Atlas of Ultrasound in Obstetrics and Gynecology Book

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Preface v

Acknowledgments vii

S E C T I O N

I Obstetrical Ultrasound 1
Normal Anatomy

1 First Trimester 31.1.

Normal Pregnancy Prior to 6 Weeks of Gestation 31.2.

Normal Pregnancy at 6–10 Weeks of Gestation 61.3.

Normal Pregnancy at 10–14 Weeks of Gestation 102

Second and Third Trimester Fetal Anatomy 152.1.

Head 152.2.

Face 182.3.

Spine 222.4.

Neck and Thorax 242.5.

Heart 272.6.

Abdomen 302.7.

Extremities 353

Second and Third Trimester Nonfetal Components 403.1.

Umbilical Cord 403.2.

Cervix in Pregnancy 433.3.

Placenta 453.4.

Amniotic Fluid 46
Fetal Abnormalities

4 Head 494.1.

Hydrocephalus 494.2.

Aqueductal Stenosis 514.3.

Dandy-Walker Malformation 524.4.

Anencephaly 544.5.

Encephalocele 564.6.

Agenesis of the Corpus Callosum 594.7.

Holoprosencephaly 604.8.

Vein of Galen Aneurysm 624.9.

Intracranial Hemorrhage and Porencephaly 644.10.

Schizencephaly 674.11.

Septo-Optic Dysplasia 684.12.

Hydranencephaly 704.13.

Cytomegalovirus and Other in Utero Infections 734.14.

Arachnoid Cyst 754.15.

Intracranial Tumors 784.16.

Lissencephaly 814.17.

Craniosynostosis 835

Spine 855.1.

Spina Bifi da and Meningomyelocele 855.2.

Hemivertebra 905.3.

Scoliosis 925.4.

Caudal Regression and Sacral Agenesis 935.5.

Sacrococcygeal Teratoma 966

Face 1006.1.

Cleft Lip and Palate 1006.2.

Macroglossia 1046.3.

Micrognathia 1066.4.

Hypotelorism 1076.5.

Cyclopia and Proboscis 1096.6.

Microphthalmia and Anophthalmia 1116.7.

Cysts and Tumors 1127

Neck 1147.1.

Thickened Nuchal Translucency (10–14 Weeks of Gestation) 1147.2.

Thickened Nuchal Fold (16–20 Weeks of Gestation) 1167.3.

Cystic Hygroma 1177.4.

Masses 1207.5.

Goiter 1218

Thorax 1238.1.

Pulmonary Masses and Dysplasias 1238.2.

Tracheal and Bronchial Atresia 1308.3.

Unilateral Pulmonary Agenesis 1318.4.

Diaphragmatic Hernia 1328.5.

Pleural Effusion and Hydrops 1369

Heart 1419.1.

Overview of Congenital Heart Disease 1419.2.

Hypoplastic Left Heart Syndrome and Aortic Stenosis 1419.3.

Hypoplastic Right Ventricle and Pulmonic Stenosis 1459.4.

Ebstein Anomaly 1479.5.

Ventricular Septal Defect 1499.6.

Atrioventricular Canal 1509.7.

Tetralogy of Fallot 1529.8.

Transposition of the Great Vessels 1539.9.

Truncus Arteriosus 1559.10.

Double Outlet Right Ventricle 1559.11.

Myocardial Tumors 1579.12.

Arrhythmias 1599.13.

Ectopia Cordis 1619.14.

Pericardial Effusion 16210

Gastrointestinal Tract 16410.1.

Esophageal Atresia 16410.2.

Duodenal Atresia 16510.3.

Small Bowel Obstruction 16710.4.

Meconium Peritonitis 16810.5.

Cholelithiasis 17110.6.

Liver Masses, Cysts, and Calcifi cations 17211

Ventral Wall 17511.1.

Omphalocele 17511.2.

Gastroschisis 17711.3.

Amniotic Band Syndrome 18012

Genitourinary Tract 18212.1.

Unilateral and Bilateral Renal Agenesis 18212.2.

Hydronephrosis: Overview 18512.3.

Ureteropelvic Junction Obstruction 18812.4.

Vesicoureteral Refl ux and Primary Megaureter 19012.5.

Posterior Urethral Valves and Urethral Atresia 19112.6.

Prune Belly Syndrome 19412.7.

Multicystic Dysplastic Kidney and Renal Dysplasia from Obstruction 19512.8.

Hereditary Polycystic Kidney Disease 19912.9.

Renal Ectopia 20012.10.

Mesoblastic Nephroma 20212.11.

Duplicated Collecting System and Ectopic Ureterocele 20412.12.

Ovarian Cysts and Masses 20512.13.

Cloacal and Bladder Exstrophy 20712.14.

Abnormal External Genitalia 20813

Extremities 21213.1.

Skeletal Dysplasia 21213.2.

Skeletal Dysostoses 21913.3.

Amputations and Limb Reduction Defects 22113.4.

Radial Ray Defects 22413.5.

Polydactyly 22613.6.

Overlapping Fingers and Clinodactyly 22813.7.

Clubfoot 23013.8.

Rocker Bottom Foot 23114

Chromosomal Anomalies 23214.1.

Trisomy 13 (Patau Syndrome) 23214.2.

Trisomy 18 (Edwards Syndrome) 23614.3.

Trisomy 21 (Down Syndrome) 24114.4.

Monosomy X (Turner Syndrome, 45X) 24514.5.

Triploidy 24714.6.

DiGeorge Syndrome (22-q11 Deletion) 251

Non-Fetal Abnormalities

15 First Trimester Pregnancy Complications 25315.1.

Failed Pregnancy 25315.2.

Subchorionic Hematoma 25515.3.

Slow Embryonic Heart Rate 25616

Placenta 25916.1.

Placenta Previa 25916.2.

Placental Abruption 26216.3.

Placenta Accreta, Increta, and Percreta 26416.4.

Chorioangioma 26817

Uterus and Cervix 27017.1.

Cervical Incompetence 27017.2.

Fibroids in Pregnancy 27417.3.

Uterine Synechia and Amniotic Sheet 27617.4.

Uterine Rupture 27717.5.

Uterine Incarceration 27818

Amniotic Fluid 28118.1.

Oligohydramnios 28118.2.

Polyhydramnios 28318.3.

Intra-amniotic Hemorrhage 28518.4.

Chorioamnionitis 28619

Umbilical Cord 28719.1.

Single Umbilical Artery 28719.2.

Abnormal Placental Cord Insertions and Vasa Previa 28919.3.

Allantoic Duct Cysts 29119.4.

Umbilical Arterial Doppler 29219.5.

Umbilical Venous Varix 29419.6.

Nuchal Cord 296

Multiple Gestations

20 Diagnosis and Characterization of Multiple Gestations 29820.1.

Fetal Number 29820.2.

Placentation: Chorionicity and Amnionicity 30321

Complications of Multiple Gestations 30821.1.

Twin–Twin Transfusion Syndrome 30821.2.

Acardiac Twinning 31021.3.

Cord Entanglement in Monoamniotic Twins 31221.4.

Conjoined Twins 31421.5.

Death of One Twin In Utero 318

Procedures

22 Diagnostic Obstetrical Procedures 32022.1.

Amniocentesis 32022.2.

Chorionic Villus Sampling 32222.3.

Percutaneous Umbilical Blood Sampling 32323

Therapeutic Obstetrical Procedures 32623.1.

Fetal Blood Transfusion 32623.2.

Thoracentesis and Thoracoamniotic Shunting 32823.3.

Bladder Drainage and Vesicoamniotic Shunting 330C O N T E N T S

xiii23.4.

Paracentesis 33323.5.

Treatment of Cardiac Anomalies 33423.6.

Ex Utero Intrapartum Treatment Procedure 33823.7.

Removal of Intrauterine Device During Pregnancy 34023.8.

Treatment of Complications of Multiple Gestations 341

S E C T I O N

II Gynecological Ultrasound 345
Normal Anatomy

24 Uterus 34724.1.

Myometrium 34724.2.

Endometrium 34825

Adnexa 35125.1.

Ovaries 35125.2.

Extraovarian Adnexal Structures 354

Pathology

26 Myometrium 35526.1.

Fibroids (Leiomyomas) and Leiomyosarcomas 35526.2.

Adenomyosis 36226.3.

Congenital Uterine Anomalies 36327

Endometrium 36827.1.

Endometrial Polyps 36827.2.

Endometrial Hyperplasia 37227.3.

Endometrial Carcinoma 37327.4.

Gestational Trophoblastic Disease 37427.5.

Retained Products of Conception 37728

Ovaries and Adnexa 38028.1.

Simple Ovarian Cysts 38028.2.

Hemorrhagic Ovarian Cysts 38128.3.

Ovarian Teratomas 38428.4.

Ovarian Benign Neoplasms Other Than Teratomas 38628.5.

Ovarian Cancer 38928.6.

Ovarian Torsion 39128.7.

Endometriosis 39528.8.

Hydrosalpinx 39728.9.

Tubo-ovarian Abscess 39729

Ectopic Pregnancy 40029.1.

Tubal Ectopic Pregnancy 40029.2.

Cornual (Interstitial) Ectopic Pregnancy 40429.3.

Cervical Ectopic Pregnancy 40629.4.

Cesarean Scar Pregnancy Implantation 40729.5.

Abdominal Ectopic Pregnancy 40929.6.

Heterotopic Pregnancy 410

Procedures

30 Diagnostic Gynecological Procedures 41230.1.

Saline Infusion Sonohysterography 41231

Therapeutic Gynecological Procedures 41631.1.

Ovarian Cyst Aspiration 41631.2.

Oocyte Retrieval 41831.3.

Ultrasound-Guided Uterine Instrumentation Through the Cervix 41831.4.

Ectopic Pregnancy Ablation 42031.5.

Pelvic Abscess Drainage 423Index 425