超声诊断先天性胎儿缺陷.ppt

3)Inbetween these two extremes: Post. Or ureth. Valves intermittent ureth. Obstruction + distended bladder. Oligohydramnios. Male foetuses (pulm.hypoplasia, Neonatal death). Fetal therapy ( intermittent catheterization) vesico amniotic shent Obstructive Uropathy cont… Congenital Cystic Disease of Kidney Isolated renal cysts : (DD: PUJO.) isolated + not communicating pelvis. Multicystic kidney (sequlae of obstructive uropthy). Infantile polycystic kidney disease: Autosomal recessive (one in 4 recurrence). Bilat. Cysts ( Microscepic to macroscepic + oligohydramnios) Adult polycystic kidney disease: Autosmal dominant - parents kidneys should be scanned serially. Cysts + normal amniotic fluid. Symptoms silent till 5 th decade. Congenital Cystic Disease of Kidney cont… Renal Dysplasia (Polycystic Kidney). Multiple or single echo- free spaces at the level of foetal kidneys. Identification should start after (22ws). If bilateral (bladder not demonstrated- amniotic fluid vol decreased or absent). Meckel’s syndrome ( encephalocele- cleft palate-polydacty + cong. Ht disease), may be associated. Neural Tube Defects 1/3 US Findings Suggestive of NTDs Anencephaly, hydranencephaly, and hydrocephalus: Difficulty in getting BPD landmarks. Wavering midline or head. Lack of cranial contour. Complete absence of midline echo. Dilated ventricles. Small choroid plexus. Enlarged BPD or HC. Progression. Other neural tube defects: Fish hook spine Widening of spinal region. Absence of vertical process. U or V shaped vertebral body Sac attached to spine or skull. Associated hydrocephaly. US Findings Suggestive of NTDs cont… Hydrocephalus First half of pregnancy (17-24 ws): Not diagnosed on basis of increased head size. Dilated lateral ventricles (V/H greater than 0.5). Late pregnancy: Increased BPD HC. BPD exceeds 11.0 cm at term. The area of foetal head is echo free. Thickness of c. cortex (future prognosis) Hydrocephalus cont… Anencephaly Absence of cranial vault (Acrania). I