Ultrasound in Pregnancy

Question 1

Ultrasound features of spina bifida?

Answer 1

1. cystic bulge overlying spine
2. lemon shaped skull
3. splaying of vertebra

Question 2

USS cranial findings T18?

Answer 2

strawberry shaped skull (pointed appearance of frontal bones)

Question 3

Most common cause of hydrocephalus detected at morphology scan?

Answer 3

aqueduct stenosis. More common in males than females due to aetiology of X-linked inheritance

Question 4

Why are choroid plexus cysts reported?

Answer 4

No pathological significance in the developing fetus but there is an association reported in literature between CPCs and trisomy 18- association is weak. Therefore, if seen, confirm aneuploidy screening performed in pregnancy. Usually resolve at 24-26 weeks.

Question 5

What is holoprosencephaly

Answer 5

severe brain abnormality arising from incomplete division of the early forebrain (prosencephalon). Also associated with midline facial defects

Question 6

How is the Dandy-Walker malformation characterised?

Answer 6

1. cystic dilatation of the fourth ventricle
2. enlargement of the posterior fossa
3. hyperplasia or aplasia of the cerebellar vermis

Question 7

Define hydrops fetalis

Answer 7

Presence of excess fluid in more than one body cavity with a combination of at least two of the following:

1. subcutaneous oedema
2. pericardial effusion
3. pleural effusion
4. abdominal or urinary ascites

Question 8

What is the ductus venous?

Answer 8

the vessel which connects the umbilical vein to the inferior vena cava shortly before the IVC enters the right atrium.

Question 9

Findings in liver that may suggest CMV or varicella infection?

Answer 9

echogenic foci

Question 10

Describe the VATER and VACTERL complexes.

Answer 10

The same, however cardiac defects are included in VACTERL but not VATER.
V= vertebral anomalies,
A = anorectal anomalies,
C= cardiac anomalies,
TE= trachea-oesophageal anomalies and duodenal atresia, R=renal anomalies, radial anomalies

Question 11

What is the significance of bright or echogenic bowel?

Answer 11

Non-specific. Can be caused by:
1. intra-amniotic bleeding
2. Cystic fibrosis
3. congenital infection
4. chromosomal abnormalities (T21)
Consider maternal TORCH and CF screening. Check MSS1/2 or NIPT normal.

Question 12

Discuss significance of a two vessel cord.

Answer 12

1% of live births. can occur in association with cardiac, urinary tract and chromosomal anomalies.
Increased risk of FGR.
Consider normal variant in presence of normal aneuploidy screening.

Question 13

What is talipes?

Answer 13

congenital deformity of the ankle joint resulting in medial deviation and inversion of the sole of the foot. Incidence 1/1000. Association with T18, 13, triploidy and spina bifida.