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Fetal Presentation: Cephalic.
Placenta: Fused, posterior placenta, Grade I to II.
Uterus: Normal,Cervix: Closed.
Adnexa: Not seen,Amniotic Fluid: AFI 5.5cm in a single AP pocket.
BIOMETRY:
BPD: 7.9cm consistent with 31weeks, 5 days gestation,HC: 31.1cm consistent with 33 weeks, 3 days gestation,AC: 30.0cm consistent with 34 weeks, 0 days gestation,FL:
EXAM:
Transvaginal ultrasound.
HISTORY:
Pelvic pain.
FINDINGS:
The right ovary measures 1.6 x 3.4 x 2.0 cm. There are several simple-appearing probable follicular cysts. There is no abnormal flow to suggest torsion on the right. Left ovary is enlarged, demonstrating a 6.0 x 3.5 x 3.7 cm complex cystic mass of uncertain etiology. This could represent a large hemorrhagic cyst versus abscess. There is no evidence for left ovarian torsion. There is a small amount of fluid in the cul-de-sac likely physiologic.
The uterus measures 7.7 x 5.0 cm. The endometrial echo is normal at 6 mm.
IMPRESSION:
1. No evidence for torsion.
2. Large, complex cystic left ovarian mass as described. This could represent a large hemorrhagic cyst; however, an abscess/neoplasm cannot be excluded. Recommend either short interval followup versus laparoscopic evaluation given the large size and complex nature.
EXAM:
OB Ultrasound.
HISTORY:
A 29-year-old female requests for size and date of pregnancy.
FINDINGS:
A single live intrauterine gestation in the cephalic presentation, fetal heart rate is measured 147 beats per minute. Placenta is located posteriorly, grade 0 without previa. Cervical length is 4.2 cm. There is normal amniotic fluid index of 12.2 cm. There is a 4-chamber heart. There is spontaneous body/limb motion. The stomach, bladder, kidneys, cerebral ventricles, heel, spine, extremities, and umbilical cord are unremarkable.
BIOMETRIC DATA:
BPD = 7.77 cm = 31 weeks, 1 day,HC = 28.26 cm = 31 weeks, 1 day,AC = 26.63 cm = 30 weeks, 5 days,FL = 6.06 cm = 31 weeks, 4 days,Composite sonographic age 30 weeks 6 days plus minus 17 days.
ESTIMATED DATE OF DELIVERY:
Month DD
YYYY.
Estimated fetal weight is 3 pounds 11 ounces plus or minus 10 ounces.
IMPRESSION:
Single live intrauterine gestation without complications as described.
EXAM:
Bilateral lower extremity ultrasound for deep venous thrombus.
REASON FOR EXAM:
Lower extremity edema bilaterally.
TECHNIQUE:
Colored, grayscale, and Doppler imaging is all employed.
FINDINGS:
This examination is limited. There is prominent edema bilaterally and there is large body habitus. These two limit assessment especially of the right lower extremity.
As visualized, there is no gross evidence of DVT. The right leg grayscale images are limited. No obvious clot identified on the color flow or Doppler images. The left leg is better visualized than the right, but again is limited. No definite clot is seen.
IMPRESSION:
Limited study secondary to body habitus and edema. No obvious DVT as visualized.
REASON FOR EXAM:
Followup for fetal growth.
INTERPRETATION:
Real-time exam demonstrates a single intrauterine fetus in cephalic presentation with a regular cardiac rate of 147 beats per minute documented.
FETAL BIOMETRY:
BPD = 8.3 cm = 33 weeks, 4 days,HC = 30.2 cm = 33 weeks, 4 days,AC = 27.9 cm = 32 weeks, 0 days,FL = 6.4 cm = 33 weeks, 1 day,The head to abdomen circumference ratio is normal at 1.08, and the femur length to abdomen circumference ratio is normal at 23.0%. Estimated fetal weight is 2,001 grams.
The amniotic fluid volume appears normal, and the calculated index is normal for the age at 13.7 cm.
A detailed fetal anatomic exam was not performed at this setting, this being a limited exam for growth. The placenta is posterofundal and grade 2.
IMPRESSION: