Comprehensive Guide to Ultrasound in Obstetrics and Gynaecology by Dr. Bhanu Deval
This detailed guide covers various aspects of ultrasound in obstetrics and gynaecology, including indications in different trimesters, types of miscarriages, ectopic pregnancies, and postpartum scenarios. Dr. Bhanu Deval, with his expertise in MBBS, MS, MRCOG, and PgC in Obs and Gynae Ultrasound, provides valuable insights and images for better understanding.
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Presentation Transcript
Ultrasound in Obstetrics and Gynaecology Dr Bhanu Deval MBBS MS MRCOG PgC Obs and Gynae Ultrasound
Obstetric Ultraound Indications-First Trimester Bleeding Pain Previous ectopic Hyperemesis Previous molar pregnancy Bad obstetric history
Indications Second Trimester NT Scan Chorionicity Cervical length surveillance Previous extreme pre term delivery <28weeks Previous cone biopsies/multiple LLETZ Multiple pregnancy Known uterine anomaly Morphology scan Fetal Echocardiogram Previous baby with congenital cardiac anomaly Diabetic women Epilepsy-medicated Women with known cardiac anomaly
Indications Third Trimester: Growth Scans with UA/MCA dopplers Presentation Post Dates-AFI
Indications Growth Scans Pregnancy related: Multiple pregnancy-DCDA from 28weeks onwards Multiple pregnancy-MCDA from 24 weeks onwards PET Reduced SFH Known IUGR APH-Placenta praevia, abruption Recurrent APH of unknown cause GDM Pre existing: Obstetric History: SB, Previous IUGR, Previous abruption Smoking/substance abuse Pre existing medical conditions-Thrombophilias, APLS, SLE, autoimmune conditions, renal disease, hypertension, severe asthma, thyroid disorders BMI>35
Indications Post partum/post miscarriage Abnormal bleeding/Secondary PPH RPOCs Endometritis Molar pregnancy Placental site trophoblastic tumours AV malformations
Gynaecological Ultrasound Indications: Menorrhagia+/-dysmenorrhoea Oligomenorrhoea/Amenorrhoea Pelvic pain Pelvic mass Subfertility Post menopausal bleeding Misplaced Mirena/IUCD
Menorrhagia Fibroids Endometrial polyps DUB Menorrhagia with Dysmenorrhoea Adenomyosis/endometriosis PID
Oligomenorrhoea/Amenorrhoea Primary Uterine agenesis- RMK syndrome Imperforate hymen Mullerian abnormalities- Vaginal septum +/- other uterine abnormalities Gonadal dysgenesis(Turner s): Streak ovaries GnRHa deficiency: Kallmann s Syndrome
Oligomenorrhoea/Amenorrhoea Secondary Hypothalamic/hypopituitary Anorexia/Bulimia Stress Pituitary tumours Sheehan s syndrome Thyroid dysfunction Ovarian: PCOS POF Uterine: Asherman s Syndrome
Pelvic pain Adenomyosis/endometriosis-Ovarian endometriomas PID Ovarian cyst accidents-Haemorrhage/rupture/torsion Simple cysts do not cause pelvic pain!
Pelvic Mass Fibroid Ovarian cysts Pre menopausal-simple/complex Post menopausal-simple/complex
Subfertility Ovaries: Ovarian reserve-AFC, AMH PCOS Endometrioma Peri ovarian adhesions/fixity Ovarian blood flow Access Adnexal: Hydrosalpinx-PID Peri tubal/intra peritoneal adhesions Uterine: 3D scan Submucous fibroid/endometrial polyps Adenomysosis-EMZ disruption, POD fixity Unexplained
Decline in Ovarian Reserve using AFC and AMH Antral Follicle Count Anti Mullerian Hormone
PMB Atrophic endometrium Endometrial Hyperplasia/Polyps Endometrial CA Ovarian cysts Clinical examination CST.
Ultrasound in Obstetrics and Gynaecology When? What?
