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The 12 Week
Scan
Early Anomaly
Scan
Dr Fred UshakovUniversity ollege London Hospital
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Dr Fred Ushakov The 12 Week Sc
FMF 11-13 wks Anatomical Assessment
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Dr Fred Ushakov The 12 Week Sc
Increased NT and normal karyotype
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Dr Fred Ushakov The 12 Week Sc
NT, TR and DV
Markers forcongenital heart defects
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Follow-up Scan at 16 weeks
Proposition for women with increased NT and/orinconclusive findings
***
Resolution:
Transabdominal scan at 16 weeks = Transvaginal scan at 12 weeks
Patient stresswaiting 3-4 weeks forreassurance
More complications in the case of TOP
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U/S visualization of fetal anatomy
Fetal structure 7 wks 8 9 10 11 12 13 14 wks
Neural tube + + + + + + + +
Head + + + + + + + +
Midgut herniation + + + +
Falx cerebri + + + + + +
Choroid plexus + + + + + +
Thalamus + + + + + +
Humerus & femur + + + + + +
Fingers + + + + + +
Tibia & radius + + + +
Toes + + + +
Cerebellum + + + +
Face + + + +
Heart - 4 chambers + + + +
Lens + + +
Stomach + +
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Transvaginal scan:Advantages
close to the region of interest high-resolution excellent Doppler irrespective of abdominal wall thickness
Good for fetal anatomy, TR, DV
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Transvaginal scan:Shortcomings
Low penetration Difficult orientation Needs preparation (to empty bladder, to clean and cover
transducer)
Less convenient to patient and operator Needs high level of expertise
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Dr Fred Ushakov The 12 Week Sc
Special Course:Technique of Transvaginal 12 Week
Anomaly Scan + Echocardiography
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Dr Fred Ushakov The 12 Week Sc
Sonographic markers of aneuploidy
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Dr Fred Ushakov The 12 Week Sc
Acrania 11 wks
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Dr Fred Ushakov The 12 Week Sc
Acrania 12 wks
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Dr Fred Ushakov The 12 Week Sc
Acrania brain 12 wks
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Dr Fred Ushakov The 12 Week Sc
Acrania 3D
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Dr Fred Ushakov The 12 Week Sc
Acrania - DCDA twins 12 wks
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Dr Fred Ushakov The 12 Week Sc
Acrania amniotic bands 12 wks
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Dr Fred Ushakov The 12 Week Sc
Amniotic bands 11 wks
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Dr Fred Ushakov The 12 Week Sc
D/D amniotic bands vitelline artery
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Dr Fred Ushakov The 12 Week Sc
D/D amniotic bands vitelline artery
CRL = 26 mm
9+3 wks
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Dr Fred Ushakov The 12 Week Sc
D/D amniotic bands vitelline artery
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Dr Fred Ushakov The 12 Week Sc
Body stalk anomaly - 12 wks
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Dr Fred Ushakov The 12 Week Sc
Body stalk anomaly - 12 wks
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Dr Fred Ushakov The 12 Week Sc
Body stalk anomaly - 12 wks
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Dr Fred Ushakov The 12 Week Sc
Thoracopagus + body stalk anomaly - 12 wks
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Dr Fred Ushakov The 12 Week Sc
Spina bifida
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Dr Fred Ushakov The 12 Week Sc
Normal brain - 12 wks
Dandy-Walker malformation triploidy
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Dr Fred Ushakov The 12 Week Sc
Dandy-Walker malformation triploidy 12 wks
Dandy-Walker malformation triploidy
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Dr Fred Ushakov The 12 Week Sc
Dandy-Walker malformation triploidy 12 wks transabdominal scan
Triploidy partial mole early IUGR
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Dr Fred Ushakov The 12 Week Sc
Triploidy, partial mole, early IUGR 12 wks
T i l id i l l 12 k
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Dr Fred Ushakov The 12 Week Sc
Triploidy, partial mole 12 wks
C l t l 12 k
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Dr Fred Ushakov The 12 Week Sc
Complete mole 12 wks
C l t l 12 k
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Dr Fred Ushakov The 12 Week Sc
Complete mole 12 wks
DCDA twins: Complete mole and
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Dr Fred Ushakov The 12 Week Sc
DCDA twins Complete mole andNormal Fetus 18 wks
E h l l 12 k
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Dr Fred Ushakov The 12 Week Sc
Encephalocele 12 wks
Encephalocele 12 wks
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Dr Fred Ushakov The 12 Week Sc
Encephalocele 12 wks
Cephalocele 11 wks
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Dr Fred Ushakov The 12 Week Sc
Cephalocele 11 wks
Cephalocele 11 wks
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Dr Fred Ushakov The 12 Week Sc
Cephalocele 11 wks
Cephalocele (not visible) 11 wks
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Dr Fred Ushakov The 12 Week Sc
Cephalocele (not visible) 11 wks
Encephalocele 12 wks missed
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Dr Fred Ushakov The 12 Week Sc
Encephalocele 12 wks - missed
Encephalocele missed 12 wks
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Dr Fred Ushakov The 12 Week Sc
now 20 wks
Cystic hygroma 12 wks
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Dr Fred Ushakov The 12 Week Sc
normal karyotype
Cystic hygroma 13 wks
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Dr Fred Ushakov The 12 Week Sc
normal karyotype - HLHS
Cystic hygroma + CPC 11 wks l k
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Dr Fred Ushakov The 12 Week Sc
normal karyotype - CDH
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Hydropic fetus - 13 wks(TOP CVS)
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Dr Fred Ushakov The 12 Week Sc
(TOP no CVS)
Abnormal 4 ventricle future vermisi 12 k
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Dr Fred Ushakov The 12 Week Sc
agenesis 12 wks
Holoprosencephaly - 12 wks( l k t )
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Dr Fred Ushakov The 12 Week Sc
(normal karyotype)
Holoprosencephaly - 12 wks(T13)
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Dr Fred Ushakov The 12 Week Sc
(T13)
Holoprosencephaly - 12 wks(T13)
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Dr Fred Ushakov The 12 Week Sc
(T13)
Holoprosencephaly + proboscis - 12 wks(T13)
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Dr Fred Ushakov The 12 Week Sc
(T13)
? Spina bifida 12 wks
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Dr Fred Ushakov The 12 Week Sc
p
Spina bifida? Umbilical cord
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Dr Fred Ushakov The 12 Week Sc
p
Cleft lip/palate 13 wks
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Dr Fred Ushakov The 12 Week Sc
p p
Cleft lip/palate + polydactylyT13
13 wks
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Dr Fred Ushakov The 12 Week Sc
13 wks
Congenital Diaphragmatic Hernia12wk
(normal karyotype)
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Dr Fred Ushakov The 12 Week Sc
(normal karyotype)
Normal Heart 4CV 13w1d
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Congenital Diaphragmatic Hernia + TR
11wks (normal karyotype)
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Dr Fred Ushakov The 12 Week Sc
11wks (normal karyotype)
Congenital Diaphragmatic Hernia +Abnormal Kidneys 11wks
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Dr Fred Ushakov The 12 Week Sc
Abnormal Kidneys 11wks
Kidneys normal 13 wks
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Dr Fred Ushakov The 12 Week Sc
Kidneys echogenic & enlarged13 wks
HLHS (normal karyotype)
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Dr Fred Ushakov The 12 Week Sc
HLHS (normal karyotype)
Kidneys echogenic & enlarged45X0
12 wks
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Dr Fred Ushakov The 12 Week Sc
w
???
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Dr Fred Ushakov The 12 Week Sc
Megacystisobstructive uropathy
12 wks (normal karyotype)
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Dr Fred Ushakov The 12 Week Sc
( y yp )
Megacystis 12 wks (normal karyotype)
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Dr Fred Ushakov The 12 Week Sc
Single Multicystic Kidney 14 wks
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Dr Fred Ushakov The 12 Week Sc
Bilateral Agenesis of Kidneys 15 wks
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Dr Fred Ushakov The 12 Week Sc
Bilateral Agenesis of Kidneys 15 wks
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Dr Fred Ushakov The 12 Week Sc
Omphalocele T18 12 wks
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Dr Fred Ushakov The 12 Week Sc
Omphalocele12 wks
(risk 1:2 normal karyotype)
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Dr Fred Ushakov The 12 Week Sc
Omphalocele nearly missedT18
12 wks
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Dr Fred Ushakov The 12 Week Sc
Omphalocele & Abnormal HandsT18
12 wks
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Dr Fred Ushakov The 12 Week Sc
Omphalocele & Abnormal LegsT18
12 wks
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Dr Fred Ushakov The 12 Week Sc
Gastroschisis - 11 weeks
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Dr Fred Ushakov The 12 Week Sc
Single Umbilical Artery T18 12 wks
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Agenesis of Ductus Venosus45X0
12 wks
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Dr Fred Ushakov The 12 Week Sc
Agenesis of Ductus Venosus15 wks
(normal karyotype)
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Dr Fred Ushakov The 12 Week Sc
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Dr Fred Ushakov The 12 Week Sc