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Missed anomalies- how not to miss?

DR VIDYALEKSHMY R DGO, DNB,MRCOG. Missed anomalies- how not to miss?. CONGENITAL ANOMALIES. Real trauma to the family Diagnosed usually after 20 Weeks. 20 Weeks is the upper limit for legal MTP in India. TAS. Done between 18-23 Weeks Should be offered to all pregnant women

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Missed anomalies- how not to miss?

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  1. DR VIDYALEKSHMY R DGO, DNB,MRCOG Missed anomalies- how not to miss?

  2. CONGENITAL ANOMALIES • Real trauma to the family • Diagnosed usually after 20 Weeks. • 20 Weeks is the upper limit for legal MTP in India.

  3. TAS • Done between 18-23 Weeks • Should be offered to all pregnant women • High sensitivity to detect fetal anomalies • To be done systematically

  4. TAS • SKULL • BRAIN • FACE • CARDIAC • THORAX • ABDOMEN • SKELETAL • PLACENTA AND CERVIX

  5. FACE AND CNS • Transverse view at Septum CavumPellucidum- to measure BPD, Head Circumference and Ventricles • Suboccipitobregmatic view- Cerebellum and Cisterna magna

  6. FACE &CNS • Transverse view of face through orbit, upper lip and maxilla • Sagittal view of face to show nasal bone.

  7. NEUROSONOGRAM • Transventricular plane • Transcerebellar plane

  8. Transventricular plane • To measure BPD • Head circumference • Cerebral hemispheres • Ventricles • Choroid plexus

  9. Transventricular plane

  10. Transventricular plane

  11. Transcerebellar view • Posterior fossa • Cisterna magna • Cerebellum

  12. Transcerebellar view

  13. COMMON CNS ANOMALIES

  14. CNS Anomalies

  15. Neural tube defects

  16. Choroid plexus cyst

  17. FACE • Forehead • Orbit • Nose • Lips • Oral cavity

  18. FACE

  19. CLEFT LIP & PALATE

  20. CLEFT PALATE

  21. CARDIAC EVALUATION • Four chamber view • 3 vessel view • Ventricular outflow tracts • Heart rate and Rhythm

  22. FETAL ECHOCARDIOGRAPHY

  23. OUTFLOW TRACTS- LV

  24. PULMONARY OUTFLOW

  25. Ventricular Septal defects

  26. CARDIAC ANOMALIES

  27. Falot’sTetrology

  28. THORAX • Shape • Lungs • Diaphragm

  29. LUNGS

  30. LUNG CYSTS

  31. Pleural effusion

  32. ABDOMEN • Abdominal circumference • Transverse view to demonstrate kidneys • Transverse view at umbilicus- Abdominal wall defects • Transverse view at the level of bladder • Stomach, Liver

  33. DIAPHRAGMATIC HERNIA • Diagnosed by the presence of stomach, intestine or liver in thorax • Mediastinal shift

  34. Diaphragmatic Hernia

  35. ANTERIOR ABDOMINAL WALL- normal appearance

  36. EXOMPHALOS

  37. GASTROSCHISIS

  38. GIT- esophageal atresia

  39. Duodenal atresia- double bubble

  40. KIDNEYS AND URINARY TRACT

  41. Renal agenesis

  42. Renal agenesis- renal artery Doppler

  43. POLYCYSTIC KIDNEY

  44. Hydronephrosis

  45. SPINE • Examination of neck for nuchal fold thickness • Longitudinal views of spine- at least 2 views • Coronalview at Lumbosacralregion • Transverse view

  46. SPINE

  47. Spinal Anomalies

  48. SKELETAL EVALUATION • Longitudinal view of femur • Longitudinal view of foot and leg • Upper limb bones • Imaging of open hand • Fetal movements

  49. SKELETON

  50. CLUBFOOT- CTEV

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