New PDF release: The 11-14-Week Scan: The Diagnosis of Fetal Abnormalities

By Kypros H. Nicolaides

ISBN-10: 185070743X

ISBN-13: 9781850707431

This can be a entire, authoritative clinician's textbook on utilizing ultrasound because the major diagnostic software within the prenatal detection of congenital abnormalities. It offers the root of studying for the theoretical portion of the certificates of Competence within the 11-14-week experiment presented via the Fetal drugs origin. The publication covers early screening for chromosomal abnormalities, implications of elevated nuchal translucency in chromosomally general fetuses, ultrasound analysis of fetal abnormalities, selection of chorionicity and implications and administration of a number of pregnancies, and multifetal being pregnant aid. Illustrated and hardcover certain.

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Extra info for The 11-14-Week Scan: The Diagnosis of Fetal Abnormalities

Example text

At 11–13+6 weeks single umbilical artery is found in about 3% of chromosomally normal fetuses and in 80% of fetuses with trisomy 18 (Rembouskos et al 2003). In the fetuses with single umbilical artery the observed number of cases of trisomy 21 is not significantly different from the number estimated on the basis of maternal age and fetal NT. In contrast, a single umbilical artery is associated with a seven fold increase in risk of trisomy 18. However, a high proportion of trisomy 18 fetuses have other major defects that are easily detectable at the 11–13+6 weeks scan and many other abnormalities that are detectable at 16–20 weeks.

The inter-examination variation in measurements is reduced considerably after an initial learning phase and after feedback to the sonographers on the distribution of their measurements and the quality of their images. The Fetal Medicine Foundation (FMF), which is a UK registered charity, has established a process of training and quality assurance for the appropriate introduction of NT screening into clinical practice. Training is based on a theoretical course, practical instruction on how to obtain the appropriate image and make the correct measurement of NT, and presentation of a logbook of images.

In trisomy 18, there is early onset fetal growth restriction, a tendency for bradycardia and exomphalos in 30% of cases, absent nasal bone in 55% and single umbilical artery in 75%. In trisomy 13, there is tachycardia in about 70% of the cases and early onset fetal growth restriction, megacystis, holoprosencephaly or exomphalos in about 40% of the cases. In Turner syndrome, there is tachycardia in about 50% of cases and early onset fetal growth restriction. In triploidy, there is early onset asymmetrical Chapter 2 • Sonographic features of chromosomal defects 45 fetal growth restriction, bradycardia in 30% of cases, holoprosencephaly, exomphalos or posterior fossa cyst in about 40% and molar changes in the placenta in about 30%.

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The 11-14-Week Scan: The Diagnosis of Fetal Abnormalities by Kypros H. Nicolaides

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