OB scanning technique questions and
answers with solutions
optimal time to perform fetal echocardiogram is - ANSWER between 18 to 22 weeks due to
adequate size to assess anatomy and function. limited before 18 weeks. after 22 weeks may
occur for visualization when cardiac structures are larger to avoid missing late developing
lesions or disease processes. with advancing gestational age, the image quality may be
compromised due to decreased amniotic fluid, fetal bone ossification and suboptimal fetal
position
the first step is to determine the - ANSWER fetal position. and establish fetal situs- left and right
sides of fetus
breech - ANSWER Fetal head is in the fundus of the uterus
vertex - ANSWER also called cephalic. fetal head is closest to the cervix
transverse - ANSWER fetal spine is perpendicular to maternal spine with head located on
maternal right or left
oblique - ANSWER head resides in one of the maternal uterine quadrants
2nd step is determine the position of fetal spine to the maternal place - ANSWER maternal left,
right. anterior indicated fetus is facing the materal spine. posterior indicated fetal spine is
closest to the maternal spine, oblique
determine the fetal situs - ANSWER in transverse axis view of the fetal abdomen, visualize the
fetal stomach should be in the left upper quadrant of the fetus, once fetal position has been
, established move transducer superior on the fetus above the diaphragm to document that the
heart is on the same side as stomach
continuing in transverse plane - ANSWER move to the level of mid abdomen, below the
diaphragm, just anterior to the fetal spine and slightly to the left of midline, the aorta should be
identifies with pulsatations. spectral doppler confirms arterial waveform. at same level IVC is
anterior to the right and elliptical in shape.
apex of the heart should be - ANSWER pointed leftward (levocardia). normal orientation with
stomach, heart, cardiac apex, and aorta residing on the left and IVC on the right is termed situs
solitus
initial assessment - ANSWER a segmenta approach is used. the sequence of views may need to
be modified secondary to fetal position
global assessment is performed to document - ANSWER four cardiac chambers, great vessel
orientation, qualitative heart size, postion of cardiac apex, pulmonary and systemic venous
return, aortic arch, ductal arch
after a global assessment is completed the standard fetal echocardiography views are obtained -
ANSWER images should be obtained in anatomically correct orientation when possible
two dimensional fetal echocardiogram - ANSWER determine fetal position and situs. cardiac axis
and position. obtain trans thoracic view of four chamber. normal axis is when interventricular
septum is 45 degrees to midline. straight line from fetal spine and anterior chest. the apex
points to left. right ventricle closet to the anterior wall. trans descending aorta should be behind
the left atrium and to the left of the spine. most of the heart should lie in the left anterior
quadrant of the thorac
normal position of heart - ANSWER levocardia. the apex points to the left
answers with solutions
optimal time to perform fetal echocardiogram is - ANSWER between 18 to 22 weeks due to
adequate size to assess anatomy and function. limited before 18 weeks. after 22 weeks may
occur for visualization when cardiac structures are larger to avoid missing late developing
lesions or disease processes. with advancing gestational age, the image quality may be
compromised due to decreased amniotic fluid, fetal bone ossification and suboptimal fetal
position
the first step is to determine the - ANSWER fetal position. and establish fetal situs- left and right
sides of fetus
breech - ANSWER Fetal head is in the fundus of the uterus
vertex - ANSWER also called cephalic. fetal head is closest to the cervix
transverse - ANSWER fetal spine is perpendicular to maternal spine with head located on
maternal right or left
oblique - ANSWER head resides in one of the maternal uterine quadrants
2nd step is determine the position of fetal spine to the maternal place - ANSWER maternal left,
right. anterior indicated fetus is facing the materal spine. posterior indicated fetal spine is
closest to the maternal spine, oblique
determine the fetal situs - ANSWER in transverse axis view of the fetal abdomen, visualize the
fetal stomach should be in the left upper quadrant of the fetus, once fetal position has been
, established move transducer superior on the fetus above the diaphragm to document that the
heart is on the same side as stomach
continuing in transverse plane - ANSWER move to the level of mid abdomen, below the
diaphragm, just anterior to the fetal spine and slightly to the left of midline, the aorta should be
identifies with pulsatations. spectral doppler confirms arterial waveform. at same level IVC is
anterior to the right and elliptical in shape.
apex of the heart should be - ANSWER pointed leftward (levocardia). normal orientation with
stomach, heart, cardiac apex, and aorta residing on the left and IVC on the right is termed situs
solitus
initial assessment - ANSWER a segmenta approach is used. the sequence of views may need to
be modified secondary to fetal position
global assessment is performed to document - ANSWER four cardiac chambers, great vessel
orientation, qualitative heart size, postion of cardiac apex, pulmonary and systemic venous
return, aortic arch, ductal arch
after a global assessment is completed the standard fetal echocardiography views are obtained -
ANSWER images should be obtained in anatomically correct orientation when possible
two dimensional fetal echocardiogram - ANSWER determine fetal position and situs. cardiac axis
and position. obtain trans thoracic view of four chamber. normal axis is when interventricular
septum is 45 degrees to midline. straight line from fetal spine and anterior chest. the apex
points to left. right ventricle closet to the anterior wall. trans descending aorta should be behind
the left atrium and to the left of the spine. most of the heart should lie in the left anterior
quadrant of the thorac
normal position of heart - ANSWER levocardia. the apex points to the left
