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APPLY OF USG TO ASSESS
FETAL ANATOMY
TJOKORDA GDE AGUNG SUWARDEWA
FETOMATERNAL DIVISION
DEP. OBSTETRIC & GYNECOLOGY.
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ULTRASONOGRAPHY
Donald and co worker (1958), firstObstetrical application
By 1989, 45% pregnant uterus inUS evaluated sonographycally
Routine Antenatal DiagnosticImaging with Ultrasound (RADIUS): all pregnant women undergoultrasound
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SOUND WAVE
infrasound Acoustic Ultrasound
20Hz 20KHz 2MHz 200MHz
Low bass notes
Animal & Chemistry
Medical Dx & NDE
Medical & destructive
Wikipedia, 2007
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Human : 16-20.000 Hertz (Hz)
Ultrasonic : > 20.000 Hz
USG unit : 1-10 MHz
(1MHz=1000.000Hz)
V = f.V : m/second
f : Hertz : meters
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Instrumentation
JARINGAN
TRANSDUCER
PULSER
RECEIVER
STORAGE MINITOR
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FETAL ANATOMY
ULTRASOUNDFINDING EARLIESVISUALIZATION
(menstrual age)
DEFINITIVEVISUALIZATION
(menstrual age)
Chorionic cavity
Yolk sac
Fetal pole
Heart activity
Limbs
Telencephalon
Movement
Stomach
Urinary bladder
Genitalia
Day 30
Day 32
Day 35
Day 37
Day 47
Day 50
Day 50
Week 10
Week 11
Week 12
Day 32
Day 34
Day 37
Day 40
Day 53
Day 54
Day 56
Week 11
Week 12
Week 14
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Week 5 of menstrual age
TVS : embryo that implanted in the decidua on the 17thdays after conception
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Two days later : development of yolk sac & embryo after reorganization
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Week 6 of menstrual age
Embryo implanted in the
uterus on postmenstrual day40.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.
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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, theembryo has separated from
the yolk sac.
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The development of umbilicalCord. Left side view. On postmenstrual day 48, the YSis in the extra amniotic-coelom &
is linked to the embryo by the
vitelline duct.
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Course of the vitelline vein
and umbilical veinThe embryo is closely envelop
by the amniotic membrane on
postmenstrual day 48.
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Coronal scan through the
embryo on postmenstrual
day 48 demonstrates upper
and lower limb.
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Week 8 of menstrual age
M-mode scan of the biventricularembryonic heart of postmenstrual
day 55. the cardiac diameter is
1.8 mm.
Midsagittal scan through the embryoOn postmenstrual day 53 shows the
Dominance of brain development
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Embryo 9.6 mm long.Coronal scan on postmenstrual day
53 show the telencephalon with
symmetrical development of the
cortical enlarge.
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Coronal scan through the posteriorsuperior fossa on postmenstrual day
55 demonstrates rombencephalone
The limb clearly identified onpostmenstrual day 56
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On postmenstrual day 56, the
embryo is surrounded by the
amniotic membrane.
The vitteline duct & yolk sac have
been displaced in to chorionic
cavity
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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.
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Embryo 24 mm long on post
menstrual day 65. Have seen
physiologic umbilical hernia.
Power Doppler
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Rhombencephalon
Telencephalon
Postmenstrual day 61Axial skeleton of the embryo
on postmenstrual day 60.
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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
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Four finger can be seen. PostMenstrual day 66.
Postmenstrual day 66.Sagittal scan show basic structure
of the facial skeleton with the
mandible and maxilla
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By day 67 the telencephalon has
Increased markedly in size and is
Beginning to enclose diencephalonBoth hemispheres are clearly
separated by falx cerebri
The amniotic fluid enclose the
Embryo on postmenstrual day
66.
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Week 11 of menstrual age
Day 72 for measuring ofBiparietal Diameter
Facial profile of embryo onPostmentrual day 73.
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Postmenstrual day 72.Urinary bladder appear
Postmenstrual day 72.Yolk sac is regression, between
amniotic & chorionic membrane
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Postmenstrual day 82.Heart with Separated ventricular
system is visible.
Postmenstrual day 81.
Demonstrated both eyes.
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Week 13 of menstrual age
Facial profile onpostmenstrual day 91.
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Umbilical cord insertionon postmenstrual day 91.
Thoraco-abdominal vessleson postmenstrual day 91.
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3 D Ultrasonogram
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4 D Ultrasonogram
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