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Fetal Growth Assessment by Sonography

Objectives On completion of this chapter, you should be able to: Describe how intrauterine growth restriction may be detected by sonography Differentiate between symmetric and asymmetric intrauterine growth restriction List which growth parameters should be used to assess intrauterine growth restriction Describe how to perform a biophysical profile on a fetus Discuss quantitative and qualitative Doppler measurements as applied to obstetrics Analyze the significance of macrosomia…

Obstetric Measurements and Gestational Age

Objectives On completion of this chapter, you should be able to: Discuss gestational sac growth, take measurements, and assess gestational age Describe how to perform a crown-rump measurement and evaluate growth Measure, calculate the biparietal diameter, head circumference, three-dimensional cranium, abdominal circumference, and extremity measurements Assess fetal parameter measurements, proportions, and fetal growth Describe when other measurements should be used to provide additional clinical information Evaluate…

Sonography of the Second and Third Trimesters

Objectives On completion of this chapter, you should be able to: List the components of a standard obstetric examination in the second and third trimesters, recognize and describe the fetal anatomy recommended for review Define terminology specific to fetal presentation and fetal situs Specify equipment and policies required for facilities performing obstetric sonography Describe sonographic techniques used to image specific fetal structures Describe normal fetal anatomy…

First-Trimester Complications

Objectives On completion of this chapter, you should be able to: Describe viable and nonviable pregnancy with appropriate terminology List sonographic features of failed pregnancy Describe sonographic findings of retained products of conception Explain the clinical and sonographic findings in ectopic pregnancy Discuss the normal range for fetal cardiac rhythm Describe the cranial abnormalities seen in the first trimester Distinguish among normal bowel herniation, gastroschisis, and…

The Early Embryonic Stage of the First Trimester

Objectives On completion of this chapter, you should be able to: Describe the early development of the embryo and its sonographic appearance at different gestational ages Explain the clinical roles of first-trimester maternal serum biochemistry Define the sonographic characteristics of the yolk sac, embryo, amnion and chorion, and gestational sac Describe the sonographic measurements performed in the first trimester and the goals of first-trimester sonography Key…

Clinical Ethics for Obstetric Sonography

Objectives On completion of this chapter, you should be able to: Identify multiple sources of moral beliefs in a pluralistic society Differentiate morality from ethics Describe the application of nonmaleficence, beneficence, justice, veracity, and autonomy in various settings where sonographic examinations are performed Define the principle of beneficence in clinical ethics Define the principle of respect for autonomy in clinical ethics Identify beneficence-based obligations to the…

The Role of Sonography in Obstetrics

Objectives On completion of this chapter, you should be able to: Discuss indications for obstetric sonography Analyze the differences among standard, limited, and specialized obstetric sonography examinations List maternal risk factors that increase the chances of producing a fetus with congenital anomalies Recount important questions to ask the patient before beginning the obstetric sonography examination Describe the biologic effects of diagnostic medical ultrasound energy and related…

Role of Ultrasound in Evaluating Female Infertility

Objectives On completion of this chapter, you should be able to: Define infertility and list its treatment options List the female pelvic organs to be imaged in an infertility workup State anatomic variations or pathologies that need to be defined when imaging an infertility patient List complications that may occur because of infertility treatments Key Terms Assisted reproductive technology (ART) Embryo transfer Human chorionic gonadotropin (hCG)…

Pathology of the Adnexa

Objectives On completion of this chapter, you should be able to: List the causes of and risk factors for pelvic inflammatory disease Describe the sonographic findings of salpingitis, pyosalpinx, tubo-ovarian abscess, endometrioma, and adenomyosis Identify the locations of endometrial implants in the body Explain the development of endometritis in the postpartum patient Discuss the role of ultrasound in pelvic inflammatory disease Key Terms Adenomyosis Endometrioma Endometriosis…

Pathology of the Ovaries

Objectives On completion of this chapter, you should be able to: Describe the effects of hormones on the ovarian cycle State the characteristics of the simple ovarian cyst and a functional ovarian cyst Discuss the sonographic findings of the common cystic and complex ovarian masses, common solid ovarian masses, and ovarian neoplasms List the characteristics of the ovarian syndromes discussed in this chapter Discuss the benign…

Pathology of the Uterus

Objectives On completion of this chapter, you should be able to: Define the pathologies discussed in this chapter and describe their causes, clinical signs, and sonographic findings Explain sonohysterography and the indications for performing the procedure Identify the role of Doppler in evaluating pelvic pathology Differentiate among the types of intrauterine contraceptive devices and describe the sonographic appearance of each Key Terms Adenomyosis Cervical polyp Cervical…

Sonographic and Doppler Evaluation of the Female Pelvis

Objectives On completion of this chapter, you should be able to: Demonstrate how to take a patient history specific to a pelvic ultrasound examination Discuss the indications and contraindications for transabdominal and transvaginal scans Name the important muscles in the pelvic cavity Describe the scan orientation for transabdominal and transvaginal ultrasonography Describe both the sonographic technique for evaluating the uterus and adnexal area and their sonographic…

Normal Anatomy and Physiology of the Female Pelvis

Objectives On completion of this chapter, you should be able to: Name the major landmarks of the bony pelvis and external genitalia Identify the sonographically significant muscles of the pelvic cavity Describe the pelvic organs and their functions Describe the major ligaments of the uterus and ovaries Discuss the physiology of the menstrual cycle and describe hormonal changes that occur during the various ovulatory and endometrial…

Peripheral Venous Evaluation

Objectives On completion of this chapter, you should be able to: Describe the anatomy encountered during a venous duplex imaging examination Understand venous physiology as it relates to the development of peripheral venous disease List the risk factors, signs, and symptoms of venous disease Outline the proper instrument control settings used during venous duplex imaging Describe the characteristics of venous Doppler signals obtained during venous duplex…

Peripheral Arterial Evaluation

Objectives On completion of this chapter, you should be able to: Describe the anatomy encountered during an arterial duplex examination Understand arterial physiology as it relates to the development of peripheral arterial disease Recognize the risk factors associated with peripheral arterial disease Discuss the changes that occur to segmental pressures and pulse volume waveforms in the presence of occlusive arterial disease Outline proper instrument control settings…

Intracranial Cerebrovascular Evaluation

Objectives On completion of this chapter, you should be able to: Distinguish normal from abnormal intracranial arterial anatomy Understand the circle of Willis physiology and hemodynamics Outline the technical aspects and proper instrumentation and control settings used to perform high-quality transcranial Doppler imaging Describe the characteristics of spectral Doppler waveforms obtained from arteries evaluated during a transcranial Doppler examination List the clinical applications of transcranial Doppler…

Extracranial Cerebrovascular Evaluation

Objectives On completion of this chapter, you should be able to: List the risk factors, signs, and symptoms for stroke and carotid artery disease Distinguish normal from abnormal carotid anatomy Understand the physiology of the carotid arterial system Discuss the technical aspects of carotid duplex imaging Recognize pathology associated with the carotid anatomy Describe the sonographic findings associated with internal carotid artery disease, specifically stenosis and…

Fetal Echocardiography: Congenital Heart Disease

Objectives On completion of this chapter, you should be able to: List the three factors that contribute to congenital heart disease Describe why the four-chamber view cannot rule out all forms of congenital heart disease Discuss the pathologic conditions covered in this chapter Discuss the echocardiographic findings for septal defects, ventricular inflow and outflow tract disturbances, great vessel abnormalities, cardiac tumors, complex cardiac abnormalities, and dysrhythmias…

Fetal Echocardiography: Beyond the Four Chambers

Objectives On completion of this chapter, you should be able to: Understand the embryologic development of the fetal heart Describe fetal circulation List the maternal risks factors that would require fetal echocardiography Explain how to sonographically evaluate the fetal heart with two-dimensional, M-mode, pulsed Doppler, and color flow Doppler imaging Locate fetal ultrasound landmarks Describe normal anatomy seen in the views discussed in this chapter Key…

Introduction to Clinical Echocardiography: Pericardial Disease, Cardiomyopathies, and Tumors

Objectives On completion of this chapter, you should be able to: Identify the echocardiographic distinction between pericardial effusion and pleural effusion Describe the echocardiographic findings in cardiac tamponade Describe the echocardiographic findings in dilated, restrictive, infiltrative, and hypertrophic cardiomyopathy Recognize the echocardiographic findings of tumors, thrombus, vegetations, and normal variants Key Terms Cardiac tamponade Constrictive pericarditis Dilated cardiomyopathy Exudative Fibrous pericardium Hypertrophic cardiomyopathy Lipomatous hypertrophy Malignant…