28 week ultrasound

28 week ultrasound.

This is rather inappropriate (too late) period for an anomaly scan, but detailed anatomy can be viewed at this gestation. And it's too early for a growth and biophysical profile scan, but we may need it at times in early growth restriction.

Anatomy viewed in this scan:
face
intracranium : BPD plane, lateral ventricles, cerebellum, cysterna magna
thorax: heart 4chamber view, outlet view, venacave.
kidneyes, intra abdomen
limbs including digits
gonads.

About biophysical profile:
No doppler done. (not necessary in a normal pregnancy.) . I would include doppler with BPP. Manning and others didnt do so, because doppler was late comer in the scene. doppler also tells us about the biophysical well being of the pregnancy.

In growth restricted baby, BPP as important as doppler. there's a tendency to make decisions solely based on doppler. the baby may be thriving even with a compromised placental flow, or it may be suffering because of it's size, even with a good blood flow. Biophysical activity tells us if the baby's blood supply is enough to keep it 'active' in addition to it's basal body function. If the baby is active, we can give it more time in utero.