英文誌(2004-)
特別プログラム 産婦人科
パネルディスカッション 産婦人科 Joint(JSUM・AFSUMB Joint Session)(English) 妊娠初期におけるスクリーニングと診断
(S388)
How may first trimester scan be improved?
MAK Annisa SL1, LEUNG Kwok Yin2
Annisa SL MAK1, Kwok Yin LEUNG2
1Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital / Department of Obstetrics and Gynaecology, University of Hong Kong, 2President, HongKong Society for Ultrasound in Medicine / Chairman, Education Committee, AFSUMB
キーワード :
Early assessment of fetal anatomy and detection of fetal anomalies offer benefits to a pregnant woman. About 40 to 50% of fetal anomalies which can be detected prenatally can be detected in the first trimester. With an advancement in ultrasound technology, many fetal major anatomical structures can be visualized in the first trimester. It is important to optimize the ultrasound machine settings. Familiarizing with normal embryology and fetal anatomy can avoid misdiagnosis. A higher frequency transducer can give a better resolution but at a shorter penetration. Transvaginal approach can overcome some of the difficulties but be limited by manipulation and orientation acceptability. A systemic approach to assess various fetal structures is very important. Examination of fetal heart including four chamber view and two great vessels is possible with the addition of color mapping. High frequency linear transducer and three-dimensional sonography may be helpful in the assessment of selected structures. A first trimester scan should be supplemented by a mid-trimester anomaly scan to avoid missing important fetal anomalies. Continuous education, auditing on performance and fetal outcomes are essential.