APPLY OF USG TO ASSESS

FETAL ANATOMY
TJOKORDA GDE AGUNG SUWARDEWA

FETOMATERNAL DIVISION DEP. OBSTETRIC & GYNECOLOGY.

ULTRASONOGRAPHY
Donald and co worker (1958), first Obstetrical application
By 1989, 45% pregnant uterus in US evaluated sonographycally Routine Antenatal Diagnostic Imaging with Ultrasound (RADIUS) : all pregnant women undergo ultrasound

SOUND WAVE
Animal & Chemistry Low bass notes Medical & destructive Medical Dx & NDE

20Hz
infrasound Acoustic

20KHz

2MHz
Ultrasound

200MHz

Wikipedia, 2007

 Human Ultrasonic USG unit

: 16-20.000 Hertz (Hz) : > 20.000 Hz : 1-10 MHz (1MHz=1000.000Hz)

V = f.

V f

: m/second : Hertz : meters

MEDIA
AIR FAT WATER ADIPOSUM KIDNEY MUSCLES BONE

SOUND SPEED (m/second) 331 1.450 1.495 1.540 1.561 1.585 4.080

Instrumentation

JARINGAN

PULSER
TRANSDUCER

STORAGE RECEIVER

MINITOR

FETAL ANATOMY
ULTRASOUND FINDING
Chorionic cavity Yolk sac Fetal pole Heart activity Limbs Telencephalon Movement Stomach Urinary bladder Genitalia

EARLIES VISUALIZATION (menstrual age)

Day 30 Day 32 Day 35 Day 37 Day 47 Day 50 Day 50 Week 10 Week 11 Week 12

DEFINITIVE VISUALIZATION (menstrual age)

Day 32 Day 34 Day 37 Day 40 Day 53 Day 54 Day 56 Week 11 Week 12 Week 14

Week 5 of menstrual age

TVS : embryo that implanted in the decidua on the 17th days after conception

Two days later : development of yolk sac & embryo after reorganization

Week 6 of menstrual age

Embryo implanted in the uterus on postmenstrual day 40.The pear-shaped fetal pole is visible on the yolk sac.

Embryo implanted in the uterus on postmenstrual day 40. M-mode trace indicates an embryonic heart rate of 105 bpm.

Week 7 of menstrual age

Embryo on postmenstrual day 43. The body is still broadly appose to the yolk sac & exhibits lordosis.

By postmenstrual day 47, the embryo has separated from the yolk sac.

The development of umbilical Cord. Left side view.

On postmenstrual day 48, the YS is in the extra amniotic-coelom & is linked to the embryo by the vitelline duct.

Course of the vitelline vein and umbilical vein

The embryo is closely envelop by the amniotic membrane on postmenstrual day 48.

Coronal scan through the embryo on postmenstrual day 48 demonstrates upper and lower limb.

Week 8 of menstrual age

M-mode scan of the biventricular embryonic heart of postmenstrual day 55. the cardiac diameter is 1.8 mm.

Midsagittal scan through the embryo On postmenstrual day 53 shows the Dominance of brain development

Embryo 9.6 mm long.

Coronal scan on postmenstrual day 53 show the telencephalon with symmetrical development of the cortical enlarge.

Coronal scan through the posterior superior fossa on postmenstrual day 55 demonstrates rombencephalone

The limb clearly identified on postmenstrual day 56

On postmenstrual day 56, the embryo is surrounded by the amniotic membrane. The vitteline duct & yolk sac have been displaced in to chorionic cavity

Week 9 of menstrual age

On postmenstrual day 60, the Upper limb of embryo is seen To consist of three segments

Transverse scan of abdomen on postmenstrual day 60. Shows an echogenic bulge in the umbilical area.

Embryo 24 mm long on post menstrual day 65. Have seen physiologic umbilical hernia.

Power Doppler

Telencephalon

Rhombencephalon

Axial skeleton of the embryo on postmenstrual day 60.

Postmenstrual day 61

Week 10 of menstrual age

Power Doppler, shows embryonic vascular system on postmenstrual day 66.

Postmenstrual day 66. The arms & legs have grown to long that they can reach cross to the contralateral

Four finger can be seen. Post Menstrual day 66.

Postmenstrual day 66. Sagittal scan show basic structure of the facial skeleton with the mandible and maxilla

By day 67 the telencephalon has Increased markedly in size and is Beginning to enclose diencephalon Both hemispheres are clearly separated by falx cerebri

The amniotic fluid enclose the Embryo on postmenstrual day 66.

Week 11 of menstrual age

Day 72 for measuring of Biparietal Diameter

Facial profile of embryo on Postmentrual day 73.

Postmenstrual day 72. Urinary bladder appear

Postmenstrual day 72. Yolk sac is regression, between amniotic & chorionic membrane

Week 12 of menstrual age

Postmenstrual day 82. The gastric bubble is v isible.

Postmenstrual day 81. Power Doppler shows aorta and renal arteries.

Postmenstrual day 82. Heart with Separated ventricular system is visible.

Postmenstrual day 81. Demonstrated both eyes.

Week 13 of menstrual age

Facial profile on postmenstrual day 91.

Umbilical cord insertion on postmenstrual day 91.

Thoraco-abdominal vessles on postmenstrual day 91.

3 D Ultrasonogram

4 D Ultrasonogram