婦產(chǎn)科疾病的超聲診斷-ENGLISH課件

UltrasonographyonGynecologyandObstetricsLiuLipingUltrasonographyonLiuLiping1Sangreal--------uterusTHEDAWINCICODESangreal--------uterusTHEDAWI2PelvicCavityPosterior:Occupiedbyrectum,colon,andileumAnterior:bladder,ureters,ovaries,fallopiantubes,uterus,andvaginaNORMALANATOMYPelvicCavityNORMALANATOMY3Pre-inspection:Moderatebladderfilling

Pre-inspection:Moderatebladd4UterusHollow,pear-shapedorganDividedintofundus,body,andcervixUsuallyanteflexedandantevertedCoveredwithperitoneumexceptanteriorlybelowtheoswhereperitoneumisreflectedontobladderSupportedbylevatoranimusclesandpelvicfasciaRoundligamentkeepsuterusinpositionUterusHollow,pear-shapedorga5UterinesizePrepubertal:3cmlongby0.5to1.0cmwideMenarcheal:8cmlongby4cmwidePostmenopausal:3.5to5.5cmlongby1to2cmwideNormalsize:2~3(thick)×4~5(width)×7~8cm(length)UterinesizePrepubertal:3cm6Uterinelongitudinaldiameter

Uterinewidediameter

UterusbeforeandaftertheTrail

Uterinelongitudinaldiameter7length7~8cmbeforeandaftertheTrail

2~3cmwidth4~5cmlength7~8cmbeforeandaftert8UterinePositionMidlineanteversion:mostcommon;degreeofanteversionisbladderdistentiondependentRightorleft:normalvariantinabsenceofpelvicmassesRetroverted:entireorgandisplacedposteriorlyRetroflexed:bodydisplacedwithrespecttocervixUterinePositionMidlineanteve9UltrasonographyofnormaluterusUterineserosalayer:Linearhigh-echo;clear,smooth;

Myometrium:Homogeneousmiddle-echo;Endometria:Themiddlelineofhighecho,aroundtheweakecho.Itiswellknownthattheendometriumchangesdynamicallyinresponsetocyclichormonalflux.Ultrasonographyofnormaluter10Uterineserosalayer

Myometrium

Endometria

NormaluterustransabdominalultrasonographyUterineserosalayerMyometriu11Transvaginalsagittalviewoftheuterus.Theroundedfundusisshowntowardtheleftoftheimagewiththeendometrialstriperummingthroughthemiddleoftheuterinecavity.MyometriumEndometriaUterineserosalayerTransvaginalsagittalviewof12FallopianTube（輸卵管）Infundibulum:funnel-shapedlateraltubethatprojectsbeyondthebroadligamenttooverlietheovariesAmpulla:sidestpartofthetubewherefertilizationoccursIsthmus:hardestpart;liesjustlateraltotheuterusLength:12cm;suppliedbyovarionarteriesandveinsFallopianTube（輸卵管）Infundibulu13Ovary（卵巢）AlmondshapedAttachedtobackofthebroadligamentbymesovarium;sometimescalledsuspensoryligamentoftheovaryLiesinovarianfossaFossaisboundedbyexternaliliacvessels,ureter,andobturatornerveReceivesbloodfromovarianarteryBlooddrainedbyovarianveinintoinferiorvenacavaonright;onleftbyovarianveinintolertrenalveinOvary（卵巢）Almondshaped14SonographyofthenormalovaryAnovoidhomogeneousechodensity;follicularcystsareoftenpresent.Thebestsonographicmarkerfortheovaryisidentificationofafollicularcyst,whichhastheclassicappearanceofbeingthinwalledandanechoicwiththrough-transmissionposteriorly.Sonographyofthenormalovary15TransabdominalsagittalimageshowstheleftovaryposteriortotheurinarybladderTransabdominalsagittalimage16TransvaginalsagittalimageoftheovaryovarianfollicleTransvaginalsagittalimageof17FollicularwallflowFollicularwallflow18CommonDiseasesofObstetricsandGynecologyGynecology：Leiomyoma；Carcinoma;；OvarianTumors;Inflammatorymass;etc.Obstetrics：

Naturalpregnancy；Abnormalpregnancy;etc.CommonDiseasesofObstetrics19TheuterusLeiomyoma/HysteromyomaTheuterusLeiomyoma/Hystero20CharacteristicsofLeiomyomasMostcommonpelvictumorSmoothmusclecellcompositionFibrosisoccursafteratrophicofdegenerativechangesDegenerationoccurswhenfibroidsoutstriptheirbloodsupply;calcificationMaybepedunculatedClinical:enlargeduterus,profuseandprolongedbleeding,painCharacteristicsofLeiomyomasM21UterineLocationsofleiomyomasSubmucosalErodeintoendomertialcavity–heavybleeding;infertilityIntramuralMayenlargetocausepressureonadjacentorgans;infertilitySubserosalMayenlargetocausepressureonadjacentorgansUterineLocationsofleiomyoma22SubserousmyomaBroadligamentmyomaCervicalmyomaintramurousmyomaSubmucousmyomaSubserousBroadligamentCervic23UltrasonicperformanceTwo-dimensional：①IncreaseduterinebodyorFormdisorders；②Sphericalhypoechoicareaintheuterinebody，Rearechoattenuation；③WithcalcificationorCysticchange,etc；④Signsofoppression；ColorDoppler：Tumoraroundwiththebloodflowsignalintheshapeofringorsemi-circularring；Dopplerspectrum：Mediumresistanceindex，RI0.6±0.1。UltrasonicperformanceTwo-dime24intramurousmyomaintramurousmyoma25SubserousmyomaintramurousmyomaSubserousmyomaintramurousmyo26SubserousmyomaSubserousmyoma27CervicalmyomaCervicalmyoma28AbundanttumorbloodflowMUTAbundanttumorbloodflowMUT29RI0.61RI0.6130SubmucousmyomawithcalcificationSubmucous31Teratoma

DermoidTummors

（卵巢良性囊性畸胎瘤/皮樣囊腫)Pathology：derivesfromgermcell，themostcommonovarianneoplasm,constituting20%ofovariantumors.upto20%arebilateral.About80%occurinwomenofchildbearingage.Teratoma

DermoidTummors

（卵巢32Sizerangesfromsmallto40cmUnliateral,roundtoovalmassContainsfaty,sebaceousmaterial,hair,cartilage,bone,teethClinical:asymptomatictoabdominalpain,enlargementandpressure;pedunculated,subjecttotorsionSonography:Cystic/complex/solidmass,echogeniccomponents;acousticshadowingSizerangesfromsmallto40c33SpecialUltrasoundFindings:1.Acysticmass:

withanechogenicmuralnodule2.Apastesign：particulateliptinite3.Afluffofhairsign4.Afat-fluidlevelsign：withfluidlevelinthecyst,fatabove,fluidbelow.5.AcomplexmassSpecialUltrasoundFindings:1.34cysticteratomaofovaryAcysticmassPastesignFluffofhairsigncysticteratomaAcysticmassP35PastesignFat-fluidlevelsignAcomplexmassPastesignFat-fluidlevelsign36A8yearsoldgirl,cuttingoffathreekilogramsbenignteratomaA8yearsoldgirl,cuttingof37TheroleofUltrasoundinObstetricsTheroleofUltrasoundinObst38TRIMESTERSFirsttrimester=0to12weeksofgestationSecondtrimester=13to26weeksofgestationThirdtrimester=27to42weeksofgetsationPosttermpregnancy=>42weeksofgestationTRIMESTERSFirsttrimester39IndicationsforFirst-TrimesterSonographyConfirmpresenceofintrauterinepregnancyEvaluateforsuspectedectopicpregnancyDefinecauseofvaginalbleedingDeterminegestationalageConfirmsuspectedmultiplegestationsAidininvasiveproceduresEvaluatepelvicmassesDetectuterineabnormalitiesIndicationsforFirst-Trimeste40NaturalpregnancyNaturalpregnancy41Nonagepregnancy

(First-Trimester)Definition：Pregnancybefore12weekend.Nonagepregnancy

(First-Trime425weekspregnant—

Gestationalsac；6-7weekspregnant—Germ;7-8Weeks—Primitivehearttubepulse；8-11weeks—Yolksac;9weeks—Embryonic,placenta.TheNormalFirstTrimester5weekspregnant—TheNormalF43SonographicFeaturesofaNormalGestationalSacShape:roundofovalPosition:fundalormiddleportionofuterus;acenterpositionrelativetoendometriumContour:smoothWall:echogenic;3mmofmoreinthicknessSonographicFeaturesofaNorm44Internallandmarks:yalksacpresentwhengestationalsacislargerthan10mm;embryopresentwhengestationalsacislargerthan18mmGrowth:1mmperday(range:0.7mmto1.5mmperday)Internallandmarks:yalksacp454-5weekspregnantInthegestationalsacwecanseeaembryopoint,theearliestembryo.4-5weekspregnant467weekspregnant

Fetuswasabout4mm，wecanseeapparentheartthrob,andsmalllimbbud.7weekspregnant478weekspregnant

Three-dimensionalultrasoundshowitsbeginningoftheshapeofahuman.8weekspregnant48UmbilicalbordEmbryonicheadEmbryonicabdomenUmbilicalbordEmbryonicheadEm49YolksacEmbronicheadAmnioticsacYolksacEmbronicheadAmniotic509weekspregnant

Knownasafetal，Developmentofthevariouspartsofthefetus,tendstoimprove.9weekspregnant5112weekspregnantThespineisidentifiable,asthetwobead-likehighecho.Ears,limbs,bonescanbeshownandmeasurement.12weekspregnant52UltrasoundoftheSecondandThirdTrimestersUltrasoundoftheSecondandT53IndicationsforSecond-and

Third-TrimesterEstimategestationalageforpatientswithuncertaindatesEvaluateuterinesizeandclinicaldatediscrepanciesEvaluatefetalgrowthEstimatefetalweightDeterminefetalpresentationEvaluatefetallifeIndicationsforSecond-and

T54provideadjuncttoamniocentesis,percutaneousumbilicalbloodsamplingprocedure,orcerclageplacementEvaluateuterineabnormalityEvaluateabnoumalmaternalserumalpha-fetoproteinvaluesEvaluateabnormalamnioticfluidEvaluateplacentaEvideadjuncttoamniocente55TheSecond-and

Third-Trimester

(Metaphaseandterminalprengancy)Mid-pregnancy:13-27weekspregnancy.Late-pregnancy:Morethan28weeksofpregnancy.TheSecond-and

Third-Trimest56ScanningTechniquesSurveyuterusObservecardiacactivityDeterminepositionandnumberofthefetusandplacentaAssessamnioticfluidLookforuterineofplacentalmassesandfetalanomaliesScanningTechniquesSurveyuter57Checkcontents1、Fetalhead：BPD

biparietaldiameter;2、Fetalabdomen:ACabdomencircumference;3、Fetallimb：FLfemurlength;4、Others：Placenta,Fetalheartrate,Amnioticfluid,etc.Checkcontents581、FetalheadMeasuringtheBiparietalDiameter(BPD)Obitainbiparietaldiameterofthefetalheadatthetransverselevelofthemidbrain:falx,cavumseptipellucidi,andthalamicnucleiMakesuretheheadissymmetricandovalMeasurefromoutertoinnermarginsoftheskullInthethirdtrimester,theBPDisnotasaccurateinpredictingfetalage1、FetalheadMeasuringtheBi59Fetalhead,after12weekendpregnantFetalhead,after12we60Fetalsideprofile,wecanobserveitsforehead,nose,lip,andchin,etc.Fetalsideprofile,we612、FetalabdomenThehepatobiliarysystem:liver,portvenoussysterm,hepaticveinsandarteries,gallbladder,andbileductsThegastrointestinalsystem:theesophagus,stomach,smallandlargeintestines(colon)2、FetalabdomenThehepatobilia62Theurinarysystem:kidneys,adrenalglands,ureters,bladder.Thefetalabdomencircumference（AC)

isthemostwidelymeasuredTheurinarysystem:kidneys,63MeasuringtheAbdominalCircumference(AC)TheACshouldbetakenfromaroundtransverseimagewiththeumbilicalportionoftheleftportalveinmidlinewithintheliverTheoutermarginoftheabdominalwallshouldbemeasuredTheabdominalwallmeasurementistheleastaccurateMeasuringtheAbdominalCircum64ThefetallivergallbladderstomachportvenousspinegallbladderstomachThefetallivergallbladderstom653、FetallimbsTheupperlimbs:theulnatheradiusthehumerusThelowerlimbs:thefemur/thethighbonethefibulathetibiaThefemuristhemostwidelymeasuredlongbone（FLfemurlength）3、FetallimbsTheupperlimbs:66FemurmeasurementHyperechoniclinearstructurerepresentstheossifiedportionofthefemoualdiaphysisandcorrespondstofemorallengthmeasurementfromthegreatertrochantertothefemoralcondylesThemormalfemurhasastraightlaeralborderandacurvedmedialborderFemurlengthmaybeusedwiththesameaccuracyasBPDtopredictgestationalageFemurlengthmayindicateskeletaldysplasiasorintrauterinegrowthrestrictionFemurmeasurementHyperechonic67LongsectionoftheupperlimbsTheradiusTheulnaThehumerus

Longsectionoftheupperlimb68Femur/thighboneFibula/perone

Tibia/shinbone

Longsectionofthe

lowerlimbs

Femur/thighboneFibula/perone694、Theplacenta（胎盤）Themajorfoleoftheplacentaistopermittheexchangeofoxygenatedmaternalblood(richinoxgenandnutrients)withdeoxygenatedfetalblood.Thethicknessoftheplacentavarieswithgestationalage,withaminimumdiameterof15mminfetusesgreaterthan23weeks.Thesizeoftheplacentararelyexceeds50mminthenormalfetus.4、Theplacenta（胎盤）Themajorf70Anteriorplacentaat21weeksofgastationTheplacentaUmbilicalbordAmnioticfluidThefetalAnteriorplacentaat21weeks71posteriorplacentaat29weeksofgestationcalcificationposteriorplacentaat29week72Anteriorplacentaat39weeksofgastationAnteriorplacentaat39weeks73CalmlittlefaceEatingtoeEatingfingersCalmlittlefaceEatingtoeEat74CryingPouttingCryingPoutting75FetalwithumbilicalcordaroundtheneckFetalwithcleftlipFetalwithumbilicalcordarou76smailingsmailing77Baobao,Beibei100daysold!Baobao,Beibei100daysold!78Baobao,Beibei1year'sbirthday!Baobao,Beibei1year'sbirth79THANKSALL!THANKSALL!80UltrasonographyonGynecologyandObstetricsLiuLipingUltrasonographyonLiuLiping81Sangreal--------uterusTHEDAWINCICODESangreal--------uterusTHEDAWI82PelvicCavityPosterior:Occupiedbyrectum,colon,andileumAnterior:bladder,ureters,ovaries,fallopiantubes,uterus,andvaginaNORMALANATOMYPelvicCavityNORMALANATOMY83Pre-inspection:Moderatebladderfilling

Pre-inspection:Moderatebladd84UterusHollow,pear-shapedorganDividedintofundus,body,andcervixUsuallyanteflexedandantevertedCoveredwithperitoneumexceptanteriorlybelowtheoswhereperitoneumisreflectedontobladderSupportedbylevatoranimusclesandpelvicfasciaRoundligamentkeepsuterusinpositionUterusHollow,pear-shapedorga85UterinesizePrepubertal:3cmlongby0.5to1.0cmwideMenarcheal:8cmlongby4cmwidePostmenopausal:3.5to5.5cmlongby1to2cmwideNormalsize:2~3(thick)×4~5(width)×7~8cm(length)UterinesizePrepubertal:3cm86Uterinelongitudinaldiameter

Uterinewidediameter

UterusbeforeandaftertheTrail

Uterinelongitudinaldiameter87length7~8cmbeforeandaftertheTrail

2~3cmwidth4~5cmlength7~8cmbeforeandaftert88UterinePositionMidlineanteversion:mostcommon;degreeofanteversionisbladderdistentiondependentRightorleft:normalvariantinabsenceofpelvicmassesRetroverted:entireorgandisplacedposteriorlyRetroflexed:bodydisplacedwithrespecttocervixUterinePositionMidlineanteve89UltrasonographyofnormaluterusUterineserosalayer:Linearhigh-echo;clear,smooth;

Myometrium:Homogeneousmiddle-echo;Endometria:Themiddlelineofhighecho,aroundtheweakecho.Itiswellknownthattheendometriumchangesdynamicallyinresponsetocyclichormonalflux.Ultrasonographyofnormaluter90Uterineserosalayer

Myometrium

Endometria

NormaluterustransabdominalultrasonographyUterineserosalayerMyometriu91Transvaginalsagittalviewoftheuterus.Theroundedfundusisshowntowardtheleftoftheimagewiththeendometrialstriperummingthroughthemiddleoftheuterinecavity.MyometriumEndometriaUterineserosalayerTransvaginalsagittalviewof92FallopianTube（輸卵管）Infundibulum:funnel-shapedlateraltubethatprojectsbeyondthebroadligamenttooverlietheovariesAmpulla:sidestpartofthetubewherefertilizationoccursIsthmus:hardestpart;liesjustlateraltotheuterusLength:12cm;suppliedbyovarionarteriesandveinsFallopianTube（輸卵管）Infundibulu93Ovary（卵巢）AlmondshapedAttachedtobackofthebroadligamentbymesovarium;sometimescalledsuspensoryligamentoftheovaryLiesinovarianfossaFossaisboundedbyexternaliliacvessels,ureter,andobturatornerveReceivesbloodfromovarianarteryBlooddrainedbyovarianveinintoinferiorvenacavaonright;onleftbyovarianveinintolertrenalveinOvary（卵巢）Almondshaped94SonographyofthenormalovaryAnovoidhomogeneousechodensity;follicularcystsareoftenpresent.Thebestsonographicmarkerfortheovaryisidentificationofafollicularcyst,whichhastheclassicappearanceofbeingthinwalledandanechoicwiththrough-transmissionposteriorly.Sonographyofthenormalovary95TransabdominalsagittalimageshowstheleftovaryposteriortotheurinarybladderTransabdominalsagittalimage96TransvaginalsagittalimageoftheovaryovarianfollicleTransvaginalsagittalimageof97FollicularwallflowFollicularwallflow98CommonDiseasesofObstetricsandGynecologyGynecology：Leiomyoma；Carcinoma;；OvarianTumors;Inflammatorymass;etc.Obstetrics：

Naturalpregnancy；Abnormalpregnancy;etc.CommonDiseasesofObstetrics99TheuterusLeiomyoma/HysteromyomaTheuterusLeiomyoma/Hystero100CharacteristicsofLeiomyomasMostcommonpelvictumorSmoothmusclecellcompositionFibrosisoccursafteratrophicofdegenerativechangesDegenerationoccurswhenfibroidsoutstriptheirbloodsupply;calcificationMaybepedunculatedClinical:enlargeduterus,profuseandprolongedbleeding,painCharacteristicsofLeiomyomasM101UterineLocationsofleiomyomasSubmucosalErodeintoendomertialcavity–heavybleeding;infertilityIntramuralMayenlargetocausepressureonadjacentorgans;infertilitySubserosalMayenlargetocausepressureonadjacentorgansUterineLocationsofleiomyoma102SubserousmyomaBroadligamentmyomaCervicalmyomaintramurousmyomaSubmucousmyomaSubserousBroadligamentCervic103UltrasonicperformanceTwo-dimensional：①IncreaseduterinebodyorFormdisorders；②Sphericalhypoechoicareaintheuterinebody，Rearechoattenuation；③WithcalcificationorCysticchange,etc；④Signsofoppression；ColorDoppler：Tumoraroundwiththebloodflowsignalintheshapeofringorsemi-circularring；Dopplerspectrum：Mediumresistanceindex，RI0.6±0.1。UltrasonicperformanceTwo-dime104intramurousmyomaintramurousmyoma105SubserousmyomaintramurousmyomaSubserousmyomaintramurousmyo106SubserousmyomaSubserousmyoma107CervicalmyomaCervicalmyoma108AbundanttumorbloodflowMUTAbundanttumorbloodflowMUT109RI0.61RI0.61110SubmucousmyomawithcalcificationSubmucous111Teratoma

DermoidTummors

（卵巢良性囊性畸胎瘤/皮樣囊腫)Pathology：derivesfromgermcell，themostcommonovarianneoplasm,constituting20%ofovariantumors.upto20%arebilateral.About80%occurinwomenofchildbearingage.Teratoma

DermoidTummors

（卵巢112Sizerangesfromsmallto40cmUnliateral,roundtoovalmassContainsfaty,sebaceousmaterial,hair,cartilage,bone,teethClinical:asymptomatictoabdominalpain,enlargementandpressure;pedunculated,subjecttotorsionSonography:Cystic/complex/solidmass,echogeniccomponents;acousticshadowingSizerangesfromsmallto40c113SpecialUltrasoundFindings:1.Acysticmass:

withanechogenicmuralnodule2.Apastesign：particulateliptinite3.Afluffofhairsign4.Afat-fluidlevelsign：withfluidlevelinthecyst,fatabove,fluidbelow.5.AcomplexmassSpecialUltrasoundFindings:1.114cysticteratomaofovaryAcysticmassPastesignFluffofhairsigncysticteratomaAcysticmassP115PastesignFat-fluidlevelsignAcomplexmassPastesignFat-fluidlevelsign116A8yearsoldgirl,cuttingoffathreekilogramsbenignteratomaA8yearsoldgirl,cuttingof117TheroleofUltrasoundinObstetricsTheroleofUltrasoundinObst118TRIMESTERSFirsttrimester=0to12weeksofgestationSecondtrimester=13to26weeksofgestationThirdtrimester=27to42weeksofgetsationPosttermpregnancy=>42weeksofgestationTRIMESTERSFirsttrimester119IndicationsforFirst-TrimesterSonographyConfirmpresenceofintrauterinepregnancyEvaluateforsuspectedectopicpregnancyDefinecauseofvaginalbleedingDeterminegestationalageConfirmsuspectedmultiplegestationsAidininvasiveproceduresEvaluatepelvicmassesDetectuterineabnormalitiesIndicationsforFirst-Trimeste120NaturalpregnancyNaturalpregnancy121Nonagepregnancy

(First-Trimester)Definition：Pregnancybefore12weekend.Nonagepregnancy

(First-Trime1225weekspregnant—

Gestationalsac；6-7weekspregnant—Germ;7-8Weeks—Primitivehearttubepulse；8-11weeks—Yolksac;9weeks—Embryonic,placenta.TheNormalFirstTrimester5weekspregnant—TheNormalF123SonographicFeaturesofaNormalGestationalSacShape:roundofovalPosition:fundalormiddleportionofuterus;acenterpositionrelativetoendometriumContour:smoothWall:echogenic;3mmofmoreinthicknessSonographicFeaturesofaNorm124Internallandmarks:yalksacpresentwhengestationalsacislargerthan10mm;embryopresentwhengestationalsacislargerthan18mmGrowth:1mmperday(range:0.7mmto1.5mmperday)Internallandmarks:yalksacp1254-5weekspregnantInthegestationalsacwecanseeaembryopoint,theearliestembryo.4-5weekspregnant1267weekspregnant

Fetuswasabout4mm，wecanseeapparentheartthrob,andsmalllimbbud.7weekspregnant1278weekspregnant

Three-dimensionalultrasoundshowitsbeginningoftheshapeofahuman.8weekspregnant128UmbilicalbordEmbryonicheadEmbryonicabdomenUmbilicalbordEmbryonicheadEm129YolksacEmbronicheadAmnioticsacYolksacEmbronicheadAmniotic1309weekspregnant

Knownasafetal，Developmentofthevariouspartsofthefetus,tendstoimprove.9weekspregnant13112weekspregnantThespineisidentifiable,asthetwobead-likehighecho.Ears,limbs,bonescanbeshownandmeasurement.12weekspregnant132UltrasoundoftheSecondandThirdTrimestersUltrasoundoftheSecondandT133IndicationsforSecond-and

Third-TrimesterEstimategestationalageforpatientswithuncertaindatesEvaluateuterinesizeandclinicaldatediscrepanciesEvaluatefetalgrowthEstimatefetalweightDeterminefetalpresentationEvaluatefetallifeIndicationsforSecond-and

T134provideadjuncttoamniocentesis,percutaneousumbilicalbloodsamplingprocedure,orcerclageplacementEvaluateuterineabnormalityEvaluateabnoumalmaternalserumalpha-fetoproteinvaluesEvaluateabnormalamnioticfluidEvaluateplacentaEvideadjuncttoamniocente135TheSecond-and

Third-Trimester

(Metaphaseandterminalprengancy)Mid-pregnancy:13-27weekspregnancy.Late-pregnancy:Morethan28weeksofpregnancy.TheSecond-and

Third-Trimest136ScanningTechniquesSurveyuterusObservecardiacactivityDeterminepositionandnumberofthefetusandplacentaAssessamnioticfluidLookforuterineofplacentalmassesandfetalanomaliesScanningTechniquesSurveyuter137Checkcontents1、Fetalhead：BPD

biparietaldiameter;2、Fetalabdomen:ACabdomencircumference;3、Fetallimb：FLfemurlength;4、Others：Placenta,Fetalheartrate,Amnioticfluid,etc.Checkcontents1381、FetalheadMeasuringtheBiparietalDiameter(BPD)Obitainbiparietaldiameterofthefetalheadatthetransverselevelofthemidbrain:falx,cavumseptipellucidi,andthalamicnucleiMakesuretheheadissymmetricandovalMeasurefromoutertoinnermarginsoftheskullInthethirdtrimester,theBPDisnotasaccurateinpredictingfetalage1、FetalheadMeasuringtheBi139Fetalhead,after12weekendpregnantFetalhead,after12we140Fetalsideprofile,wecanobserveitsforehead,nose,lip,andchin,etc.Fetalsideprofile,we1412、FetalabdomenThehepatobiliarysystem:liver,portvenoussysterm,hepaticveinsandarteries,gallbladder,andbileductsThegastrointestinalsystem:theesophagus,stomach,smallandlargeintestines(colon)2、FetalabdomenThehepatobilia142Theurinarysystem:kidneys,adrenalglands,ureters,