Ultrasonography of Congenital fetal Defects

1. Ultrasonography of
Congenital fetal
Defects
Prof Aboubakr Elnashar
Benha university. Egypt
Aboubakr Elnashar

2. 1. Introduction
Incidence
2.5% of total births
1/3: NTD
1/3: congenital heart
1/3: other anomalies
20% of S.B
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3. Importance of diagnosis
1. Terminate pregnancy or not.
2. Fetal therapy
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4. 2. Indications for targeted U/S
 In the past
I. From history
1. Maternal age >35 years
2. Previous child with structural or
chromosomal. anomalies.
3. Family history
4. Exposure to irradiation or teratogen
5. IDDM
6. Repeated pregnancy loss
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5. II. From examination
1. Ab. MSAFP
2. Multiple pregnancy
3. Severe poly. or oligohydramnios.
4. Suspicious finding on routine U/S.
5. IUGR
6. Ab. Placenta (thick, cystic, hydropic)
7. Abnormal Doppler velocimetry of umbilical cord
 Today:
Routine mid-trimester fetal ultrasound scan
(ISUOG, FMF, RCOG, SMFM)
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6. 3. Role of Ultrasonography
1. Direct visualization of the defect
Anencephaly.
2. Visualization of the pathology due to the defect
Dilated stomach and duodenum
{duod. Atrsia}.
Increased nuchal folds & short femurs
{Down syndrome}
3. Ultrasonic markers of chromosomal abnormalities.
4. Guide to obtain fetal tissue
Amniocentesis
Fetoscopy
Chorionic villous biopsy
Cordocentesis. Aboubakr Elnashar

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8. CVB
amnicentesis
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9. Cordocentesis
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10. 7. Anomaly scan
Indication
All pregnant women
NICE
All pregnant women should be offered 2 scans in
pregnancy :
- 1st : 11-13 w
- 2nd : around 20 w
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11. Mid-trimester fetal ultrasound scan
 Objective
1. Congenital malformations
2. Gestational age.
3. Fetal measurements for the timely detection of growth
abnormalities later in pregnancy.
4. Multiple pregnancies.
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12. When:
between 18 and 22 w.
Sonographer:
well-trained
US machine:
 Real time, gray-scale
 TA transducers (3–5-MHz range)
 adjustable acoustic power output controls with output display
standards
 freeze frame capabilities
 electronic calipers
 capacity to print/store images
 regular maintenance and servicing
Chick list Aboubakr Elnashar

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14. RCOG, 2000: anomaly scan
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43. 3 vessel –
tracheal view
P A SV
C
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57. 3 vessel Umb A
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67. First Trimester Ultrasound Scan
Objective
1. Towards the end of the first trimester, gross fetal
abnormalities.
2. aneuploidy screening
3. viability
4. gestational age accurately
5. number of fetuses
6. Assess chorionicity and amnionicity.
Aboubakr Elnashar

68. When:
 between 11 and 13+6 w.
 Any time if there clinical concerns, pathological
symptoms or specific indications.
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You can get this lecture from:
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Aboubakr Elnashar Lectures.
https://www.facebook.com/groups/2277
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2.Slide share web site
3.elnashar53@hotmail.com
4.My clinic: Elthwara St. Mansura