Foetal and maternal scanning

Question 1

Why is x-ray imagine (e.g. CT) bad?

Answer 1

Ionizing radiation

Question 2

Why is ionising radiation bad?

Answer 2

Birth defect s- teratogenic
Increased cancer risk - carcinogenic
Germ cell mutation - genetic risk

Question 3

Characteristics of MRI

Answer 3

Magnets
Non-ionising radiation
Works without amniotic fluid
Difficult to use when baby moving

Question 4

When do most routine scans take place in pregnancy?

Answer 4

11-14 weeks and 18-21 weeks

Question 5

What is the Saving Babies’ lives programme?

Answer 5

More scans and care for high risk pregnancies

Question 6

What is an embryo?

Answer 6

until 8 weeks post fertilisation

Question 7

What is a foetus?

Answer 7

From 8 weeks fertilisation

Question 8

Why do we not use CRL after 14+1 weeks?

Answer 8

Inaccurate - use head circumference instead

Question 9

Ultrasound in pregnancy

Answer 9

Sound waves create image
Less damaging
Main modality in pregnancy
Diagnosis/assessment of early pregnancy conditions
Higher frequency = more detail but less depth
early pregnancy = higher frequency

Question 10

When will an early pregnancy be non viable (CRL)?

Answer 10

When CRL is less than 7mm

Question 11

What is ectopic pregnancy?

Answer 11

+ve pregnancy test

No gestation sac

Question 12

What is chronicity?

Answer 12

Multiple pregnancies

Chorion around them but separate amnion

Question 13

Why are dichorionic babies good?

Answer 13

No twin-twin transfusions

Question 14

When is first appointment?

Answer 14

Between 8-10 weeks

Question 15

Which chromosome causes Down’s?

Answer 15

21

Question 16

Which chromosome causes Edward’s?

Answer 16

18

Question 17

Which chromosome causes Patau’s?

Answer 17

13

Question 18

What measurements are taken in ultrasounds?

Answer 18

CRL and nuchal translucency

Question 19

What does a low PAPP-A indicate?

Answer 19

T21/18/13

Question 20

What does high hCG indicate?

Answer 20

T21

Question 21

What does low hCG indicate?

Answer 21

T13/18

Question 22

What does low PAPP-A indicate?

Answer 22

Placenta isn’t growing very well, start aspirin and more growth scans

Question 23

What happens in the 11-14 week scan?

Answer 23

First ultrasound
Heart rate detection
Accurate dating
Screening for abnormalities

Question 24

When will combined test be done?

Answer 24

CRL 45-84

Question 25

When will quad test be done?

Answer 25

CRL is larger than 85

Question 26

What is Booker's appointment?

Answer 26

14+1 to 20 weeks - screen for Down's

Question 27

Hormonal changes in Down's syndrome?

Answer 27

AFP and estriol go down and hCG and inhibin go up

Question 28

What is the borderline for aneuploidy action?

Answer 28

1:150

Question 29

When do you do amniocentesis?

Answer 29

Less than 16 weeks

Question 30

When do you do CVS?

Answer 30

11-14 weeks

Question 31

What is NIPT?

Answer 31

Non-invasive prenatal testing

Question 32

Where is NIPT currently offered?

Answer 32

Twins

Question 33

How does NIPT work?

Answer 33

Taking blood from mother which also contains baby's blood | cffDNA in maternal plasma increases with gestation

Question 34

What happens at 20 week scan?

Answer 34

Looks for 11 different conditions

Question 35

What happens in mid-pregnancy scan?

Answer 35

Identifies any abnormalities that indicate baby will die shortly after birth/need treatment before birth

Question 36

Conditions screened between 18 and 20 weeks

Answer 36

``` Anencephaly Open spina bifida Cleft lip Diaphragmatic hernia Gastrochisis Exomphalos Cardiac abnormalities Renal genesis Skeletal dysplasia Edward's syndrome Patau's syndrome ```

Question 37

What is anencephaly?

Answer 37

Absence of cortical brain tissue and cranial vault - incompatible with life

Question 38

What is spina bifida?

Answer 38

Neural tube fails to close, varying severity

Question 39

What is cleft lip?

Answer 39

Gap between lip and nose

Question 40

What is gastroschisis?

Answer 40

Extra-abdominal herniation of bowel loops through para-umbilical abdominal wall defect

Question 41

What is omphalocele?

Answer 41

Gut herniation via abdominal wall defect, covered by membrane, strong association with other abnormalities and belly button

Question 42

Examples of cardiac anomalies in babies

Answer 42

Transposition of great arteries Atrioventricular septal defect Tetralogy of Fallot HLHS

Question 43

Kidney issues in foetus

Answer 43

Bilateral renal agenesis | No amniotic fluid

Question 44

What is pulmonary hypoplasia?

Answer 44

No amniotic fluid means lungs can't grow