During pregnancy, ultrasound is performed at least three times. Ultrasound examination is simple, painless and safe. Thanks to the ultrasound, you will see your baby before it is born, know its gender and make sure the pregnancy is developing properly. Here are answers to the most common questions about pregnancy ultrasound. Krzysztof Maj, MD, PhD, specialist obstetrician gynecologist from the hospital at ul. Inflancka in Warsaw.
About what it looks likepregnancy ultrasound , what is it for and why it is so important, with Krzysztof Maj, MD, specialist in obstetrician gynecology from the hospital at ul. Inflancka in Warsaw, interviewed by Marta Radzik-Maj.
- Ultrasound examination in pregnant women is a luxury, a necessity or maybe a duty?
It is a standard in pregnancy management these days. Ultrasound examination allows you to monitor the development of the fetus and supervise the course of pregnancy. The Polish Gynecological Society recommends that it be performed three times - the first between weeks 11 and 14 of pregnancy, the second between weeks 18 and 22 and the third after the 30th week of pregnancy. This, of course, applies to a normal physiological pregnancy. For example, if the patient has high blood pressure, diabetes or is pregnant in twins, more frequent tests are necessary. If bleeding occurs, an ultrasound is performed even every few days.
- Is such frequent ultrasound not harmful? We are dealing with ultrasonic waves …
If there are medical indications for additional tests, they should be performed as often as needed. Despite various speculation and rumors, so far no negative effects of ultrasound have been proven for either the woman or the fetus.
- When is vaginal examination, and when is vaginal examination?
Until 11-12. During the week of pregnancy, ultrasound is performed with a vaginal probe, and later - a transabdominal probe. The doctor puts a layer of a special gel on the patient's abdomen and runs it over it with the head of the device.
- Should a pregnant woman prepare for an ultrasound scan somehow?
No, a pregnant ultrasound does not require any preparation. The examination is painless and takes about 20 minutes. When signing up for them, it is worth asking the doctor whether it is possible to register its course. If so, you will need to bring your own DVD - thiswill be a great souvenir.
- When is it possible to find out the sex of a child?
After the 20th week of pregnancy, we usually have some diagnosis. Mistakes happen, but less and less. A modern camera in the hands of a good specialist makes it possible to determine gender in almost one hundred percent.
- Is it possible to calculate the exact due date using ultrasound?
Based on the measurements taken by the doctor, the computer in the ultrasound machine calculates the age of pregnancy and the approximate date of delivery. The greatest precision in the calculations is achieved during the examination performed up to the 14th week of pregnancy. The accuracy is then several days. In early pregnancy, the distance from the top of the head to the tailbone is measured, then certain parts of the baby's body are measured, such as the size of the head, the circumference of the fetal abdomen, and the length of the femur. Sometimes the due date of the USG examination is different from the due date of the last menstruation. If the discrepancy is less than two weeks, then there is no need for concern. Patients are also often concerned about the fact that, for example, the measurement of the head indicates a different pregnancy age than the measurement of the abdomen. Meanwhile, slight deviations are normal, they result from the fact that children grow at different rates and - like adults - they differ in height, dimensions …
- What else can you learn during a CT scan?
The doctor checks whether the pregnancy is developing properly, whether the size of the fetus is consistent with the duration of the pregnancy. It assesses the structure of the internal organs of a child: heart, kidneys, brain, stomach, spine, bladder. These organs are most visible around the 20th week of pregnancy and possible defects can be detected, e.g. spina bifida, hydrocephalus. The position of the fetus, the condition and location of the placenta are analyzed, e.g. whether it is prominent. The cervix and the amniotic fluid volume are also examined.
- Is it possible to exclude genetic defects of the fetus during an ultrasound examination?
Yes, in recent years the role of ultrasound in detecting fetal birth defects has increased enormously. On its basis, it is already possible to determine the likelihood of occurrence of, for example, Down's syndrome. For this purpose, between the 11th and 14th week of pregnancy, the so-called nuchal translucency, i.e. a reservoir of fluid on the nape of the fetus, and the presence or absence of a nasal bone. This is a specialized examination that should be carried out by properly trained doctors. The list of fully accredited gynecologists can be found on the website of the English Foundation of Fetal Medicine.
- But genetic defects can also be ruled out through other tests?
In the lightPolish regulations, patients with an increased risk of fetal defects, i.e. women over 35 years of age, are offered amniocentesis, i.e. collection of amniotic fluid or chorionic villus sampling - collection of placental tissues. There is then a small risk (1%) of miscarriage. Meanwhile, ultrasound is a non-invasive method, harmless to the child. Supplemented with blood tests, rules out Down syndrome 90 percent.
Important- FL - femur length
- AC - abdominal circumference
- BPD - head width from crown to crown
- HC - head circumference
- CRL - parietal-seat length, i.e. from the top of the head to the end of the child's torso
- FHR - baby's heartbeat measured in beats per minute
- EDD - approximate date of delivery
- EFW - approximate weight of the child
Pregnancy tests - which are mandatory?
- What happens if the doctor finds that the pregnancy is abnormal?
We do not do ultrasound examinations out of curiosity or for the sole knowledge of how a child develops - although the doctor's and the patient's awareness of the actual he alth condition of the unborn child is very important. They are performed in order to provide the child and mother with the best possible protection and medical care if any irregularities are detected. When a serious defect is found, e.g. a diaphragmatic hernia, the doctor refers the patient for additional tests to a specialist center, which confirms the diagnosis and determines further treatment. In the case of heart rhythm disturbances in a child, drugs are given to the mother - they go to the mother through the placenta. The possibilities of intrauterine treatment are very limited, but if we know what disease we are dealing with, then a lot. There are heart defects, the so-called Criticals that require treatment right after birth. Recognizing them during post-ultrasound examination enables the patient to be referred to a hospital, where the child is taken into the care of a cardiologist immediately after delivery. Early diagnosis makes it possible to choose the method of delivery; in some situations a caesarean section is indicated. Sometimes you don't wait for the 40th week of pregnancy, but decide on early delivery and treatment of the newborn.
- Information that a child is not developing properly is probably a shock to a woman?
This is obviously a very difficult situation, but at the same time an early diagnosis allows parents to get used to the facts. They know what awaits them, they can mentally prepare for it, especially when the defect is minor, such as the more and more frequently detected cleft palate and lip. After the first shock, parents usually focus on helping the child, they planhis treatment. If such news falls on dad and mom at the time of birth, the stress is much greater.
- How do I find a good pregnancy ultrasound specialist?
It is worth asking the gynecologist in charge of the pregnancy to recommend someone. The doctor performing the ultrasound should have a certificate of the ultrasound section of the Polish Gynecological Society, which proves that he has participated in several ultrasound trainings. This is the minimum of competences and permissions.
- Is the quality of the ultrasound machine during pregnancy important?
In my opinion, the most important thing is the doctor's knowledge and experience. You can have weaker equipment and correctly evaluate the image obtained. Usually, the doctor and the patient view a 2D image on the screen, which is hardly readable for the mother. The most modern cameras allow you to obtain a three-dimensional 3D image, as well as 4D - three-dimensional in motion, which gives the impression that there is a camera in the mother's belly. The photos are clear and realistic, you can see the baby's face, hands, watch it move - you can see it with a slight delay. However, 3D and 4D USG really only serve the patient; diagnostically, except in special situations, they are of little importance. Classic 2D equipment is usually sufficient for the doctor. But I am not surprised that patients want to perform ultrasound using the most modern devices - observing your baby before it is born is an amazing experience. Not only mothers are moved, but also dads: the husband of one of the patients fainted from the impression.
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