Radiology Notes

My notes during radiology residency, fellowship, and beyond…

Archive for the ‘OB’ Category

Cord Insertion Types

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Required element in a complete >14wk OB ultrasound report.

Cord Insertion types: central, eccentric, marginal, and velamentous

Nice youtube video for ultrasound images.

Written by lmwong

May 16, 2013 at 11:05 am

Posted in OB, ultrasound

Ultrasound Landmarks for Early Pregnancy Failure

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Written by lmwong

March 6, 2011 at 7:45 am

Posted in OB, ultrasound

Beta-HCG levels and Gestational Age

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Discrim. Zone = 1500

3 weeks LMP: 5 – 50 mIU/ml
4 weeks LMP: 5 – 426 mIU/ml
5 weeks LMP: 18 – 7,340 mIU/ml
6 weeks LMP: 1,080 – 56,500 mIU/ml
7 – 8 weeks LMP: 7, 650 – 229,000 mIU/ml
9 – 12 weeks LMP: 25,700 – 288,000 mIU/ml
13 – 16 weeks LMP: 13,300 – 254,000 mIU/ml
17 – 24 weeks LMP: 4,060 – 165,400 mIU/ml
25 – 40 weeks LMP: 3,640 – 117,000 mIU/ml
Non-pregnant females: <5.0 mIU/ml
Postmenopausal females: <9.5 mIU/ml

 

Written by lmwong

December 11, 2010 at 5:04 pm

Posted in OB, ultrasound

Uterine Shapes

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Written by lmwong

February 2, 2010 at 5:57 pm

Posted in differential, GU, OB, uterus

Twin Types

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Written by lmwong

January 21, 2010 at 8:05 pm

Posted in differential, OB

Uterine Filling Defect Differential

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  • bubble
  • bloodclot
  • mucoid material
  • fold
  • synechiae; uterine adhesion
  • submucosal fibroid
  • septate uterus
  • uterine carcinoma
  • retained conceptus
  • molar pregnancy
  • pregnancy related
  • IUD

Written by lmwong

January 16, 2010 at 9:00 am

Cervical Incompetence

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  • ultrasound diagnosis: funnelling of proximal cervix
  • reduced cervical length of less than 30 mm
  • increased risk of preterm delivery
  • place patient in Trendelenburg position and call OB STAT.

Written by lmwong

May 24, 2008 at 7:46 pm

Posted in OB, ultrasound

Ectopic Pregnancy

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  • Classic Triad of symptoms: irregular mestrual bleeding, pain, palpable adnexal mass
  • gestational sac seen only if bHCG greater than 2000 IU/L
  • Location: fallopian tubes (95%), in ampullary or isthmus
  • heterotopic pregnancy 1 in 7000 pregnancies.

Risk Factors

  • prior infection
  • developmental defects or prior tubal surgery
  • IUD
  • ovulation-inducing agents
  • IVF
  • prior ectopic

Intrauterine Findings

  • normal or thickened endometrial lining
  • look for IUP (gestational sac with yolk sac and DDS sign)

Extrauterine findings

  • extrauterine embryo with positive heart motion (100% PPV)
  • adnexal mass containing a yolk sac or nonliving embryo (100%)
  • Ring of Fire = “tubal” or “adnexal” ring surrounding a fluid collection (95%)
  • Complex or solid adnexal mass (no embryo, yolk sac, or tubal ring) (92%)
  • intraperitoneal fluid

distinguish ectopic from corpus luteal cyst:

  • less vascularity
  • intra-ovarian vs para-ovarian
  • surrounding follicles


http://www.iame.com/learning/ectopic/ectopic.html

Written by lmwong

April 27, 2008 at 4:35 am

Posted in ectopic, OB, ultrasound

Pelvis Ultrasound – Emergency department OB ultrasound Dictation

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INDICATION: [x]

TECHNIQUE: Limited sonographic obstetrical examination for the basis of emergency evaluation. This exam is not in lieu of a formal anatomical obstetrical scan. The exam was performed transabdominally.
*Transvaginal examination was also performed for assessment of the cervix.

COMPARISON EXAM: [x]

FINDINGS:
*Gestational Age: [x]
Status: Alive or Demise
Number: Singleton or Twin
Activity: Present or Absent
Position: Vertex, Breech, Tranverse head right , Tranverse head left, etc (if >25 weeks)
Placenta: State position and whether previa or not (if > 16 weeks)
Cervix: Cervix is greater than 3 cm and there is no funneling / Cervix is open and the residual cervix measures [x] cm
Amniotic fluid: if >16 weeks
Normal
Mild Oligo, Moderate Oligo, Severe Oligohydramnios
Mild Poly, Moderate Poly, Severe Polyhydramnios
Fetal cardiac activity: (Give FHR if <8weeks). Note as present or absent otherwise.
Ovaries: Both Normal
Right not seen, Left normal
Left not seen, Right normal
Both not seen
Other findings: [x]
*Basis for gestational age: LMP or EDC provided by patient

Findings were discussed with [x].

Written by lmwong

April 7, 2008 at 4:08 am