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The 12 Week Scan

Early Anomaly Scan


Dr Fred Ushakov
University College London Hospital

FMF 11-13 wks Anatomical Assessment

Dr Fred Ushakov The 12 Week Scan

Increased NT and normal karyotype

Dr Fred Ushakov The 12 Week Scan

NT, TR and DV

Markers for congenital heart defects

Dr Fred Ushakov The 12 Week Scan

Follow-up Scan at 16 weeks


Proposition for women with increased NT and/or inconclusive findings *** Resolution:

Transabdominal scan at 16 weeks = Transvaginal scan at 12 weeks


Patient stress waiting 3-4 weeks for reassurance More complications in the case of TOP

Dr Fred Ushakov The 12 Week Scan

U/S visualization of fetal anatomy


Fetal structure
Neural tube

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14 wks
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Head
Midgut herniation Falx cerebri Choroid plexus

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Thalamus
Humerus & femur Fingers Tibia & radius Toes

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Cerebellum
Face Heart - 4 chambers Lens Stomach

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Dr Fred Ushakov The 12 Week Scan

Transvaginal scan: Advantages

close to the region of interest high-resolution excellent Doppler irrespective of abdominal wall thickness Good for fetal anatomy, TR, DV

Dr Fred Ushakov The 12 Week Scan

Transvaginal scan: Shortcomings

Low penetration Difficult orientation Needs preparation (to empty bladder, to clean and cover transducer) Less convenient to patient and operator Needs high level of expertise

Dr Fred Ushakov The 12 Week Scan

Technique of Transvaginal 12 Week Anomaly Scan + Echocardiography

Special Course:

Dr Fred Ushakov The 12 Week Scan

Sonographic markers of aneuploidy

Dr Fred Ushakov The 12 Week Scan

Acrania 11 wks

Dr Fred Ushakov The 12 Week Scan

Acrania 12 wks

Dr Fred Ushakov The 12 Week Scan

Acrania brain 12 wks

Dr Fred Ushakov The 12 Week Scan

Acrania 3D

Dr Fred Ushakov The 12 Week Scan

Acrania - DCDA twins 12 wks

Dr Fred Ushakov The 12 Week Scan

Acrania - DCDA twins 12 wks

Dr Fred Ushakov The 12 Week Scan

Acrania amniotic bands 12 wks

Dr Fred Ushakov The 12 Week Scan

Amniotic bands 11 wks

Dr Fred Ushakov The 12 Week Scan

D/D amniotic bands vitelline artery

Dr Fred Ushakov The 12 Week Scan

D/D amniotic bands vitelline artery

CRL = 26 mm 9+3 wks

Dr Fred Ushakov The 12 Week Scan

D/D amniotic bands vitelline artery

Dr Fred Ushakov The 12 Week Scan

Body stalk anomaly - 12 wks

Dr Fred Ushakov The 12 Week Scan

Body stalk anomaly - 12 wks

Dr Fred Ushakov The 12 Week Scan

Body stalk anomaly - 12 wks

Dr Fred Ushakov The 12 Week Scan

Thoracopagus + body stalk anomaly - 12 wks

Dr Fred Ushakov The 12 Week Scan

Spina bifida

Dr Fred Ushakov The 12 Week Scan

Normal brain - 12 wks

Dr Fred Ushakov The 12 Week Scan

Dandy-Walker malformation triploidy 12 wks

Dr Fred Ushakov The 12 Week Scan

Dandy-Walker malformation triploidy 12 wks transabdominal scan

Dr Fred Ushakov The 12 Week Scan

Triploidy, partial mole, early IUGR 12 wks

Dr Fred Ushakov The 12 Week Scan

Triploidy, partial mole 12 wks

Dr Fred Ushakov The 12 Week Scan

Complete mole 12 wks

Dr Fred Ushakov The 12 Week Scan

Complete mole 12 wks

Dr Fred Ushakov The 12 Week Scan

DCDA twins: Complete mole and Normal Fetus 18 wks

Dr Fred Ushakov The 12 Week Scan

Encephalocele 12 wks

Dr Fred Ushakov The 12 Week Scan

Encephalocele 12 wks

Dr Fred Ushakov The 12 Week Scan

Cephalocele 11 wks

Dr Fred Ushakov The 12 Week Scan

Cephalocele 11 wks

Dr Fred Ushakov The 12 Week Scan

Cephalocele (not visible) 11 wks

Dr Fred Ushakov The 12 Week Scan

Encephalocele 12 wks - missed

Dr Fred Ushakov The 12 Week Scan

Encephalocele missed 12 wks now 20 wks

Dr Fred Ushakov The 12 Week Scan

Cystic hygroma 12 wks normal karyotype

Dr Fred Ushakov The 12 Week Scan

Cystic hygroma 13 wks normal karyotype - HLHS

Dr Fred Ushakov The 12 Week Scan

Cystic hygroma + CPC 11 wks normal karyotype - CDH

Dr Fred Ushakov The 12 Week Scan

Axillar and cervical cysts T21 13 wks

Dr Fred Ushakov The 12 Week Scan

Hydropic fetus - 13 wks (TOP no CVS)

Dr Fred Ushakov The 12 Week Scan

Abnormal 4 ventricle future vermis agenesis 12 wks

Dr Fred Ushakov The 12 Week Scan

Holoprosencephaly - 12 wks (normal karyotype)

Dr Fred Ushakov The 12 Week Scan

Holoprosencephaly - 12 wks (T13)

Dr Fred Ushakov The 12 Week Scan

Holoprosencephaly - 12 wks (T13)

Dr Fred Ushakov The 12 Week Scan

Holoprosencephaly + proboscis - 12 wks (T13)

Dr Fred Ushakov The 12 Week Scan

? Spina bifida 12 wks

Dr Fred Ushakov The 12 Week Scan

Spina bifida? Umbilical cord

Dr Fred Ushakov The 12 Week Scan

Cleft lip/palate 13 wks

Dr Fred Ushakov The 12 Week Scan

Cleft lip/palate + polydactyly T13 13 wks

Dr Fred Ushakov The 12 Week Scan

Congenital Diaphragmatic Hernia 12wk (normal karyotype)

Dr Fred Ushakov The 12 Week Scan

Normal Heart 4CV 13w1d

Dr Fred Ushakov The 12 Week Scan

Congenital Diaphragmatic Hernia 11wks (normal karyotype)

Dr Fred Ushakov The 12 Week Scan

Congenital Diaphragmatic Hernia + TR 11wks (normal karyotype)

Dr Fred Ushakov The 12 Week Scan

Congenital Diaphragmatic Hernia + Abnormal Kidneys 11wks

Dr Fred Ushakov The 12 Week Scan

Kidneys normal 13 wks

Dr Fred Ushakov The 12 Week Scan

Kidneys echogenic & enlarged 13 wks HLHS (normal karyotype)

Dr Fred Ushakov The 12 Week Scan

Kidneys echogenic & enlarged 45X0 12 wks

Dr Fred Ushakov The 12 Week Scan

???

Dr Fred Ushakov The 12 Week Scan

Megacystis obstructive uropathy 12 wks (normal karyotype)

Dr Fred Ushakov The 12 Week Scan

Megacystis 12 wks (normal karyotype)

Dr Fred Ushakov The 12 Week Scan

Single Multicystic Kidney 14 wks

Dr Fred Ushakov The 12 Week Scan

Bilateral Agenesis of Kidneys 15 wks

Dr Fred Ushakov The 12 Week Scan

Bilateral Agenesis of Kidneys 15 wks

Dr Fred Ushakov The 12 Week Scan

Omphalocele T18 12 wks

Dr Fred Ushakov The 12 Week Scan

Omphalocele 12 wks (risk 1:2 normal karyotype)

Dr Fred Ushakov The 12 Week Scan

Omphalocele nearly missed T18 12 wks

Dr Fred Ushakov The 12 Week Scan

Omphalocele & Abnormal Hands T18 12 wks

Dr Fred Ushakov The 12 Week Scan

Omphalocele & Abnormal Legs T18 12 wks

Dr Fred Ushakov The 12 Week Scan

Gastroschisis - 11 weeks

Dr Fred Ushakov The 12 Week Scan

Single Umbilical Artery T18 12 wks

Dr Fred Ushakov The 12 Week Scan

Agenesis of Ductus Venosus & Hepatic Artery 12 wks (karyotype?)

Dr Fred Ushakov The 12 Week Scan

Agenesis of Ductus Venosus 45X0 12 wks

Dr Fred Ushakov The 12 Week Scan

Agenesis of Ductus Venosus 15 wks (normal karyotype)

Dr Fred Ushakov The 12 Week Scan

Dr Fred Ushakov The 12 Week Scan