2002-02-11-15 Ultrasound examination in the second and third trimester © Novakov www.thefetus.net/
Ultrasound examination in the second & third trimester
Aleksandra Mikic Novakov, MD, PhD
Novi Sad, Yugoslavia
Normal fetal morphology
Transverse section of the skull at the biparietal diameter level
 | -
complete ossification of the skull -
choroid plexuses fill the anterior and posterior horns of the lateral ventricles -
anterior and posterior horns less than 10 mm (Va/Hem ratio less than 0.5) |
Biometry of the skull and brain at the biparietal diameter level
Transverse section of the skull at the level of the posterior fossa
 | - cerebellum exists, normal shape
- vermis seen in whole
- cisterna magna bigger than 3.5 mm
- nuchal fold less than 5 mm.
|
Biometry of the skull and brain at the level of the posterior fossa
 | Measurement of : - transcerebellar diameter (TCD),
- cisterna magna (CM),
- nuchal fold (NF)
|
Transverse section of the head at the level of the orbits
Hard palate
 | - continuity of the hard palate
|
Coronal section of the face
 | -
continuity of the upper and lower lip -
normal shape of the nostril -
the tip of the nose and the chin seen at the same time |
Fetal profile
Neck
 | - continuity of the cervical spine and the skin that covers it
|
Chest
 | -
lungs of normal echogenicity, homogenous -
apex of the heart points to the front and left -
right chamber closer to the thorax, seems shorter and coarser than the right one -
both ventricles of the same size -
both atria of the same size -
continuity of the interventricular septum -
continuity of the interatrial septum |
Heart - left ventricle outflow tract
 | - continuity of the interventricular septum and front wall of the aorta
|
Heart - great vessels
Heart - longitudinal section of the aortic arch
 | - aortic arch with the branches for head and neck (t. brachiocephalicus, a. carotis communis sin, a. subclavia sin)
|
Longitudinal section of the fetus - chest and abdomen
 | -
diaphragm completely divides thorax from the abdomen -
stomach in the abdomen only -
thorax of the normal size compared to the abdom en |
Abdomen - measurement of abdominal circumference
 | - continuity of the ribs
- stomach at the left, normal size and shape
- measurement of the abdominal circumference
 |
Abdomen - umbilical cord insertion
 | - complete continuity of the abdominal wall
- normal cord insertion
|
Kidneys
Bladder
 | - normal size and shape of the bladder
|
Fetal sex- female / male
Arm and hands
 | -
both hands seen at the same time or enough away from each other to be sure that they both exist -
all phalanx seen -
extension of all the fingers on both hands -
normal length and form of all the long bones -
movements seen in all the joints  |
Leg and foot
 | -
both feet seen -
five toes, normal position of the big toe -
normal position of the foot, shin and thigh -
normal length and form of all the long bones -
movements seen in all the joints  |
Spine - longitudinal section
 | - continuity of the spine and the skin above it
|
Spine - transverse section
Spine - coronal section
Umbilical cord
 | - three vessels in the umbilical cord - one vein and two arteries
|
Uterine cervix
 | - measure the length of the cervix
- check whether there is funneling
|