10 (Development of the Placental circulation) (torphoblast) 1/3 20.
1. (Placental Calcification). : 2 (Plaques) : 3 (33 ),. 2. (Subchorionic fibrin deposition) (10 15%) (laminated collection). 3. (Intervillous thrombosis).. 50%. mm cm. Rh 4. (Perivillous fibrin deposition) 22%
. 5. Maternal lakes. (Doppler ) 6. (Infarcts) (25%) AFP (Antiphospholipid antibody syndrome). :
.. 1. (Gestational trophoblastic disease) (1 per 1,200) a. (complete mole)
, ( ), (46 XX). theca lutein cysts. b. (Partial mole) molar change. (69 ) 2. (Primary neoplasm) a. (Teratomas) ( ) b. (Chorioangioma) (,1%)
. (shunt), (IUGR) AFP 3. (Secondary neoplasm) (melanoma) ( ) unbranched, uncoiled ( ),,,. Grade 0 : Grade I:. Grade II : cotyledon cotyledon Grade III : cotyledon 3
1. (contraction) (Braxton Hicks contraction) 2... Doppler. 2. (Placenta accreta/"adhere")
(uteroplacental 2cm ) lakes,, (lacunae).. :. 3 (Placenta accreta) : (Placenta increta) : (Placenta percreta) :
1. (Placenta extrachorialis) 2. : (Circummarginate placenta) (Circumvallate placenta). a. (Succenturiate lobes) (8%) b. (Placenta membranacea). 1 :. c. (Circumvallate placenta),.
1. :5cm. (. ;20 2 cm, 30 3 cm) ( ) (, )
2. (Small placenta) 1. (Retroplacental/Submembranous hematoma), 1... : 60cc 4%.
2. (Abruptio placenta) ( 1%),, 30 40%.. :,, / / / / / 4.4cm echogenic.
40%.
(uteroplacental vesseles myometriumd 2cm ) 3. (Placenta previa) (1% ) 30 (Translabial ultrasound). 2 5% 90% : (4 8%) (3 factors) Pitfalls.. <2% 90%( 2 )
: 1. (Amniotic band) sheet 7 16 12 14 15 16.. (2 mm ) 16..
4, 2, 2 :2.4mm (2 Twin peak sign ). Doppler ( avascular ). 3 50% 50% 54% 35% <Lazebnik, Ultrasound in Obstet and Gynecol, 1996>,
,. :,,..
90% 97%, 3% ( 10 ) / /twin peak sign
Body stalk yolk stalk. Body stalk :,,. Yolk stalk :, ( 63 ). (30 120cm),,, Wharton jelly.,.
7 (90%),, (9%), (1%) Battledore placenta: 3cm Velamentous placenta: ( 1026 ). (vasa previa),., (Vasa previa).
. 1. :55cm(30~100 cm) 2.. (uterine inversion) Infrafunicular hemorrhage (cord neck), (Knots),, (coiling).. 3. (single umbilical artery) : 1%, 5%, 2.5%. (, ),
: Doppler. : 4 ( 20%) <Heifet 1984>,, (30 60% ) 12 25%, 25%, 1.. 1. (False knots), bulging.. 2. (True knots),,.
3. (Umbilical cord hematoma) 1/5,500 : 4. (True cord cysts) Wharton jelly 1 5. (Neoplasm),,,, : AFP 6. (Umbilical hernia)
Beckwith :. intracranial calcification/microcephaly/brain atropy/ventriculomegaly cardiomegaly intrahepatic calcification/echogenic bowel/ascites fetal hydrops IUGR microcephaly/cataracts VSD/ASD hepatosplenomegaly IUGR ventriculomegaly/microcephaly intracranial calcification liver calcification/hepatomegaly/ascites IUGR thickened placenta Varicella ventriculomegaly/microcephlay club feet/decreased fetal motion echogenic liver parenchyme single umbilical artery Parvovirus B19 ascites hydrops fetalis/pericardial effusion thickened placenta abnormal curvature and bowing of the long bones
ascies/hepatosplenomegaly hydrops fetalis large placenta <Benacerraf, Ultrasound of fetal syndrome. 1998> Fleischer, Sonography in Obstetrics and Gynecology, 5th Ed, Appleton and Lange, 1996 Structural fetal abnormalities Roger C. Saunders 1996, MosbyYear book, Inc Peter W. Callen. Ultrasonography in Obstetrics and Gynecology. 3rd Edition 1994, Sanders company Hyett JA, Increased nuchal translucency at 1014 weeks of gestation as a marker for major cardiac defects. Ultrasound Obstet Gynecol 10:24246, 1997 Todros,Umbilical Doppler wave forms and placental villous angiogenesis in pregnancies complicated by fetal growth
restriction. Obstet &Gynecol 1999,Vol. 93, No. 4;499503 Terry j, DuBose, Fetal sonography. 1996,W.B. Saunders company Fleischer,Sonography in obstetrics and gynecology,5th Ed, Appleton and Lange,1996 fetal abnormalities Roger C. Saunders 1996, MosbyYear book, Inc Peter W. Callen. Ultrasonography in Obstetrics and Gynecology. 3rd Edition 1994,Sanders company Thummala MR, isolated single umbilical artery anomaly and the risk for congenital malformations: Ametaanalysis. J Pediatr Surg 33; 58085,1998