Now in its second edition, Atlas of Ultrasound in Obstetrics and Gynecology is ideal as a visually-oriented reference and comprehensive tutorial for expanding your knowledge of ultrasound.
Developed from one of the best and broadest sonographic collections in the field, this powerful atlas provides images and authoritative commentary covering all aspects of obstetric and gynecologic ultrasound. The text is integrated with over 200 video clips available online to enhance diagnostic skills and learn about ultrasound-guided procedures.
Whether you’re a radiologist, obstetrician, gynecologist or sonographer this exciting visual resource is a valuable tool for achieving diagnostic accuracy for your patients.

Inside you’ll find:
Large, clear illustrations – more than 110 0, most new to this edition – and informative text highlighting normal anatomy and pathological conditions, interventional procedures, and much more.
Fully searchable website with access to the complete content of the book and integrated video clips.
Over 200 real-time clips on the companion website that add another dimension to illustrate many sonographic abnormalities.
Guidance from two well-known experts lets you benefit from the experience of Drs. Doubilet and Benson – both known for their research in obstetric and gynecologic ultrasound.

Online Video Icon iii
Preface v Acknowledgments vii
S E C T I O N I Obstetrical Ultrasound
1 Normal Anatomy 1 First Trimester 3
1.1. Normal Pregnancy Prior to 6 Weeks of Gestation 3
1.2. Normal Pregnancy at 6–10 Weeks of Gestation 6
1.3. Normal Pregnancy at 10–14 Weeks of Gestation 10

2 Second and Third Trimester Fetal Anatomy 15
2.1. Head 152.2. Face 18
2.3. Spine 22
2.4. Neck and Thorax 24
2.5. Heart 272.6. Abdomen 30
2.7. Extremities 35

3 Second and Third Trimester Nonfetal Components 40
3.1. Umbilical Cord 40
3.2. Cervix in Pregnancy 43
3.3. Placenta 45
3.4. Amniotic Fluid 46
Fetal Abnormalities

4 Head 49
4.1. Hydrocephalus 49
4.2. Aqueductal Stenosis 51
4.3. Dandy-Walker Malformation 52
4.4. Anencephaly 54
4.5. Encephalocele 56
4.6. Agenesis of the Corpus Callosum 59
4.7. Holoprosencephaly 60
4.8. Vein of Galen Aneurysm 62
4.9. Intracranial Hemorrhage and Porencephaly 64
4.10. Schizencephaly 67
4.11. Septo-Optic Dysplasia 68
4.12. Hydranencephaly 70
4.13. Cytomegalovirus and Other in Utero Infections 73
4.14. Arachnoid Cyst 75
4.15. Intracranial Tumors 78
4.16. Lissencephaly 81
4.17. Craniosynostosis 83

5 Spine 85
5.1. Spina Bifi da and Meningomyelocele 85
5.2. Hemivertebra 90
5.3. Scoliosis 92
5.4. Caudal Regression and Sacral Agenesis 93
5.5. Sacrococcygeal Teratoma 96

6 Face 100
6.1. Cleft Lip and Palate 100
6.2. Macroglossia 104
6.3. Micrognathia 106
6.4. Hypotelorism 107
6.5. Cyclopia and Proboscis 109
6.6. Microphthalmia and Anophthalmia 111
6.7. Cysts and Tumors 112

7 Neck 114
7.1. Thickened Nuchal Translucency (10–14 Weeks of Gestation) 114
7.2. Thickened Nuchal Fold (16–20 Weeks of Gestation) 116
7.3. Cystic Hygroma 117
7.4. Masses 120
7.5. Goiter 121

8 Thorax 123
8.1. Pulmonary Masses and Dysplasias 123
8.2. Tracheal and Bronchial Atresia 130
8.3. Unilateral Pulmonary Agenesis 131
8.4. Diaphragmatic Hernia 132
8.5. Pleural Effusion and Hydrops 136

9 Heart 141
9.1. Overview of Congenital Heart Disease 141
9.2. Hypoplastic Left Heart Syndrome and Aortic Stenosis 141
9.3. Hypoplastic Right Ventricle and Pulmonic Stenosis 145
9.4. Ebstein Anomaly 147
9.5. Ventricular Septal Defect 149
9.6. Atrioventricular Canal 150
9.7. Tetralogy of Fallot 152
9.8. Transposition of the Great Vessels 153
9.9. Truncus Arteriosus 155
9.10. Double Outlet Right Ventricle 155
9.11. Myocardial Tumors 157
9.12. Arrhythmias 159
9.13. Ectopia Cordis 161
9.14. Pericardial Effusion 162

10 Gastrointestinal Tract 164
10.1. Esophageal Atresia 164
10.2. Duodenal Atresia 165
10.3. Small Bowel Obstruction 167
10.4. Meconium Peritonitis 168
10.5. Cholelithiasis 171
10.6. Liver Masses, Cysts, and Calcifi cations 172

11 Ventral Wall 175
11.1. Omphalocele 175
11.2. Gastroschisis 177
11.3. Amniotic Band Syndrome 180

12 Genitourinary Tract 182
12.1. Unilateral and Bilateral Renal Agenesis 182
12.2. Hydronephrosis: Overview 185
12.3. Ureteropelvic Junction Obstruction 188
12.4. Vesicoureteral Refl ux and Primary Megaureter 190
12.5. Posterior Urethral Valves and Urethral Atresia 191
12.6. Prune Belly Syndrome 194
12.7. Multicystic Dysplastic Kidney and Renal Dysplasia from Obstruction 195
12.8. Hereditary Polycystic Kidney Disease 199
12.9. Renal Ectopia 200
12.10. Mesoblastic Nephroma 202
12.11. Duplicated Collecting System and Ectopic Ureterocele 204
12.12. Ovarian Cysts and Masses 205
12.13. Cloacal and Bladder Exstrophy 207
12.14. Abnormal External Genitalia 208

13 Extremities 212
13.1. Skeletal Dysplasia 212
13.2. Skeletal Dysostoses 219
13.3. Amputations and Limb Reduction Defects 221
13.4. Radial Ray Defects 224
13.5. Polydactyly 226
13.6. Overlapping Fingers and Clinodactyly 228
13.7. Clubfoot 230
13.8. Rocker Bottom Foot 231

14 Chromosomal Anomalies 232
14.1. Trisomy 13 (Patau Syndrome) 232
14.2. Trisomy 18 (Edwards Syndrome) 236
14.3. Trisomy 21 (Down Syndrome) 241
14.4. Monosomy X (Turner Syndrome, 45X) 245
14.5. Triploidy 247
14.6. DiGeorge Syndrome (22-q11 Deletion) 251
Non-Fetal Abnormalities

15 First Trimester Pregnancy Complications 253
15.1. Failed Pregnancy 253
15.2. Subchorionic Hematoma 255
15.3. Slow Embryonic Heart Rate 256

16 Placenta 259
16.1. Placenta Previa 259
16.2. Placental Abruption 262
16.3. Placenta Accreta, Increta, and Percreta 264
16.4. Chorioangioma 268

17 Uterus and Cervix 270
17.1. Cervical Incompetence 270
17.2. Fibroids in Pregnancy 274
17.3. Uterine Synechia and Amniotic Sheet 276
17.4. Uterine Rupture 277
17.5. Uterine Incarceration 278

18 Amniotic Fluid 281
18.1. Oligohydramnios 281
18.2. Polyhydramnios 283
18.3. Intra-amniotic Hemorrhage 285
18.4. Chorioamnionitis 286

19 Umbilical Cord 287
19.1. Single Umbilical Artery 287
19.2. Abnormal Placental Cord Insertions and Vasa Previa 289
19.3. Allantoic Duct Cysts 291
19.4. Umbilical Arterial Doppler 292
19.5. Umbilical Venous Varix 294
19.6. Nuchal Cord 296 Multiple Gestations

20 Diagnosis and Characterization of Multiple Gestations 298
20.1. Fetal Number 298
20.2. Placentation: Chorionicity and Amnionicity 303

21 Complications of Multiple Gestations 308
21.1. Twin–Twin Transfusion Syndrome 308
21.2. Acardiac Twinning 310
21.3. Cord Entanglement in Monoamniotic Twins 312
21.4. Conjoined Twins 314
21.5. Death of One Twin In Utero 318
Procedures

22 Diagnostic Obstetrical Procedures 320
22.1. Amniocentesis 320
22.2. Chorionic Villus Sampling 322
22.3. Percutaneous Umbilical Blood Sampling 323

23 Therapeutic Obstetrical Procedures 326
23.1. Fetal Blood Transfusion 326
23.2. Thoracentesis and Thoracoamniotic Shunting 328
23.3. Bladder Drainage and Vesicoamniotic Shunting 330

C O N T E N T S xiii
23.4. Paracentesis 333
23.5. Treatment of Cardiac Anomalies 33423.6. Ex Utero Intrapartum Treatment Procedure 338
23.7. Removal of Intrauterine Device During Pregnancy 340
23.8. Treatment of Complications of Multiple Gestations 341

S E C T I O N II Gynecological Ultrasound 345
Normal Anatomy

24 Uterus 347
24.1. Myometrium 34
724.2. Endometrium 348

25 Adnexa 351
25.1. Ovaries 351
25.2. Extraovarian Adnexal Structures 354 Pathology

26 Myometrium 355
26.1. Fibroids (Leiomyomas) and Leiomyosarcomas 355
26.2. Adenomyosis 362
26.3. Congenital Uterine Anomalies 363

27 Endometrium 368
27.1. Endometrial Polyps 368
27.2. Endometrial Hyperplasia 372
27.3. Endometrial Carcinoma 373
27.4. Gestational Trophoblastic Disease 374
27.5. Retained Products of Conception 377

28 Ovaries and Adnexa 380
28.1. Simple Ovarian Cysts 380
28.2. Hemorrhagic Ovarian Cysts 381
28.3. Ovarian Teratomas 384
28.4. Ovarian Benign Neoplasms Other Than Teratomas 386
28.5. Ovarian Cancer 389
28.6. Ovarian Torsion 391
28.7. Endometriosis 395
28.8. Hydrosalpinx 397
28.9. Tubo-ovarian Abscess 397

29 Ectopic Pregnancy 400
29.1. Tubal Ectopic Pregnancy 400
29.2. Cornual (Interstitial) Ectopic Pregnancy 404
29.3. Cervical Ectopic Pregnancy 406
29.4. Cesarean Scar Pregnancy Implantation 407
29.5. Abdominal Ectopic Pregnancy 409
29.6. Heterotopic Pregnancy 410 Procedures

30 Diagnostic Gynecological Procedures 412
30.1. Saline Infusion Sonohysterography 412

31 Therapeutic Gynecological Procedures 416
31.1. Ovarian Cyst Aspiration 416
31.2. Oocyte Retrieval 418
31.3. Ultrasound-Guided Uterine Instrumentation Through the Cervix 418
31.4. Ectopic Pregnancy Ablation 420
31.5. Pelvic Abscess Drainage 423
Index 425