초음파 통계 OBGYhyster o Dop 정밀정밀 양수양수 3DBPP 합계 ~ ~

OB case presentation sonographer 권혜영

 F/34  LMP : / EDC ;  임신주수 :12+3w  산전진료 : 우먼메디   초음파상 아기 움직임이 잘 보이지않음  가족력 :NO / 환자병력 NO  G( 2 ) P( ) AA( ) SA( 1 )  emesis(+)  spotting(+), IM done

 CRL:5.0Cm-> 11w5d size  NT: 1.8mm  head: normal appearance  heart: 4CV, 3VS(+)  TCD: 0.64Cm, CTAR: 0.4/ 0.7  stomach: 0.7 x 0.4; 0.4 x 0.3 cM sized echoic foci  bladder: (-)  heart 가 있는 chest 와 stomach 이 있 는 복부가 나뉘어져 보입니다.  복부 size: 2.3 x 1.6Cm  bowel herniated appearance( 1.0 x 0.7CM)  herniated side: not detected  spine: severe extention position  both upper extremity, include, both hand: Ok  both lower extremity: caudal dysplasia flexion 상태에서 큰 movement 관찰 안됨  both foot: valgus position  fibrous band within sac  avascular  Imp: Single preg sized 12w6d  R/O amniotic band syd.  R/O gastroschisis  R/O VACTERL syn.  sign: 권혜영 / staff. 김석영

 GROSS :  태반의 크기는 5.0x4.0x1.5cm, 무게는 24.0gm 이었다.  양막은 회백색으로 반투명하였다.  탯줄은 길이 5.0cm, 외직경 0.5cm 이었고, 단면상 2 개의 혈관이 관찰되었다.  태아의 무게는 16.0gm 이었고, crown-rump length 는 4.0cm, head circumference 는 7.0cm, femur length 는 1.5cm 이었다.  Skin 은 다소 어두운 회갈색을 띄었고 두경부에 외관상 기형은 없었다.  흉부와 흉강내 장기에 육안상 특이소견 없었다.  Scoliosis 가 관찰되었고, abdomen 은 collapse 되어 있었다.  우측 신장이 신체 외부로 돌출되어 있었고, intestine 은 따로 떨어져 분리되어 있었다.  좌측 신장은 관찰되지 않았다.  Anal opening 은 관찰되지 않았다.  좌측 하지는 대퇴부만 부착되어 있었고, 하퇴부는 따로 떨어져 있었다.  DIAGNOSIS :  Placenta; Single umbilical artery  Fetus, 12+3weeks of gestation, removal ;  - Gastroschisis  - Unilateral (left) renal agenesis  - Anal agenesis

Amniotic Band syn.

Amniotic bands  1 in 1200 (0.08%) of all pregnancies  They are fibrous strands of membrane stretching from the outer membrane surface into the amniotic cavity.  They are thought to originate when the inner membranes (amnion) rupture without injury to the outer membrane (chorion).  The ruptured amnion remains as a plaque or fragments into bands which stretch across the chorionic cavity. Amniotic bands are thought to happen spontaneously or in association with trauma to the abdomen.  There has been the suggestion of a relationship between amniotic bands, limb shortening and early chorion villous sampling (CVS).

Amniotic sheet  most common with an incidence of 0.6%.  They are thought to be caused by scarring inside the womb or 'senechiae' from previous operations, such as D&C.  As the membranes develop, they surround these sheets of scar tissue. Often they aren't seen until later on in pregnancy, presumably following rupture or compression by the growing baby.rupture  Amniotic sheets have been found to be associated with an increased risk of early labour.

body-stalk anomaly  This lethal, sporadic abnormality, characterized by the presence of a major abdominal wall defect, severe kyphoscoliosis and a rudimentary umbilical cord  about 1 in 15,000.  The pathogenesis is uncertain  Early amnion rupture with amniotic band syndrome

VACTERL syn.  Definition: V (vertebral anomalies) A (anal atresia) C (cardiac anomalies) TE (tracheoesophageal fistula or esophageal atresia) R (renal/urinary anomalies) L (limb defect). The most frequent defects -> tracheoesophageal fistula and anal or vertebral anomalies.  Incidence: Uncommon.  Etiology: sporadic event, a high frequency among offspring of diabetic mothers has been observed..  Recurrence risk: Varies from 1% to 50%