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lec. 1 U/S Dr. Lina Hammad Level 9
Obstetric sonography lec. 1 U/S Dr. Lina Hammad Level 9
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Obstetric sonogaphy is usually obtained twice during normal pregnancy
calculated from LMP weeks. (1st scan in 2nd trimester) 32 – 36 weeks. (2nd scan in 3rd trimester)
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Indication for 1st scan (18-22week)
Measurement of gastational age. Diagnose multiple pregnancy. Diagnose fetal abnormality. Locate placenta Recognize pelvic masses that will interfere with the pregnancy myomas.
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Indication for 2nd scan (32 - 36week)
Diagnose intrauterine growth retardation. Diagnose fetal abnormality. Confirm the presentation and position of the fetus. Locate the placenta more accurately. Assess the amount of amniotic fluid. Exclude complication.
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Indication for an early (pre 18 weeks) ultrasound
To confirm pregnancy and it’s location (intra / extrauterine) Estimation of gestational age. To identify multiple pregnancies. Exclude molar pregnancy. Exclude pseudo-pregnancy. To diagnose pelvic masses.
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1st trimester scaning Afetus between weeks of age for nuchal translucency measurement .
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Normal early pregnancy (18 weeks)
Gestational sac. The embryo. Yolk sac. Corpus luteum Multiple pregnancy. IUCD
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Gestational sac Ahypoechogenic sac surrounded by double echogenic ring. Seen at 5-6 weeks of pregnancy Estimation of gestational age from G.sac volume is done.
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The embryo Visible at 8 week.
(Echogenic area within the G.sac With cardiac motion). Movement of the embryo and fetal head is observed seen >9-10 week The skull is visible from 12 week.
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Yolk sac Occasionally seen 7-11 weeks.
Around cystic structure adjacent to the fetus. 4-5mmø Intrauterine pregnancy at 8 weeks' gestation, demonstrating embryo (E) and yolk sac (YS).
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Corpus luteum Can be seen until 12th week up to 4 cmø
can rupture causing hemorrhages
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Multiple pregnancy Can be seen at 8 weeks
Have to be confirmed after 14 weeks. (18 – 22 weeks) as not all G.sac contains viable embryo.
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IUCD Locate the IUD location, if inside the uterus:
IUD well away from G.sac. (no interferance) IUD string is seen in vagina. (IUD will be removed) Abortion might occur especially if IUD is near to implantation site.
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