2nd and 3rd trimester

in femur length do not measure

femoral head or distal femoral condyles

in abdominal circumference you should NOT SEE

kidneys or lungs

AC should show

round abdomen w flat ribs on each side

stomach and J view of umbilical/portal vein

placenta previa

leading edge of placenta within 2cm

BPD calipers

outer to inner

CSP sits _____ to thalamus

anterior

cerebellum and cisterna magna

cerebral peduncles behind thalamus

when measuring nuchal fold what do you have to have in image

CSP

nuchal fold where to measure

outer skull to outer skin

thickened nuchal fold

vertebrae numbers

7 cervical

12 thoracic

5 lumbar

5 sacral

stomach and heart on ____ side

left

in sagittal _______ should be imaged to ensure you are imaging the cervical spine

occipital bone

in transverse, the ______ should be visualized to ensure you are imaging cervical spine

fetal clavicles

thoracic spine, _____ or _____should be seen

heart or stomach

lumbar spine, ____ should be seen

kidneys

sacral spine, _____ is landmark

iliac crest

BPD is ____ to _____ caliper placement

outer to inner

in HC do not include ____ ____

skin line

BPD and HC do not include

cerebellum or orbits

what landmarks in HC and BPD

thalamus, cavum septum pellucidum (CSP), portion of falx

3V cord be sure to show

split around bladder and not just 2 vessesls

1.Coronal Suture

2.Parietal Bone

3.Posterior Fontanel

4.Squamous Suture

5.Mastoid Fontanel

6.Temporal Bone

7.Sphenoid fontanel

8.Sagittal Suture

9.Posterior Fontanel

10.Frontal Bone

cerebral aqueduct aka

aqueduct of sylvius

lateral ventricles should not exceed

1-1.1 cm

calipers of choroid plexus and lateral ventricles

inner to inner

measure _____ portion of lateral ventricle through the most _____ portion of choroid plexus

posterior, posterior

back of brain / posterior fossa includes

cerebellum, cisterna magna, vermis, 4th vent, cerebral peduncles, brainstem, and tentorium

cisterna magna should be less than

1cm

if you see the distal femoral epiphysis, the baby is at least

33 weeks

bimetry not typically done until

13-14 weeks

cannot reliably use femur length after ??? weeks

14 weeks

AC typically not done until ??? - ??? weeks

13-14

cervical length measurement typically done ??? - ??? weeks

16-24

AFI typically done around ??? weeks +

28

what separates the cerebrum from the cerebellum and brainstem

tentorium

cerebellum has a ___:___ ratio in mm to gestational age from ___-___ weeks

1:1 ratio

16-24 weeks

nuchal fold measurement routinely performed ___ - ___ weeks

15-19.6

nuchal fold measurement should be less than ___ mm

6 mm

nuchal fold calipers

outer skull to outer skin

what is important to include in spine images

skin line

echotexture of lungs

symmetrically homogeneous

increases as gestation progresses

pulmonary artery comes out of ???

right ventricle

pulmonary artery quickly passes _____ and ____ of ascending aorta

anterior and left

right pulmonary artery passes ____ to the aorta

posterior

normally what is closest to anterior abdominal wall

right ventricle

what is closest to spine

left atrium

blood flow through foramen ovale

right to left

where is moderator band located

right ventricle

tricuspid valve on ____ side

right

mitral valve on ____ side

left

what is foramen ovale

fetal shunt allowing connection between atrium

4 chamber heart should sit at a ___ degree angle and take up about ____ of the chest

45 degree

1/3

___ of the herat located in left chest with apex pointing ____

2/3

left

pulmonary veins drain into

left atrium

there are 4 but we usually see 2

tricuspid valve is slightly displaced _____ vs mitral valve

apically

best way to evaluate interventricular septum (IVS) and why

sub-costal bc angle is closer to 90 degrees

checklist for 4 chamber heart

situs

heart position

cardiac size

squeeze ok?

chamber ID and symmetry

septum appearance

AV valve offset

foramen ovale flap

area behind heart

rate and rhytm

what does pulmonary artery split into

right and left pulmonary artery and ductus arteriosus

right pulmonary artery goes _____ aorta

behind

MPA always ____ or ____ ____ than aorta

equal or slightly bigger

RVOT

LVOT

3 vessel view (3VV)

pulmonary artery and aorta junction

ductus arteriosus

Where pulmonary artery and aorta join (ductus arteriosus) in the 3VT view is sometimes also referred to as the

transverse arches

transverse arches

3vt (thymus)

pulmonary artery vs aorta color flow

same color and flow towards spine

3VV with trachea

in-flow tracts

SVC/IVC

normal HR in 2nd and 3rd trimesters

120-160 bpm

what can be observed with XDCR pressure

bradycardia

persistent bradycardia below ___-___ required timely evaluation

100-110

persistent tachycardia above ___ requires timely evaluation

180

mild tachycardia ___-____ can occur with fetal movement

160-180

what is it called when organs in the chest and abdomen may be in the wrong position

heterotaxy

heart and stomach on ____ side

left

inability to see fetal stomach raises the concern of

tracheoesophageal fistula or esophageal atresia

tracheoesophageal fistula and esophageal atresia are typically accompanied by ???

polyhydramnios due to inability to swallow correctly

GB typically seen as early as ___-___ weeks

16-20

bowel is ____ echogenic than the liver and ____ echogenic than bone

more, less

what is the material occasionally seen in the stomach

vernix (skin cells or blood if placental bleeding)

the material collecting in the fetal intestines is termed

meconium

kidney echogenicity

1st trimester nearly isoechoic but then decrease until they become hypoechoic in comparison to the liver

what makes up 90% of amniotic fluid by 20 weeks

fetal urine

MPV of less than __ cm or an AFI less than _ is typically categorized as oligohydramnios (too little fluid)

2 cm

5