IN THE NAME OF GODIN THE NAME OF GOD

3RD

TRIMESTER

SONOGRAPHY

Historical UltrasoundHistorical Ultrasound

• 1876 : 1st used dog

• 1880 discovery of piezoelectric effect

• 1940 Ultrasonic energy was 1st applied in human body for medical purpose.

• 1954 Medical application of ultrasound.

How to work Ultrasound ?How to work Ultrasound ?

• Air 331 m/s

• Water 1340 m/s

• Soft tissue 1450 m/s

• Bone 1540 m/s

How to work Ultrasound ?How to work Ultrasound ?

• Tranceducer

• According to wavelength and speed and density tissue reflect to oscillator

• Display to monitor

• A-Mode, B-Mode , M-Mode

• 2 D , 3D ,4D

Safety UltrasoundSafety Ultrasound

• Ti:up to 1 degree Celsius

• Tis: Soft tissue

• TiC: Cranium

• TiB: Bone

• Routine 2D may be safe

• 3D & 4D unsafe or hasard

Routine prenatal sonographyRoutine prenatal sonography as a screening tool as a screening tool

• CDC reported 67% routine sonography

• Support the use of ultrasound when there is a specific medical indication

• ACOG• AIUM• ACR• RCOG

Using ultrasound in OBsUsing ultrasound in OBs

• Confirm date of delivery ( EDC)

• Diagnosis of abnormal pregnancy

EP , Blighted ovum(1st Trimester)

• Anomaly

• Reduced diagnose of

IUGR(RGF) ,Postdatisem

Prevent abuse tocolytic (date )

33rdrd Trimester Trimester

• Abnormal Placenta Location

• IUGR(RGF)

• Maturity :osification proximal femur 32

distal tibia ,humerus 35 w

• BPD,FL,HC,AC,CI (2-3 w error )

• Amniotic fluid volum

• BPP,MBPP, Cervical lenght

33rdrd Trimester TrimesterMultiple MarkersMultiple Markers

• HC,FL equal to PD,FL,AC,HC

• HC/AC

• BPD/FL

• FL/AC

• Others: interaorbital,clavicle length

Foot length….etc.

Ponderal IndexPonderal Index

• = birth weight(gr) x 100 crown-heel length(cm)

nasal bone Ossification

Head Circumference HDHead Circumference HD

Femoral Length FLFemoral Length FL

CRLCRL

ACAC

جنون ” ای قطره همیشه عشق درهمیشه هم جنون در و هست

عقل ای “قطره( نیچه (فردریک

“Always there is a drop of madness in love, yet always there is a drop of reason in madness” (F. Nietzshe)