The 8th Romanian " Ian Donald ” Course
Al XII-lea Congres Națíonal de Medicină Perinatală assisted reproduction procedure . The possibilities of using ultrasound examination in assisted reproduction are presented in a practical manner .
Possibilities and limits of the early fetal morphological scan
Muresan D 1 , 2 ., Ona D ., Rotar I . C . 1
1 University of Medicine “ Iuliu Hatieganu ” Cluj-Napoca 2 MOGEN Research Center , Cluj-Napoca , Romania .
The evolution of the ultrasound technologies and the advancements in the knowledge of the embryologic and early fetal development have allowed an earlier assessment of the pregnancies in relation with a normal morphological , syndromic and sometimes even a genetic development .
The ultrasound scan between 11 and 13 + 6 weeks allow a progressive analyze of fetal structures , with improvement in visualization from 45 to 82 mm of CRL . There are however structures , as the fetal heart , renal system and the fetal brain that cannot be completely evaluated at this age due to their unFinished development . In case of doubt about an anomaly identiFication the patient must be rescan at 16-17 weeks . However , the complete morphological scan between 19-23 weeks remains mandatory , especially in difFicult cases , as in obese patients . It must be also remembered that some fetal anomalies or fetal diseases become visible only in the second late or the third trimester .
The ultrasound scan at 11-13 + 6 weeks is also involved in the genetic assessment of the fetus with the NT , nasal bone , ductus venosus and tricuspid regurgitation being included in the First trimester combined test . Abnormal NT , even in a chromosomic normal pregnancy , can be a marker for later pregnancy complication , such as cardiac malformation , fetal hypotrophy or even fetal death . The identiFication of an ultrasound malformation or an association of malformations during an abnormal combined test will determine the genetic follow-up , with a clear preference for a complete karyotype or even an array comparative genomic hybridization ( aCGH ) and with the exclusion of FISH .
The actual paradigm of the pregnancy evaluation , with a focus on the First trimester for the selection of high or low risk pregnancies is also appropriate for the morphological evaluation , with clear beneFit for the parents and for the medical team .
Obstetrica și Ginecologia ! 6 27 - 30 Septembrie 2017