and Marcelo Zugaib4
(1)
São Paulo University, Bauru, Brazil
(2)
Parisian University, Bauru, France
(3)
Member of International Fetal Medicine and Surgery Society, Bauru, Brazil
(4)
Obstetrics, University of São Paulo, Bauru, Brazil
Morphological ultrasound includes a systematic and organized study of each fetal segment to make a detailed description of most of the fetal anatomy and attachments (amniotic fluid, cord, and placenta).
Fig. 1.1
Transverse view of the fetal head, showing the midline structures. The section also shows the normal brain in the cerebral hemispheres and vermis (VER) and hippocampus spins (HS). The arrow indicates the Sylvian fissure lateral to the cephalic pole. FC falx cerebri, TL thalami, M midbrain, PF posterior fossa
Fig. 1.2
Same section as in the previous figure: largest increase showing a normal central nervous system; the structures listed must be seen constantly and systematically. PF posterior fossa, CSP cavum septum pellucidum, TL thalami, CP cerebellar peduncle, FC falx cerebri, HS hippocampus region, FS Sylvian fissure or cerebral large groove, CER cerebellum
Fig. 1.3
Also in a cross-section of the cephalic pole, slightly oblique caudally, the thickness of the nuchal fold can be measured (arrow)
Fig. 1.4
In the same section as in the previous figure, we proceed to the visualization of the cerebellar hemispheres (CH) and the cerebellar vermis in its entirety (arrow)
Fig. 1.5
Cross-section, laterally oblique (lateral tilting), shows the posterior horn of the lateral ventricle (arrow). WM white matter, P choroid plexus
Fig. 1.6
Same section as in the preceding figure showing where to measure the posterior horn of the lateral ventricle (arrow and calipers). The atrioventricular width is measured where the choroid plexus ends (P) and corresponds to the transition of the body with the posterior horn of the lateral ventricle
Fig. 1.7
Median sagittal section of the fetal head showing the corpus callosum (CC) in the anterior portion, medially above the cavum septi pellucidi (CSP)
Fig. 1.8
Same section as in the previous figure, but with the fetal body showing in the cephalic pole the corpus callosum completely (arrows). Notice in particular the posterior-most portion of the corpus callosum. This should be observed because it is absent in partial agenesis of the corpus callosum
Fig. 1.9
Cross-section in the base of the brain showing the arterial circle (circle of Willis) and indicating the power doppler with the middle cerebral artery in the topographies of smaller wings of the sphenoid (arrows)
Fig. 1.10
Median sagittal section of the face showing the usual profile. Normal alignment is observed between the forehead and the chin (absence of retrognathism or undershot)
Fig. 1.11
Same view as in the previous figure used to measure nasal bones (calipers)
Fig. 1.12
Same section as in the previous figure at the dynamic time of fetal yawning
Fig. 1.13
Still in the sagittal face section, the tongue (arrow) is observed in the normal position inside the mouth. LL lower lip, UL upper lip
Fig. 1.14
Coronal section of the fetal face through the chin (M) and tip of the nose (N), showing an intact upper lip (arrows). Note that this cut, which is due to fetal bending, can pass transversely through the chest and fetal heart (C)
Fig. 1.15
Same section as in the preceding figure, with the fetal mouth open, facilitating the observation of the upper lip integrity (arrows). Also, the fetal nostrils are observed. N nose, M chin
Fig. 1.16
Cross-section complementing the analysis of facial clefts where the superior alveolar arch integrity is observed (–arrows dental arch)
Fig. 1.17
Coronal section of the face, which is more posterior than the lips, passing through the eyeball and showing the fetal lens
Fig. 1.18
Complementary element in the cephalic pole analysis is the paramedian sagittal section for tangenting lateral surface to observe the outer ear (arrow)
Fig. 1.19
Cross section of the fetal chest through the heart and showing four chambers with normal appearance. VE left ventricle, VD right ventricle, LA left atrium, RA right atrium
Fig. 1.20
Cross-sections of the fetal chest showing normal four chambers, an intact ventricular septum and foramen ovale (arrow)
Fig. 1.21
Cross-sections of the fetal chest showing four normal chambers, an intact ventricular septum and foramen ovale (arrow)
Fig. 1.22
Cross-section of the chest showing four cardiac chambers with a normal appearance. Right atrioventricular valve (arrow) implanted slightly lower than the left
Fig. 1.23
Same section as in the previous figure showing the foramen ovale with its valve (arrow) opened to the left atrium (LA)
Fig. 1.24
View of the four chambers, out of the foramen ovale’s plan, to show the foramen ovale (arrow). The integrity of the rest of the atrial septum is seen to the left and to the right of the arrow
Fig. 1.25
Slightly oblique sections of the chest showing the left and right ventricular outflow tract. VE left ventricle, AO aorta, VD right ventricle, PA pulmonary artery
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