Normal Level 2 Ultrasound

NORMAL LEVEL-TWO ULTRASOUND SCAN Ultrasound examination during should include a systematic evaluation of fetal anatomy. Apart from anencephaly, the fetal organs cannot be accurately measured before 17-18 weeks of gestation. After 30-35 weeks, evaluation becomes increasingly difficult. Hence level-two ultrasound scan is done at 18 to 20 weeks of gestation.

CLASSIFICATION OF FETAL SONOGRAPHIC EXAMINATIONS 1. First-Trimester Ultrasound 2. Standard Second- or Third-Trimester Ultrasound a. Fetal presentation, amniotic fluid volume, b. Cardiac activity, placental position c. Fetal biometry, anatomic survey d. Maternal cervix, adnexae 3. Limited Examination a. Fetal cardiac activity b. Fetal presentation 4. Specialized Examination (also called a Level 2 or Targeted Examination) a. Detailed anatomic study b. Fetal Doppler, biophysical profile, echocardiogram

RECOMMENDED FETAL ANATOMY 1. Head: Cerebral ventricle, Cerebellum, Cisterna magna, Midline falx, CSP Lips. 2. Chest: 4 chamber heart and great vessels. 3. Abdomen: Stomach, Kidneys. Urinary bladder, echogenicity. 4. Umbilical cord: Insertion and vessels. 5. Limbs: upper and lower. 6. Spine: Cervical, Thoracic, Lumbar, Sacral, Spina bifida, Meningomyelocoele

ADDITIONAL VIEWS IN A TARGETED OR DETAILED EXAMINATION 1. Skull: Configuration, mineralization, contiguity 2. Brain: Cerebral hemispheres, third ventricle, fourth ventricle, trans-cerebellar diameter 3. Face: Profile, nasal bridge, oral cavity/tongue, ears, outer orbital diameter 4. Neck: Soft tissues and external contours 5. Thorax: Configuration of bony thorax, thoracic circumference 6. Heart: Four chamber, outflow tracts, descending aorta, septa, valves 7. Abdominal cavity / bowel / liver / spleen: Any mass, calcification, dilatation 8. Umbilical Cord: Assess insertion. 9. Spine: assess for Spina