Fetal Positions

Question 1

what structures do we describe w/ regards to fetal position?

Answer 1

Use terms: Breech, Transverse, Vertex

Correlate to maternal abdomen: Stomach, spine as applicable (Maternal right and Maternal left)

Placenta location

Question 2

descirbe this image (31 week fetus)

Answer 2

spine shows this is transverse on mom. liver is to maternal rt, spine anterior, stomach posterior/maternal lt

Question 3

Answer 3

ant/post/rrt/lt. placenta posterior at fundus

Question 4

18 weeks

Answer 4

placenta posterior

external os hyperechoic line

bladder

Question 5

18 weeks

Answer 5

liver anterior, spine rt, stomach posterior, aorta and ivc seen posterior on mom

Question 6

what plane was this image taken on mom? how can you tell?

Answer 6

long. cervix, vagina. seen . baby vertex

Question 7

where is the bladder always located on mom in long?

how is the first midline image taken on mom?

Answer 7

inferior

in long

Question 8

3rd tri

Answer 8

long (ant, post, sup, inf) bladder straighten and pushes bowel out of the way.

Question 9

3rd tri

Answer 9

trans (ant, post, rt, lt)myometrium post, placenta ant (thicker. pooling blood oblique right, stomach posterior)

Question 10

3rd tri

Answer 10

long (ant post, sup, inf)

placenta fills up most of inferior side w/ umbilical cord into placenta around midline.

Question 11

3rd tri

Answer 11

trans (ant post rt lt)

venous pools of blood midline, placenta fills the left half (maternal side to the lt, babe side of placenta to the rt of the venous pools. vessels to the lt of the placenta

Question 12

16 weeks

Answer 12

long

bladder (inf) baby superior, cervix, internal os (usually hyerechoic stripe) vabgina

Question 13

16 weeks

Answer 13

long on mom. baby breech. mom’s bladder inf. rump facing inf, knee post

Question 14

what position should this fetus be in in long or trans.

Answer 14

if in long baby stomach superior, spine anter = breech

if trans spine = ant, stomach = rt = vertex

Question 15

what position would this fetus be in long/trans?

Answer 15

in long spine = post, stomach = inf = trans, head to mom’s rt

in trans – spine post, stomach lt = breech face ant

Question 16

what positoin should this fetus be in long/trans?

Answer 16

in long - stomach inf spine ant baby trans w/ head to maternal rt and face post

in trans - spine ant stomach lt baby vertex head inf

Question 17

what position should this fetus be in long/trans?

Answer 17

in long spine inf, stomach ant = trans head to maternal lt face supe

in trans - spine lt, stomach ant breech head supe face to moms right

Question 18

what position should this fetus be in trans/long?

Answer 18

in long - spine supe, stomach ant baby trans head to mar rt

in trans - spine rt, stomach ant baby vertex hrad inf face to mat left

Question 19

How was the transducer/beam going
through the fetal head to get this
image?

Answer 19

The ultrasound beam/transducer was placed longitudinal to the midline of the fetal face to produce the profile view

Question 20

Where are the anterior & posterior
portions of this fetal head?

Answer 20

The thalami (t) point towards the posterior portion of the fetal head
 • The (v) is pointing to the anterior portion of the lateral ventricles
 • Cavum septum pellucidum (c) must be seen at the level of BPD to rule out anomalies and it is always anterior

Question 21

To produce this image how was the transducer/beam in relation to the fetal face?

Answer 21

coronal to the face

Question 22

Draw an imaginary line on this picture of the baby head that represents the ultrasound beam in relation to the fetal face that created this image

Answer 22

Beam is at an angle cutting through the face to be able to get the mouth (not chin), cheeks, a very little of the eyelid and the forehead

Question 23

1st Draw an imaginary line on this picture of the baby head where the ultrasound beam would be in relation to the fetal head to create this image

• 2nd Hold the transducer appropriately over the head

Answer 23

• The transducer/beam is going through the fetal head axial or transverse

Question 24

• 1st Draw an imaginary line on this picture of the baby head where the ultrasound beam would be in relation to the fetal head to create this image
• 2nd Hold the transducer angle where the ultrasound beam is going through the fetal head to get this image of orbits

Answer 24

The ultrasound beam is going through the fetal orbits in a transverse/axial cross-section, the face is anterior

Question 25

Draw an imaginary line on this picture where the ultrasound beam is going to create this image

Answer 25

The beam is going through the nose, nasal septum, lips and chin

Question 26

Why is there an anechoic space between the upper and lower lips as well as in the nostrils?

Answer 26

The fetus has its’ mouth open and the amniotic fluid is in the mouth, amniotic fluid is in the nostrils as well and that is what makes the nasal septum easier to visualize

Question 27

* What is being documented between the white arrows? * What does the letter ‘m’ document?

Answer 27

The cerebellum is between the arrows and the cisterna magna is the ‘m’

Question 28

Draw an imaginary line on this picture of the baby head where the ultrasound beam would be in relation to the fetal head to create this image

Answer 28

Not only are they documenting the posterior portion of the fetal brain but they have the body of the lateral ventricles (with choroid plexus) as well as the thalami

Question 29

Draw an imaginary line on this picture of the baby head where the ultrasound beam would be in relation to the fetal head to create this image

Answer 29

The beam is going through the top/anterior portion of the fetal brain as well as the orbital sockets The beam is symmetrical through the head as well

Question 30

Draw an imaginary line on this picture of the baby head where the ultrasound beam would be in relation to the fetal head to create this image

Answer 30

This image is of the both lateral ventricles and is attained in a transverse/axial manner toward the top of the fetal head

Question 31

Based on these 2 images which is the right and left sides of the fetus?

Answer 31

Because the fetus is vertex and semi-prone the sides of the fetus are

Question 32

1st Place the transducer on the mannequin where the sonographer is holding the transducer to get this image 2nd Hold the transducer so the beam matches the scan plane used to get this image. Really look at the image & identify the portion of the uterus imaged.

Answer 32

Sonographer’s label to the uterus to document the location of the placenta We know it is midline because of the label Because we can see the rounded fundal portion of the uterus we know it is the superior portion of the uterus

Question 33

How is the fetus positioned in this ultrasound image if it is a long midline image? – Be specific & don’t go on yet, place the baby on the mannequin's belly in the correct fetal position Next, hold the transducer over the mannequin & baby the way the sonographer positioned the beam over the baby

Answer 33

The fetal position is vertex & prone The transducer is longitudinal to the fetus getting spine and the head

Question 34

Based on these 2 images place the baby on the mannequin the way this fetus is positioned in the uterus

Answer 34

It is vertex, laying on its’ left side with the spine to maternal left

Question 35

1st Place the baby on the mannequin according to the fetal lie of this image (same case) 2nd Place the transducer on the mannequin where the sonographer is holding the transducer to get this image 3rd Hold the transducer so the beam matches the scan plane used to get this image

Answer 35

The transducer is transverse to the fetus as well as transverse to mom The transducer position would be more to the maternal left and the fetus would be on its’ side with it’s spine on the left

Question 36

Where is the placenta on this image/case?

Answer 36

The placenta is posterior with the edge going to the left of the uterus on this image

Question 37

1st Place the transducer on the mannequin where the sonographer is holding the transducer to get this image 2nd Hold the transducer so the beam matches the scan plane used to get this image

Answer 37

The sonographer is on the lower left quadrant of the maternal abdomen with the transducer held longitudinal because they are getting an amniotic fluid volume or AFI & have it labeled ‘LL’ for left lower (quadrant) or LLQ

Question 38

Where is the placenta on this image?

Answer 38

This is a very nice image of a posterior placenta Note the fetal parts do not greatly shadow or cover the placenta – There is some shadowing

Question 39

1st Place the transducer on the mannequin where the sonographer is holding the transducer to get this image 2nd Hold the transducer so the beam matches the scan plane used to get this image

Answer 39

The transducer is held transverse and midline to get the placenta

Question 40

Where are mom’s aorta and IVC on this image? Can you identify them?

Answer 40