Presymposium questionnaire

(i) During early first trimester ultrasound 3 brain vesicles are visible between 7-8 weeks gestation T/F
(ii) The falx cerebri is visible on ultrasound between 8-9 Weeks gestation T/F
(iii) Cranial ossification has commenced by 10 weeks gestation and is complete by 12 complete weeks T/F
(iv) Measurement of the BDP and HC  is mandatory component of the routine first trimester scan T/F
(v) The choroid plexuses are usually of the same size and shape T/F
(vi) In routine first trimester anatomy screening coronal imaging of the fetal brain is of limited or no value in most cases T/F

(i) With both transvaginal and transabdominal ultrasound, meningoceles may be readily distinguished from encephaloceles at 11- 14 weeks gestation T/F
(ii) Encehpaloceles may occur in association with the autosomal recessive group of ciliopathies (eg  Meckel-Gruber, Joubert Walker Warburg ) in about 5-10% of cases T/F
(iii) Lateral encephaloceles should raise the suspicion of amniotic band syndrome T/F
(iv) While Alobar holoprosenephaly is detectable up to 100% of cases between 11-14 weeks most forms of semilobar remain undetectable during the first trimester T/F
(v) Cerebral ventriculomegaly is defined as a maximum lateral ventricular width > 5mm at 11- 14 weeks T/F
(vi) A specific diagnosis of both Dandy Waker malformation and inferior vermian hypoplasia can be made  in many fetuses  between 12-14 weeks gestation T/F
(vii)A dilated 4th cerebral ventricle at 11-14 weeks gestation is strongly associated with triploidy, trisomy 13 and  Trisomy 18.  T/F

Fetal heart motion first appears around 5 weeks gestation.

While current ISUOG guidelines do not as yet recommend the routine use of Colour Doppler, recent evidence suggests both the 4chamber and especially the outflow tracts are best assessed using 2D in combination with colour Doppler

The incidence of congenital heart disease is highest in the first trimester ~ 1% and unlike the second trimester may present with indirect extracardiac findings in many cases

Approximately 1 in 5 fetuses with a nuchal translucency >99th centile have an underlying congenital heart defect

Cardiac axis deviation is a significantly better marker  for first trimester congenital heart defects than the ‘older’ indirect markers
( Nuchal translucency, Tricuspid valve regurgitation, abnormal ductus venosus waveform either used in isolation or in combination )

(i) The diagnosis of global skeletal dysplasias can be made in up to 50% of cases in the first trimester.  T/F
(ii) The diagnosis of radial ray deformity carries a much better prognosis when compared to transverse limb defects in the first trimester.  T/F
(iii) Key sonographic clues of skeletal abnormalities include increased nuchal translucency, hydrops fetalis and abnormal ductus venosus waveform. T/F
(iv) Definitive genetic testing by CVS should be considered in all cases of isolated first trimester talipes equinovarus.  T/F
(v) First trimester post axial polydactyly is a far more frequent finding when compared to pre axial polydactyly.  T/F

(i) Major anterior abdominal wall are sonographically no different in the first trimester when compared to the second trimester and detectable in up to 100% of cases. T/F
(ii) Features of bowel obstruction may appear solely in the first trimester and disappear with no features evident at any stage later during the pregnancy, but confirmed postnatally. T/F
(iii) In most cases the diagnosis of bowel obstruction in the first trimester is made prior rather than after 12 weeks of gestation.    T/F
(iv) No sonographic findings of large bowel obstruction have as yet been described at 11-14 weeks of gestation. T/F

(i) The urinary bladder and kidneys can be identified in 90% of fetuses at 13 weeks gestation.     T/F
(ii) The accuracy of genitalia prediction of fetal sex is > 90% for a crown rump length > 70mm.     T/F
(iii) First trimester pyelectasis is defined as a maximum AP measurement >1.5mm.    T/F
(iv) First trimester megacystis is defined as a maximum longitudinal bladder length > 5mm.     T/F
(v) First trimester lower urinary tract obstruction is caused by posterior urethral valve syndrome in male fetuses in 70-80% of cases.     T/F
(vi) Fetal cystic renal disease is detected within 20-30% cases at 11-13 weeks.      T/F
(vii) A two vessel umbilical cord is readily identified at 11-14 weeks and a helpful marker in the diagnosis of both bladder extrophy and cloacal dystrophy.      T/F


The information provided in this course is designed for informational and educational purposes. Neither Dr Simon Meagher nor any member of the faculty accept or assume any responsibility for the use of the information during the first trimester ultrasound symposium and understand and agree that neither Dr Simon Meagher nor any member of the faculty takes responsibility for clinical material or information conveyed by any lecturer during the course.

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