Fetal Doppler and 3D/4D

fetal doppler

can differentiate between SGA/IUGR, identify fetal anemia and high risk for adverse outcomes with uterine artery doppler

factors affecting doppler waveforms

pt position, fetal/maternal breathing, fetal cardiac arrythmias, meds taken by mom

uterine artery doppler helps predict _____ and is sampled where it crosses over _____

hypertensive disorders, internal iliac

uterine artery flow during 1st trimester/non-gravid

high resistance

uterine artery during 2nd/3rd trimester

low resistance

the normal diastolic notch in ______ can be seen up to _____

uterine artery, 26 weeks

a notch in doppler seen after 26 weeks, could indicate _____ or ______

IUGR, placental insufficiency

a uterine artery ratio of greater than _____ could indicate _____ to uterus

2.6, decreased flow

umbilical vein sampling location

free-floating cord

umbilical vein flow should be constant, and non-pulsatile after

20 weeks

abnormal umbilical vein waveform could indicate

fetus with growth restriction, non-immune hydrops, fetal compromise

umbilical artery sampling location

fetal CI, placenta CI, mid uterine artery

umbilical artery is always a ______ vessel and _____ is an ominous sign

low resistance, flow reversal

umbilical artery normal s/d ratio

<3 after 30 weeks

abnormal umbilical artery waveform could indicate

early delivery, IUGR, death or other complications

MCA doppler can be used if ______ or ______ are suspected

fetal anemia, IUGR

MCA doppler sampling location

below BPD, ant to thalamus, at circle of willis, close to ICA

if MCA doppler waveform is _____, it could indicate increased flow to preserve brain, “______”

low resistance, brain sparing

ductus venosus can be evaluated

11-13w6d or 2nd/3rd trimester

ductus venosus is useful for suspected _____ or ______

down syndrome, cardiac defects

normal ductus venosus waveform

triphasic, with positive atrial contraction

absent ____ in ductus venosus waveform, indicates that baby should be ______

a-wave, delivered asap

multiple pregnancy mom is at risk for

hypertension, pre-term labor, placenta abruption, pre-eclampsia

multiple pregnancy fetus is at risk for

umbilical cord problems, congenital abnormalities, IUGR, twin-to-twin transfusion

fetal sac A location

above internal OS

ideal time to identify amnionicity/chorionicity

10-14 weeks

day 4

chorion forms

day 9

amnion forms

chorion=

placenta=

amniotic sac=

yolk sac=

dizygotic twins types

di-di

di-di twins are ____ fertilized by _____

two ova, two sperm

dizygotic di-di twins

most common type of twinning with the least amount of complications

on US, di-di twins can only be identified if

2 different genders

lambda sign AKA

delta, twin sign AKA

monozygotic twin types

di-di, mo-di, mo-mo

monozygotic di-di twins days

one zygote decides during days 0-4

mo-di twins days

one zygote divides during days 4-8

mo-di sign

T-sign

mo-di twins

most common monozygotic twinning

mo-di twins major complication

twin-to-twin transfusion

mo-mo twins days

one zygote divides during days 8-12

mo-mo twins complications

twin-to-twin transfusion, umbilical cord problems

conjoined twins

occurs if zygote divides after 13 days

most common site for conjoined twins

thorax/thoracopagus

head

craniopagus

thorax

thoracopagus

abdomen

oomphalopagus

pelvis

pyopagus

fetus papyraceous

twin dies later in pregnancy and is markedly flattened from loss of fluid and most soft tissue

twin-to-twin transfusion AKA

poly-oli syndrome/stuck twin syndrome AKA

stuck twin syndrome occurs in _______ pregnancies

only monochorionic

poly-oli syndrome treatments

serial amniocentesis, selective feticide, laser of placental vessels

donor twin in t-t-t

IUGR and oli

recipient twin in t-t-t

poly and normal/LGA

recipient twin in t-t-t can get _____ 25% of the time, increasing the risk of _____

hydrops, heart failure

acardiac anomaly

rare anomaly occurring in mo-mo twins

in acardiac anomaly one twin develops without

heart and often upper half of body

in acardiac anomaly, pump twin is usually normal except for ______ and _____

cardiomegaly, hydrops

arcuate uterus

concave indentation with obtuse angle

subseptate

central point of septum at acute angle