, RCOG, SMFM)

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3. Role of Ultrasonography

1. Direct visualization of the defect

Anencephaly.

2. Visualization of the pathology due to the defect

Dilated stomach and duodenum

{duod. Atrsia}.

Increased nuchal folds & short femurs

{Down syndrome}

3. Ultrasonic markers of chromosomal abnormalities.

4. Guide to obtain fetal tissue

Amniocentesis

Fetoscopy

Chorionic villous biopsy

Cordocentesis.Aboubakr Elnashar

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CVB

amnicentesisAboubakr Elnashar

Cordocentesis

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7. Anomaly scan

Indication

All pregnant women

NICEAll pregnant women should be offered 2 scans in pregnancy :

- 1st : 11-13 w- 2nd : around 20 w

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Mid-trimester fetal ultrasound scan

Objective

1. Congenital malformations

2. Gestational age.

3. Fetal measurements for the timely detection of growth

abnormalities later in pregnancy.

4. Multiple pregnancies.

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When:

between 18 and 22 w.

Sonographer:

well-trained

US machine:

Real time, gray-scale

TA transducers (3–5-MHz range)

adjustable acoustic power output controls with output display

standards

freeze frame capabilities

electronic calipers

capacity to print/store images

regular maintenance and servicing

Chick listAboubakr Elnashar

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RCOG, 2000: anomaly scan

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3 vessel –

tracheal view

P A SV

C

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3 vessel Umb A

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First Trimester Ultrasound Scan

Objective

1. Towards the end of the first trimester, gross fetal

abnormalities.

2. aneuploidy screening

3. viability

4. gestational age accurately

5. number of fetuses

6. Assess chorionicity and amnionicity.

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When:

between 11 and 13+6 w.

Any time if there clinical concerns, pathological

symptoms or specific indications.

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You can get this lecture from:1.My scientific page on Face book:

Aboubakr Elnashar Lectures.

https://www.facebook.com/groups/2277

44884091351/

2.Slide share web site

[email protected]

4.My clinic: Elthwara St. Mansura

ultrasonography of congenital fetal defects

Health & Medicine