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The anomaly scan, also sometimes called the anatomy scan, 20-week ultrasound, or level 2 ultrasound, evaluates anatomic structures of the fetus, placenta, and maternal pelvic organs. This scan is an important and common component of routine prenatal care . [ 1 ]
In the second trimester, a standard ultrasound exam typically includes: [12] Fetal number, including number of amnionic sacs and chorionic sacs for multiple gestations; Fetal cardiac activity; Fetal position relative to the uterus and cervix; Location and appearance of the placenta, including site of umbilical cord insertion when possible
In a circumvallate placenta, the chorionic plate, which forms the fetal surface of the placenta, tends to be smaller than the basal plate, which forms the maternal surface of the placenta. This results in the elevation of the placental margin and the appearance of an annular shape. [3]
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Both abdominal and vaginal ultrasound may be used, but vaginal ultrasound allows for earlier visualization of the pregnancy. With obstetric ultrasonography the gestational sac (intrauterine fluid collection) can be visualized at 4.5 to 5 weeks gestation , the yolk sac at 5 to 6 weeks gestation, and fetal pole at 5.5 to 6 weeks gestation.
An important risk factor for placenta accreta is placenta previa in the presence of a uterine scar. Placenta previa is an independent risk factor for placenta accreta. Additional reported risk factors for placenta accreta include maternal age and multiparity, other prior uterine surgery, prior uterine curettage, uterine irradiation, endometrial ablation, Asherman syndrome, uterine leiomyomata ...
Velamentous cord insertion is often diagnosed using an abdominal ultrasound. [3] [4] This is most successful in the second trimester, [13] however Color Doppler ultrasound [14] or transvaginal ultrasound [15] can be used in difficult cases, such as when the placenta is located
In addition to a shared placenta, monochorionic twins also have their circulatory systems intermingled in random and unpredictable circulatory anastomoses. This can cause disproportionate blood supply, resulting in twin-to-twin transfusion syndrome (TTTS) in 20% [1] of MoDi pregnancies. This is the main complication of monochorionic twins.