Chapter 27
SONOGRAPHIC FINDINGS OF EBSTEIN ANOMALY
1. Malpositioned tricuspid valve 2. Right and left atrial shunting 3. Tricuspid regurgitation 4. Enlarged right atrium 5. Deviation of the atrial septum to the left 6. Fetal hydrops (secondary to cardiac failure)
What is described as the absence of the pulmonary valve, which in turn prohibits blood flow from the right ventricle into the pulmonary artery essentially to the lungs?
Pulmonary atresia
A separate mass of nonfunctioning fetal lung tissue is referred to as:
Pulmonary sequestration
SONOGRAPHIC FINDINGS OF ATRIAL SEPTAL DEFECTS
1. Absence of part of the atrial septum 2. Color Doppler is helpful at detecting small defects
SONOGRAPHIC FINDINGS OF VENTRICULAR SEPTAL DEFECTS
1. Absence of part of the ventricular septum 2. Color Doppler is helpful at detecting small defects
SONOGRAPHIC FINDINGS OF ATRIOVENTRICULAR SEPTAL DEFECTS
1. Absence of the atrial and ventricular septum 2. Color Doppler findings are helpful at showing mixture of flow patterns
SONOGRAPHIC FINDINGS OF HYPOPLASTIC LEFT HEART SYNDROME
1. Absent or small left ventricle 2. No communication between the left atrium and the left ventricle 3. Aortic atresia (possibly) 4. Aortic stenosis (possibly) 5. Coarctation of the aorta (possibly)
SONOGRAPHIC FINDINGS OF HYPOPLASTIC RIGHT HEART SYNDROME
1. Absent or small right ventricle 2. Enlarged left ventricle 3. Fetal hydrops (secondary to cardiac failure) 4. Narrowing of the pulmonary valve
SONOGRAPHIC FINDINGS OF A PLEURAL EFFUSION
1. Anechoic fluid surrounding the fetal lung(s) - "bat-wing" sign 2. Other signs of hydrops may be present
SONOGRAPHIC FINDINGS OF PERICARDIAL EFFUSION
1. Anechoic fluid surrounding the heart
SONOGRAPHIC FINDINGS OF AN ECHOGENIC INTRACARDIAC FocUs
1. Echogenic structure most commonly located within the left ventricle
SONOGRAPHIC FINDINGS OF PULMONARY SEQUESTRATION
1. Echogenic, triangular-shaped mass within the fetal chest 2. Pleural effusion may be present
SONOGRAPHIC APPEARANCE OF CYSTIC ADENOMATOID MALFORMATIONS
1. Lung mass with varying degrees of cystic and solid components 2. Completely echogenic mass within the lungs 3. Pleural effusion may be present
SONOGRAPHIC FINDINGS OF TETRALOGY OF FALLOT
1. Overriding aortic root 2. VSD 3. Pulmonary stenosis 4. Right ventricular hypertrophy
The fetal heart is fully formed by:
10 weeks
The mitral valve is located:
Between the left ventricle and the left atrium
Blood from the right ventricle can flow through the ___ and into the ____
Blood from the right ventricle can flow through the ductus arteriosus and into the descending aorta.
Blood is shunted directly into the ___ via a small branch of the umbilical vein called the ____
Blood is shunted directly into the IVC via a small branch of the umbilical vein called the ductus venosus.
The narrowing of the aortic arch is indicative of:
Coarctation of the aorta
The most common cause of cardiac malposition is:
Diaphragmatic hernia
The visualization of the fetal stomach within the fetal chest is most indicative of:
Diaphragmatic hernia
What is the fetal shunt that connects the pulmonary artery to the aortic arch?
Ductus arteriosis
The condition in which the heart is located outside the chest wall is termed:
Ectopic cordis
All of the following are sonographic signs of Ebstein anomaly
Enlarged right atrium, Fetal hydrops, Malpositioned tricuspid valve
The most common form of diaphragmatic hernia is the:
Foramen of Bochdalek
What is the opening located right anteromedially within the diaphragm?
Foramen of Morgagni
What is the normal opening in the lower middle third of the atrial septum?
Foramen ovale
A group of anomalies characterized by a small or an absent left ventricle is:
Hypoplastic left heart syndrome
A group of anomalies characterized by a small or an absent right ventricle is:
Hypoplastic right heart syndrome
Fetal lung maturity can be assessed using the:
LS ratio
The blood returning from the lungs through the pulmonary veins enters into the:
Left atrium
An EIF is most often seen within the:
Left ventricle
All of the following are sonographic features of pentalogy of Cantrell
Omphalocele, Cleft sternum, Diaphragmatic defect
Tetralogy of Fallot consists of all of the following
Overriding aortic root, VSD, Pulmonary stenosis
The accumulation of fluid around the lungs is termed:
Pleural effusion
The sonographic "bat-wing" sign is indicative of
Pleural effusion
The most common fetal cardiac tumor is the:
Rhabdomyoma
The moderator band is located within the:
Right ventricle
The most common sonographic appearance of pulmonary sequestration is a(n):
Triangular, echogenic mass within the chest
The ___ is the most common form of cardiac defect.
VSD
What is an opening within the septum that separates the right and the left ventricles?
VSD
Which of the following is considered to be the most common cardiac defect?
VSD
rhabdomyoma?
a fetal heart tumor found within the myocardium
fetal hydrops?
abnormal accumulation of fluid in at least two fetal body cavities
pleural effusion?
abnormal accumulation of fluid in the pleural space
atrioventricular defect?
abnormal development of the central portion of the heart; also referred to as endocardial cushion defect
aortic stenosis?
abnormal narrowing of the aortic valve
transposition of the great vessels?
abnormality in which the pulmonary artery arises from the left ventricle and the aorta arises from the right ventricle
aortic atresia?
abnormality in which there is a small or absent opening between the left ventricle and aorta
When talking about fetal outflow tracts, The normal pulmonary artery should be positioned ___ to the aorta and should be visualized crossing over it.
anterior
omphalocele?
anterior abdominal wall defect where there is herniation of the fetal bowel and other abdominal organs into the base of the umbilical cord
There is a normal opening within the ___ septum of a normal fetal heart
atrial
trisomy 18?
chromosomal aberration in which there is a third chromosome 18; also referred to as Edwards syndrome
trisomy 21?
chromosomal aberration in which there is a third chromosome 21; also referred to as Down syndrome
Turner syndrome?
chromosomal aberration where one sex chromosome is absent; may also be referred to as X monosomy
aneuploidy?
condition of having an abnormal number of chromosomes
pericardial effusion?
fluid accumulation around the heart in the pericardial cavity
DiGeorge syndrome?
genetic disorder characterized by an absent or hypoplastic thymus, which ultimately leads to impairment of the immune system and susceptibility to infection, as well as cognitive disorders, congenital heart defects, palate defects, and hormonal abnormalities
tetralogy of Fallot?
group of abnormalities consisting of an overriding aortic root, ventricular septal defect, pulmonary stenosis, and right ventricular hypertrophy
pentalogy of Cantrell?
group of anomalies that includes an omphalocele, along with ectopic cordis, cleft sternum. anterior diaphragmatic defect, and pericardial defects
Bochdalek hernia?
herniation of abdominal contents into the chest cavity because of an opening in the left posterolateral portion of the diaphragm
diaphragmatic hernia?
herniation of the abdominal contents into the chest cavity through a defect in the diaphragm
hypoplastic left heart syndrome?
incomplete development of the left ventricle, resulting in a small or absent left ventricle
hypoplastic right heart syndrome?
incomplete development of the right ventricle, resulting in a small or absent right ventricle
The chamber closest to the fetal spine is the
left atrium.
The ventricular septum in a normal fetal heart should be uninterrupted and of equal thickness to the
left ventricular wall.
oligohydramnios?
lower-than-normal amount of amniotic fluid for the gestational age
Ebstein anomaly?
malformation or malpositioning of the tricuspid valve that causes multiple heart defects
Cystic adenomatoid malformation?
mass consisting of abnormal bronchial and lung tissue that develops within the fetal chest
biophysical profile?
method of fetal monitoring with sonography to produce a numeric scoring system that predicts fetal well-being
The normal heart will fill approximately____ of the fetal chest.
one-third
foramen of Bochdalek?
opening located in the left posterolateral portion of the diaphragm
foramen ovale?
opening within the fetal heart within the atrial septum that allows blood to flow from the right atrium to the left atrium
ventricular septal defect?
opening within the septum that separates the right and the left ventricles
The most common fetal cardiac tumor is ___. It is associated with tuberous sclerosis.
rhabdomyoma.
The aorta arises from the ______, and the pulmonary artery arises from the____.
right ventricle. left ventricle.
bat-wing sign?
sonographic appearance of a fetal unilateral pleural effusion
Potter syndrome?
syndrome characterized by bilateral renal agenesis, abnormal facies, pulmonary hypoplasia, and limb abnormalities
tuberous sclerosis?
systemic disorder that leads to the development of tumors within various organs
chordae tendineae?
tendons within the heart that attach the tricuspid valve in the right ventricle and the mitral valve the left ventricle to their respective papillary muscle
tricuspid regurgitation?
the leakage of blood back through the tricuspid valve
pulmonary stenosis?
the narrowing of the pulmonary valve
Often, the four-chamber view of the heart is normal in the presence of
transposition of the great vessels.
With a normal fetal heart, Between the right ventricle and the right atrium, one should visualize the ____ valve.
tricuspid valve.
An EIF may be seen in the normal fetus. However, there have been studies that have linked the EIF with ___
trisomy 21.
The tricuspid valve is located:
Between the right ventricle and the right atrium
papillary muscle?
paired muscles in both sides of heart that hold in place either the mitral or tricuspid valves
thoracentesis?
procedure that uses a needle to drain fluid from the pleural cavity for either diagnostic or therapeutic reasons
SONOGRAPHIC FINDINGS OF A DIAPHRAGMATIC HERNIA
1. Malposition of the heart 2. Anechoic stomach bubble noted adjacent to the fetal heart in the four-chamber heart view 3. Other abdominal organs, including the liver, pancreas, and spleen, may be located along the chest
____ or ____ is a separate mass of nonfunctioning lung tissue with its own blood supply.
Pulmonary sequestration, or bronchopulmonary sequestration,
The most common location of a diaphragmatic hernia is on the ___ side. This type may also be referred to as a ___ hernia.
The most common location of a diaphragmatic hernia is on the left side. This type may also be referred to as a Bochdalek hernia.
The normal fetal heart will fill approximately ____ of the fetal chest, with its apex forming a ____ degree angle with the fetal spine. The chamber closest to the fetal spine is the ____
The normal fetal heart will fill approximately one-third of the fetal chest, with its apex forming a 45-degree angle with the fetal spine. The chamber closest to the fetal spine is the left atrium.
An EIF would most likely be associated with:
Trisomy 21
The embryonic heart begins as:
Two tubes
SONOGRAPHIC FINDINGS OF A RHABDOMYOMA
1. Echogenic tumor(s) within the myocardium of the heart
SONOGRAPHIC FINDINGS OF COARCTATION OF THE AORTA
1. Narrowing of the aortic arch 2. Right ventricular enlargement 3. Pulmonary artery enlargement
Eventration of the diaphragm is best described as:
A lack of muscle in the dome of the diaphragm
What structure shunts blood into the IVC from the umbilical vein?
Ductus venosus
What is the term for underdevelopment of the lungs?
Pulmonary hypoplasia
Which of the following are fetal rhabdomyomas associated with?
Tuberous sclerosis
lecithin to sphingomyelin ratio?
test of the amniotic fluid that predicts fetal lung maturity
The embryonic heart begins as ____ which ultimately fuse and fold to form into four chambers, two atria and two ventricles.
two tubes
What is the Basic assessment of the fetal outflow tracts?
1. The aortic outflow tract originates from the left ventricle. 2. The pulmonary outflow tract originates from the right ventricle. 3. The outflow tracts should be comparable in size. 4. The ascending aorta and the main pulmonary artery are perpendicular to each other because they exit their respective ventricles. They should be seen crossing and not lying in the same plane.
SONOGRAPHIC FINDINGS OF TRANSPOSsITION OF THE GREAT VESSELS
1. The pulmonary artery abnormally arises from the left ventricle, and the aorta abnormally arises from the right ventricle. 2. The outflow tracts will be positioned parallel to each other rather than crisscrossing. 3. VSD be present may
A coexisting pericardial effusion and a pleural effusion is consistent with the diagnosis of:
Fetal hydrops
SONOGRAPHIC FINDINGS OF ECTOPIC CORDIS
Heart located either partially or completely outside the chest