Dr Salma Hashmi's Ultrasound Clinic

28/10/2025

Strawberry shaped head at 13- weeks. Fetus had Trisomy 18 pls note the flattening of occipital and narrowing of the frontal part of the head.( best seen at sub occipito bragmatic view ).

28/10/2025

Few manifestations of trisomy 18:
1- strawberry shaped head
2-Choroid plexus cysts
3-Absent Corpus callosum
4-Enlarged cisterna magna
5-facial cleft
6- Micrognathia
7-Nuchal Edema
8-Heart defects
9-Diaphragmatic hernia
10-Esophageal Atresia
11-Omahalocele ( usually with only bowel in the sac)
12- Single umbilical artery
13- Renal defects
14- Echogenic bowel
15-Myelomeningocele
16-Growth Restriction
17- Shortening of the limbs
18- Radial aplasia
19- Overlapping fingers
20- Talipes or Rocker bottom feet .

Choroid plexus cysts( bilateral).

27/10/2025

Signs of trisomy 21:
1-brachycephaly
2-mild ventriculomegaly
3-nasal hypoplasia
4-4- Nuchal oedema.( Increased nuchal fold thickness )
5-Cardiac defects, mainly Atrioventricular septal defects .
6- Duodenal Atresia,
7- echogenic bowel
8-mild Hydronephrosis
9- shortening of the femur/ humerus
10- clinodactyly or mild pharyngeal hypoplasia of the fifth finger.
One or all signs may be present.

27/10/2025

An 18 week fetus with absent nasal bone. ( sagittal view )Later on Trisomy 21 was confirmed.

27/10/2025

An 18 week fetus with normal nasal bone

27/10/2025

Normal nasal bone in a 12 week fetus.

22/10/2025

Plz note the foremen ovale.

18/10/2025

Non- immune Hydrops Fetalis.

Plz note-
1- bilateral Pleural effusion.
2-Fetal Ascetes.
3- Scrotal oedema.
4-polyhydramnios
5-Macrosomic Placenta.
6- Absent end Diastolic flow on colour Doppler.

14/10/2025

This image shows Doppler waveforms of key fetal and maternal vessels used to assess fetal and placental circulation, especially in cases of fetal growth restriction (FGR) or suspected placental insufficiency.
Here’s an explanation of each vessel shown:

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1. Uterine Artery

Normal PI: Normal pulsatility index, smooth waveform.

Mean PI >95th centile: Indicates increased resistance in uteroplacental circulation — may suggest uteroplacental insufficiency or preeclampsia risk.

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2. Umbilical Artery

Normal PI: Normal diastolic flow.

PI >95th centile: Increased resistance; early sign of placental dysfunction.

AEDV (Absent End-Diastolic Velocity): No flow in diastole — severe compromise.

REDV (Reversed End-Diastolic Velocity): Flow reversal during diastole — critical fetal distress.

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3. Middle Cerebral Artery (MCA)

Normal PI: Normal brain resistance.

PI 95th centile: Increased resistance.

Absent ‘a’ wave: Sign of cardiac compromise.

Reversed ‘a’ wave: Indicates severe fetal cardiac dysfunction — often seen before fetal demise.

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6. Aortic Isthmus

Normal PI: Forward flow throughout the cycle.

PI >95th centile: Increased resistance.

IFI (Isthmic Flow Index):

≥1: Normal

0–1: Reduced forward flow

≤0: Reversed flow — advanced fetal compromise.

06/10/2025

Diagnosed as hemangioma

02/10/2025

30/09/2025

Hemartoma of liver/ Biliary hemartoma

a-They may show diffuse heterogeneous echotexture
b-Can be hyper echoec.
c-larger lesions can be hypoechoic or anechoic with an echogenic periphery.