The two tiered Health care in USA.
Friday, November 02, 2018
Wednesday, October 31, 2018
Stop paying people for not working and the use of Opioids will automatically come down
If we had a time machine we can get some information from China and England which can throw some light on USA's Opioid epidemic.
Although there are people who have alternate "FACTS" Like Fox news ( Julia Lovell Opium wars)
THE OPIUM WAR AND THE END OF CHINA'S LAST GOLDEN AGE STEPHEN R. PLATT
The study authors were also surprised by the tremendous differences between states in opioid use. “There was a fivefold difference between the highest state, Rhode Island, and the lowest state, North Dakota,” Dr. Piper said. “Pain is a biopsychosocial condition, but there is no reason to believe that the citizens of Rhode Island are biologically different than those from North Dakota. Hence, there is much left to learn about the sociocultural and economic factors that are responsible for the substantial opioid prescribing differences across states.”
Although there are people who have alternate "FACTS" Like Fox news ( Julia Lovell Opium wars)
THE OPIUM WAR AND THE END OF CHINA'S LAST GOLDEN AGE STEPHEN R. PLATT
The study authors were also surprised by the tremendous differences between states in opioid use. “There was a fivefold difference between the highest state, Rhode Island, and the lowest state, North Dakota,” Dr. Piper said. “Pain is a biopsychosocial condition, but there is no reason to believe that the citizens of Rhode Island are biologically different than those from North Dakota. Hence, there is much left to learn about the sociocultural and economic factors that are responsible for the substantial opioid prescribing differences across states.”
“Not being able to report methadone is a barrier for pharmacoepidemiological research, adversely impacts evidence-based medicine, and, most crucial, is an impediment to informed decision making and communication for the health providers of the 345,000 methadone patients in the U.S.,” Dr. Piper said.
The authors advocate three strategies that should be considered to curb opioid use: thoroughly vetting potential policymakers who make decisions about opioids at a state or national level for their conflicts of interest; the ability to report methadone from narcotic treatment programs in PDMPs; and eliminating direct-to-consumer marketing for controlled substances.
"If you stand outside the wall, it is impossible to gauge the size of the city. Canton is built on a plain, so the low, flat buildings of brick and wood that lie inside are invisible from where you stand. The wall is thirty feet high and crenellated, built from large blocks of sandstone at its base and smaller bricks above. It stretches as far as you can see in either direction, with forts visible on top at regular intervals, cannons peering outward. Near you is one of the twelve massive wooden gates that open into the city, a shadowed cave guarded by soldiers and horsemen. The gates creak open each morning at dawn, and close again each evening around 9 p.m. Not that you will be allowed in. As a foreigner, you are stopped at the gate and turned away. You Mill not see the fantastic warren of narrow streets inside, paved with thick slabs of granite. You will not see the dense brick houses with their sloping tiled roofs, the vast examination hall with its thousands of cells, the lavish mansions, the temples, the gardens, or the government offices that lie within. Instead, you stay outside and wander back through the suburbs, the sprawling and amorphous settlements surrounding the wall where you could walk for miles without any sense of their coming to an end. It is steamy weather, so humid your sweat seems to just blend into the air around you. The paved streets are twisting and so very narrow that you can sometimes touch the walls on both sides at the same time. The buildings here, fronted with fragrant carved wood, are mostly two stories high, with tall shutters on the windows. Above you, laundry hangs to dry on lines stretched across the top of the alley, creating a canopy effect. It is hard to hear over the din of the hawkers and the shouting of porters and chair-bearers as they try to push their way through. Everywhere is the press of humanity—people traveling on foot or carried in sedan chairs, lounging in the alleyways, eating in open-air restaurants as street performers and beggars"
Just like New York of today.
The Chinese of the early nineteenth century are often described as being uniformly insular and scornful of anything foreign, thanks mainly to an overly literal reading of the boilerplate language in Qianlong's edict to George Ill where he claimed that he did not value foreign things. But this was not really the case. For wealthy urbanites in China, Western goods were all the rage by the 1820s—furs, glass, intricate clocks, cotton textiles, and other products of the Canton import trade, which were highly sought after by those with sufficient money to buy them. Far from encountering any kind of disdain for foreign objects, Chinese retailers in the early nineteenth century found that attaching the adjective "Western" to their merchandise was in fact the key to a higher selling price.
This consumer fashion for foreign products helps explain why the opium from British India became so popular in China. Against latter-day nationalist claims that the British came and forced opium down the throats of helpless Chinese consumers, there was in fact an existing system of domestic opium production in China already in place to compete with the import market at Canton (especially in the empire's western and southwestern provinces). There were also separate avenues for importing the drug overland from Central Asia—and opium from all of those sources was much cheaper than the Indian opium the British brought to Canton.23 But opium was a luxury good, and its wealthy consumers weren't looking for a bargain; they were looking for status. "
like Walmart and Crack users of New york & cocaine and Sacks fifth avenue , Versace clients of LA
For all the protestations of Palmerston and his supporters that the war was not meant to support the opium trade, it certainly proved a great boon for that commerce. In the years that followed the war, opium exports from India, mostly destined for China, surpassed their previous highs and went on to reach new ones—forty thousand chests per year by 1846, fifty thousand by 1849, more than seventy thousand by 1855.57 As the opium trade regained steam thanks to the war, even the Americans of Russell & Co.—proving themselves more pragmatic than an ri ht back in a ain. The East India
three times over by 1848 to dramatically increase its income from the free growth and production of opium by independent farmers who were not British subjects.58 British India's financial dependence on opium grew accordingly. Whereas opium revenues had made up less than a tenth of the Bengal government's income at the time of the Opium War, by the 1850s the share had risen to nearly one-sixth.59 Within China, opium was still technically a clandestine trade after the war (if more omnipresent than ever), but by the mid-1850s, faced with a gigantic rebellion by the quasi- Christian peasant forces of the Taiping Heavenly Kingdom —an insurrection to make the White Intus look like a tempest in a teapot—some provincial officials resuscitated the dormant issue of legalization, proposing domestic
the dormant issue of legalization, proposing domestic taxes on opium to help fund the war effort.60 And though George Staunton continued with his ineffectual efforts to force an end to Britain's involvement in opium after the war, by 1856 he conceded that such efforts were no longer necessary because the trade was by that time effectively legal in China.61 That de facto legality would be made concrete in 1858 on the heels of another war, With Britain and France, after which the British plenipotentiary Lord Elgin would, much to his own mortification, sign a document setting a formal tariff for the import of opium into China. But already by that time, the only limit to the growth of the drug's use in the Qing Empire was its price,
a very interesting exchange of words from the movie Traffic
Robert Wakefield: [1:58:53] I can't believe you brought my daughter to this place.
Seth Abrahams: Woah. Why don't you just back the fuck up, man. "To this place"? What is that shit? Ok, right now, all over this great nation of ours, 'hundred thousand white people from the suburbs are cruisin' around downtown asking every black person they see "You got any drugs? You know where I can score some drugs?" *Think* about the effect that that has on the psyche of a black person, on their possibilities. I... God I guarantee you bring a hundred thousand black people into your neighborhood, into fuckin' Indian Hills, and they're asking every white person they see "You got any drugs? You know where I can score some drugs?", within a *day* everyone would be selling. Your friends. Their kids. Here's why: it's an unbeatable market force man. It's a three-hundred percent markup value. You can go out on the street and make five-hundred dollars in two hours, come back and do whatever you want to do with the rest of your day and, I'm sorry, you're telling me that... you're telling me that white people would still be going to law school?
The symbolic power of the Opium War is almost limitless. It has long stood as the point when China's weakness was laid bare before the world, the opening of a "Century of Humiliation" in which Western (and later Japanese) predators would make war on China to bully it into granting territorial concessions and trading rights. It marked a sea change in relations with the West—the end of one era, when foreigners came to China as supplicants, and the dawn of another, when they would come as conquerors. And it carries especially strong power because China unquestionably had the moral high ground: as remembered since, and as charged by critics at the time, Great Britain unleashed its navy on a nearly defenseless China in order to advance the interests of its national drug dealers, who for years had been smuggling opium to China's coast against the laws of the country. The shocking grounds of the war have provided the very foundation of modern Chinese nationalism—from the overthrow of the Qing dynasty in 1912 and the rise, first of the Republic, and then the People's Republic of China, the Opium War has stood for the essence of everything modern China has tried to leave behind: weakness, victimhood, shame. Because we live in a world so heavily shadowed by this
When was the real Opioid epidemic actually happen?
In addition, due to the dramatic reductions in opioid prescribing since 2011, led by –58% for meperidine and –28% for both hydrocodone and oxymorphone, “the high visibility and frequency of the terms ‘opioid epidemic’ or ‘opioid crisis’ in the media continue to be surprising,” Dr. Piper said. “The ‘opioid epidemic’ should be viewed in the context of the number of deaths caused each year by cigarette smoking or alcohol.”
Most Prescription Opioid Use in the U.S. Fell from 2011 to 2016
Compared with both 2006 and 2016, prescription opioid use peaked in 2011 and has declined rapidly since then, according to a study of 10 opioids.
But buprenorphine bucked the trend by being the only opioid that showed an increase during the 10-year study period.
“A prior publication examining use and misuse of opioids in Maine made it abundantly clear that there were substantial gaps in state prescription drug monitoring programs [PDMPs],” said lead study author Brian Piper, PhD, an assistant professor of neuroscience at Geisinger Commonwealth School of Medicine, in Scranton, Pa. “Members of our research team began to suspect that estimates of the morphine milligram equivalents [MMEs] per capita in the United States, although highest in the world, were underestimated.” Three other authors of the current study, which was published in the American Journal of Preventive Medicine (2018;54[5]:652-660) are a psychiatric pharmacist, geriatric pharmacist and specialist in addiction medicine.
image
The findings that medical use of opioids reached its apex in 2011 and has been decisively on the retreat ever since reflects that “the culture surrounding opioid prescribing continues to change,” Dr. Piper said. “But an important exception to this general pattern has been the pronounced increase of 75% in buprenorphine.” Buprenorphine is an opioid partial agonist that is most often used to treat opioid addiction.
A prior publication by the CDC estimated that the MME per year was 640. “However, by using a data source that overcame earlier data gaps and included the Veterans Affairs, Indian Health Services and, most importantly, narcotic treatment programs, we found that the MME was 93% higher [1,237 MMEs],” Dr. Piper said.
When expressed as a percentage of total MMEs, the most prevalent opioid was methadone, which accounted for over 40% of MMEs in 2016 in the United States.
“Given the high profile of opioids and the substantial gaps in other data sources like PDMPs, it was surprising that someone else had not conducted the same study already,” Dr. Piper said.
The study authors were also surprised by the tremendous differences between states in opioid use. “There was a fivefold difference between the highest state, Rhode Island, and the lowest state, North Dakota,” Dr. Piper said. “Pain is a biopsychosocial condition, but there is no reason to believe that the citizens of Rhode Island are biologically different than those from North Dakota. Hence, there is much left to learn about the sociocultural and economic factors that are responsible for the substantial opioid prescribing differences across states.”
In addition, due to the dramatic reductions in opioid prescribing since 2011, led by –58% for meperidine and –28% for both hydrocodone and oxymorphone, “the high visibility and frequency of the terms ‘opioid epidemic’ or ‘opioid crisis’ in the media continue to be surprising,” Dr. Piper said. “The ‘opioid epidemic’ should be viewed in the context of the number of deaths caused each year by cigarette smoking or alcohol.”
The authors advocate three strategies that should be considered to curb opioid use: thoroughly vetting potential policymakers who make decisions about opioids at a state or national level for their conflicts of interest; the ability to report methadone from narcotic treatment programs in PDMPs; and eliminating direct-to-consumer marketing for controlled substances.
“Not being able to report methadone is a barrier for pharmacoepidemiological research, adversely impacts evidence-based medicine, and, most crucial, is an impediment to informed decision making and communication for the health providers of the 345,000 methadone patients in the U.S.,” Dr. Piper said.
Meanwhile, methadone and buprenorphine are two important evidence-based treatments for opioid use disorder that save lives, according to Dr. Piper. “These two medications are as effective as medications for other chronic diseases like diabetes. However, there continues to be too many barriers to treatment access, both economic and social-like stigma.”
Dr. Piper said methadone and buprenorphine work best when combined with psychological interventions, such as contingency management, “which are too often unavailable.”
Charles E. Argoff, MD, the director of the Comprehensive Pain Center at Albany Medical Center, in New York, said the analysis of prescribing trends is very interesting, but the data do not support that opioids are being misused or abused—prescribed or illicit use—any less.
“In fact, the number of people dying from opioid abuse and misuse has actually increased during the study period,” he said, noting that the increase in buprenorphine use also parallels increased abuse. “But the paper does not tell us why people are abusing buprenorphine, nor does it adequately address the increase in illicit use.”
However, reducing the amount of opioid used “does not correlate per se with the effective treatment of pain,” said Dr. Argoff, who also is a Pain Medicine News editorial advisory board member. “The analysis says nothing about the quality of pain management during the study period.”
Overall, the analysis provides quantitative information but scant qualitative information, according to Dr. Argoff. “For instance, is whatever is still being prescribed being used appropriately?” he said. “Similarly, is some of that reduction harming people who previously benefited from these medicines?”
—Bob Kronemyer
Most Prescription Opioid Use in the U.S. Fell from 2011 to 2016
Compared with both 2006 and 2016, prescription opioid use peaked in 2011 and has declined rapidly since then, according to a study of 10 opioids.
But buprenorphine bucked the trend by being the only opioid that showed an increase during the 10-year study period.
“A prior publication examining use and misuse of opioids in Maine made it abundantly clear that there were substantial gaps in state prescription drug monitoring programs [PDMPs],” said lead study author Brian Piper, PhD, an assistant professor of neuroscience at Geisinger Commonwealth School of Medicine, in Scranton, Pa. “Members of our research team began to suspect that estimates of the morphine milligram equivalents [MMEs] per capita in the United States, although highest in the world, were underestimated.” Three other authors of the current study, which was published in the American Journal of Preventive Medicine (2018;54[5]:652-660) are a psychiatric pharmacist, geriatric pharmacist and specialist in addiction medicine.
image
The findings that medical use of opioids reached its apex in 2011 and has been decisively on the retreat ever since reflects that “the culture surrounding opioid prescribing continues to change,” Dr. Piper said. “But an important exception to this general pattern has been the pronounced increase of 75% in buprenorphine.” Buprenorphine is an opioid partial agonist that is most often used to treat opioid addiction.
A prior publication by the CDC estimated that the MME per year was 640. “However, by using a data source that overcame earlier data gaps and included the Veterans Affairs, Indian Health Services and, most importantly, narcotic treatment programs, we found that the MME was 93% higher [1,237 MMEs],” Dr. Piper said.
When expressed as a percentage of total MMEs, the most prevalent opioid was methadone, which accounted for over 40% of MMEs in 2016 in the United States.
“Given the high profile of opioids and the substantial gaps in other data sources like PDMPs, it was surprising that someone else had not conducted the same study already,” Dr. Piper said.
The study authors were also surprised by the tremendous differences between states in opioid use. “There was a fivefold difference between the highest state, Rhode Island, and the lowest state, North Dakota,” Dr. Piper said. “Pain is a biopsychosocial condition, but there is no reason to believe that the citizens of Rhode Island are biologically different than those from North Dakota. Hence, there is much left to learn about the sociocultural and economic factors that are responsible for the substantial opioid prescribing differences across states.”
In addition, due to the dramatic reductions in opioid prescribing since 2011, led by –58% for meperidine and –28% for both hydrocodone and oxymorphone, “the high visibility and frequency of the terms ‘opioid epidemic’ or ‘opioid crisis’ in the media continue to be surprising,” Dr. Piper said. “The ‘opioid epidemic’ should be viewed in the context of the number of deaths caused each year by cigarette smoking or alcohol.”
The authors advocate three strategies that should be considered to curb opioid use: thoroughly vetting potential policymakers who make decisions about opioids at a state or national level for their conflicts of interest; the ability to report methadone from narcotic treatment programs in PDMPs; and eliminating direct-to-consumer marketing for controlled substances.
“Not being able to report methadone is a barrier for pharmacoepidemiological research, adversely impacts evidence-based medicine, and, most crucial, is an impediment to informed decision making and communication for the health providers of the 345,000 methadone patients in the U.S.,” Dr. Piper said.
Meanwhile, methadone and buprenorphine are two important evidence-based treatments for opioid use disorder that save lives, according to Dr. Piper. “These two medications are as effective as medications for other chronic diseases like diabetes. However, there continues to be too many barriers to treatment access, both economic and social-like stigma.”
Dr. Piper said methadone and buprenorphine work best when combined with psychological interventions, such as contingency management, “which are too often unavailable.”
Charles E. Argoff, MD, the director of the Comprehensive Pain Center at Albany Medical Center, in New York, said the analysis of prescribing trends is very interesting, but the data do not support that opioids are being misused or abused—prescribed or illicit use—any less.
“In fact, the number of people dying from opioid abuse and misuse has actually increased during the study period,” he said, noting that the increase in buprenorphine use also parallels increased abuse. “But the paper does not tell us why people are abusing buprenorphine, nor does it adequately address the increase in illicit use.”
However, reducing the amount of opioid used “does not correlate per se with the effective treatment of pain,” said Dr. Argoff, who also is a Pain Medicine News editorial advisory board member. “The analysis says nothing about the quality of pain management during the study period.”
Overall, the analysis provides quantitative information but scant qualitative information, according to Dr. Argoff. “For instance, is whatever is still being prescribed being used appropriately?” he said. “Similarly, is some of that reduction harming people who previously benefited from these medicines?”
—Bob Kronemyer
pain med news why it is obvious " high price " STUPID!
In the OCT 18 issue of " pain medicine news" a free magazine .
OCTOBER 18, 2018
Disability Presents Significant Barrier to Nonopioid Treatment
Vancouver, British Columbia—Patients with disabilities who require nonopioid pain medications appear to face increased barriers to medically necessary pain treatments, according to a Chicago-based research team. Their analysis revealed that with the exception of tricyclic antidepressants, all nonopioid pain drugs had quantity restrictions and were more likely to need prior authorization compared with opioid medications.
“We had a patient with a spinal cord injury who asked why he could get Norco [hydrocodone and acetaminophen, Astellas] without a problem, but had a difficult time getting Vesicare [solifenacin succinate, Astellas], a medication he uses for management of a neurogenic bladder,” said Allison Glinka Przybysz, MD, MPH, a resident at the University of Chicago’s Schwab Rehabilitation Hospital and Care Network. “So, that got us wondering if there are differences in the access that patients with disabilities [spinal cord injuries, post-stroke pain, phantom pain and neuropathies] have to different types of medication, specifically with respect to pain medications.”
To answer this question, ( it is pretty simple narco 30 tabs cost 15$ vesicare 30 tab cost 380$, does this need a big study ?)the researchers conducted a cross-sectional review of 2017 registry data from the Centers for Medicare & Medicaid Services, Medicare Part D for prescription drug plan formularies in Illinois. They examined first-line pharmacologic pain therapies for common rehabilitation diagnoses. “We analyzed three specific variables: tier level or associated cost per patient, prior authorizations and quantitative restrictions,” Dr. Glinka Przybysz explained. “We used these as a proxy for access to medications.”
Presenting the study at the 2018 annual meeting of the American Academy of Pain Medicine (abstract 287), the investigators said quantity restrictions on gabapentin and pregabalin were present 47% and 76% of the time, respectively, across all drug plans. Tricyclic antidepressants were 2.5 times more likely to require prior authorization (P>0.05) and transdermal lidocaine products were 33 times more likely to require prior authorization, compared with opioid pain medications (P<0 .05="" font="">
No differences were found among tricyclic antidepressant, gabapentinoid and opioid tier levels. In contrast, tier levels for lidocaine products were significantly greater compared with opioid tier level (P<0 .05="" font="">
The researchers concluded that patients with disabilities requiring nonopioid pain medications may face barriers to medically necessary pain treatments. “Nonopioid pain medications other than tricyclic antidepressants had quantity restrictions and were more likely to require prior authorizations,” Dr. Glinka Przybysz said. “What’s more, these patients may face other barriers in obtaining nonopioid pain medications, such as increased cost.
“And while we’re still working on the ‘why’ part of it, our data do indicate that these differences may, in fact, exist,” Dr. Glinka Przybysz noted. “And they may create increased barriers to obtaining necessary treatment for patients with disabilities.”
Vancouver, British Columbia—Patients with disabilities who require nonopioid pain medications appear to face increased barriers to medically necessary pain treatments, according to a Chicago-based research team. Their analysis revealed that with the exception of tricyclic antidepressants, all nonopioid pain drugs had quantity restrictions and were more likely to need prior authorization compared with opioid medications.
“We had a patient with a spinal cord injury who asked why he could get Norco [hydrocodone and acetaminophen, Astellas] without a problem, but had a difficult time getting Vesicare [solifenacin succinate, Astellas], a medication he uses for management of a neurogenic bladder,” said Allison Glinka Przybysz, MD, MPH, a resident at the University of Chicago’s Schwab Rehabilitation Hospital and Care Network. “So, that got us wondering if there are differences in the access that patients with disabilities [spinal cord injuries, post-stroke pain, phantom pain and neuropathies] have to different types of medication, specifically with respect to pain medications.”
To answer this question, ( it is pretty simple narco 30 tabs cost 15$ vesicare 30 tab cost 380$, does this need a big study ?)the researchers conducted a cross-sectional review of 2017 registry data from the Centers for Medicare & Medicaid Services, Medicare Part D for prescription drug plan formularies in Illinois. They examined first-line pharmacologic pain therapies for common rehabilitation diagnoses. “We analyzed three specific variables: tier level or associated cost per patient, prior authorizations and quantitative restrictions,” Dr. Glinka Przybysz explained. “We used these as a proxy for access to medications.”
Presenting the study at the 2018 annual meeting of the American Academy of Pain Medicine (abstract 287), the investigators said quantity restrictions on gabapentin and pregabalin were present 47% and 76% of the time, respectively, across all drug plans. Tricyclic antidepressants were 2.5 times more likely to require prior authorization (P>0.05) and transdermal lidocaine products were 33 times more likely to require prior authorization, compared with opioid pain medications (P<0 .05="" font="">
No differences were found among tricyclic antidepressant, gabapentinoid and opioid tier levels. In contrast, tier levels for lidocaine products were significantly greater compared with opioid tier level (P<0 .05="" font="">
The researchers concluded that patients with disabilities requiring nonopioid pain medications may face barriers to medically necessary pain treatments. “Nonopioid pain medications other than tricyclic antidepressants had quantity restrictions and were more likely to require prior authorizations,” Dr. Glinka Przybysz said. “What’s more, these patients may face other barriers in obtaining nonopioid pain medications, such as increased cost.
“And while we’re still working on the ‘why’ part of it, our data do indicate that these differences may, in fact, exist,” Dr. Glinka Przybysz noted. “And they may create increased barriers to obtaining necessary treatment for patients with disabilities.”
Tuesday, October 30, 2018
Access the Right Treatment: Steps Patients Can Take to Minimize Delays with Prescription Refills
Access the Right Treatment: Steps Patients Can Take to Minimize Delays with Prescription Refills
Visit your pharmacist at least 7 days before your prescription is due to be renewed. Doing so, provides the pharmacy with additional time to sort out any issues.
Bring your “discharge instructions” to your next doctor’s visit. That way your caregivers are on the same page.
Set up a visit-schedule with your doctor in advance of your needs – if you have experienced refill delays by your provider. For example, if you need a refill in three months, make an appointment for 3 months minus a week
Visit your pharmacist at least 7 days before your prescription is due to be renewed. Doing so, provides the pharmacy with additional time to sort out any issues.
Bring your “discharge instructions” to your next doctor’s visit. That way your caregivers are on the same page.
Set up a visit-schedule with your doctor in advance of your needs – if you have experienced refill delays by your provider. For example, if you need a refill in three months, make an appointment for 3 months minus a week
HEALTH INSURANCE: 12 TERMS EVERY PATIENT NEEDS TO KNOW
Insurance companies make it difficult to understand health care policies. To help clear up the confusion and empower patients, here are 12 insurance terms that every patient needs to know.
From patient rising website
Health insurance policies are complicated and confusing.
It can be especially difficult for patients to decipher health insurance policies because they are written with complicated terms and legal jargon.
To help clear up the confusion and empower patients, here are 12 health insurance terms that every patient needs to know.
Allowed Maximum Benefit
Allowed Maximum Benefit or “maximum dollar limit” is the maximum amount of money that your health insurance company will pay within a certain period of time. That could refer to a lifetime maximum benefit, or an annual maximum benefit.
Copayment (Copay)
A copayment or “copay” is the amount you pay each time you use a health care service. Not all services require a copay, but most do. For example, a doctor’s visit usually requires a patient to pay a copay. Some insurance policies do not require a copay for an annual physical exam.
Copays can vary based on the service. Emergency room visits frequently have a higher copay. Copayments are not usually counted towards your out-of-pocket limits.
Coinsurance
Coinsurance is the amount of money you pay out-of-pocket after you have met your deductible. Usually, coinsurance is a percentage of a services cost. The amount you pay in coinsurance is applied towards your out-of-pocket maximum. That could be 70 percent for the patient — while the insurance covers the remaining 30 percent.
Deductible
Before health insurance pays anything, the patient is required to pay a deductible. Different plans set different deductible levels. If you have a $2,500 deductible, you must pay $2,500 out-of-pocket before your insurance covers any health care services.
There are often exceptions to the deductible for certain preventive services, immunizations and health screenings.
Essential Benefits
Essential benefits are covered by your insurance, regardless of whether you have met your annual deductible.
Under the Affordable Care Act, essential benefits are defined as services that every health care plan must cover. Essential Benefits include the following ten services:
Ambulatory patient services (aka, outpatient care)
Emergency services
Hospitalization
Pregnancy Care (including maternity and newborn care)
Mental health and substance abuse
Prescription Drugs
Habilitation and Rehabilitation (includes devices)
Laboratory services
Preventive and wellness services
Pediatric care (includes dental and vision for pediatric patients)
Health savings account (HSA)
A health savings account (HSA) allows patients to set aside pre-tax money into a special account that can be used for health care expenses. Money in a health savings account can go towards copayments, hospital fees, prescriptions. Unused funds in your health savings account can be rolled over to the next fiscal year.
Health Maintenance Organization (HMO)
An HMO is a type of health coverage insurance that restricts patients access “to care from doctors who work for or contract with the HMO.”
If you decide to see a physician outside of the HMO, it likely will not be covered by the HMO, meaning you may be responsible for 100% of the cost. Under an HMO, all services must be funneled through your Primary Care Physician. In other words, you cannot see a cardiologist without a referral from your PCP.
Maximum (Out-of-Pocket Maximum)
A “maximum” is just what it sounds like – the limit on how much either you will have to pay out-of-pocket in an “out-of-pocket maximum.” Maximums can apply to what your insurance will cover for you in a year or a lifetime.
If you see the word “maximum,” pay close attention to the what counts towards the cost.
Medical Necessity
Insurance companies frequently deny patients access to a medication, service or treatment by claiming it’s not a medical necessity. When an insurance company denies a treatment, the burden of proof falls on the patient to provide proof of medical necessity from their doctor or specialist.
To challenge an insurance denial, a physician will provide a letter of medical necessity.
Out-of-Pocket
Out-of-pocket costs are the amount that the patient pays for a service, treatment or medication. If a service is not paid by your insurance, the patient pays for that service entirely — with no amount paid by insurance.
Out-of-pocket applies to any healthcare cost you have to bear, including coinsurance or uncovered services. Some health insurance plans include out-of-pocket maximums, or out-of-pocket limits, which cap a patient’s costs during a period of time.
Premium
Every month, a patient pays an insurance premium as the cost of obtaining health insurance.
If you get your health insurance through your job, your employer may pay a portion of the premium. If you have insurance through a state health insurance marketplace, you pay the full premium yourself.
Point of Service (POS)
Point of Service plans, like HMOs, require a patient to see a Primary Care Physician before visiting a specialist. Point of Service plans differ from HMOs in that there is usually a larger network of contracted doctors and providers.
Just like any other kind of network of care, if you go out of the POS network, your out-of-pocket costs will be higher.
Preferred Provider Organization (PPO)
PPOs differ from HMOs in that, you do not need to have a Primary Care Physician. You can see a cardiologist without a referral. You can also see doctors and get services outside of the PPO, though you will pay more out-of-pocket for those services. Services within a PPO network are normally covered with a copayment.
From patient rising website
Health insurance policies are complicated and confusing.
It can be especially difficult for patients to decipher health insurance policies because they are written with complicated terms and legal jargon.
To help clear up the confusion and empower patients, here are 12 health insurance terms that every patient needs to know.
Allowed Maximum Benefit
Allowed Maximum Benefit or “maximum dollar limit” is the maximum amount of money that your health insurance company will pay within a certain period of time. That could refer to a lifetime maximum benefit, or an annual maximum benefit.
Copayment (Copay)
A copayment or “copay” is the amount you pay each time you use a health care service. Not all services require a copay, but most do. For example, a doctor’s visit usually requires a patient to pay a copay. Some insurance policies do not require a copay for an annual physical exam.
Copays can vary based on the service. Emergency room visits frequently have a higher copay. Copayments are not usually counted towards your out-of-pocket limits.
Coinsurance
Coinsurance is the amount of money you pay out-of-pocket after you have met your deductible. Usually, coinsurance is a percentage of a services cost. The amount you pay in coinsurance is applied towards your out-of-pocket maximum. That could be 70 percent for the patient — while the insurance covers the remaining 30 percent.
Deductible
Before health insurance pays anything, the patient is required to pay a deductible. Different plans set different deductible levels. If you have a $2,500 deductible, you must pay $2,500 out-of-pocket before your insurance covers any health care services.
There are often exceptions to the deductible for certain preventive services, immunizations and health screenings.
Essential Benefits
Essential benefits are covered by your insurance, regardless of whether you have met your annual deductible.
Under the Affordable Care Act, essential benefits are defined as services that every health care plan must cover. Essential Benefits include the following ten services:
Ambulatory patient services (aka, outpatient care)
Emergency services
Hospitalization
Pregnancy Care (including maternity and newborn care)
Mental health and substance abuse
Prescription Drugs
Habilitation and Rehabilitation (includes devices)
Laboratory services
Preventive and wellness services
Pediatric care (includes dental and vision for pediatric patients)
Health savings account (HSA)
A health savings account (HSA) allows patients to set aside pre-tax money into a special account that can be used for health care expenses. Money in a health savings account can go towards copayments, hospital fees, prescriptions. Unused funds in your health savings account can be rolled over to the next fiscal year.
Health Maintenance Organization (HMO)
An HMO is a type of health coverage insurance that restricts patients access “to care from doctors who work for or contract with the HMO.”
If you decide to see a physician outside of the HMO, it likely will not be covered by the HMO, meaning you may be responsible for 100% of the cost. Under an HMO, all services must be funneled through your Primary Care Physician. In other words, you cannot see a cardiologist without a referral from your PCP.
Maximum (Out-of-Pocket Maximum)
A “maximum” is just what it sounds like – the limit on how much either you will have to pay out-of-pocket in an “out-of-pocket maximum.” Maximums can apply to what your insurance will cover for you in a year or a lifetime.
If you see the word “maximum,” pay close attention to the what counts towards the cost.
Medical Necessity
Insurance companies frequently deny patients access to a medication, service or treatment by claiming it’s not a medical necessity. When an insurance company denies a treatment, the burden of proof falls on the patient to provide proof of medical necessity from their doctor or specialist.
To challenge an insurance denial, a physician will provide a letter of medical necessity.
Out-of-Pocket
Out-of-pocket costs are the amount that the patient pays for a service, treatment or medication. If a service is not paid by your insurance, the patient pays for that service entirely — with no amount paid by insurance.
Out-of-pocket applies to any healthcare cost you have to bear, including coinsurance or uncovered services. Some health insurance plans include out-of-pocket maximums, or out-of-pocket limits, which cap a patient’s costs during a period of time.
Premium
Every month, a patient pays an insurance premium as the cost of obtaining health insurance.
If you get your health insurance through your job, your employer may pay a portion of the premium. If you have insurance through a state health insurance marketplace, you pay the full premium yourself.
Point of Service (POS)
Point of Service plans, like HMOs, require a patient to see a Primary Care Physician before visiting a specialist. Point of Service plans differ from HMOs in that there is usually a larger network of contracted doctors and providers.
Just like any other kind of network of care, if you go out of the POS network, your out-of-pocket costs will be higher.
Preferred Provider Organization (PPO)
PPOs differ from HMOs in that, you do not need to have a Primary Care Physician. You can see a cardiologist without a referral. You can also see doctors and get services outside of the PPO, though you will pay more out-of-pocket for those services. Services within a PPO network are normally covered with a copayment.
COPAY ACCUMULATORS: HOW INSURERS GET PAID TWICE
Yet another health Insurer atrocity
COPAY ACCUMULATORS: HOW INSURERS GET PAID TWICE
article from patient rising
COPAY ACCUMULATORS: HOW INSURERS GET PAID TWICE
article from patient rising
Steven W of Long Island, New York is a recent victim of the Accumulator Adjustment Programs, also known as the copay accumulator. Two years ago, Steven who is a psoriatic arthritis patient, saw his doctor who had a new drug for him to try. The drug was far too expensive for Steven to afford but Steven’s doctor assured him that wasn’t an issue. He could get signed up on the spot for a copay coupon for the drug.
Copay coupons are one way a drug manufacturer can make their drug affordable for patients. The copay coupon works like this:
- A Patient is prescribed a drug and signs up for a copay coupon
- Then the Patient goes to the pharmacy to get their drug
- The Patient uses the manufacturer’s copay coupon to pay whatever the insurer will not cover (often minus a typical copay amount of $5-30)
- The pharmacy processes the coupon which means the manufacturer pays the copay for the patient
A BIG PROBLEM WITH THE COPAY ACCUMULATOR
Where things went wrong for Steven are where they go wrong for many patients. After using up the value of the coupons (in his case $9000) Steven was then expected to pay the copayments himself because coupons no longer applied. This was a complete surprise. He was shocked to find that to continue on the drug that his doctor had prescribed would cost him $4,822.30 a month! This was completely out of his ability to pay even once, not to mention on an ongoing basis.
SO, WHAT WENT WRONG HERE?
The $9000 value of the copay coupons should have been applied to Steven’s insurance deductible. After all, the pharmacy processed the coupons and got the money from the drug manufacturer, so no one didn’t-get their money. But instead, the pharmacy did not apply the value of the copay coupons to Steven’s deductible so, with shock, Steven was suddenly expected to pay off his deductible from scratch after already being on the drug for three months. This shell game is called the “copay accumulator” or an “accumulator adjustment program” and it basically means the insurer will get paid twice for the same drug.
No that was not a type-o. If an insurer does not apply the copay coupon towards your deductible, they actually get paid twice! Once by the value of the coupon, then again by you when you start meeting your deductible. Imagine if supermarkets processed your coupon for groceries then didn’t subtract the value of the coupon from your total! That wouldn’t fly would it? And it shouldn’t here either.
DOES THAT MEAN COPAY COUPONS ARE A BAD THING?
No. If you are a patient with a rare disease (like hypoparathyroidism) and you only have one drug option (Natpara) to treat your condition, having copay coupons makes great sense. Copay coupons can make that drug more affordable for you.
However, if you have a condition that has multiple treatment options (like psoriatic arthritis) then copay coupons might make you more likely to choose a more expensive drug. This means insurers pay those higher costs – a financial burden they pass down to their customers.
But it’s not just the insurers who want your money. Manufacturers want to sell their expensive drugs. If they get you started on a drug that is $9000/month there is a good chance that when your coupons run out you will feel obliged to stay on that particular drug, you may even need to, even if it means paying enormous copayments until your deductible is satisfied.
AS USUAL, PATIENTS MUST BE VIGILANT
If the manufacturer’s coupon is fully transparent it will explain just how much a patient will have to pay once the coupons run out. No one wants the kind of surprise Steven got. Steven stopped that expensive drug immediately when he learned how much it would cost him. He and his doctor found another treatment that Steven could manage. But Steven was still on the hook for $4,822.30.
HOW TO AVOID BEING TRAPPED
- Make sure you know what you are getting into when you are offered copay coupons for a drug.
- Contact your insurer and make sure that the value of the copay coupon will be applied to your annual deductible.
- If your insurer does not accept the copay coupon towards your deductible, then make sure you are aware what your out of pocket costs will be once the coupon runs out.
Unfortunately for Steven, the copay accumulator left him with a huge bill he was responsible for.
The best thing Steven, or anyone, can do is be informed. If you have questions about copay coupons or Accumulator Adjustment Programs, speak to your insurance company. You can also read some of the other articles provided by Patients Rising:
The Copay Surprise by the Alliance for Patient Access
Saving Lives does not always require heroic measures. .Preventable causes of death Certificate in Community Health Science
Certificate in Community Health Science
Saving Lives does not always require heroic measures.
Just see how many deaths can be prevented by the general public with no medical involvement at all
ble 1–1. Estimated annual deaths from preventable causes in the United States in 2000.
Preventable Cause Estimated Number of Deaths (% total deaths)
Tobacco 435,000 (18%)
Poor diet and physical inactivity 365,000 (15%)
Alcohol 85,000 (3%)
Motor vehicle 43,000 (2%)
Firearms 29,000 (1%)
Illicit drug use 17,000 (0.7%)
Reprinted, with permission, from Mokdad AH et al. Actual causes of death in the United States, 2000. JAMA.
2004 Mar 10;291(10):1238–45. Errata in: JAMA. 2005 Jan 19;293(3):293–4, 298.
you can multiply theses numbers by 4 or five to get an approximate number for India
Saving Lives does not always require heroic measures.
Just see how many deaths can be prevented by the general public with no medical involvement at all
ble 1–1. Estimated annual deaths from preventable causes in the United States in 2000.
Preventable Cause Estimated Number of Deaths (% total deaths)
Tobacco 435,000 (18%)
Poor diet and physical inactivity 365,000 (15%)
Alcohol 85,000 (3%)
Motor vehicle 43,000 (2%)
Firearms 29,000 (1%)
Illicit drug use 17,000 (0.7%)
Reprinted, with permission, from Mokdad AH et al. Actual causes of death in the United States, 2000. JAMA.
2004 Mar 10;291(10):1238–45. Errata in: JAMA. 2005 Jan 19;293(3):293–4, 298.
you can multiply theses numbers by 4 or five to get an approximate number for India
8. Lip Laceration Scott C. Sherman FIGURE 1. Laceration through the vermillion border of the lip. Save Image Enlarge Image FIGURE 2. This laceration extended through to the oral mucosa. Save Image Enlarge Image Clinical Presentation May be due to blunt or sharp trauma; frequently due to a fist Special attention should be made to determine whether the laceration involves the vermillion border or extends through the skin to the oral mucosa. Diagnosis Diagnosis is based on a thorough physical examination. Radiographs are only necessary if there is concern for a mandible fracture or that a tooth avulsed and entered into the soft tissues. Management Anesthetize the lip using a mental or infraorbital nerve block. This avoids tissue distortion that occurs with local anesthetic into the wound. Irrigate with saline. Start the repair by approximating the vermillion border with a single 6-0 nonabsorbable suture. Next, close the muscle layer using 5-0 absorbable suture. Then, close the mucosal layer with 5-0 absorbable suture. Finally, close the skin with interrupted 6-0 nonabsorbable suture. Prophylactic antibiotics are controversial.
8. Lip Laceration
Scott C. Sherman
FIGURE 1. Laceration through the vermillion border of the lip.
FIGURE 2. This laceration extended through to the oral mucosa.
Clinical Presentation
- May be due to blunt or sharp trauma; frequently due to a fist
- Special attention should be made to determine whether the laceration involves the vermillion border or extends through the skin to the oral mucosa.
Diagnosis
- Diagnosis is based on a thorough physical examination.
Management
- Anesthetize the lip using a mental or infraorbital nerve block. This avoids tissue distortion that occurs with local anesthetic into the wound.
- Irrigate with saline.
- Start the repair by approximating the vermillion border with a single 6-0 nonabsorbable suture. Next, close the muscle layer using 5-0 absorbable suture. Then, close the mucosal layer with 5-0 absorbable suture. Finally, close the skin with interrupted 6-0 nonabsorbable suture.
- Prophylactic antibiotics are controversial.
7. Exudative Pharyngitis
John Moorhead and Colby Austin
FIGURE 1. Exudative pharyngitis. (Photo courtesy of American Academy of Pediatrics.)
Clinical Presentation
- Fever, sore throat, and odynophagia are most common complaints.
- Associated symptoms of an upper respiratory infection may be present.
- Patients should not have any airway compromise, uvular deviation, or trismus; which would be more indicative of deeper tissue infections such as peritonsillar abscess, submandibular/retropharyngeal space infections, and epiglottitis.
Diagnosis
- Diagnosis is made by history and physical exam alone.
- Must be able to rule out life threats such as epiglottitis, peritonsillar abscess, submandibular space infections, and retropharyngeal space infections
- Time course and risk factors are important elements of history.
Management
- Typically bacterial in etiology; rarely can be associated with viral etiologies such as acute infectious mononucleosis
- Most common organism is group A β-hemolytic Streptococcus (GABHS). Penicillin is considered first-line treatment.
- If GABHS is suspected, use Centor criteria to determine if treatment with antibiotics is warranted. Centor criteria include tonsillar exudates, tender anterior cervical lymphadenopathy, abscence of cough, and fever. For patients with two or more criteria, consider rapid strep test. For patients with three or more criteria, consider empiric antibiotic treatment.
- Be vigilant for infection due to atypical organisms such as gonococcal pharyngitis or diphtheria from Corynebacterium diphtheria in high-risk patients.
Certificate in Community Health Science; medical terminology some words to practice
Learning Terminology
Prefixes and
Suffixes in Medical Terms
Body Structure
The Integumentary
System
DERMATOLOGY
The Musculoskeletal
System
ORTHOPEDICS RHEUMATOLOGY
The Cardiovascular
System
CARDIOLOGY
The Respiratory
System
OTORHINOLARYNGOLOGY PULMONOLOGY
The Nervous System
NEUROLOGY ANESTHESIOLOGY
The Urinary System
UROLOGY
The Female
Reproductive System
OBSTETRICS GYNECOLOGY
The Male
Reproductive System
UROLOGY
The Blood System
HEMATOLOGY
The Lymphatic and
Immune Systems
IMMUNOLOGY
The Digestive System
GASTROENTEROLOGY
The Endocrine System
ENDOCRINOLOGY
The Sensory System
OPHTHALMOLOGY OTOLOGY
Human Development
PEDIATRICS GERONTOLOGY
thi_fm_i-xxxii.indd Seciii // PM
Rev. Confirming Pages
iv
Terms in Oncology—Cancer
and Its Causes
ONCOLOGY
Diagnostic Imaging
Radiation Oncology and Surgery
RADIOLOGY ONCOLOGY SURGERY
Terms in Psychiatry
PSYCHIATRY PSYCHOLOGY
Terms in Dental
Practice
DENTISTRY
Terms in
Pharmacology
PHARMACOLOGY
Terms in Complementary
and Alternative Medicine
APPENDIX A Combining Forms Prefixes and Suffixes
APPENDIX B Abbreviations—Ones to Use and Ones to Avoid
APPENDIX C English Glossary
APPENDIX D Normal Laboratory Values
APPENDIX E Medical Terminology Style
A
Abdomen
examination of fetal
f
normal appearance of
f
topographic detection of fetal anomalies
in
Abdominal and abdominal wall
abnormalities
anterior abdominal wall anomalies
–
bladder exstrophy f
cloacal exstrophy f
ectopia cordis f
exomphalos
gastroschisis
first trimester detection
body stalk anomaly
f f
fetal MRI of
gastrointestinal abnormalities
ascites f
duodenal atresia f
ileal atresia
jejunal atresia
large bowel obstruction
f
large bowel pathology
meconium ileus
meconium peritonitis
f
megacystis microcolon intestinal
hypoperistalsis syndrome
f
oesophageal atresia f
t
stomach
intra-abdominal
adrenal haemorrhage f
adrenal masses f
calcification t
choledochal cyst t f
cysts t
extra-lobar pulmonary sequestration
f
gall bladder
liver
neuroblastoma
normal anatomy of f
spleen f
limb-body wall complex
f
normal appearances of anterior
abdominal wall f
normal variants pitfalls and artefacts
f
Abdominal cavity calcification
f
Abdominal circumference (AC)
f
Abdominal cysts
Abdominal lymphangioma f
Abdominal tumours
Aberrant right subclavian artery (ARSA)
f
Abnormal growth fetal
Abnormalities
cardiac
skeletal
urinary tract
Abruption placental f
‘Absent’ bladder
Absent pulmonary valve syndrome
f
AC. see Abdominal circumference (AC)
Acardiac twins
Achondrogenesis f t
diagnostic tests in utero
frontal bossing b
incidence of
prognosis of
recurrence risk and screening strategy
of
type I
type II
ultrasound findings of
Achondroplasia f f
frontal bossing b
heterozygous
homozygous
Acrania
Acrocallosal syndrome t
ADPKD. see Autosomal dominant
polycystic kidney disease
(ADPKD)
Adrenal gland renal agenesis and
f
Adrenal haemorrhage f
Adrenal masses f
Agenesis of the cerebellar vermis f
Agenesis of the corpus callosum
f
Agyria
Aicardi syndrome
Alagille syndrome t
Alcohol teratogenic effects of t
Algorithm for trisomy
Alobar holoprosencephaly diagnosis of
f
Index
Page numbers followed by ‘f’ indicate figures ‘t’ indicate
tables and ‘b’ indicate boxes.
Alpha fetoprotein (AFP) fetal growth
restriction and
Alpha-thalassaemia with mental handicap
t
Alveolar ridge f
Ambiguous genitalia f
f
Amelia t
Amniocentesis
of pleural effusion f
timing of
Amniotic band syndrome f
f
facial clefting and t
Amniotic bands with constriction of right
index finger f
Amniotic fluid (AF)
fetal skin
fetal swallowing
fetal urine production
measurement of sonographic technique
of f
oligohydramnios f t
particulate matter
nd trimester
rd trimester
pathways contributing to production
of t
polyhydramnios
pre-term premature rupture of
membranes
production of t
quantification of
removal of
subjective assessment of
twin-to-twin transfusion syndrome
f
ultrasound evaluation of
volume assessment of fetal growth and
volume disorders of
volume regulation of
f
Amniotic fluid index (AFI)
f
Amniotic sludge f
Anaemia
aplastic
assessment of
fetal
causes of t
invasive methods for assessing
non-invasive methods for assessing
–
Index
Parvovirus B infection and
–
treatment of
haemolytic
placental chorioangioma and
Anal atresia
Androgens teratogenic effects of t
Anechoic hypo-echoic lakes
f
Anencephaly f
associated anomalies and risk of
chromosomal defect
differential diagnosis
first-trimester detection
obstetric management
Aneuploidies
common phenotypic expression of
–
fetal
fetal defects associated with
screening for
Aneurysm of vein of Galen
f
Angelman syndrome t
Angiomatous stroma
Anhydramnios f
due to urethral atresia f
Anophthalmia
Antenatal monitoring
amniotic fluid volume assessment
biophysical profile
fetal biometry
fetal Doppler
ductus venosus (DV) f
middle cerebral artery (MCA)
f
umbilical artery f
fetal heart rate monitoring
Anterior meningocoele
Anterior sacral meningocoele
f
Antero-posterior abdominal diameter
(APAD)
Aorta f
coarctation of t
Aortic arch f
interrupted
Aortic atresia t
Aortic stenosis t
Apert syndrome t t
Aplastic anaemia
Appendicular skeleton
Arachnoid cyst
Arm skeletal abnormalities f
Arnold Chiari II malformation f
f
ARPKD. see Autosomal recessive polycystic
kidney disease (ARPKD)
Arrhythmias. see Fetal arrhythmias
ARSA. see Aberrant right subclavian artery
(ARSA)
Arteriovenous (AV) malformations
Arthrogryposis (joint contractures)
f
investigations of
Ascites f
fetal f f f
isolated f
Association fetal anomalies
t
Atresia
duodenal f
oesophageal
Atrial isomerism
left f
right
Atrioventricular connection absent
left
right
Atrioventricular septal defect (AVSD) f
t
Atrioventricular valves reverse off-setting
of f
Autoimmune thrombocytopaenia
–
Autolysis f
Autopsy
identification of unsuspected or
associated findings
perinatal
cardiac defects
CNS abnormalities and
fetal hydrops
gastrointestinal tract anomalies
intrauterine growth restriction
(IUGR)
late stillbirth
renal system anomalies
respiratory tract anomalies
f
skeletal dysplasias and
potential uses of data
samples for genetic analysis
Autosomal dominant inheritance t
f
Autosomal dominant polycystic kidney
disease (ADPKD)
postnatal management of
in pregnancy/delivery
sonographic diagnosis of
f
Autosomal recessive inheritance t
f
Autosomal recessive polycystic kidney
disease (ARPKD)
f
postnatal management of
in pregnancy/delivery
sonographic diagnosis of
Axial skeleton
Axial venous sinus thrombosis f
B
‘Ballantyne syndrome’
‘Banana’ sign
Bardet-Beidl syndrome t
Barth syndrome
Beckwith-Wiedemann syndrome f
t t f
Beemer-Langer syndrome
Bent bones t
Bifid rib with vertebral abnormality
f
Bilateral cystic kidney dysplasia f
Bilateral pleural effusions f
Biophysical profile score (BPS) fetal
growth and
Biparietal diameter (BPD)
Bird headed dwarfism
f
Bladder
abnormalities of fetal
distended
exstrophy of f
f
fetal f
formation of f
non-obstructed distended
obstruction f
use of colour flow Doppler for location
of f
Bladder outlet obstruction
Blake’s pouch cyst f
Blood group systems t
Blood transfusion fetal f
Body-stalk anomaly
f f
Borderline ventriculomegaly. see Mild
ventriculomegaly
BPS. see Bronchopulmonary sequestration
(BPS)
Brachycephaly
Bradycardias
Brain development normal fetal MRI of
Brain/liver weight ratio
Brain malformations fetal
Brain structure
transcerebellar plane f
transthalamic plane f
transventricular plane f
ultrasound
see also Central nervous system
Brain sulcation
Brain teratomas
Brain vesicles
Bronchial/tracheal atresia
f
Bronchogenic cyst f
Bronchopulmonary sequestration (BPS)
–
definition and spectrum of disease
differential diagnosis of
f
outcome of
pitfalls of f
prognosis of
ultrasound findings of
Index
C
Calcification
abdominal cavity f
of placenta f
Campomelic dysplasia
f
Carbimazole teratogenic effects of t
Cardiac abnormalities
f
–
abbreviations
abnormal heart
additional malformations in fourchamber
view
Ebstein’s anomaly f
tricuspid valve dysplasia
f
ventricular septal defect
atrioventricular connection absent
left
right
atrioventricular septal defect (AVSD)
cardiac failure
counselling and management in
–
disproportion of ventricles
f
double inlet ventricle
f
early fetal echocardiography
technique of
tricuspid valve assessment and
tricuspid regurgitation
examination of
four-chamber view
great artery and arch views
fetal arrhythmias
bradycardias
tachycardias
great artery abnormalities
hypoplastic left heart syndrome
–
isomerism
mitral atresia
pericardial effusion
f
primary tumours
reverse off-setting of atrioventricular
valves f
risk groups for and indications for
referral t
spatio-temporal image correlation and
rendering for
Cardiac failure
Cardiac malformations
t
Cardiac rhabdomyoma t
Cardiomegaly f
Cardiomyopathies
Cardiotocograph (CTG) use of
Carpenter syndrome t
Cataracts congenital
f
Catecholaminergic polymorphic
ventricular tachycardia (CPVT)
Caudal regression syndrome
f
versus sirenomelia t
ultrasound diagnosis of
Cavum septum pellucidum (CSP)
f
abnormalities of
absence of f
Cavum septum vergae f
CCAM. see Congenital cystic adenomatoid
malformation (CCAM) of the
lung
CCD. see Cleidocranial dysplasia (CCD)
CDH. see Congenital diaphragmatic
hernia (CDH)
Cebocephaly
Cell free fetal DNA (cffDNA)
Central nervous system
brain structure
transcerebellar plane f
transthalamic plane f
transventricular plane f
–
ultrasound
normal appearance
Central nervous system abnormalities
acrania
agenesis of corpus callosum
anencephaly
aneurysm of vein of Galen
arachnoid cyst
Arnold Chiari II malformation
cerebellar hypoplasia
cisterna magna enlarged
Dandy-Walker malformation
exencephaly
fetal MRI of
heterotopias
holoprosencephaly
lissencephaly
mega cisterna magna
porencephaly
schizencephaly
septo-optic dysplasia
sonographic approach to
ventriculomegaly
Central nervous system anomalies
anencephaly/exencephaly first-trimester
detection
Dandy-Walker malformation
first-trimester detection
first-trimester detection
holoprosencephaly
spina bifida
ventriculomegaly first-trimester
detection
Centric fusion. see Robertsonian
translocation
Centrum
Cerebellar abnormalities
f
Cerebellar hypoplasia
b
f
frontal lobe atrophy with f
Cerebellum f
f
Cerebral cortex acquired defects of
Cerebral mantle
abnormalities of
acquired defects of
Cerebral toxoplasmosis f
Cerebrum
Cervical teratoma f
cffDNA. see Cell free fetal DNA (cffDNA)
CGH. see Comparative genomic
hybridization (CGH)
CHAOS. see Congenital high airway
obstruction syndrome (CHAOS)
CHARGE syndrome
Chest defects in polyhydramnios and
Chest wall hamartomas
Chiari III malformation
CHM. see Complete hydatidiform mole
(CHM)
Choledochal cyst t f
Chondrodysplasia punctata f
f t
Chorioangiomas of placenta
f
ultrasound features of
Chorionicity f
determination of in twin pregnancies
Choroid plexus f
cysts f
papillomas
thinning of in ventriculomegaly
–
Chromosomal anomalies
aneuploidies
contiguous gene syndromes/
microdeletions
deletions/duplications
and fetal hydrops
nomenclature f
risk assessment for
Chromosomal microdeletion syndromes
t
Chromosome puffs
Cisterna magna (CM)
f
f
effacement
enlarged
Cleft lip/palate t–t
f
D f
D f f
angled insonation technique
f
flipped face view f
reverse face view f
alveolus f f
Index
bilateral f
midline f
Clefting
Cleidocranial dysplasia (CCD)
Cloaca
abnormalities of
exstrophy of f f
persistent f
Cloacal dysgenesis
sequence
Cloacal folds
Closed lip schizencephaly
Closed spinal dysraphisms (CSDs) f
f
Cloverleaf skull f
CM. see Cisterna magna (CM)
Cocaine teratogenic effects of t
Coffin Lowry syndrome
Colonic atresia
Colour Doppler
for bronchopulmonary sequestration
–
for CCAM
for location of bladder
f
Colpocephaly f
Comparative genomic hybridization
(CGH) f
Complete hydatidiform mole (CHM)
Computed tomography D in skeletal
assessment
Congenital arachnoid cysts
Congenital cystic adenomatoid
malformation (CCAM) of the
lung
definition and spectrum of disease
–
differential diagnosis of
outcome of
pitfalls of
prognosis of
ultrasound findings of
Congenital diaphragmatic eventration
f
Congenital diaphragmatic hernia (CDH)
definition spectrum of disease and
incidence
differential diagnosis and pitfalls of
prognosis management and outcome
of f t
ultrasound findings of
Congenital heart defects
Congenital heart disease (CHD)
Congenital high airway obstruction
syndrome (CHAOS)
f
Congenital/infantile fibrosarcoma
–
Congenital mesoblastic nephroma
–
Congenital pulmonary airway
malformation f
Congenital talipes equinovarus (CTEV)
f
Conjoined twinning f
Connatal cysts f
Consent for prenatal autopsy
Cord insertion f
Cordocentesis
Corpus callosum f
f
lipoma of
Counselling
cardiac abnormalities and
parents
Cowden syndrome t
CPVT. see Catecholaminergic polymorphic
ventricular tachycardia (CPVT)
Cranial abnormalities
brain structure
transcerebellar plane
transthalamic plane
transventricular plane
ultrasound scan
of cranial vault
embryology t f
head shape and size
brachycephaly
cloverleaf
dolicocephaly
encephalocoele
‘lemon shaped’ head
macrocephaly
microcephaly
strawberry-shaped head
of midline posterior fossa
of midline structures
neurosonography
normal anatomy and development
–
pitfalls and normal variants
sonographic approach to
Cranial meningocoele
Cranial vault abnormalities
Craniofrontonasal dysplasia t
frontal bossing b
Craniopharyngiomas f
Craniosynostosis syndromes
t f
Crossed ectopic kidney
f
Crouzon syndrome t
frontal bossing b
CSDs. see Closed spinal dysraphisms
(CSDs)
CTEV. see Congenital talipes equinovarus
(CTEV)
Cyclopia f
Cystic abnormalities of midline
structures
Cystic adenomatoid malformation
polyhydramnios and f
Cystic hygroma t
f
fetal tumours t f
neck f
Cystic renal disease
first-trimester detection
Cysts
abdominal
arachnoid
Blake’s pouch f
bronchogenic f
choledochal t f
choroid plexus f
connatal f
duplication t f
hepatic f t
intra-abdominal t
mesenteric t f
ovarian t f
posterior fossa f
pseudo t f
renal f
subarachnoid f
subependymal
Tarlov
transient abdominal t
umbilical cord f
unilocular f
Cytomegalovirus (CMV)
f
f f
management and counselling
outcome of fetal infection with
–
prenatal diagnosis of
teratogenic effects of t
teratogenicity
ultrasound features with
D
Dacrocystocoele f
Dandy-Walker malformation
f
first-trimester detection
f
Dandy-Walker syndrome. see DandyWalker
malformation
Dangling choroid
Databases
Dating in twin pregnancies
De Morsier syndrome
Death determination of cause of
Deepest vertical pool (DVP)
Defects absence of in fetal aneuploidies
Deformations
in fetal anomalies
vs. disruptions and malformations t
Development stages of defects resulting
from disruption at t
Index
Diabetes maternal
polyhydramnios and
teratogenic effects t
Diaphragmatic hernia
f
first-trimester detection
f
magnetic resonance imaging of
Diastematomyelia
prenatal associations of
type B f
Diastrophic dysplasia
Dichorionic diamniotic twin pregnancy
f
Dichorionic triamniotic triplet pregnancy
f
Dichorionic twin gestation lambda sign
of f
Diffusion tensor imaging (DTI)
Diffusion-weighted MR imaging (DWI)
DiGeorge syndrome t f
polyhydramnios and f
Digoxin anti-arrhythmic drug t
Diprosopus
Disorders of sexual development (DSDs)
f t
Disruptions
in fetal anomalies
vs. malformations and deformations
t
Dizygotic twins
structural anomaly in
Dolicocephaly
Doppler ultrasound evaluation of the
middle cerebral artery
f
Double inlet ventricle
f
DSDs. see Disorders of sexual
development (DSDs)
Ductus venosus Doppler
f
Ductus venosus flow first-trimester
ultrasound features of trisomies
t f
Ductus venosus waveforms
f
Duodenal atresia f
first-trimester detection
Duodenum atresia of f
Duplex kidney f
Duplication cyst t f
Dural sinus thrombosis
f
Dysplasia
campomelic f
cleidocranial
diastrophic
short rib t
skeletal
thanatophoric
Dysplastic cerebellum f
Dysplastic kidneys f
Dysraphisms
in foetus diagnosis of spina bifida and
–
spinal
closed f f
open f f
E
Ear
anomalies of
embryology of
normal appearance of f
ultrasound of f
Ebstein’s anomaly f
Echogenic bowel
f f
Echogenic kidneys t
Echogenic lung f
Echolucent cysts in CCAM f
Ectopia cordis f
Ectopic beat f
Ectopic kidney
Ectrodactyly t f t
Ectrodactyly-ectodermal dysplasia clefting
(EEC) syndrome t f
t
EDD. see Expected date of delivery (EDD)
Edward syndrome. see Trisomy
EEC syndrome. see Ectrodactylyectodermal
dysplasia clefting
(EEC) syndrome
Ellis-van Creveld (EVC) syndrome
t–t f
t
Embryology
cranial t f
facial f
skeletal system
urinary tract
Encephalocoele
–
associated anomalies and risk of
chromosomal defects
–
first-trimester detection
f
frontal f
occipital
Enterolithiasis f
Environmental factors
t
Ependymomas
Epidermolysis bullosa lethalis
Epignathus f t f
Epulis f t
Equinus
Erythrovirus
Estimated fetal weight (EFW) in large
gestational age (LGA) babies
–
Ethmocephaly
holoprosencephaly associated with
f
EUROCAT (European Concerted Action
on Congenital Anomalies and
Twins)
EUROFETUS study
European Growth Restriction Intervention
Trial (GRIT) in preterm
delivery
EUROSCAN study
EVC. see Ellis-van Creveld (EVC)
syndrome
Ex utero intrapartum therapy
Exencephaly
first-trimester detection
f
EXIT procedure f
types of
EXIT-to-airway procedure
EXIT-to-resection procedure
Exomphalos f
–
physiological f
postnatal management of
pregnancy management of
f
sonographic findings of
Expected date of delivery (EDD)
External genitalia development of f
Extra-lobar pulmonary sequestration
f f
Extremities normal appearance
Eyes
embryology of f
ultrasound of f
F
Face
normal appearance f
sonographic approach
f
Facial abnormalities
classification of
craniosynostosis syndromes
t
detection rates of
diprosopus
ear
embryology of
first-trimester detection
f
forehead
flat profile
frontal bossing b f
lips and mouth
facial clefting f t
tongue abnormalities
mandible
DiGeorge syndrome f
hydrolethalus syndrome
micrognathia f t
f
Pena-Shokeir syndrome
Pierre Robin syndrome
Seckel syndrome f
nose and orbits
anophthalmia
cebocephaly f
congenital cataracts
f
Index
cyclopia f
dacrocystocoele f
ethmocephaly f
frontal encephalocoele
f
frontonasal dysplasia
f
holoprosencephaly
hypotelorism f
median clefting f
microphthalmia f
otocephaly
pitfalls and artefacts
tumours f
harlequin ichthyosis
f
teratoma f
ultrasound
see also Cranial abnormalities
Facial clefting f t
amniotic band syndrome t
cleft lip/palate
f t–
t f
ectrodactyly-ectodermal dysplasia
clefting syndrome t
f
first-trimester detection
holoprosencephaly
Miller syndrome t
Mohr syndrome t
Nyberg’s classification
f
Roberts syndrome t
ultrasound
Facio-auriculo-vertebral syndrome
f
FADS. see Fetal Akinesia Deformation
Sequence (FADS)
Fallot’s tetralogy t
False-positive rate screening by maternal
age and
Family history fetal anomalies and
–
Fanconi anaemia t
FBS. see Fetal blood sampling (FBS)
FBV. see Fetal body volume (FBV)
Feet abnormalities of
f
t
Femoral facial syndrome (FFS)
Femur
length f
short
skeletal abnormalities f
Femur-fibula-ulna complex (FFUC)
Feticide
Fetoscopic endotracheal balloon occlusion
(FETO)
Fetoscopic laser coagulation for
twin-to-twin transfusion
syndrome
FFS. see Femoral facial syndrome (FFS)
FFUC. see Femur-fibula-ulna complex
(FFUC)
FGR. see Fetal growth restriction (FGR)
Fibroblast growth factor receptor
(FGFR)
Fibroma
‘Fifth disease.’ see Parvovirus B
First-trimester detection of fetal
anomalies
abnormalities
advantages t
central nervous system anomalies
–
anencephaly/exencephaly
Dandy-Walker syndrome
encephalocoele
holoprosencephaly
spina bifida
considerations of embryological
development
diagnosis
disadvantages t
facial abnormalities
f
fetal anomaly scan
gastrointestinal tract abnormalities
–
abdominal and umbilical-cord cysts
–
body stalk anomaly f
duodenal atresia
exomphalos
gastroschisis
omphalocoele f
hands and feet abnormalities
neck abnormalities
normal appearances (sonoembryology)
–
abdomen f
central nervous system
extremities
face f
gestational sac yolk sac and fetal
pole
heart f
urinary tract
nuchal translucency screening
screening t–t
skeletal abnormalities
thoracic abnormalities
diaphragmatic hernia
pleural effusion
urinary tract abnormalities
cystic renal disease
hydronephrosis
low urinary tract obstruction
f
minor renal anomalies
renal agenesis
viability multiple pregnancy and
gestational age assessment
Flecainide anti-arrhythmic drug t
FMF. see Frontomaxillary facial (FMF)
angle
FNAIT. see Fetal and neonatal alloimmune
thrombocytopaenia (FNAIT)
Fetal akinesia f
Fetal Akinesia Deformation Sequence
(FADS)
Fetal anaemia
causes of
donor blood for f
invasive methods for assessing
non-invasive methods for assessing
–
Parvovirus B and
treatment of
Fetal and neonatal alloimmune
thrombocytopaenia (FNAIT)
f
Fetal aneuploidies
additional first-trimester sonographic
markers in t
performance of screening
approach to patient management based
on findings
first trimester detection of
t
screening for
by maternal age
by maternal serum biochemistry
–
by ultrasound at - weeks
–
by ultrasound in second trimester
–
second trimester detection of
Fetal arrhythmias
bradycardias
tachycardias
supraventricular f
ventricular
Fetal autopsy
Fetal biometry
Fetal blood sampling (FBS)
Fetal blood transfusion f
Fetal body volume (FBV)
Fetal bowel calcification
f
Fetal bradycardia f
Fetal cardiomyopathy
genetic causes of
Fetal cerebral lateral ventricle f
Fetal death changes secondary to
Fetal defects
associated with aneuploidies
Fetal echocardiography
Fetal fingers f
Fetal genotype prenatal testing of
–
Fetal goitre f f
Fetal growth
antenatal monitoring
fetal growth restriction
delivery of timing of
differential diagnosis of t
screening for f
surveillance of f
macrosomia/large gestational age
babies
Index
Fetal growth restriction (FGR)
–
delivery of timing of
differential diagnosis of t
early onset
late onset f
neurodevelopment in
screening for f
surveillance of f
Fetal haemoglobin concentration
reference ranges for t
Fetal head examination of f
Fetal hydronephrosis
Fetal hydrops f
causes of t–t f
cardiac
non-cardiac
in CCAM f
investigation of
invasive testing
maternal blood
ultrasound abnormalities
management
metabolic syndromes associated with
t
pathophysiology of
ultrasound features of
f
Fetal infections
causing fetal hydrops
prenatal diagnosis of
Fetal intracranial haemorrhage f
Fetal ischaemia
Fetal kidneys f
Fetal leukaemia f
Fetal macrosomia
causes of
clinical importance-perinatal
consequences
definition of
diagnosis of
long-term consequences of
management of
Fetal megacystis f
Fetal MRI. see Magnetic resonance
imaging (MRI)
Fetal neoplasms benignity of
Fetal neural structures sequential
appearance of during
first-trimester f
Fetal neurosonography
Fetal nuchal translucency thickness
first-trimester screening followed by
second-trimester biochemical
testing for
measurement of f
performance of screening for trisomy
screening for aneuploidies and
screening in twin pregnancies
Fetal oral lymphangioma f
Fetal pathology
Fetal pole
Fetal profile f
Fetal spine
delayed ossification of
f
kyphosis of
three-dimensional imaging
f
Fetal subarachnoid space
Fetal tachycardia f
polyhydramnios and f
Fetal thrombocytopaenia
causes of t
fetal intracranial haemorrhage and
–
Fetal thrombotic vasculopathy (FTV)
f
Fetal thyroid dysfunction
Fetal thyrotoxicosis
Fetal tissue samples prenatal diagnosis
from
Fetal tumours
classification of t
complications generic management of
–
versus fetal malignancy
general features of
f
obstetric management of
organ specific signs of
f
prognosis/outcome of
sonographic diagnosis of
–
sonographic features of
specific features of
specific signs of
Fetal varicella syndrome
Foetus
euploid defects/markers of t
evaluation of with abnormal skeletal
findings
examination of
abdomen
amniotic fluid volume
face
fetal movements
genitalia f
heart
limbs f
placenta f
skull brain and spine
thorax
urinary tract
uterus cervix adnexae
with skeletal dysplasia polyhydramnios
and
tumours of polyhydramnios and
f
ultrasound of with a short femur
–
Foramen ovale f
Foregut
Forehead anomalies of
flat profile
frontal bossing b f
Fornices f
Fragile X syndrome
Fraser syndrome t t
Frontal bossing b f
Frontal lobe atrophy with cerebellar
hypoplasia f
Frontomaxillary facial (FMF) angle
Frontonasal dysplasia
f
Fryns syndrome t
FTV. see Fetal thrombotic vasculopathy
(FTV)
G
Gadolinium-based contrast material
Gall bladder
anomalies of
choledochal cyst t f
duplication of f
non-visualization of
Gastrointestinal obstruction (GIO)
Gastrointestinal tract
defects in polyhydramnios and
Gastrointestinal tract abnormalities
first-trimester detection
–
abdominal and umbilical-cord cysts
–
body-stalk anomaly
duodenal atresia
exomphalos
gastroschisis
omphalocoele f
Gastrointestinal tract anomalies
fetal MRI of
Gastroschisis f
first-trimester detection
f
Genetic analysis autopsy samples for
–
Genetic disorder types of
Genetic heterogeneity
Genetics fetal anomalies
associations
chromosomal anomalies
aneuploidies
contiguous gene syndromes/
microdeletions
deletions/duplications
nomenclature f
translocations
comparative genomic hybridization
f
databases
deformation t
diagnosis
confirmation of
Index
discussing available information and
diagnostic dilemmas with
parents
disruption t
embryological timing of anomalies
t
environmental factors
t
examination of foetus/baby
family history
further investigations
identification of high risk families
isolated single anomalies
t
malformation t
malformation sequence
malformation syndrome
maternal disease
mosaicism f
multifactorial inheritance
multiple malformation syndromes
multiple malformations
nature of anomalies
pattern of anomalies
pedigree f t
pregnancy and personal medical
histories
prognosis
recurrence risks
single congenital malformation
single gene disorders t
b
autosomal dominant inheritance
t f
autosomal recessive inheritance
t f
single-gene malformation syndromes
X-linked recessive inheritance t
f
sources of information
teratogens
ultrasound examination in subsequent
pregnancies
underlying cause of anomalies
f
unusual patterns of inheritance
–
anticipation
genetic heterogeneity
genomic imprinting
mosaicism
uniparental disomy
variability of anomalies
Genital ridges formation of f
Genitalia fetal examination of f
Genito-urinary pathologies fetal MRI of
–
Genomic imprinting
Germinal matrix
Gestation
risk for trisomy
relation to t
risk for trisomy
relation to t
risk for trisomy
relation to t
Gestational age
assessment
at which primary fissures and sulci are
visible at US and MRI
examinations t
Gestational sac
Gestational trophoblastic neoplasia
(GTN)
Giant omphalocoele
Glass-body mode lung sequestration
f
Goitre t
Goldenhar syndrome t
f
Gorlin syndrome t
Great arteries
abnormalities of
function of f
malformations differential diagnosis of
t
obtaining views of
parallel appearance of
f
position of f
simple transposition of
t
size of f
structure of f f
GTN. see Gestational trophoblastic
neoplasia (GTN)
H
Haemangioendothelioma
f
Haemangioma f
of fetal neck t f
of umbilical cord f
Haematological disorders
Haematoma of umbilical cord
Haemolytic anaemia
Haemolytic disease of the foetus and
newborn (HDFN)
Haemolytic disease of the newborn
(HDN) incidence of with
atypical maternal red blood cell
antibodies t
Haemorrhage
adrenal f
fetal f
Haemorrhagic infarction f
Hamartomas chest wall
Hands abnormalities of
f
t
Hanhart’s syndrome f
Harlequin ichthyosis
f
HDFN. see Haemolytic disease of the
foetus and newborn (HDFN)
Head defects in polyhydramnios and
Head circumference (HC)
Head shape and size
brachycephaly
cloverleaf f
dolicocephaly
encephalocoele
‘lemon shaped’ head
macrocephaly
microcephaly
strawberry-shaped head
see also Central nervous system
abnormalities; Cranial
abnormalities
Heart
abnormal
crux of
four-chamber view of
anomalies fetal MRI of
f
defects polyhydramnios and
examination methodology of
four chambers of f
function of f
normal appearance f
normal position of f
normal size of f
normal structure of
Helsinki Ultrasound trial
Hemifacial microsomia
f
Hemimegalencephaly f
t
f
Hemivertebra
syndromes associated with t
Hepatic artery flow in fetal aneuploidies
screening f
Hepatic cyst t
Hepatic hyperechogenicities
Hepatic lymphangioma
Hepatic mesenchymal hamartoma
Hepatoblastoma
Hepatocellular adenoma
Hepatomegaly f
Hernia
congenital diaphragmatic
diaphragmatic f
Herpes simplex virus infection
Herpesvirus varicellae
Heterokaryotypia
Heterotopias
Heterozygous achondroplasia
Holoprosencephaly (HPE)
f
alobar f
Holt-Oram syndrome t
Horseshoe kidney f
Horseshoe shaped monoventricle f
Human immunodeficiency virus
maternal
Human Tissue Authority (HTA)
Humerus skeletal abnormalities f
Hurlers syndrome frontal bossing b
Hydatidiform molar pregnancies
–
Hydrocephalus
asymmetrical f
Index
Hydrolethalus syndrome
Hydrometrocolpos
Hydronephrosis f f
first-trimester detection
f
Hydrops
fetal f
with pleural effusion f
Hydrops fetalis anaemia and
Hydrothorax
Hydroureter f
Hyperechogenic bowel
teratogenic effects t
Hyperechoic serosa thinning/disruption
of
Hypertelorism b f
Hyperthermia teratogenic effects t
Hypertrophic cardiomyopathy t
Hypophosphatasia t
Hypoplasia nasal
Hypoplastic left heart syndrome
Hypoplastic lungs f
Hypotelorism f f
Hypothyroidism fetal
I
Idiopathic polyhydramnios
Idiopathic thrombocytopaenia (ITP)
f
Ileum atresia of
In utero magnetic resonance imaging
(IUMRI)
Infantile polycystic kidney disease
first-trimester detection
Infection viral in prenatal diagnosis
Inferior vena cava f
Iniencephaly
International Society of Obstetrics and
Gynaecology list of structures in
first trimester routine screening
examination t
International Society of Ultrasound in
Obstetrics and Gynecology
(ISUOG)
guidelines for ventriculomegaly
–
recommended minimum requirements
for mid-trimester fetal
anatomical survey by t
Interrupted aortic arch
Intervillous thrombosis
Intestinal obstruction
Intra-abdominal cysts
f
Intra-amniotic bleeding polyhydramnios
and f
Intracardiac echogenic foci
f
Intracardiac transfusion
Intracerebral haemorrhage secondary to
cytomegalovirus f
Intracranial haematoma
f
Intracranial haemorrhage
f
Intracranial teratoma
f
Intracranial translucency (IT) for spina
bifida detection f
Intracranial tumours
t
Intramembranous pathway in amniotic
fluid production
Intrapericardial teratoma f
Intraperitoneal transfusion (IPT)
Intraplacental choriocarcinoma
Intrathoracic herniation f
Intrathoracic teratoma
Intrauterine blood transfusion (IUT)
–
Intrauterine growth restriction (IUGR)
f
Intrauterine therapy with beta-/
dexamethasone
Intravascular transfusion (IVT)
Intravenous immunoglobulin
IPT. see Intraperitoneal transfusion (IPT)
Isolated mild fetal ventriculomegaly
–
Isolated septal agenesis
Isolated single anomaly
t
Isomerism cardiac abnormalities
–
ITP. see Idiopathic thrombocytopaenia
(ITP)
IUMRI. see In utero magnetic resonance
imaging (IUMRI)
IUT. see Intrauterine blood transfusion
(IUT)
Ivemark syndrome
IVT. see Intravascular transfusion (IVT)
J
Jarcho-Levin syndrome
f
Jejunum atresia of
Jelly-like placenta f
Jervell-Langer-Nielson syndrome
Jeune’s asphyxiating thoracic dystrophy
t–t f
Joint dislocations fetal
K
Karyotyping fetal
Kasabach-Merritt sequence
Kidneys
fetal f
Klippel-Feil syndrome t
L
Laboratory based analysis of tissue and
fluid samples
Lactate fetal growth restriction and
Lambda sign f f
Langer-Giedion syndrome t
Large bowel obstruction
f
Large gestational age (LGA) babies
–
definition of
Laryngeal atresia f
Late stillbirth
Leg skeletal abnormalities f
‘Lemon shaped’ head f
Lemon sign
Leukaemia fetal f
Limb abnormalities f
t
Limb-body wall complex
f
Limb reduction defects (LRDs)
–
Limbs examination of
f
Lipomyelocoele
Lipomyelomeningocoele
Lips and mouth abnormalities of
–
facial clefting f
tongue
ultrasound of f
Lips and nostrils f
Lissencephaly b
Liver
abnormalities of
calcifications of f
cyst of f
enlargement causes of
Long QT syndrome
autosomal recessive
Lower limb
Lower urinary tract obstruction (LUTO)
LRDs. see Limb reduction defects (LRDs)
Lung malformations fetal hydrops
–
Lung-to-head ratio (LHR)
Lungs
anomalies fetal MRI of
bronchial/tracheal atresia
f
bronchogenic cyst f
bronchopulmonary sequestration
–
congenital cystic adenomatoid
malformation of
congenital high airway obstruction
syndrome f
echogenic f
mucous plug f
normal and abnormal appearance of
pulmonary hypoplasia
f
t
Lymphangiomas
abdominal f
features of f
of fetal chest f
of fetal mouth f
of neck f
Lymphatic disorders fetal
f
Lymphoedema
Index
M
M-mode for fetal rhythm evaluation
f
Maceration f
macroscopic and microscopic findings
t
Macrocephaly
syndromes associated with t
Macroglossia f f
Macrosomia fetal
Magnetic resonance imaging (MRI)
–
aspects and techniques
of fetal brain
main applications of
MR autopsy
safety in pregnant patient
Magnetic resonance (MR) of placenta
accreta
Majewski syndrome
Major defects in fetal aneuploidies
management of
Malformation sequence
Malformation syndrome
Malformations
associated with environmental factors
in fetal anomalies
single congenital
vs. deformations and disruptions t
Malignant rhabdoid tumour
Mandible
abnormalities of
DiGeorge syndrome f
hydrolethalus syndrome
micrognathia t f
Pena-Shokeir syndrome
Pierre Robin syndrome
Seckel syndrome f
ultrasound of f
Mandibular facial dysostosis
f
Map-kinase pathway disorders of
Maternal age
risk for trisomy
relation to t
risk for trisomy
relation to t
risk for trisomy
relation to t
screening by for fetal aneuploidies
twin pregnancies screening and
Maternal serum biochemistry screening
by for fetal aneuploidies
MCA. see Middle cerebral artery (MCA)
MCDK. see Multicystic dysplastic kidney
(MCDK)
McKusick-Kaufman syndrome
f
Meckel-Gruber syndrome
f
t t
hypotelorism
Meconium f
Meconium ileus
Meconium peritonitis
f
f
Meconium pseudocyst f
Median cleft syndrome
f
Mediastinal tumours
Mega cisterna magna f
Megacystis f
due to urethral atresia f
Megacystis-megaureter syndrome
Megacystis microcolon intestinal
hypoperistalsis syndrome
(MMIHS) f
f
Megalourethra f
Membranes pre-term premature rupture
of
Meningocoele f
anterior sacral f
closed spina bifida with
Meningomyelocoele sacral f
Meromelia t
Mesenteric cyst t f
Mesonephros f
‘Mickey mouse ears’ appearance of
pelvi-ureteric junction (PUJ)
obstruction f
‘Mickey Mouse’ sign f
Microcephaly f
f
Microglossia
Micrognathia f t
f
diagnosis of f
Microphthalmia f
Micturating cystourethrogram (MCUG)
Mid-trimester fetal anatomical survey
minimum requirements for t
Middle cerebral artery (MCA)
Doppler ultrasound evaluation of
f
peak systolic velocity of t f
Middle cerebral artery Doppler f
Midline posterior fossa abnormalities of
–
Midline structures abnormalities of
–
Mild ventriculomegaly
f
Miller-Dieker lissencephaly t
Miller syndrome
cleft lip/palate t
Minor defects in fetal aneuploidies
management of
‘Mirror-hydrops’
Miscarriage f
Mitral atresia
MMIHS. see Megacystis microcolon
intestinal hypoperistalsis
syndrome (MMIHS)
Moderate ventriculomegaly
f
Moderator band f
Mohr syndrome
cleft lip/palate t
Molar placenta f
Molecular autopsy
Monoamniotic twinning
Monochorionic twin pregnancies fetal
nuchal translucency thickness
and
Monochorionic twins
f
placenta of f f
Monozygotic twins
Mosaicism
Mouth
defects in polyhydramnios and
fetal lymphangioma of
f
Movement posture and abnormalities of
–
focal
generalized
MRI spectroscopy (MRS)
Mucous plug f
Mullerian duct
Multicystic dysplastic kidney (MCDK)
first-trimester detection
postnatal management of
in pregnancy/delivery
sonographic diagnosis of
Multifactorial inheritance
Multifocal cerebral necrosis due to
cytomegalovirus f
Multiple cysts in CCAM f
Multiple irregular lacunae in the
placental substance
Multiple malformation syndromes
–
Multiple of the median (MOM) of
unaffected pregnancies
Multiple pregnancy
Multiple segmentation defects f
MURCS association t
Musculoskeletal anomalies fetal MRI of
–
Myelocystocoele f
Myelomeningocoele f
Myotonic dystrophy
N
Nager acrofacial dysostosis syndrome
Nasal bone first-trimester ultrasound
features of trisomies
t f
Nasal hypoplasia f
National Institute for Health and Care
Excellence (NICE)
National Screening Committee Fetal
Anomaly Screening Programme
UK t
Neck abnormalities
cystic hygroma t
f
Index
goitre f
occipital encephalocoele
tumours
ultrasound
Neoplasia fetal anomalies and
Nephroblastoma
Neural arch density similar to iliac wings
t
Neural plate
Neural tube
formation f
malformations recurrence risk of t
Neural tube defects (NTDs)
f f
Neuroblastoma
cystic f
intra-abdominal
solid f
Neuromuscular disorders fetal
Neuronal ceroid lipofuscinoses f
Non-refluxing non-obstructed primary
megaureter
Non-Rhesus D isoimmunization
clinical management of f
Noonan’s syndrome f
Normal growth fetal
Normal variants in routine fetal anomaly
scan
Nose and orbits anomalies of
anophthalmia
cebocephaly f
congenital cataracts
f
cyclopia f
dacrocystocoele f
ethmocephaly f
frontal encephalocoele
f
frontonasal dysplasia
f
holoprosencephaly
hypotelorism f
median clefting f
microphthalmia f
Nuchal fold (NF)
Nuchal oedema f
Nuchal translucency screening for fetal
abnormalities t
O
Ocular abnormalities
Oedema fetal f
OEIS complex
Oesophageal atresia
f t
polyhydramnios and f
Oesophagus defects in polyhydramnios
and
Offsetting of atrio-ventricular valves
–
Oligohydramnios f
aetiology in the nd and rd trimesters
t
fetal anomaly
fetal sequelae of
intrauterine growth restrictions
pre-term premature rupture of
membranes
prognosis of
Omphalocoele
first-trimester detection f
see also Exomphalos
One-stop clinics for assessment of risk
(OSCAR)
Open lip schizencephaly
Orbital measurements graphs of f
Orbits f
Oro-facial-digital syndrome t
OSCAR. see One-stop clinics for
assessment of risk (OSCAR)
Ossification in spine f
Ossification centres
axial view of
coronal view of f
sagittal view of f
Osteogenesis imperfecta f
–
diagnostic tests in utero
features of t
incidence of
prognosis of
recurrence risk and screening strategy
of
type t
type t f
type t
type t
ultrasound findings of
Otocephaly
Outflow tract view f
Ovarian cyst t f f
P
Pachygyria f
Palate f
embryology of f
Pallister-Hall syndrome t
Pallister-Killian syndrome t
PAPP-A. see Pregnancy associated plasma
protein A (PAPP-A)
Paramesonephric duct
Parieto occipital fissure f
Partial hydatidiform mole
Parvovirus
management and counselling
prenatal diagnosis of
teratogenicity of
ultrasound findings on
f
Parvovirus B
investigation for f
management of f
Patau syndrome. see Trisomy
Peak systolic velocity (PSV)
assessment of in fetal aneuploidies
screening
of the middle cerebral artery
multiples of the median of f
reference values of t
Pedigree interpretation of in fetal
anomalies f
Pelvi-ureteric junction (PUJ) obstruction
–
Pelvic kidneys f
Pena-Shokeir syndrome
Pentalogy of Cantrell
Pericardial effusion
f
in foetus f
Pericardial teratoma f
Perinatal autopsy
consent
external dysmorphic findings
associations and practical issues
t
practical considerations
procedure
role of
specific issues associated with
–
Perinatal mortality
Periventricular leukomalacia (PVL)
f
Perivillous fibrin deposition
Perlman syndrome
Pfeiffer syndrome t
frontal bossing b
PFFD. see Proximal focal femoral
deficiency (PFFD)
PH. see Pulmonary hypoplasia (PH)
Phenylketonuria teratogenic effects t
Phenytoin teratogenic effects of t
Phocomelia
Pierre Robin syndrome
Pitfalls in amniotic fluid measurement
f
PIV. see Pulsatility index for veins (PIV)
Placenta
additional primary abnormalities of
–
and cervix relation between f
disorders of
architectural features of
attachment f
associations/risk factors of
imaging findings of
development/structure of
f
placental position
examination of
indications for t
in twin pregnancies f
grading of
Placenta accreta f
management for
Index
Placenta increta
Placenta percreta
Placenta praevia
associations/risk factors of
ultrasound signs of
Placental hypo-echoic lesion common
Placental malignancy
Placental mesenchymal dysplasia (PMD)
f f
Placental metastasis from maternal
disease
Placental pathology
polyhydramnios and
specific clinicopathological issues in
–
Placentitis in a foetus with CMV
infection f
Platelet disorders
Platyspondyly f
Pleural effusions f f
definition and spectrum of disease
differential diagnosis and pitfalls of
f
first-trimester detection
f
isolated
prognosis management and outcome
of
ultrasound findings of
Pleuropulmonary blastoma
PMD. see Placental mesenchymal
dysplasia (PMD)
Poland syndrome t t
Polydactyly t
fetal disorders with t
of the foot f
of the hand f
in Meckel-Gruber syndrome
f
Polyhydramnios f
f
aetiologies of
chest
fetal tone
fetal tumours
foetus with skeletal dysplasia
head
heart
intra-amniotic bleeding
maternal causes
oesophagus/upper gastrointestinal
tract
placental pathology
throat/mouth
twinning
idiopathic
placental chorioangioma and
Pompe disease f
Pool in amniotic fluid index
f
Porencephalic cyst f
Porencephaly f
Post axial polydactyly t
Posterior fossa f
abnormalities
cerebellum
cyst
Posterior urethral valves (PUV)
postnatal management of
in pregnancy/delivery
sonographic diagnosis of
Postmortem magnetic resonance imaging
(PM-MRI) f
Postmortem needle biopsy
Posture and movement abnormalities of
–
focal
generalized
PPROM. see Preterm premature rupture of
membranes (PPROM)
Prader-Willi syndrome t
Preaxial polydactyly t
Prefrontal space (PFS) ratio
Pregnancies
pseudodiamniotic
see also Twin pregnancies
Pregnancy associated plasma protein A
(PAPP-A)
fetal aneuploidies and
fetal growth restriction and
Prenasal thickness f
Prenatal diagnosis
of fetal infections
viral infections
Prenatal non-visualization of the fetal gall
bladder (PNVGB)
Prepontine subarachnoid cyst f
Preterm premature rupture of membranes
(PPROM)
pulmonary hypoplasia and
Primary obstructive megaureter
Primary refluxing megaureter
Primitive gut
Primum septum f
Proton magnetic resonance spectroscopy
in fetal growth restriction
Proximal focal femoral deficiency (PFFD)
t f
Prune belly syndrome f
Pseudocyst t f
meconium
Pseudodiamniotic pregnancies
PSV. see Peak systolic velocity (PSV)
Pulmonary abnormalities
congenital diaphragmatic hernia
–
intrathoracic teratoma
lungs
bronchial/tracheal atresia
f
bronchogenic cyst f
bronchopulmonary sequestration
–
congenital cystic adenomatoid
malformation
congenital high airway obstruction
syndrome f
echogenic f
mucous plug f
pulmonary hypoplasia
f t
normal and abnormal appearance f
pleural effusion
syndromes with t
Pulmonary arteries f f
Pulmonary atresia
f t
Pulmonary hypoplasia (PH)
f
aetiological groups at high risk for t
unilateral
Pulmonary stenosis t
isolated f t
Pulsatility index for veins (PIV) in fetal
aneuploidies screening
Pulsed wave Doppler in monoamniotic
twinning f
PUV. see Posterior urethral valves (PUV)
PVL. see Periventricular leukomalacia
(PVL)
Pyelectasia
Q
Quintero staging system in TTTS
–
R
Rachischisis
Radial aplasia t f
Radial ray anomalies
Radius skeletal abnormalities f
RADIUS study
Reciprocal translocation
f
Rectum formation of f
Recurrence risks of fetal anomalies
–
Red cell disorders
Renal agenesis
bilateral in oligohydramnios
f
first-trimester detection
postnatal management of
in pregnancy/delivery
sonographic diagnosis of
Renal cystic dysplasia in Meckel-Gruber
syndrome f
Renal cysts f
Renal echogenicity abnormalities of
f
Renal pelvis dilatation
f
t
pelvi-ureteric junction (PUJ)
obstruction
Index
postnatal management of
f
in pregnancy/delivery
sonographic diagnosis of
f
transient hydronephrosis
Renal system anomalies
Renal tumours
Respiratory tract anomalies
f
Retroperitoneal tumours
Retroplacental sonolucent zone loss/
irregularity of
Reverberation artefact amniotic fluid
measurement and f
Rhabdomyomas f
Rhesus D (RhD) alloimmunization
pathogenesis of f
Rhombencephalon f f
Rib length normal f
Right lung agenesis f
Roberts syndrome f
cleft lip/palate t
Robertsonian translocation
f
Robin anomalad
Robinson syndrome frontal bossing b
Routine fetal anomaly scan
audit
perinatal mortality
sensitivity and specificity
second trimester t
soft markers
topographic detection
abdomen
face
heart
limbs and skeleton
skull brain and spine
thorax
urinary tract
women’s views
Rubella
clinical syndromic manifestations of
management and counselling
prenatal diagnosis of
teratogenic effects of t
teratogenicity of
ultrasound findings on
Rubenstein-Taybi syndrome t
Russell Silver syndrome frontal bossing
b
S
Sacral agenesis
ultrasound diagnosis of
Sacrococcygeal teratoma (SCT) f
f
Saethre-Chotzen syndrome t
Sagittal venous sinus thrombosis f
Saldino-Noonan syndrome
Samples for autopsy f
Scaphocephaly f
Schizencephaly
occipital closed lip f
Scimitar syndrome t f
Scoliosis
SCT. see Sacrococcygeal teratoma (SCT)
Seckel syndrome f
Second trimester detection fetal anomaly
scan
detection rate for specific major
structural malformations
optimal time for t
purpose of t
structures to be examined and
minimum standard views
during t
Secondary megaureter
Septal agenesis
Septal cysts of placenta
Septal defect ventricular
Septo-optic dysplasia (SOD)
Septum cavum pellucidum f
Sex determination fetal
f
Short femur t
isolated with no other abnormalities
t
plus non-skeletal abnormalities
t
plus other skeletal abnormalities
t
ultrasound of foetus with
Short humerus
Short rib dysplasias
t
Short rib polydactyly syndromes (SRPS)
f t–t t
Shprintzen syndrome
Simpson-Golabi-Behmel syndrome
Single congenital malformation
Single deepest pocket technique (SDP)
Single gene disorders
b
autosomal dominant inheritance t
f
autosomal recessive inheritance
f
fetal hydrops and
pedigree patterns for t
X-linked recessive inheritance
f
Single-gene malformation syndromes
Single shot turbo spin echo (SSTSE)
protocol of
Sirenomelia f
versus caudal regression syndrome
t
ultrasound diagnosis of
Skeletal abnormalities
embryology of t
first-trimester detection
normal ultrasound appearances and
pitfalls of
Skeletal dysplasias
f
–
fetal hydrops f
foetus with polyhydramnios and
lethal
micrognathia
ribs in f
Skin oedema f
foetus with f
Skull sutures of f
Skull anomalies
cloverleaf skull f
strawberry-shaped skull
f
‘Slapped cheek syndrome.’ see Parvovirus
B
Small bowel
atresia
obstruction
Small ears with trisomy
Smith-Lemli-Opitz syndrome t
Smith-Magenis syndrome t
SOD. see Septo-optic dysplasia (SOD)
Sodium valproate teratogenic effects of
t
Soft markers
in fetal aneuploidies
in trisomy t
Soft tissue lymphangioma f
Soft tissue tumours of the extremities
–
Sonoembryology
Sonography. see Ultrasound
Sotalol anti-arrhythmic drug t
Soto syndrome t
Spatio-temporal image correlation (STIC)
technique of
Spectroscopy
Spina bifida
associated anomalies of
banana sign f
cystica
diagnosis of and other dysraphisms in
foetus
embryology
normal head and spine
differential diagnosis of
fetal cranial biometry
first-trimester detection
lemon sign f
obstetric management of
occulta
prognosis of
ambulation
intelligence
mortality
sphincter control
risk of chromosomal anomalies in
Index
ultrasound features of
axial plane f
coronal plane f
sagittal plane f
variants
see also Neural tube defects (NTDs)
Spinal anomalies
caudal regression syndrome
closed spinal dysraphisms f
–
diastematomyelia
hemivertebrae f
iniencephaly
open spinal dysraphisms
f
f
sacral agenesis
scoliosis
sirenomelia
spina bifida
aetiology and pathogenesis of
closed with meningocoele
definition of
first-trimester detection
indirect signs
ultrasound diagnosis of
split notochord syndrome
f
Spinal cord normal f
Spinal cord malformations
Spinal dysraphisms
closed f f
open f f
Spinal signs direct
Spine
development of f
examination of
Spleen abnormalities of
Splenomegaly f f
‘Split brain’
Split notochord syndrome (SNS)
f
Spondylothoracic dysostosis
f
SRPS. see Short rib polydactyly syndromes
(SRPS)
Steady-state free precession (SSFP) MR in
foetus with normal cardiac
anatomy f
‘Steer horn’ sign f
Sternum f
Stillbirth late
Stomach f
gastrointestinal abnormalities in
Strawberry-shaped head
f
Strawberry-shaped skull
f
Subarachnoid cyst f
Subchorionic fibrin deposition
Subcutaneous occipital haemangioma
Subependymal calcification f
Subependymal cysts
Subependymal heterotopias f
Sulcation
defects of
Superior vena cava f
Supratentorial midline vascular
abnormalities
Supraventricular tachycardia
Sylvian fissures
Syndactyly t
T-weighted MR imaging (T WI)
T-weighted MR imaging (T WI)
normal cerebral cortex f
Tachycardias
fetal
supraventricular
ventricular
Talipes
first-trimester detection
trisomy
Talipes equinovarus
TAPS. see Twin anaemia polycythemia
sequence (TAPS)
TAR. see Thrombocytopaenia absent
radius (TAR)
Tarlov cyst
TD. see Thanatophoric dysplasia (TD)
Teardrop-shaped ventricle
Teratogens
dose and interaction with other
environmental and genetic
factors
mechanisms of in causation of
malformations
timing of exposure
Teratomas
cervical
facial fof neck
tetralogy of Fallot
Tetrophthalmos
Thanatophoric dysplasia (TD)
diagnostic tests in utero
frontal bossing b
incidence of
prognosis of
recurrence risk and screening strategy
ultrasound findings of
The Human Tissue Act
Theca lutein cyst
Thoracic abnormalities first-trimester
detection
diaphragmatic hernia
pleural effusion
Thoracic anomalies fetal MRI of
Thoracic hypoplasia
Thoraco-omafalopagus conjoined twin
Thoracopagus
Thorax tumours of
Three vessel view
four vessels in
Throat defects in polyhydramnios and
Thrombocytopaenia fetal
–
causes of
Thrombocytopaenia absent radius (TAR)
Thymomas
Thyrotoxicosis fetal
Tongue
abnormalities of
ultrasound of
Toxoplasmosis
management and counselling of
prenatal diagnosis of
teratogenic effects
teratogenicity of
transmission rate of
ultrasound findings on
Transcerebellar diameter (TCD)
Transcerebellar plane f
Transfusion of blood products
Transient abdominal cyst
Transient hydronephrosis
Transmembranous pathway in amniotic
fluid production
Transplacental haemorrhage
Transposition of great arteries
Transvaginal scanning
of -week pregnancy
of -week pregnancy
type of abnormalities detected using t
Transventricular plane
Transverse abdominal diameter (TAD)
Transverse arch
TRAP. see Twin reversed arterial perfusion
sequence (TRAP)
Treacher Collins syndrome
Trial of Umbilical and Fetal Flow in
Europe (TRUFFLE) fetal growth
restriction and
Tricuspid atresia
Tricuspid flow in fetal aneuploidies
screening
Tricuspid regurgitation
Tricuspid valve dysplasia
Triploidy
Index
Trisomy
estimated risk for
first-trimester biochemical features of
first-trimester ultrasound features of
phenotypic expression of
Trisomy
choroid plexus cysts and
estimated risk for t
first-trimester biochemical features of
first-trimester ultrasound features of
micrognathia
phenotypic expression of
polyhydramnios and f
strawberry-shaped skull with
f
Trisomy
with absent nasal bone f
algorithm for
defects/markers in t
estimated risk for t
first-trimester biochemical features of
first-trimester ultrasound features of
likelihood ratio for t
methods of screening for
phenotypic expression of
pleural effusion and
prefrontal space (PFS) ratio and screening for small ears
Trophoblast
True isolated ventriculomegaly
True parenchymal hyperechogenicities
aetiology of
TRUFFLE. see Trial of Umbilical and Fetal Flow in Europe
(TRUFFLE)
T sign
TTTS. see Twin-to-twin transfusion
syndrome (TTTS)
Tuberous sclerosis
Tumours
abdominal
cardiac
facial
harlequin ichthyosis
teratoma
fetal and placental
fetal MRI of
intracranial
neck
renal
thorax
umbilical cord
Turner syndrome
phenotypic expression of
Twin anaemia polycythemia sequence
(TAPS) spontaneous
Twin gestation
assessment of
monochorionic complications to
Twin pregnancies
aneuploidy in screening test for
cervical length measurement
demise of one twin
dichorionic pair
monochorionic pair
detection of structural anomalies in
fetal abnormalities
monochorionic twins
twin reversed arterial perfusion
sequence (TRAP)
first trimester assessment of
–
chorionicity determination
dating
labelling of twins
follow-up scheme of
management of
placental examination in
poor growth in one of the twins
in a dichorionic pair
in a monochorionic pair
twins of unknown chorionicity
preterm birth
screening in
chorionicity
structural anomaly in one of the twins
dichorionic pregnancies
monochorionic pregnancies
vanishing twin
Twin reversed arterial perfusion sequence
(TRAP)
development
Twin-to-twin transfusion syndrome
(TTTS)
pathophysiology of
prognosis of
severity of
Twinning
amniotic fluid volume
conjoined
monoamniotic
polyhydramnios and
Twins labelling of
U
Ulna skeletal abnormalities
Ultrasound
D/D visualization
bronchopulmonary sequestration (BPS)
congenital cystic adenomatoid
malformation (CCAM)
congenital diaphragmatic hernia (CDH)
echogenic bowel
evaluation of amniotic fluid volume
amniotic fluid index
quantification of amniotic fluid
single deepest pocket technique
subjective assessment
in twinning
facial cleft
fetal aneuploidies
at - weeks
in second trimester
fetal macrosomia
gastroschisis
macroglossia
micrognathia
nasal hypoplasia neck
placental attachment disorders
pleural effusion
routine fetal anomaly scan
skeletal
abnormalities of talipes
Umbilical arteries fetal Doppler for
Umbilical cord cysts
haematoma
tumours
Unilateral bronchial atresia
Unilateral pulmonary agenesis f
Unilateral pulmonary hypoplasia
Unilocular cyst
Uniparental disomy (UPD)
Upper limb
abnormalities of
Ureter
dilatation of
ectopic
Ureterocoeles
Urethral atresia
anhydramnios and megacystis due to Urinary tract
abnormalities
–
autosomal dominant polycystic kidneydisease
autosomal recessive polycystic kidney disease
bladder exstrophy
bladder obstruction
first trimester
second and third trimester
cloacal dysgenesis sequence
cloacal exstrophy
cystic renal disease first-trimester
detection
distended bladder
echogenic kidneys
embryology
of fetal bladder
‘absent’ bladder
megacystis
fetal genital system
ambiguous genitalia
hydrometrocolpos and urogenital
sinus
hydronephrosis
low urinary obstruction
megacystis microcolon intestinal
hypoperistalsis syndrome
(MMIHS)
megacystis-megaureter syndrome
megalourethra
minor renal anomalies
multicystic dysplastic kidney disease
non-obstructed distended bladder
non-refluxing non-obstructed primary
megaureter
normal appearances
normal sonographic appearances of
pelvi-ureteric junction (PUJ)
obstruction
pelvic kidney
persistent cloaca
position and number of fetal kidneys
crossed ectopic kidney
duplex kidney
ectopic kidney
horseshoe kidney
renal agenesis
posterior urethral valves
primary obstructive megaureter
prune belly syndrome
renal agenesis first-trimester detection
renal collecting system
hydroureter
renal pelvis dilatation
renal cysts
renal parenchyma
cystic changes of
dysplastic kidneys
secondary megaureter
transient hydronephrosis
ureterocoeles
urethral atresia
urinoma
vesico-ureteric reflux
Urine production of
Urinoma
Urogenital membrane
Urogenital sinus
USS placental examination correlation
Uterine arteries FGR screening
V
VACTERL skeletal abnormalities
VACTERL association
VACTERL constellation
Van der Woude syndrome
Vanishing twin
Varicella
management and counselling of
perinatal infection with
prenatal diagnosis of
teratogenic effects
teratogenicity of
ultrasound findings on
Vasa praevia
Vascular tumours features of
VATER association
VATER syndrome
Vein of Galen malformations
Velamentous cord insertion
Velocardiofacial syndrome
Ventricles
disproportion of
double inlet
Ventricular atrium (VA)
Ventricular septal defect
subaortic
Ventricular septum
Ventricular tachycardia
Ventriculomegaly
associations of
causes of
congenital brain abnormality linked
first-trimester detection
Verma-Naumoff syndrome
Vermian agenesis
Vermis
Vesico-amniotic shunt
Vesico-ureteral junction (VUJ)
obstruction of
Vesico-ureteric reflux
Viability assessment of
Villitis
Villitis of unknown etiology (VUE)
f
Viral infections
causing fetal disease
cytomegalovirus
not associated with fetal disease
parvovirus
in prenatal diagnosis
rubella
toxoplasmosis
varicella
Vitamin A teratogenic effects of
VSD. see Ventricular septal defect
W
WAGR syndrome
Walker-Warburg syndrome
Warfarin embryopathy
Williams syndrome
Wilms’ tumour
Wilms’ tumour-aniridia syndrome
Winter-Baraitser Dysmorphology Database
(WBDD)
Wolman disease f
X
X-linked dominant inheritance
X-linked recessive inheritance
X-rays teratogenic effects of
Yolk sac
Z
Zellweger syndrome
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