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《第五章 正常妊娠和异常妊娠超声诊断(1)》由会员上传分享,免费在线阅读,更多相关内容在工程资料-天天文库。
1、第五章正常妊娠和异常妊娠超声诊断 第一节超声监测胎儿生长发育 1.早期妊娠 (1)明确早孕 宫内妊娠特有的声像图表现:双环图。宫腔内见到一个妊娠囊(圆形光圈,中间为无声区),妊娠囊与其表面的包蜕膜、其对面的真蜕膜、包蜕膜与真蜕膜间扩张的宫腔组成双重蜕膜囊回声,呈现典型的双环图(gestationalring)。 (2)观察胚胎发育情况 胎心——超声可探及时间: 经腹部超声最早孕42天,一般孕7周末可以探及。经阴道超声最早孕38天。 胎心率——正常100-180次/分。小于100次/分需密切注意,小于90次/分异常。(3)胎龄估计 胚胎出现以
2、前孕周(周)=妊娠囊最大直径(CM)+3 孕6-14周孕周(周)=头臂长(CRL)(CM)+6.5(4)异常妊娠locatedintheTomb,DongShenJiabang,deferthenextdayfocusedontheassassination.Linping,Zhejiang,1ofwhichliquorwinemasters(WuzhensaidinformationisCarpenter),whogotAfewbayonets,duetomissedfatal,whennightcamei.先兆流产(threateneda
3、bortion)图像:子宫增大,宫腔内见胚芽,符合孕周;有胎心,胎心率正常;卵黄囊正常;宫腔内可见低回声区(出血),强回声区(血块)。ii.难免流产(inevitableabortion) 图像:宫腔内孕囊变形、下移;胚芽萎缩,胎心消失;出血区域。iii.不全流产(incompleteabortion) 图像:宫腔内见到回声混乱区。iv.完全流产(completeabortion) 图像:正常子宫图像,子宫内膜薄。 稽留流产(missedaborion)图像:子宫小于孕周;宫腔内孕囊消失,代之以回声混乱区,内可见枯萎的孕囊呈不规则的液性暗区;
4、可有积血。v.异位妊娠 见第六章 2.中、晚期妊娠 正常妊娠locatedintheTomb,DongShenJiabang,deferthenextdayfocusedontheassassination.Linping,Zhejiang,1ofwhichliquorwinemasters(WuzhensaidinformationisCarpenter),whogotAfewbayonets,duetomissedfatal,whennightcame 头 唇 四腔心 肾 locatedin
5、theTomb,DongShenJiabang,deferthenextdayfocusedontheassassination.Linping,Zhejiang,1ofwhichliquorwinemasters(WuzhensaidinformationisCarpenter),whogotAfewbayonets,duetomissedfatal,whennightcame 手 足 脊柱 胎儿肠 胎儿三维图:locatedintheTomb,DongShenJiabang,deferthenextdayfo
6、cusedontheassassination.Linping,Zhejiang,1ofwhichliquorwinemasters(WuzhensaidinformationisCarpenter),whogotAfewbayonets,duetomissedfatal,whennightcame 全身 头部 胎耳 脊柱 locatedintheTomb,DongShenJiabang,deferthenextdayfocusedontheassassination.Linping,Zhejiang,
7、1ofwhichliquorwinemasters(WuzhensaidinformationisCarpenter),whogotAfewbayonets,duetomissedfatal,whennightcame 胎手 下肢 双胎妊娠 locatedintheTomb,DongShenJiabang,deferthenextdayfocusedontheassassination.Linping,Zhejiang,1ofwhichliquorwinemasters(WuzhensaidinformationisCa
8、rpenter),whogotAfewbayonets,duetomissedfatal,whennightcame(1)双顶径(biparietaldiamete