Fetal Soft Markers

Question 1

Increased risk of aneuploidy (7)?

Answer 1

1. Ventriculomegaly
2. Increased NT
3. Absent or hypoplastic nasal bone
4. EICF
5. Echogenic bowel
6. CPC
7. Short femur

Question 2

Increased risk of NON-chromosomal abnormalities (3)?

Answer 2

1. Pyelectasis - increased APRPD (normal is <5mm)
2. SUA
3. Enlarged CM (>10mm)

Question 3

Soft Markers in BC (10)?

Answer 3

1. Ventriculomegaly
2. CPC
3. Pyelectasis
4. CM
5. Nasal bone
6. Nuchal thickness
7. Nuchal index
8. Echogenic bowel
9. EICF
10. 2VC

Question 4

How to calculate nuchal index?

Answer 4

Nuchal thickness/BPD

Question 5

Nuchal fold thickness 16-18 weeks?

Answer 5

5mm

Question 6

Nuchal fold thickness 18-24 weeks?

Answer 6

6mm

Question 7

If you are scanning a fetus at 17 weeks and their NT = 5.5mm, is it normal or abnormal?

Answer 7

Abnormal: From 16-18 weeks, NT should be less than 5mm

Question 8

MVM is what measurement?

Answer 8

10-15mm

Question 9

Severe ventriculomegaly is what measurement?

Answer 9

> 15mm

Question 10

Why are ventriculomegaly measurements taken in the far field?

Answer 10

Due to near field artifacts

Question 11

EICF is defined as?

Answer 11

Echogenic cardiac focus as bright as bone

Question 12

In CPC, what must be the measurement to be considered a cyst?

Answer 12

3mm or greater

Question 13

When would a CM measurement be overestimated?

Answer 13

Steep scan angle through posterior fossa or dolicocephaly

Question 14

Mild pyelectasis measurement?

Answer 14

5-10mm

Question 15

If you measure renal pelvis and is 4.9mm, should it be reported?

Answer 15

NO: abnormal measurement begins at 5mm

Question 16

What is normal femur/foot ratio?

Answer 16

0.9 or greater

Question 17

What abnormality is usually associated with sandal-toe gap?

Answer 17

Trisomy 21

Question 18

Do you note sandal gap on tech report?

Answer 18

YES

Question 19

For cases of pyelectasis seen on ultrasound, when would follow-up be? (how many days postnatally?)

Answer 19

5-30 days

Question 20

In what trimester are soft markers usually detected?

Answer 20

second

Question 21

If an EICF is found and is an isolated marker, what is the next step?

Answer 21

1. Quad screen if less than 20 weeks if they have not had prior testing
2. If the NIPT comes back negative, no follow up is required

Question 22

If a shortened femur is found as an isolated marker, what is the next step?

Answer 22

1. Quad screen if less than 20 weeks if they have not had prior testing
2. If the NIPT comes back negative, no follow up is required

Question 23

If an EICF, pyelectasis, and abnormal femur/foot ratio is NOT an isolated marker, what is the next step?

Answer 23

Refer to medical genetics

Question 24

If pyelectasis is found as an isolated marker, what should happen next?

Answer 24

Follow up ultrasound within 5-30 days

Question 25

If a CPC is found with no other abnormalities, what should happen next?

Answer 25

1. Quad screen if less than 20 weeks if they have not had prior testing
2. If the NIPT comes back negative, no follow up is required

Question 26

If CPC is found with either IUGR or other abnormalities, what should happen next?

Answer 26

Refer to med genetics

Question 27

In cases of echogenic bowel or increased NT > or equal to 6mm or absent nasal bone, what should happen next?

Answer 27

Refer to medical genetics

Question 28

What should happen in cases of ventriculomegaly?

Answer 28

Refer to FDS (fetal diagnosis service) MFM (maternal fetal medicine)