First trimester ultrasound
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first trimester problems ... a simplified way of explanation
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First trimester ultrasound
- 1. First trimester ultrasound Dr. Kosar Kamal Ahmed H.D diagnostic radiology Lecture 2
- 2. General considerations - How pregnancy is detected ? Urine test Blood test ( beta hCG ) Role of ultrasound Confirm intra uterine pregnancy Follow up the growth of pregnancy Evaluate complications Diagnose ectopic pregnancy and other pathologies
- 3. General considerations Transabdominal and TV US have complementary role ; TV can show structures in a more detail First sonographic finding in pregnancy is visualization of the GS A normal GS is rounded , with a thick echogenic rim around ( double decidual sac sign ) a GS is expecte to be seen when hCG levels reach 1000 – 1200 IU .
- 6. General considerations How to measure GS ? Calipers should be placed from in to in
- 7. General considerations What is the rate of growth of a normal embryo and GS ? Amniotic sac and embryo increase in size 1 mm / day MSD in mm + 30 = GA in days CRL in mm + 42 = GA in days
- 8. Problems of early pregnancy Miscarriage ( abortion ) Spontaneous abortion Threatened abortion Missed abortion Blighted ovum Complete abortion Incomplete abortion Traumatic abortion
- 9. Problems of early pregnancy Ectopic pregnancy Gestational trophoblastic disease Ovarian problems Uterine fibroids Pregnancy with IUCD
- 10. Problems of early pregnancy abortion Approximately 20 % of women attending early pregnancy units suffer a miscarriage Most women will present with history of vaginal bleeding and or abdominal pain
- 11. Ultrasound diagnosis of miscarriage According to ultrasound findings , miscarriage is classified into : Threatened Missed Incomplete Complete ( history of V. bleeding + live embryo seen by US ) ( absence of cardiac activity in fetal pole ) ( V. bleeding , cramps + RPOC ) ( V. bleeding , cramps + thin ndometrium “ no RPOC “
- 12. Ultrasound diagnosis of miscarriage threatened abortion
- 13. Ultrasound diagnosis of miscarriage missed abortion - Absence of cardiac activity in embryonic poles ( plate ) - Blighted ovum ( Un embryonic pregnancy ) Absence of embryonic poles in a GS that measures 8 weeks
- 14. Ultrasound diagnosis of abortion complete abortion Complete abortion V. bleeding , cramps + empty uterine cavity with thin endometrium Note : pregnancy should be proven .
- 15. Ultrasound diagnosis of abortion incomplete abortion RPOC Persistent V. bleeding , cramps decresed + finding of RPOC
- 16. Ultrasound diagnosis of abortion incomplete abortion RPOC
- 17. Ultrasound diagnosis of abortion incomplete abortion RPOC
- 18. Ultrasound diagnosis of abortion incomplete abortion RPOC
- 19. Ectopic pregnancy Is implantation of the GS any where outside the endometrial cavity .
- 20. Ectopic pregnancy Is a life threatening condition which if not diagnosed may lead to internal bleeding and death Abdominal pain +/- vaginal bleeding Shock
- 23. Ectopic pregnancy ultrasound findings - About 26 % of ectopic pregnancies have a normal US examination - A potential pitfall is pseudo GS
- 25. Ectopic pregnancy ultrasound findings Scar pregnancy
- 26. Gestational trophoblastic disease molar pregnancy
- 27. Gestational trophoblastic disease molar pregnancy clinical features
- 28. Gestational trophoblastic disease molar pregnancy clinical features
- 29. Gestational trophoblastic disease molar pregnancy
- 30. Gestational trophoblastic disease molar pregnancy complete mole
- 31. Gestational trophoblastic disease molar pregnancy complete mole
- 32. Gestational trophoblastic disease molar pregnancy partial mole
- 33. Gestational trophoblastic disease molar pregnancy partial mole
- 34. Gestational trophoblastic disease molar pregnancy invasive mole
- 35. Gestational trophoblastic disease molar pregnancy invasive mole
- 36. Gestational trophoblastic disease molar pregnancy invasive mole
- 37. Ovarian problems Most of the ovarian cysts seen in early pregnancy are corpus luteum cysts Normally resolve spontaneousely by the end of first trimester Complicated ( hemorrhagic ) cysts are of concern and are most responsible for symptoms “ if not resolve by 16 weeks of gestation may require surgery as any un resolving complicated cyst harbors risk of malignancy .
- 38. Ovarian problems
- 39. Normal position of IUCD
- 40. Pregnancy associated with IUCD