Normal Fetal Structural Ultrasound

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).

A385010_1_En_1_Fig1_HTML.jpg


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


A385010_1_En_1_Fig2_HTML.jpg


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


A385010_1_En_1_Fig3_HTML.jpg


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)


A385010_1_En_1_Fig4_HTML.jpg


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)


A385010_1_En_1_Fig5_HTML.jpg


Fig. 1.5
Cross-section, laterally oblique (lateral tilting), shows the posterior horn of the lateral ventricle (arrow). WM white matter, P choroid plexus


A385010_1_En_1_Fig6_HTML.jpg


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


A385010_1_En_1_Fig7_HTML.jpg


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)


A385010_1_En_1_Fig8_HTML.jpg


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


A385010_1_En_1_Fig9_HTML.jpg


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)


A385010_1_En_1_Fig10_HTML.jpg


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)


A385010_1_En_1_Fig11_HTML.jpg


Fig. 1.11
Same view as in the previous figure used to measure nasal bones (calipers)


A385010_1_En_1_Fig12_HTML.jpg


Fig. 1.12
Same section as in the previous figure at the dynamic time of fetal yawning


A385010_1_En_1_Fig13_HTML.jpg


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


A385010_1_En_1_Fig14_HTML.jpg


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)


A385010_1_En_1_Fig15_HTML.jpg


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


A385010_1_En_1_Fig16_HTML.jpg


Fig. 1.16
Cross-section complementing the analysis of facial clefts where the superior alveolar arch integrity is observed (–arrows dental arch)


A385010_1_En_1_Fig17_HTML.jpg


Fig. 1.17
Coronal section of the face, which is more posterior than the lips, passing through the eyeball and showing the fetal lens


A385010_1_En_1_Fig18_HTML.gif


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)


A385010_1_En_1_Fig19_HTML.jpg


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


A385010_1_En_1_Fig20_HTML.jpg


Fig. 1.20
Cross-sections of the fetal chest showing normal four chambers, an intact ventricular septum and foramen ovale (arrow)


A385010_1_En_1_Fig21_HTML.jpg


Fig. 1.21
Cross-sections of the fetal chest showing four normal chambers, an intact ventricular septum and foramen ovale (arrow)


A385010_1_En_1_Fig22_HTML.jpg


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


A385010_1_En_1_Fig23_HTML.jpg


Fig. 1.23
Same section as in the previous figure showing the foramen ovale with its valve (arrow) opened to the left atrium (LA)


A385010_1_En_1_Fig24_HTML.jpg


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


A385010_1_En_1_Fig25_HTML.jpg


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

Only gold members can continue reading. Log In or Register to continue

Stay updated, free articles. Join our Telegram channel

Dec 28, 2017 | Posted by in GYNECOLOGY | Comments Off on Normal Fetal Structural Ultrasound

Full access? Get Clinical Tree

Get Clinical Tree app for offline access