Medical Specialty:
Obstetrics / Gynecology
Sample Name: Ultrasound OB - 3
Description: A 37 year-old female with twin pregnancy with threatened premature labor.
(Medical Transcription Sample Report)
This is a 37 year-old female with twin pregnancy with threatened premature labor.
GENERAL EVALUATION: Twin B
Fetal Cardiac Activity: Normal at 166 BPM
Fetal Lie: Longitudinal, to the maternal right.
Fetal Presentation: Cephalic.
Uterus: Normal
Cervix: Closed.
Adnexa: Not seen
Amniotic Fluid: AFI 5.5cm in a single AP pocket.
BPD: 7.9cm consistent with 31weeks, 5 days gestation
HC: 31.1cm consistent with 33 weeks, 3 days gestation
AC: 30.0cm consistent with 34 weeks, 0 days gestation
FL: 6.4cm consistent with 33 weeks, 1 day gestation
CI (BPD/OFD): 77 (70-86)
FL/BPD: 81 (71-87)
FL/HC: 21.3 (19.9-21.5)
FL/AC 21 (20-24)
HC/AC: 1.00 (0.96-1.11)
GESTATIONAL AGE BY CURRENT ULTRASOUND: 33 weeks, 0 days +/- 2 weeks, 2 days FETAL WEIGHT BY CURRENT ULTRASOUND: 2194 gms (4 lbs 13 oz) = 6th percentile EDD BY CURRENT ULTRASOUND: 07/30/07
GESTATIONAL AGE BY DATES: 35 weeks, 5 days
L M P: Not given.
EDD BY DATES: 07/11/07
GESTATIONAL AGE BY PREVIOUS ULTRASOUND: 35 weeks, 2 days DATE OF PREVIOUS ULTRASOUND: 04/20/07 EDD BY PREVIOUS ULTRASOUND: 07/13/07
FETAL ANATOMY:
Fetal Cerebellum: Normal
Fetal Cranium: Normal
Fetal Face: Normal Nose and Mouth
Fetal Heart (4 Chamber View): Normal
Fetal Diaphragm: Normal
Fetal Stomach: Normal
Fetal Cord: Normal three vessel cord, there is a nuchal cord
Fetal Abdominal Wall: Normal
Fetal Spine: Normal
Fetal Kidneys: Normal
Fetal Bladder: Normal
Fetal Limbs: Normal
IMPRESSION:
Monochorionic diamniotic twin pregnancy.
Twin B is small for gestational age and equivalent to twin A (size and dates as detailed above).
Nuchal cord.
Low amniotic fluid volume.
Keywords: obstetrics / gynecology, normal fetal, premature labor, amniotic fluid, nuchal cord, twin pregnancy, gestational age, fetal, pregnancy, gestation, gestational, cord, twin, ultrasound,