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Pogrados latinoamérica medicina fetal Eduard Gratacós Francesc Figueras Specialization Diploma in Fetal Neurology
Calculadora v2021 en español

DATING BY LMP AND BIOMETRIES

LMP (Last Menstrual Period)

First TM 1 (CRL<=84mm)

Second TM 2 (BDP<= 70mm)

Third TM 3 (BPD>70mm)

Estimate fetal weight

DBP, PC, PA, LF (Hadlock FL)

PA, LF (Hadlock FL)

Growth centile in II TM

Gender:

Unique percentile III TM

Gender:

Multiple percentile III TM

Monochorionic Twins

Bichorionic Twins

Preeclampsia 1T

Epidemiologic data

Biometric data

First Trimester Data

Risk early PE: 1/

Low risk

High risk

Congenital Diaphragmatic Hernia Calculator

Left side Hernia

o/e LHR (%)

Longest diameter method

Right Lung to Head Ratio

Prediction of survival

Prediction of survival in left CDH

Right side hernia

o/e LHR (%)

Longest diameter method

Left Lung to Head Ratio

Prediction of survival

Prediction of survival in right CDH

Anemia

Cerebral Doppler

CALCULATE VOLUME TO TRANSFUSE

Doppler

Umbilical artery

Middle cerebral artery

Cerebroplacental ratio

Uterine arteries

Ductus venosus

Aortic isthmus

TEI index

Percentile:


Percentile:

Percentile:


CPR (Percentile: 1)

Mean Ut. A (Percentile: 64)

Percentile:







Fetal Growth restriction:

Stage 2

* If persistent >6h apart

Recommended management:

Follow-up in 1 week

+ Consider steroids and Magnesium Sulfate if ≤ 34.6 weeks

** An abnormal DV in the absence of a pulsatile umbilical artery is very unlikely to reflect a risk of acidosis. Therefore, before 34 weeks the decision to delivery should be relied upon the CTG. Rule out cardiac dysfunction or malformation.

Recommendations:

  • Control every two weeks
  • Amniotic fluid (maximum vertical pocket) + estimated fetal weight or abdominal circumference + peak systolic velocity middle cerebral artery

DIAGNOSTIC ALGORITHM


GA by LMP:

Twins gender

TWIN 1


TWIN 2


Twin-twin transfusion syndromePSV-MCA values not entered, the risk for TAPS can not be assessed.

"TTTS is normally associated with discordant bladders (large in the recipient, small or non visible in the donor), but the main diagnostic criterion is the amniotic fluid imbalance. In Europe 10cm is used after 20 weeks GA."


STAGING

Quintero RA et al. J Perinatol. 1999 Dec;19 (8 Pt1): 550-5.

TWIN 1

MVP-AF (mm):

Bladder:





TWIN 2

MVP-AF (mm):

Bladder:






RISK OF IUFD AFTER LASER

Eixarch E et al. Prenat Diagn. 2013 Nov;33(11):1033-8.

TWIN 1

Gestational age:

Estimated fetal weight discordance (%):


TWIN 2

Gestational age:

Estimated fetal weight discordance (%):


Selective IUGRPSV-MCA values not entered, the risk for TAPS can not be assessed.


TYPE OF IUGR

Diastolic flow in free loop in Umbilical artery of small fetus:

Please select your option


Recomendations:

Gestational age:

Estimated fetal weight discordance (%):

Maximum vertical pocket of Amniotic fluid (mm):






Recomendations:

Gestational Age

Cardiac dimensions (GA)

See support images

cardiac_dimensions_drawing cardiac_dimensions_ultrasound

LV: Left ventricle - RV: Right ventricle - PV: Pulmonary veins - FO: Fossa ovalis - MB: Moderator band - TCD: Transverse cardiac diameter - LCD: Longitudinal cardiar diameter - CA: Cardiac area

Transverse diameter Z-score: XX

Please check the value Transverse diameter

Longitudinal diameter Z-score: XX

Please check the value Longitudinal diameter

Cardiac area Z-score: XX

Please check the value Cardiac area

Atrial dimensions (GA)

Left Atrium

See support images

atrial_dimensions_drawing atrial_dimensions_ultrasound

PV: Pulmonary veins - FO: Fossa ovails - LA: Left atria - RA: Right atria - LATD: LA transverse diameter - LALD: LA longitudinal diameter - LAA: LA area - RATD: RA transverse diameter - RAA: RA area - RALD: RA longitudinal diameter

Transverse diameter Z-score: XX

Please check the value Transverse diameter

Longitudinal diameter Z-score: XX

Please check the value Longitudinal diameter

Area Z-score: XX

Please check the value Area

Right Atrium

See support images

atrial_dimensions_drawing atrial_dimensions_ultrasound

PV: Pulmonary veins - FO: Fossa ovails - LA: Left atria - RA: Right atria - LATD: LA transverse diameter - LALD: LA longitudinal diameter - LAA: LA area - RATD: RA transverse diameter - RAA: RA area - RALD: RA longitudinal diameter

Transverse diameter Z-score: XX

Please check the value Transverse diameter

Longitudinal diameter Z-score: XX

Please check the value Longitudinal diameter

Area Z-score: XX

Please check the value Area

Ventricular dimensions (GA)

Left Ventricle

See support images

ventricular_dimensions_drawing ventricular_dimensions_ultrasound

LV: Left ventricle - RV: Right ventricle - PV: Pulmonary veins - FO: Fossa ovails - MB: Moderator band - LVBD: LV basal diameter - LVMTD: LV midtransverse diameter - LVLD: LV longitudinal diameter - RVBD: LV basal diameter - RVMTD: RV mistransverse diameter - RVLD: RV longitudinal diameter

Basal Transverse diameter Z-score: XX

Please check the value Basal Transverse diameter

Mid-Transverse diameter Z-score: XX

Please check the value Mid-Transverse diameter

Longitudinal diameter Z-score: XX

Please check the value Longitudinal diameter

Area Z-score: XX

Please check the value Area

Right Ventricle

See support images

ventricular_dimensions_drawing ventricular_dimensions_ultrasound

LV: Left ventricle - RV: Right ventricle - PV: Pulmonary veins - FO: Fossa ovails - MB: Moderator band - LVBD: LV basal diameter - LVMTD: LV midtransverse diameter - LVLD: LV longitudinal diameter - RVBD: LV basal diameter - RVMTD: RV mistransverse diameter - RVLD: RV longitudinal diameter

Basal Transverse diameter Z-score: XX

Please check the value Basal Transverse diameter

Mid-Transverse diameter Z-score: XX

Please check the value Mid-Transverse diameter

Longitudinal diameter Z-score: XX

Please check the value Longitudinal diameter

Area Z-score: XX

Please check the value Area

2D Wall Thickness (GA)

See support images

wall_thickness_drawing wall_thickness_ultrasound

LV: Left ventricle - RV: Right ventricle - LVWT: LV wall thickness - RVWT: RV wall thickness - SWT: Septal wall thickness

Left Ventricle Z-score: XX

Please check the value Left Ventricle

Right Ventricle Z-score: XX

Please check the value Right Ventricle

Septum Z-score: XX

Please check the value Septum

Valvular dimensions (GA)

See support images

valvular_dimensions_1_drawing valvular_dimensions_1_ultrasound

LV: Left ventricle - RV: Right ventricle - MV: Mitral valve - TV: Tricuspid valve - FO: Foramen ovale

valvular_dimensions_2_drawing valvular_dimensions_2_ultrasound

Ao: Aorta - PV: Pulmonary valve

valvular_dimensions_3_drawing valvular_dimensions_3_ultrasound

AV: Aortic valve - LA: Left atrium - LV: Left ventricle

Tricuspid annulus Z-score: XX

Please check the value Tricuspid annulus

Mitral annulus Z-score: XX

Please check the value Mitral annulus

Pulmonary annulus Z-score: XX

Please check the value Pulmonary annulus

Aortic annulus Z-score: XX

Please check the value Aortic annulus

Cardiac vessels dimensions (GA)

Aorta

See support images

aorta_dimensions_1_drawing aorta_dimensions_1_ultrasound

AV: Aortic valve - AAo: Ascending aorta - AoI: Aortic Isthmus - DAo: Descending aorta - IVC: Inferior Vena Cava

aorta_dimensions_2_drawing aorta_dimensions_2_ultrasound

AoI: Aortic Isthmus - DA: Ductus arteriosus - T: Trachea - SVC: Superior Vena Cava

Ascending aorta Z-score: XX

Please check the value Ascending aorta

Aortis isthmus (3VT) Z-score: XX

Please check the value Aortic isthmus (3VT)

Aortic isthmus (aortic arch) Z-score: XX

Please check the value Aortic isthmus (aortic arch)

Descending aorta Z-score: XX

Please check the value Descending aorta

Pulmonar

See support images

pulmonar_dimensions_1_drawing pulmonar_dimensions_2_ultrasound

Ao: Aorta - PT: Pulmonary trunk - RPA: Right Pulmonary artery - LPA: Left Pulmonary artery

pulmonar_dimensions_2_drawing pulmonar_dimensions_2_ultrasound

AoI: Aortic Isthmus - DA: Ductus arteriosus - T: Trachea - SVC: Superior Vena Cava

Pulmonary trunk Z-score: XX

Please check the value Pulmonary trunk

Right pulmonary artery Z-score: XX

Please check the value Right pulmonary artery

Left pulmonary artery Z-score: XX

Please check the value Left pulmonary artery

Ductus arteriosus (3VT) Z-score: XX

Please check the value Ductus arteriosus (3VT)

Venas cavas

See support images

cavas_dimensions_drawing cavas_dimensions_ultrasound

AV: Aortic valve - AAo: Ascending aorta - AoI: Aortic Isthmus - DAo: Descending aorta - IVC: Inferior Vena Cava

Inferior vena cava Z-score: XX

Please check the value Inferior vena cava

Fetal biometry

Cardiac dimensions (EFW)

See support images

cardiac_dimensions_drawing cardiac_dimensions_ultrasound

LV: Left ventricle - RV: Right ventricle - PV: Pulmonary veins - FO: Fossa ovails - MB: Moderator band - TCD: Transverse cardiac diameter - LCD: Longitudinal cardiar diameter - CA: Cardiac area

Transverse diameter Z-score: XX

Please check the value Transverse diameter

Longitudinal diameter Z-score: XX

Please check the value Longitudinal diameter

Cardiac area Z-score: XX

Please check the value Cardiac area

Atrial dimensions (EFW)

Left Atrium

See support images

atrial_dimensions_drawing atrial_dimensions_ultrasound

PV: Pulmonary veins - FO: Fossa ovails - LA: Left atria - RA: Right atria - LATD: LA transverse diameter - LALD: LA longitudinal diameter - LAA: LA area - RATD: RA transverse diameter - RAA: RA area - RALD: RA longitudinal diameter

Transverse diameter Z-score: XX

Please check the value Transverse diameter

Longitudinal diameter Z-score: XX

Please check the value Longitudinal diameter

Area Z-score: XX

Please check the value Area

Right Atrium

See support images

atrial_dimensions_drawing atrial_dimensions_ultrasound

PV: Pulmonary veins - FO: Fossa ovails - LA: Left atria - RA: Right atria - LATD: LA transverse diameter - LALD: LA longitudinal diameter - LAA: LA area - RATD: RA transverse diameter - RAA: RA area - RALD: RA longitudinal diameter

Transverse diameter Z-score: XX

Please check the value Transverse diameter

Longitudinal diameter Z-score: XX

Please check the value Longitudinal diameter

Area Z-score: XX

Please check the value Area

Ventricular dimensions (EFW)

Left Ventricle

See support images

ventricular_dimensions_drawing ventricular_dimensions_ultrasound

LV: Left ventricle - RV: Right ventricle - PV: Pulmonary veins - FO: Fossa ovails - MB: Moderator band - LVBD: LV basal diameter - LVMTD: LV midtransverse diameter - LVLD: LV longitudinal diameter - RVBD: LV basal diameter - RVMTD: RV mistransverse diameter - RVLD: RV longitudinal diameter

Basal Transverse diameter Z-score: XX

Please check the value Basal Transverse diameter

Mid-Transverse diameter Z-score: XX

Please check the value Mid-Transverse diameter

Longitudinal diameter Z-score: XX

Please check the value Longitudinal diameter

Area Z-score: XX

Please check the value Area

Right Ventricle

See support images

ventricular_dimensions_drawing ventricular_dimensions_ultrasound

LV: Left ventricle - RV: Right ventricle - PV: Pulmonary veins - FO: Fossa ovails - MB: Moderator band - LVBD: LV basal diameter - LVMTD: LV midtransverse diameter - LVLD: LV longitudinal diameter - RVBD: LV basal diameter - RVMTD: RV mistransverse diameter - RVLD: RV longitudinal diameter

Basal Transverse diameter Z-score: XX

Please check the value Basal Transverse diameter

Mid-Transverse diameter Z-score: XX

Please check the value Mid-Transverse diameter

Longitudinal diameter Z-score: XX

Please check the value Longitudinal diameter

Area Z-score: XX

Please check the value Area

2D Wall Thickness (EFW)

See support images

wall_thickness_drawing wall_thickness_ultrasound

LV: Left ventricle - RV: Right ventricle - LVWT: LV wall thickness - RVWT: RV wall thickness - SWT: Septal wall thickness

Left Ventricle Z-score: XX

Please check the value Left Ventricle

Right Ventricle Z-score: XX

Please check the value Right Ventricle

Septum Z-score: XX

Please check the value Septum

Valvular dimensions (LF)

See support images

valvular_dimensions_1_drawing valvular_dimensions_1_ultrasound

LV: Left ventricle - RV: Right ventricle - MV: Mitral valve - TV: Tricuspid valve - FO: Foramen ovale

valvular_dimensions_2_drawing valvular_dimensions_2_ultrasound

Ao: Aorta - PV: Pulmonary valve

valvular_dimensions_3_drawing valvular_dimensions_3_ultrasound

AV: Aortic valve - LA: Left atrium - LV: Left ventricle

Tricuspid annulus Z-score: XX

Please check the value Tricuspid annulus

Mitral annulus Z-score: XX

Please check the value Mitral annulus

Pulmonary annulus Z-score: XX

Please check the value Pulmonary annulus

Aortic annulus Z-score: XX

Please check the value Aortic annulus

Cardiac vessels dimensions (LF)

Aorta

See support images

aorta_dimensions_1_drawing aorta_dimensions_1_ultrasound

AV: Aortic valve - AAo: Ascending aorta - AoI: Aortic Isthmus - DAo: Descending aorta - IVC: Inferior Vena Cava -

aorta_dimensions_2_drawing aorta_dimensions_2_ultrasound

AoI: Aortic Isthmus - DA: Ductus arteriosus - T: Trachea - SVC: Superior Vena Cava

Ascending aorta Z-score: XX

Please check the value Ascending aorta

Aortis isthmus (3VT) Z-score: XX

Please check the value Aortic isthmus (3VT)

Aortic isthmus (aortic arch) Z-score: XX

Please check the value Aortic isthmus (aortic arch)

Descending aorta Z-score: XX

Please check the value Descending aorta

Pulmonar

See support images

pulmonar_dimensions_1_drawing pulmonar_dimensions_2_ultrasound

Ao: Aorta - PT: Pulmonary trunk - RPA: Right Pulmonary artery - LPA: Left Pulmonary artery

pulmonar_dimensions_2_drawing pulmonar_dimensions_2_ultrasound

AoI: Aortic Isthmus - DA: Ductus arteriosus - T: Trachea - SVC: Superior Vena Cava

Pulmonary trunk Z-score: XX

Please check the value Pulmonary trunk

Right pulmonary artery Z-score: XX

Please check the value Right pulmonary artery

Left pulmonary artery Z-score: XX

Please check the value Left pulmonary artery

Ductus arteriosus (3VT) Z-score: XX

Please check the value Ductus arteriosus (3VT)

Venas cavas

See support images

cavas_dimensions_drawing cavas_dimensions_ultrasound

AV: Aortic valve - AAo: Ascending aorta - AoI: Aortic Isthmus - DAo: Descending aorta - IVC: Inferior Vena Cava

Inferior vena cava Z-score: XX

Please check the value Inferior vena cava

Dating

1. Robinson HP. A critical evaluation of sonar ‘crown-rump length’ measurements. BJOG 1975;82:702-710. Revised BUMS sept 2008.

2. Mul T. A comparative analysis of second-trimester ultrasound dating formulas in pregnancies conceived with artificial reproductive techniques. UOG 1996; 8:397-402.

3. Mongelli M. Third trimester ultrasound dating algorithms derived from pregnancies conceived with artificial reproductive techniques. UOG 2005; 26:129-131.

Fetal Growth

1. Hadlock FP. Estimation of fetal weight with the use of head, body and femur measurements a prospective study. Am J Obstet Gynecol 1985;151(3):333.

2. Hadlock FP. Sonographic estimation of fetal weight. The value of femur length in addition to head and abdomen measurements. Radiology, 1984 Feb; 150(2):535.

Growth centile in II TM

1. Pedersen N, Figueras F, Tabor A. Obstetrics and Gynecology 2008; 112(4):765-71.

Unique percentile in III TM

1. Figueras F. Customized birthweight for a Spanish Population. EJOGRM 2008; 136(1):20-4.

Multiple percentile in III TM

1. Kuno A. Comparision of fetal growth in singleton, twin and triplet pregnancies. Hum Reprod 1999.

2. Corbes de referència de pes, perímetro craneal i longitud en nèixer de nounats d'embarassos únics, bessons i trigèmins a Catalunya. Departament de Salut. Generalitat de Catalunya 2000.

3. Gender-Specific Antenatal Growth Reference Charts in Monochorionic Twins - https://pubmed.ncbi.nlm.nih.gov/29268248/pubmed.ncbi.nlm.nih.gov/29268248/

Congenital Diaphragmatic hernia

1. Jani J, UOG 2007; 30:67-71.

2. Dekoninck P, BJOG 2015; 122:940-946.

Normal Doppler Values

1. Arduini D J Perinat Med 1990; 18:165.

2. Baschat AA UOG 2003; 21:124.

3. Mari G N Engl J Med 2000; 342:9.

4. Hecher K UOG 1994; 4:381.

5. Rizzo G UOG 1996; 7:401.

Fetal Biometries

1. CC: Snijders RL, UOG 1994.

2. Extremidades: Chitty, LS BJOG 2002.

Monochorionic Twins

1. Van Mieghem T et al.Ultrasound Obstet Gynecol. 2011 Jan; 37(1):15-21.

2. Hadlock FP, et al., In utero analysis of fetal growth: a sonographic weight standard.Radiology. 1991 Oct;181(1):129-33. PMID: 1887021

3. Hadlock FP, et al., Estimating fetal age:Computer-assisted analysis of multiple fetal growth parameters. Radiology 1984; 152:497-5011

Cardiac Morphometry

1. Schneider UOG 2005 - RANGE 15-39 weeks

2. Pasquini UOG 2007 - RANGE 18-37 weeks