Obstetric Ultrasound Analysis - Full Report

Annotated Reference Diagram

Scan Parameters (from image text)

Image Components - Annotated

TOP PANEL: 2D (B-mode) Fetal Cardiac View

• A cross-sectional (axial) view of the fetal thorax showing the four-chamber cardiac view
• The fetal heart is seen in the center of the chest, with the apex directed toward the left side (normal levocardia)
• Two ventricular chambers are visible symmetrically - left ventricle (LV) and right ventricle (RV)
• The interventricular septum is visible as a bright echogenic line between the chambers
• Chordae tendineae/valve leaflets appear as bright echogenic structures within the chambers
• The fetal spine creates a bright posterior acoustic shadow (typical posterior or lateral position)
• The pericardial border is visible as a thin echogenic ring around the heart

BOTTOM PANEL: M-mode Echocardiography Strip

• Periodic anterior and posterior ventricular wall excursions - the regular undulating wave pattern
• Anterior wall - the upper set of oscillating lines
• Posterior ventricular wall / ventricular cavity - the thicker lower waves
• Regular, rhythmic, uniform spacing of waveforms = normal sinus rhythm
• The waveform amplitude and regularity indicate normal ventricular systole and diastole

• Vc (М): 52 - ventricular chamber diameter
• ДД: 136 (diastolic dimension)
• Крт: 9
• Дав: 95%

Biometric Data (Left Panel)

• Vc: 73 - 2D ventricular dimension
• ДД (DD): 134 - diastolic dimension
• Крт: 9 - (fractional shortening-related index)
• УЖ: 5
• Дав: 96% - concordance/reliability index

1 ЧСС пп: 131 bpm (Fetal heart rate = 131 beats per minute)

Diagnosis

NORMAL 2nd/Early 3rd Trimester Fetal Cardiac Ultrasound with M-mode Assessment

1. Normal fetal cardiac four-chamber view - symmetric biventricular morphology with normal cardiac axis and position (levocardia, cardiac apex pointing left)
2. Fetal heart rate: 131 bpm - within the normal range of 120-160 bpm for a fetus at this gestational age (normal baseline FHR: 120-160 bpm per standard obstetric references - Harriet Lane Handbook, 23rd ed.)
3. Normal M-mode waveform - regular, rhythmic ventricular wall motion with consistent amplitude, indicating normal cardiac contractility and rhythm
4. No obvious structural cardiac anomaly visible on this view - no pericardial effusion, no cardiomegaly, no obvious septal defect visible
5. Appropriate imaging parameters - MI 0.8, TIb 0.4, both within ISUOG/ALARA safety limits

Clinical Interpretation

Key Teaching Points

• M-mode echocardiography in obstetrics is used to measure fetal heart rate precisely, assess ventricular function (fractional shortening), diagnose arrhythmias (SVT, heart block), and evaluate cardiac wall motion
• The scan is performed in Harmonic mode (Гармонически) which suppresses near-field artifacts and improves image contrast - this is the preferred mode for fetal cardiac assessment
• The 2.3 trimester label corresponds approximately to ~23 weeks gestation (the "point" in Russian obstetric notation refers to fractional weeks), which is within the standard anomaly scan window (18-24 weeks)
• Normal fractional shortening (FS) in a mid-trimester fetus is approximately 28-40%; the Крт (shortening fraction index) value of 9 is consistent with normal systolic function

Recommendation

Note: This is a single-view assessment. Final clinical diagnosis should be made by a qualified sonologist/perinatologist with full review of all scan views and clinical context.