Fetal Anomaly Scan

8/17/2019 Fetal Anomaly Scan

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FETAL ANOMALYSCAN

[PART 2]DR. ARIF KHAN S


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TYPES OF ANOMALIES

◦Physical strctral !"#"cts$◦Single structure is afected.◦Multiple structures are afected.

◦N%&'strctral !"#"cts◦ I&h"rit"! ("ta)%lic !"#"cts◦F&cti%&al a&! )"ha*i%ral !"+cits ".,. c%&,"&ital ("&tal r"ta


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I&tr%!cti%&

◦-astr%i&t"sti&al tract

◦ri&ary tract

◦Mscl%'s/"l"tal !ys0lasias


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-IT


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◦ ltras%&! a00"ara&c" *ari"s si,&i+ca&tly!ri&, 0r",&a&cy a&! als% #%r s%(" sit"si& th" c%rs" %# th" sa(" ltras%&!"3a(i&ati%& !" t% th" 0hysi%l%,y %#s4all%4i&,st%(ach "(0tyi&, a&!i&t"sti&al 0"ristalsis.

◦ th" %ri,i& %# a cystic %r s%li! (ass !"t"ct"!

i& th" a)!%(i&al ca*ity ca& als% )" !i5cltt% i!"&ti#y 4ith c"rtai&ty


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A)!%(i&al *i"4s◦ 6il"( 7"7&( c%l%& li*"r s0l""& a&!

a)!%(i&al 4all8.

◦ a3ial *i"4 %# th" 00"r a)!%("&$ st%(ach a&!ri,ht h"0atic l%)"

◦ a3ial *i"4 %# th" l%4"r a)!%("&$ s(all )%4"l


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◦ 9 (i!'sa,ittal *i"4 %# th" a)!%("&$c%r! i&s"rti%& a&! r"ctal 0%ch i&th" 0"l*is

◦ 6a8 Mi!sa,ittal *i"4 %# th"a)!%("&$ th" c%r! i&s"rti%&

hi,hli,ht"! )y 0%4"r D%00l"r a&!0art %# th" s(all )%4"l6arr%4h"a!8ar" *isi)l".

◦ 6)8 :ith s(all (%*"("&ts %# th"tra&s!c"r it is0%ssi)l" t%

*isali;" i& th" 0"l*is th" )la!!"ra&! )"hi&! it th" r"ctal0%ch6arr%48.

◦Ri,ht 0arasa,ittal *i"4 %# th"a)!%("&$ th" ri,hth"0atic l%)" 6Li8 7st )"l%4 th" hy0%"ch%ic lay"r %#

th" !ia0hra,(6arr%4h"a!s8 a&!s%(" il"al l%%0s ar" *isi)l". RLri,ht l&,.


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◦ "s%0ha,"al atr"sia$ &%&'*isali;ati%& %#th" ,astric )))l"

◦ 9 !%!"&al atr"sia


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Es%0ha,s

◦ ltras%&! a00"ara&c" %# th" "s%0ha,s

◦ as a 0%ch #ll %# a(&i%tic

◦ Fli! "s0"cially i# th" #"ts has 7st s4all%4"!

◦Ca& )" r"c%,&i;"! as a thi& 0r"*"rt")rala&"ch%ic strctr" 4h"& +ll"! 4ith s%("a(&i%tic >i!.6(ay r"s"()l" a *"ss"l8

◦Als% %& th" ?'cha()"r *i"4 th" cr%ss's"cti%&al a00"ara&c" %# th" "s%0ha,s!ist"&!"! )y s%(" a(&i%tic >i! (ay )"(ista/"& #%r that %# a& a)&%r(al *"ss"l as i&a)&%r(al 0l(%&ary %r syst"(ic 6a;y,%sc%&ti&ati%&8 *"&%s r"tr&.

◦4h"& "(0ty a00"ars as @t4% %r (%r" 0arall"l"ch%,"&ic li&"s.


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ESOPHA-EAL ATRESIA

◦ I&ci!"&c". Fr"B"&t$


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◦ Es%0ha,"al atr"sia ca& %ccr as a& is%lat"! a&%(aly 6 %# cas"s8 %r (#r"B"&tly )" ass%ciat"! 4ith a trach"%"s%0ha,"al 6TE8 +stla 6 %# c

◦Etiology and pathogenesis. Th" "ti%l%,y %# th" !"#"ct is &/&%4&. It %4h"& at G 4""/s %# ,"stati%& th" 0ri(iti*" #%r",t !%"s &%t !i*i!" i&t%*"&traltrach"%)r%&chial 0art a&! th" !%rsal !i,"sti*" 0art

◦

Ty0" A$ C%rr"s0%&!s t% 0r" "s%0ha,"al atr"sia 4ith%t +stla.◦ Ty0" J$ is "s%0ha,"al atr"sia 4ith +stla )"t4""& th" 0r%3i(al 0%ch a&

trach"a.

◦ Ty0" C$ is "s%0ha,"al atr"sia a&! +stla #r%( th" trach"a %r th" (ai& )r%th" !istal "s%0ha,"al s",("&t. 6(%st c%((%&8

◦ Ty0" D$ is "s%0ha,"al atr"sia 4ith )%th 0r%3i(al a&! !istal +stlas

◦

Ty0" E$ is trach"%"s%0ha,"al +stla 4ith%t atr"sia.


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◦Ultrasound diagnosis

◦ Th" %*"rall !"t"cti%& rat" c%&si!"ri&, all 0%ssi)l" si,&s %# "s%0ha,"al atr"sia ra&," %# 2??2

◦M%r" tha& G1 %# cas"s %# "s%0ha,"al atr"sia ar" &%t !"t"ct"! i& t"r% !" t% tc%&crr"&t TE +stla$ this +stla !%"s &%t 0r"*"&t &%r(al st%(ach +lli&, i& (%s

%&ly i& a r"!c"! &()"r %# cas"s is a c%&sta&tly &!"r+ll"! st%(ach #%&!.◦ P%ch si,&$ !ilatati%& %# 0r%3i(al "s%0ha,"al tract.

◦ This si,& is %)s"r*"! tra&si"&tly als% i& th" &%r(al #"ts a#t"r s4all%4i&, i& #"tst%(ach a&! 0%lyhy!ra(&i%s th" !"t"cti%& %# a 0"rsist"&t 0%ch si,& 4%l! i&0r"s"&c" %# a TE +stla.

◦non-visualization of the gastric bubble is the only sign if present is highesophageal atresia (but only in the 8–10% of cases that are not associated wi

◦ Th" %th"r si,& 0%ssi)ly i&!icati*" %# "s%0h"a,al atr"sia is 0%lyhy!ra(&i%s 4hiccl"arly "*i!"&t %&ly i& th" lat" 2&! tri("st"r

◦ FGR : 0% of cases of TE stula

◦!own"s syndro#e $0 ercent assosciation with Tye &


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◦Dierential diagnosis'Oli,%hy!ra(&i%s $ PROM a&! J


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D!"&al atr"sia

◦ I&ci!"&c". Fr"B"&t


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◦Etiology and pathogenesis. Th" "ti%l%,y %# th" !"#"ct

◦ is &/&%4&. Th" 0ath%,"&"tic ("cha&is( i&*%l*"s

◦ a& i&t"rr0ti%& %# )l%%! s00ly !ri&, %r,a&%,"&"tic

◦ 0"ri%! as #%r (%st -I tract atr"sias. Acc%r!i&, t%

◦ a&%th"r th"%ry th" !"#"ct (ay )" !" t% a lac/ %# !%!"&al

◦ r"ca&ali;ati%& al4ays !ri&, "arly "()ry%,"&"sis


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ltras%&! !ia,&%sis◦ . This is )as"! 0%& r"c%,&iti%& %#

◦

th" classic !%)l" )))l" ass%ciat"! 4ith0%lyhy!ra(&i%s

◦4hich %#t"& !"*"l%0s i& th" lat" 2&! "arlyr! tri("st"r. sally 0%lyhy!ra(&i%s isa)s"&t a&! th" !%)l" )))l"

◦ Th" %&ly +&!i&, c%&sists %# a& "*i!"&tly!ilat"! st%(ach 4ith i&itial !ilatati%& %&ly %#

th" !%!"&(◦ I& (%st cas"s %& #%ll%4 0 th" !%)l" )))l"

si,& )"c%("s cl"arly *isis)l".

◦Car" sh%l! )" ta/"& i& !"(%&strati&, ac%((&icati%& )"t4""& th" t4% a&"ch%ic)))l"s t% %)tai& c%&+r(ati%& that th"s"c%&! )))l" is actally th" !ilat"!

0r%3i(al !%!"&(


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◦ I& #"4 cas"s 4h"r" th" !i)l" )))l" si,& 4ill )" s"")%&ly i& lat" ,"stati%& %r (ay "*"& &%t %ccr a&!!ia,&%s"! 0%st &atally.

◦E3tr"("/y rar" cas"s :h"& Da%!"&al atr"sia isas%sciat"r! 4ith esophagela atresisa th" %*"r!ist"&ti%& %# st%(ach a&! 0r%3i(al !%!"&( is(assi*".

◦)iferential diagnosis. This sh%l! i&cl!" all %th"rc%&!iti%&s #"atri&, a cystic strctr" i& th" (i!!l" %rri,ht 00"r a)!%("& $ ch%l"!%chal cysts "&t"ric!0licati%& cysts a&! h"0atic cysts.

◦*rognostic indicators. Th" ass%ciati%& 4ith %th"ra&%(ali"s 4hich is r"lati*"ly #r"B"&t r"0r"s"&ts th"(ai& 0%%r 0r%,&%stic si,&.

◦Association with other malormations. Ma7%ra&%(ali"s ar" ass%ciat"! 4ith !%!"&al atr"sia i& ?1 %# cas"s

M%stly -I (al#%r(ati%&s *"rt")ral a&! car!iac. 0t%


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◦Risk o chromosomal anomalies. This is hi,h. O*"rall ? 6ra&," 2cas"s %# !%!"&al atr"sia ar" ass%ciat"! 4ith D%4& sy&!r%(". C%&*"rs"%# &"%&at"s 4ith tris%(y 2 ha*" !%!"&al atr"sia.

◦Risk o non+chromosomal syndromes. This is l%4.


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SMA+-/E ATRES0A◦ 0ncidence. Fr"B"&t$


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◦ ty0" I 6 %# cas"s8 i& 4hich th" atr"sia i&*%l*"s (lti0l" sit"s

As #ar as th" a&at%(ic sit" %# th" atr"sia is c%&c"r&"!

◦ th" 7"7&( %&ly is i&*%l*"! i& 1

◦ th" il"s %&ly i& ? %# cas"s

◦ )%th i&t"sti&al tracts i& th" r"(ai&i&, %# cas"s.

Il"al atr"sias ar" (%r" %#t"& si&,l" a&! sh%4 hi,h"r t"&!"&cy t% 0"r#%rati%&

◦ 7"7&al atr"sias ar" (%r" %#t"& (lti0l" t"&! t% !ilat" rath"r tha& t% 0"r#%sh%4 a si,&i+ca&tly l%4"r &"%&atal ("a& 4"i,ht a&! l"ss a!*a&c"! ,"staat !"li*"ry i& c%(0aris%& 4ith il"al atr"sias.


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◦

"7&al atr"sia 6 4""/s %#,"stati%&8. N%t" th" "3tr"("lys"*"r" !ilatati%& 4ith%t "*i!"&c"%# 0"r#%rati%& 6a)s"&c" %#("c%&i( 0"rit%&itis8. Th"arr%4h"a!s i&!icat" th" sit" %# th"0"ristaltic 4a*" %0"&i&, a&!cl%si&, th" c%((&icati%&

)"t4""& a!7ac"&t l%%0s


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◦Etiology and pathogenesis.

◦ . I&*"sti,ati%&s i& a&i(al (%!"ls a&! i& h(a&s ha*" !"(%&strat"! thatatr"sia is !" t% a *asclar i&slt c%&sisti&, %# a& atr"sia %r t%rsi%& %# th"art"ry !ri&, th" r%tati%& %# th" (i!,t.

◦ Th" a00l"'0""l *aria&t has )""& hy0%th"si;"! t% )" th" "="ct %# *ascla%# a s0"ri%r ("s"&t"ric art"ry )ra&ch.

◦Ultrasound diagnosis 1


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Ultrasound diagnosis 1

◦(ai&ly %& th" !"t"cti%& %# th" s"*"r" !ilatati%& %# th" Qi&t"sti&al l%%0s 0r%3i(al tth" %)strcti%& 4hich is a)s"&t i& (%st cas"s 0ri%r t% 21 4""/s %# ,"stati%&.

◦ 0%lyhy!ra(&i%s is als% %# lat" %&s"t.

◦ H"&c" th" +rst s%&%,ra0hic "*i!"&c" %# a 0%ssi)l" s(all')%4"l atr"sia Is th"is%lat"! !ilatati%& %# a& il"al l%%0 sh%4i&, a tra&s*"rs" !ia("t"r %# ,r"at"r tha&((.

◦A!!iti%&al si,&s that c%&tri)t" t% c%&+r(i&, th" !ia,&%sis ar" a C"&tr% a)!%(i&l%cati%& %# th" a="ct"! l%%0 its hy0"r "ch%ic 4alls.

◦ i&cr"as"! 0"ristalsis a&! th" 0r"s"&c" %# "&!%a)!%(i&al calci+cati%&s 0%ssi)lyi&!icati*" %# a ("c%&i( il"s.

◦J"tt"r !"(%&strat"! i& r! tri("st"r 4ith (assi*"ly !ilat"! )%4"l l%%0s a&!

i&cr"as"! 0"ristalitic (%*"("&ts

it i t i)l t i! ti# th l it # th ) t ti 6il l 7 7 l8


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◦ it is &%t 0%ssi)l" t% i!"&ti#y th" r"al sit" %# th" %)strcti%& 6il"al %r 7"7&al8.

◦ Th" %&ly #"atr"s that (ay 0%i&t t%4ar!s %&" %# th" t4% sit"s ar" th" "*i!"&c" %# 0"r#%rati%& 6ascit"s 4ith 0articlat" (att"r a&!


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MECONIM ILES◦ 0ncidence. N% !ata a*aila)l".

◦)iagnosis. M"cha&ical il"al %)strcti%& !" t% th" i&cr"as"! c%&sist"&cy %# (

si,&i+ca&t ris/ %#

◦0"r#%rati%& a&! c%&s"B"&t ("c%&i( 0"rit%&itis.

◦Risk o chromosomal anomalies. R"lati*"ly l%4.

◦Risk o non+chromosomal syndromes. I# cystic +)r%sis is c%&si!"r"! h"r" t"3tr"("ly hi,h 68.

◦utcome. D"0"&!s %& th" &!"rlyi&, cystic +)r%sis a&! its 0h"&%ty0ic "30r"s

◦)e5nition. M"c%&i( il"s is charact"ri;"! )y a& il"al ("cha&ical %)strcti%&i&s0issat"! ("c%&i(. Th" ("c%&i( is thic/"r tha& &%r(al !" t% a hi,h 0r%0ri(ary cas" %# 4hich is cystic +)r%sis ass%ciat"! 4ith (%st cas"s %# ("c%&

◦ This %)strcti%& l"a!s r"lati*"ly %#t"& t% il"al 0"r#%rati%& a&! c%&s"B"&tly ("0"rit%&itis.

◦ I& s%("cas"s th" %)strcti%& %ccrs (%r" !istally i& th" c%l%& 4h"r" th" ("(cs 0l, that %)strct th" r"ct(.

◦Eti%l%,y a&! 0ath%,"&"sis Cystic +)r%sis is ass%ciat"! i& (%r" tha& %# cas


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◦Eti%l%,y a&! 0ath%,"&"sis. Cystic +)r%sis is ass%ciat"! i& (%r" tha& %# cas

◦ #"4 cas"s &%t ass%ciat"! 4ith this ,"&"tic c%&!iti%& th" "ti%l%,y %# th" i&t"sti&ar"(ai&s &cl"ar.

◦ Th" 0ath%,"&"tic ("cha&is( l"a!i&, t% th" %)strcti%& is r"0r"s"&t"! )y th" scha&,"s i& th" c%(0%&"&ts %# ("c%&i(

i&cr"as" i& 0%r%ti"& c%&t"&t

i&cr"as"! *isc%city

i&s0issati%&

%)strcti%&'

0r%3i(al l%%0s a&! 0"r#%rati%&.

◦4ith th" thic/ ("c%&i( s0illi&, i&t% th" a)!%(i&al ca*ity 4ith a c%&s"B"&t s0"rit%&itis.

Ultrasound diagnosis.1

◦ This is )as"! 0%& r"c%,&iti%& %# a& il"al %)strcti%& 4ith %&" %r (lti0l" !ilat"charact"ristically sh%4 hy0"r"ch%ic c%&t"&t a&! si(ilarly hy0"r"ch%ic 4alls.

◦ I& ("c%&i( il"s th" %)strcti%& is sally %# lat" %&s"t )"c%(i&, "*i!"&t i& tri("st"r a#t"r 2?21 4""/s %# ,"stati%&

◦ Th" ltras%&! a00"ara&c" is 0l"%(%r0hic. Th" !ilat"! il"al l%%0s (ay sh%4 hy%r i& %th"r cas"s ("c%&i(i! l"*"ls th" 4alls (ay a00"ar &%r(al %r thic/"hy0"r"ch%ic.

◦Or sh%4 #"atr"s %# ("c%&i( 0"rit%&itis.

◦ I# th" %)strcti%& i&*%l*"s th" il"s th"


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" %)s c % % "s " "s "c%l%& is ty0ically "(0ty si&c" ("c%&i(

tra&sit is )l%c/"!.

◦ Firstr si,& is hyperechoic Ileus. "arly(i! 2&! tri("st"r

◦Di="r"&tial !ia,&%sis$

Small 6owell atresias


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ANORECTAL ANOMALIES◦ 0ncidence. E3tr"("ly rar".

◦)iagnosis. Lat"'%&s"t !ilatati%& %# si,(%i! c%l%& a&! r"ct( %#t"& 4ith hy0"r("c%&i(. N%r(al a(&i%tic >i!.

◦Risk o chromosomal anomalies. Hi,h$ tris%(i"s G a&! 2.

◦Risk o non+chromosomal syndromes. Hi,h$ 0r"!%(i&a&tly ass%ciat"! 4ith "30r"ssi%&s %# th" ca!al r",r"ssi%& s"B"&c".

◦utcome. -%%! i# is%lat"!. I# sy&!r%(ic !"0"&!s %& th" ass%ciat"! (al#%r(atca!al r",r"ssi%&8.


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◦O# th" a)%*"'("&ti%&"! (al#%r(ati%&s %&ly a&%r"ctal atr"sia is !"t"cta)l" )y


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y y

◦ i& a (i&%rity %# cas"s i& th" r! tri("st"rr %# 0r",&a&cy. Th" (ai& ltras%&! +i&!icati*"%# sch a (al#%r(ati%& is %*"r!ist"&si%& %# th" r"ct( a&! t% a l"ss"si,(%i! c%l%&

◦R"lati*"ly %#t"& th" ("c%i( i& th" !ilat"! r"ctal 0%ch )"c%("s hy0"r"ch%ic

◦ Th" a(%&t %# a(&i%tic >i! is &cha&,"!.

◦ I# th" a&%r"ctal atr"sia is ass%ciat"! 4ith a r"ct%*"sical +stla the amniotic

◦ I# 0%lyhy!ra(&i%s is &%t"! i& ass%ciati%& 4ith a&%r"ctal atr"sia this is !" t% ta&%(ali"s.


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HEPATOME-ALY


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Eti%l%,y a&! 0ath%,"&"sis

:i!" s0"ctr( %# cas"s.

◦ I&trat"ri&" #%"tal i"cti%&s$ CM i"cti%& 4h"&s"*"r" is c%((%&ly ass%ciat"! 4ithh"0at%s0l"&%(",aly

◦

D%4&s sy&!r%("◦ rar" )"&i,& a&! (ali,&a&t h"0atic t(%rs sch as

h"(a&,i%(a %r h"0at%)last%(a

◦"&%s c%&,"sti%& as i& car!iac %r "3tracar!accas"s

◦J"c/4ith:i"!"(a&& a&! "ll4","r sy&!r%("sthat ca& )" ass%ciat"! 4ith h"0at%(",aly.

◦-ach"r a&! Ni"(a&&Pic/ sy&!r%("s 4hich i&th" lat" r! tri("st"r (ay l"a! t% s0l"&%(",aly.


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OMPHALOCELE

◦0ncidence. R"lati*"ly #r"B"&t.


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◦ T4% *aria&ts $ 0r"s"&c" %r a)s"&c" %# th" li*"r i& th" sac. E()ry%,"&tically !i=!i="r"&t 0r%,&%sis

◦R0tr" %# sac i& 0"rc"&t cas"s

◦

Ultrasound diagnosis. A& %(0hal%c"l" is s%&%,ra0hically r"0r"s"&t"! )y a )that

◦ 6i8 aris"s #r%( th" a&t"ri%r a)!%(i&al 4all 6ii8 c%&tai&s s%(" a)!%(i&al *isc"ra)%4"l8 a&! 6iii8 0r"s"&ts th" c%r! i&s"rti%& %& its c%&*"3ity

◦ Th" 0r"s"&c" %# th" ()ilical *"i& 4ithi& th" %(0hal%c"l" is a& i&!ir"ct si,& %# tl t i l ! # t # th )! i l ll


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a&%(aly r"0r"s"&ts a 0ri(ary cl%sr" !"#"ct %# th" a)!%(i&al 4all

◦Ascit"s (ay )" s""& .

I# 0r"s"&t th"& car" sh%l! th"& )" ta/"& &%t t% (ista/" th" ascit"s #%r a(&i%tic aa& "rr%&"%s !ia,&%sis %# ,astr%schisis.

◦

P%lyhy!ra(&i%s (ay )" s""& .◦ I# th" li*"r is !"t"ct"! 4ithi& th" %(0hal%c"l" th" !ia,&%sis is c"rtai& als% "arly

◦ i# %& th" c%&trary %&ly s%(" )%4"l l%%0s ar" s""& i& it car" sh%l! )" ta/"& t%%(0hal%c"l" #r%( th" 0hysi%l%,ic h"r&iati%& %# th" i&t"sti&" 4ithi& th" c%r! tha&til th" th 4""/ %# ,"stati%&. Ma/"s r"sca&&i&, i& a 4""/s ti(" &"c"ssary.


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-ASTROSCHISIS◦ I&ci!"&c". Rar".

◦Dia,&%sis. J%4"l l%%0s #r""ly >%ati&, i& th" a(&i%tic >i!. Para'()ilical 4all !c%r! i&s"rti%&.

◦Ris/ %# chr%(%s%(al a&%(ali"s. "ry l%4.

◦Ris/ %# &%&'chr%(%s%(al sy&!r%("s. L%4. C%&crr"&t 7%i&t c%&tractr"s %# th" hy0%0lastic l%4"r li()

◦(scl"s i&!icat" th" 0r"s"&c" %# c%&,"&ital a(y%0lasia.

◦Otc%(". "ry ,%%! &l"ss rar" c%(0licati%&s i&cl!i&, 0"r#%rati%& iarcti%&h"r&iat"! l%%0s %ccr.

◦)e5nition. -astr%schisis is charact"ri;"! )y a 0ara()ilical !"#"ct %# th" a)!%thr%,h 4hich )%4"l l%%0s h"r&iat" t% >%at #r""ly i& th" a(&i%tic >i!

◦ Th" !"#"ct i&*%l*"s all th" lay"rs %# th" a)!%(i&al 4all a&! th" h"r&iat"! *isc"r%*"r4h"l(i&, (a7%rity %# cas"s %# )%4"l l%%0s %&ly i& *"ry rar" circ(sta&c"s


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, 7 y 0 y y

◦ r%,"&ital strctr"s (ay h"r&iat" as 4"ll.

◦Ultrasound diagnosis.

th" r"c%,&iti%& %# #r""ly >%ati&, )%4"l %tsi!" th" #"tal a)!%("& is th" (ai& #"a


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RINARY TRACTANOMALIES


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RENAL A-ENESIS


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RENAL A-ENESIS

◦ 0ncidence. &ilat"ral #%r($ i!.

◦Risk o chromosomal anomalies. L%4 ris/ i& is%lat"! &ilat"ral #%r(s 6U 8is%lat"! )ilat"ral

◦ r"&al a,"&"sis.

◦Risk o non+chromosomal syndromes. Hi,h$ 221.

◦utcome. Jilat"ral #%r($ &i#%r(ly #atal. &ilat"ral #%r($ ,%%! i# is%lat"!

◦)e5nition. R"&al a,"&"sis is !"+&"! as c%(0l"t" a)s"&c" %# %&" %r )%th /i!&")ilat"ral r"&al a,"&"sis8.

◦Etiology and pathogenesis. This a&%(aly is !" t% #ailr" Q%# th" !"*"l%0("&)! 4ith a)s"&c" %# a&y i&t"racti%& 4ith th" ("ta&"0hric )last"(a.


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◦ Th" i&ci!"&c" is


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RENAL ECTOPIA


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RENAL ECTOPIA◦ 0ncidence.


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HORSESHOE KIDNEY


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HORSESHOE KIDNEY◦)iagnosis. I& a3ial sca&s th" isth(s li&/i&, th" t4% i"ri%r 0%l"s %# th" /i!&"y

#r%&t

◦ %# th" !"sc"&!i&, a%rta.

◦Risk o chromosomal anomalies. 1G$ Tr&"r sy&!r%(" a&! tris%(y G.

◦Risk o non+chromosomal syndromes. (%!"rat"ly hi,h$ 2.

◦utcome. I& is%lat"! #%r(s h%rs"sh%" /i!&"y is asy(0t%(atic i& a)%t hal# %# cai&ci!"&c" %# i"cti%&s a&! *"sic%'r"t"ral r">3..

◦)e5nition. Th" /i!&"ys ar" #s"! 4ith a& "Bal a(%&t %# r"&al tiss" %& "ach s

Th" i"ri%r 0%l"s %# th" /i!&"ys ar" li&/"! )y a& isth(s %# +)r%s tiss" %r 0ar"r"t"rs !% &%t cr%ss th" (i!li&" )"#%r" "&t"ri&, th" r"&al si&s"s.

◦Etiology and pathogenesis. 7usion anomaly Th" a&%(aly %ri,i&at"s a#t"r thr"t"ral )!s 4ith th" ("ta&"0hric )last"(a )t )"#%r" th" (i,rati%& a&! r%tati%

◦ Th" h%rs"sh%" /i!&"y is sally 0%siti%&"! l%4"r tha& &%r(al )"cas" its asc"&t 0%siti%& is i(0"!"! )y th" "("r,"&c" %# th" i"ri%r ("s"&t"ric art"ry

◦Ultrasound diagnosis. O& tra&s*"rs" %r %)liB" *i"4s %# th" #"tal a)!%("& thc%&&"cti&, th" i"ri%r 0%l"s %# th" t4% /i!&"ys ca& )" s""& i& #r%&t %# th" !"sc"/i! !i ll ! t i l t t !


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/i!&"ys a00"ar ("!ially a&! a&t"ri%rly r%tat"!.

◦ I& this sca&&i&, 0la&" it is als% 0%ssi)l" t% s"" th" t4% r"&al 0"l*is"s 4hichha*a&t"ri%r l%cati%& a&! ar" %#t"& sli,htly !ilat"!.

HYDRONEPHROSIS HYDRO'RETERONEPHRO


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HYDRONEPHROSIS HYDRO RETERONEPHROANDJLADDER DILATATION

◦ I&ci!"&c". 1


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◦Ultrasound diagnosis$ %&" %# th" (%st 4i!"ly acc"0t"! is th" #%ll%4i&,$ th"a&t"r%0%st"ri%r


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◦!ia("t"r %# th" 0"l*is %& a tra&s*"rs" *i"4 %# th" a)!%("& sh%l! &%t &!"r &c%&!iti%&s "3c""! ? (( 0 t% 2 4""/s %# ,"stati%& a&! (( #r%( th" r! 4%&4ar!s


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HYDRO'RETERONEPHROSIS


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JLADDER


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RENAL TMORS


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RENAL TMORS◦ 0ncidence. E3tr"("ly rar" i& th" #"ts.


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, 7 y

◦sally ("s%)lastic &"0hr%(as sh%4 ill!"+&"! (ar,i&s !" t% th" a)s"&c" %# a&"0rh%)last%(as ar" sally ca0slat"!. I&cr"as"! *asclari;ati%& (ay )" !"t"c%l%r


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Date post:	06-Jul-2018
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Fetal Anomaly Scan

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