Ultrasound in Obstetrics and Gynecology Gynecology/Oncology Infertility

Ultrasound in Obstetrics Early gestation ultrasound First trimester screening Ultrasound guided procedures Cervical length Level II ultrasound Targeted scan Fetal echocardiography Growth scan Doppler sonography

Early gestation ultrasound Intra- or extra-uterine pregnancy Prognosis of pregnancy Number of fetuses Dating

First trimester screening with ultrasound Screening for Down syndrome: Nuchal translucency Nasal bone Combination with biochemical markers Screening for cardiac defects:

Level II sonogram Should it be performed routinely? When should it be performed? Which organs should level II sonogram include?

Indications for Fetal -Echocardiography Suspected cardiac anomalies on sonogram Non cardiac fetal anomalies detected Fetal arrhythmia Maternal/Paternal/Siblings with cardiac defects Exposure to teratogens: viral and drugs Diabetes SLE (anti Ro/La) Genetic and chromosomal diseases

Twin-to-Twin-Transfusion Doppler Sonography Indications: IUGR Pre-eclampsia Twin-to-Twin-Transfusion Isoimmunization

Middle cerebral artery Doppler Sonography Vessels to study: Umbilical artery Middle cerebral artery Inferior vena cava Ductus venosus Umbilical vein

Doppler Sonography Pathological findings: Umbilical artery – RDV, AEDV, high S/D MCA – Low S/D or PI, high PV IVC – Increased reversed flow DV – decreased forward and appearance of reverse flow Umbilical vein - pulsations