产科超声标准幻灯片课件.ppt

The Scan ‘Menu’ Trish Chudleigh Advanced Practitioner Manager Cambridge University Hospitals Rationale for the Scan Menu to provide consistency in the scan procedure to specify measuring techniques to define the range of anatomical structures to be assessed to provide the minimum assessment that should be undertaken The NHS FASP Anomaly Screening Service population pre-screened low risk for Down’s (or declined screening) examination focused towards optimising perinatal management pathways addresses 11 selected conditions Includes target detection rates incorporates annual audit Key Ultrasound Features gestational age 18+0 – 20+6 weeks - change from ~20 weeks - no need to recall if scanned ‘early’ appointment time 30 minutes - times currently vary from 10-30 mins, 61% 20mins - underpins clinical importance of examination - supports extension of scanning time to incorporate additional views measurements Scan Menu – ‘tick list’ Area Views 1, 2 Head and neck HC (Chitty) + suboccipito-bregmatic 3 Face Lips coronal 4-7 Chest 4ch, both outflow tracts, lungs 8-12 Abdomen AC, cord insertion, kidneys, bladder 13-14 Spine Sagittal transverse, skin covering 15-19 Limbs FL, metacarpals metatarsals x 2 20-21 Uterine cavity Amniotic fluid, placenta position noted Scan Menu – fetal biometry HC Chitty et al Br J Obstet Gynaecol 1994 101:35-43 AC Chitty et al Br J Obstet Gynaecol 1994 101:125-131 Scan Menu – fetal biometry FL Chitty et al Br J Obstet Gynaecol 1994 101:132-135 small measurements compared to dating scan (significantly less than 5th centile on national charts) - refer Scan Menu – images diagrams Scan Menu – other measurements ISUOG Guideline. Ultrasound Obstet Gynecol 2007;29:109-116 Goldstein et al. Am J Obstet Gynecol 1987:156:1065-9 atrium 10.0mm – refer nuchal fold 6.0mm - refer Scan Menu – tick list referral echogenic bowel (with density equivalent to bone) – refer renal pelvic dilatation (AP measurement 7.