Ultrasound examination (ultrasound) is considered one of the most widespread diagnostic methods during pregnancy. The appointment of ultrasound in the early stages of gestation (up to 12 weeks) helps to determine the exact duration of pregnancy and the time of onset of labor.
However, the main purpose of diagnostics is routine ultrasound during pregnancy - this is necessary not to determine the timing, but for the purpose of early diagnosis of potential problems in the development of the fetus, as well as to assess the state of the internal organs of a pregnant woman.
Ultrasound diagnostics has a number of special advantages, it is used to:
- Obtaining the clearest and most reliable information about the size, shape and position of the pelvic organs of each particular woman, and also gives an idea of \u200b\u200bthe intrauterine development of the fetus;
- This study is considered very convenient, public, painless and does not require any additional preparation;
- Ultrasound is considered practically harmless to living tissues and organs.
This kind of research is carried out in real time, this makes it possible to independently control the scanning process and get an instant result, since it does not need to process materials.
Due to all the advantages described above, ultrasound is a widely used method of diagnosing and monitoring pregnancy. In addition, today, ultrasound diagnostics is considered the only method of traditional medicine that allows you to objectively monitor the development of the embryo, starting from the earliest stages of its development.
Information about the ultrasound procedure
During the diagnosis, a special ultrasound apparatus is installed on the skin of the abdomen of a pregnant woman, at the location of the organs under investigation, which converts the data into an image. It simultaneously receives and transmits a stream of sound waves with a high frequency (from 2 to 10 megahertz), which are not perceived by the human hearing organs.
Sound waves pass through the body and, as it were, are reflected from the organs. At this time, the ultrasound scanner receives them, and with the help of a computer, the image can be observed on the screen for the purpose of detailed study.
There is also a transvaginal examination method, it takes place when the scanner probe must be inserted directly into the vagina. The method of transvaginal ultrasound diagnostics is also considered absolutely painless.
Is ultrasound harmful during pregnancy?
Today, ultrasound diagnostics is one of the safest methods for research, both in general medical and obstetric practice. However, this method is a relatively young method of diagnosing and monitoring pregnancy (widely used for about 40 years). The information on the negative effects of this method on the fetus is not yet fully understood, since a long-term statistical base of observations has not yet been established.
Ultrasonic waves can strongly affect the liquid medium of the body, causing oscillatory phenomena in it - the effect of cavitation (the formation of cavities and their sharp decline). That is why, in theory, it can have an adverse effect on fluid-rich tissues - in particular, the brain of the unborn child, which can cause some pathologies after the birth of the child.
In this regard, it is better not to expose the unborn child to unnecessary risk, that is, not to use ultrasound more than necessary. Qualified specialists recommend three routine ultrasound examinations during the normal course of pregnancy (9 months). The appointment of additional studies takes place only in cases of any suspicions of a specialist regarding complications during gestation.
Information about the timing of ultrasound during pregnancy
It is customary to distinguish between "screening" periods: - approximately 10-14, 20-24 and 30-34 weeks, they are considered the most informative for the diagnosis of fetal pathologies and are made to all pregnant women without exception. If we talk about the mandatory timing of ultrasound diagnostics during pregnancy, they are described in the order of the Ministry of Health of the Russian Federation "On improving prenatal diagnostics in the prevention of congenital and hereditary diseases in children."
Ultrasound of early diagnosis during pregnancy
Such a study means an optional diagnosis at a period of 5-8 weeks. It is prescribed in order to confirm the fact of pregnancy and in order to determine the place of implantation of the ovum, the result of an early study allows you to give a medical opinion on the fact of the viability of the embryo.
The first planned ultrasound scan during pregnancy
Such a study means diagnostics at a period of 11-13 weeks.
The task of the first planned ultrasound scan is to identify the main fetal malformations: checking the presence of visible organs, determining multiple pregnancy, identifying genetic pathologies of the fetus. At this time, the predicted time of delivery is quite accurately determined (the error is not more than 3 days).
The second planned ultrasound during pregnancy
Such a study means diagnostics at a period of 20-22 weeks. This study is considered the most basic and mandatory, since it provides a large amount of information about the development of the fetus and the course of pregnancy. At this time, the most detailed examination of the fetus is carried out, it allows you to identify possible deviations in the anatomical structure, gives information about the formation and development of the main systems and organs of the unborn child. It was at this time that an ultrasound scan can determine the exact sex of the child.
Third planned ultrasound scan during pregnancy
This term means diagnostics for a period of 30-32 weeks (up to 35 weeks if medically indicated).
At this time, the amount of amniotic fluid, the maturity of the placenta, weight, presentation of the fetus and its motor activity are determined. In cases of any complications during pregnancy, a Doppler study (Doppler) can be added to the ultrasound examination. This procedure helps to assess the intensity of fetoplacental and uteroplacental blood flow.
An ultrasound scan immediately before the onset of labor
Such research is optional. It is carried out in order to determine the condition of the child, his weight and position. The time of the prenatal examination is selected individually for each woman by a leading specialist.
So, in this article, two optional and three planned ultrasounds during pregnancy were considered. However, additional studies may be recommended as directed by a qualified pregnancy supervisor. If a pregnant woman has suspicions of a pathology, ultrasound can be performed quite often in order to track the dynamics of the development of a particular disease.
At what time is ultrasound done during pregnancy? What is the purpose of the research? After all, it is so important to know that nothing threatens the child, and its formation occurs without pathologies, therefore, ultrasound is used without fail and not rarely according to indications.
When to do an ultrasound during pregnancy
The importance of ultrasound for assessing the condition of the fetus and the internal organs of the mother is invaluable. The diagnostic method is safe and painless for a pregnant woman. The principle of operation of the device is based on the use of ultrasonic waves, which are transmitted through the sensor, are reflected from tissues of different density, thus, an image of internal organs appears on the screen.Mandatory ultrasound examinations are supposed to be carried out at various times. The doctor prescribes the first examination at 11-13 weeks, the next at 20-24 weeks and the last at 31-34 weeks. It is better to adhere to precisely these terms, but situations often arise when an ultrasound scan during pregnancy is required unscheduled, with suspicion of any pathology.
If it becomes necessary to conduct a study earlier than the second trimester, to confirm pregnancy or in case of unsatisfactory tests, then a vaginal ultrasound is used. This method implies an examination with the introduction of a sensor into the vagina, the method is quite safe and as informative as possible. Already from 3 weeks after conception, you can see the ovum, which is attached in the uterine cavity, and from 5-6 weeks, an ultrasound of the fetal heart is performed, which begins to beat.
The ultrasound schedule always depends on the condition of the pregnant woman. Basically, with a normal course, these are three examinations for the entire 9-month period, but if a diagnosis of diseases is required that cannot be confirmed only by tests, then ultrasound is additionally used.
Diagnostics allows you to determine the state and size of the embryo, the functionality of the placenta, assesses the risks of congenital malformations, in the last months, ultrasound helps to reliably find out the location of the fetus inside the womb, which becomes important during the onset of labor.
Ultrasound - 1 trimester of pregnancy
A primary ultrasound scan is always scheduled between 11 and 14 weeks of gestation. In some situations, you can do 1 ultrasound earlier than this period, the situation is associated with any abnormalities during gestation. Early ultrasound is often required:- if you suspect an ectopic or frozen pregnancy;
- in case of a history of miscarriages;
- poor health and the occurrence of bloody discharge;
- after conception with IVF.
In addition, the decoding implies an assessment of the child's development and the compliance of the parameters with the accepted norms. The anatomical structure is studied, all necessary measurements are taken, including CTE (coccygeal-parietal size).
With the help of ultrasound, the mother's internal organs are examined, an ultrasound of the kidneys and liver is performed to assess their condition, since as the fetus grows, the load on these organs increases significantly.
Ultrasound - 2nd trimester of pregnancy
The timing of ultrasound of pregnancy in the 2nd trimester corresponds to 20-24 weeks of gestation. At this stage, they watch and track:- growth and weight gain of the fetus in dynamics compared with the indicators of the first study;
- intrauterine defects are more accurately determined;
- the amount of amniotic fluid is diagnosed;
- the placental membrane is evaluated.
During the deciphering of the study, specialists assess the blood circulation between the mother, the placenta and the fetus, conduct a study of the placenta according to the degree of maturity, its structure and location, since normal intrauterine formation depends on these parameters. Often, the thickening of the placental membrane is associated with infectious and pathological processes in the body or with the presence of diabetes mellitus.
Ultrasound 3 trimester
Ultrasound in the third trimester is done for a period of 31 to 34 weeks of gestation, in order to exclude the presence of pathological processes or to be prepared for complications as labor develops. On ultrasound, they look at the size of the fetus, the location in relation to the cervix, and a more accurate delivery time is calculated.Basically, the decoding of the 3rd trimester of pregnancy is associated with the functional features of the placental membrane. The location of the placenta and the degree of maturity are being studied, since not only the choice of the method of childbirth, but also the further development of the baby depends on these parameters. The last ultrasound helps to assess the formation of the baby's internal organs, how ready he is for independent life. If hypoxia or malnutrition is detected, drug therapy is prescribed, and doctors are preparing to provide emergency assistance immediately after his birth.
Nowadays, most women know that doctors send all pregnant women for ultrasound diagnostics. Regardless of the presence of complaints and pathologies, each expectant mother undergoes this study three times during the period of gestation.
It is difficult to overestimate the first ultrasound scan during pregnancy. How long does this procedure take? Why is it needed? We will discuss these and other questions of patients in this article.
Take, for example, the most prosperous situation: a young healthy girl learns about the desired pregnancy and her condition does not cause concern for doctors. If the pregnant woman does not make any complaints, the leading obstetrician-gynecologist is still legally obliged to send the expectant mother for an ultrasound scan three times per pregnancy.
The following terms of perinatal screenings, including ultrasound examination, appear in the regulations.
The first screening is performed at 10-14 weeks (it must be carried out in a clearly defined time frame, otherwise the study is uninformative), it includes not only ultrasound, but also a biochemical blood test of the expectant mother for markers of fetal pathologies.
The second compulsory study is carried out in less fixed terms, but the recommended period is 20-24 weeks of gestation. And last but not least, the doctor prescribes a mandatory study from 30 to 34 weeks from the day of the last menstruation.
Earliest possible date
How long is pregnancy visible on ultrasound? Some expectant mothers are concerned about this issue even before the onset of a delay in menstruation. This is important when a pregnancy is planned and long-awaited, or if a woman has a history of unsuccessful pregnancies (missed pregnancies and miscarriages).
Today, the equipment allows the sonologist to see and confirm the presence of pregnancy at a very early period - approximately in the fifth week from the day of the last menstruation.
During this period, an ultrasound scan can and should be done in case of unsuccessful attempts to get pregnant, the presence of obstetric and gynecological pathology, or when a woman has complaints.
Yes, at this time, ultrasound will show pregnancy. But do not expect miracles from the ultrasound examination in the early stages! Based on the results of an ultrasound scan, the doctor will certainly say: is the pregnancy developing well, is there an embryo in the uterus, are the heart contractions of the embryo visible and whether their frequency is normal.
According to the results of the conclusion, drugs may be prescribed to preserve the pregnancy or a special regimen for the expectant mother. However, sex determination and other important characteristics of the embryo must be postponed for several months.
Decoding of the table: BRGP (BPR) - biparietal head size, DGrC - chest diameter, DB - thigh length. Weight is calculated in grams, height - in centimeters, and BRGP, DB and DGrK in millimeters.
First ultrasound screening of pregnancy
How long is the ultrasound scan performed for all expectant mothers - many pregnant women are interested in this question. The first "meeting" with a baby is always long-awaited and exciting.
So, if 10 weeks have passed since the last menstruation, the leading woman's doctor recommends doing the so-called first perinatal screening. It includes ultrasound, which all expectant mothers are waiting for, and a number of laboratory tests.
During an ultrasound of the uterus and fetus at the end of the first trimester of pregnancy, the doctor sees and assesses:
- correspondence of the size of the embryo and the gestational age (the gestational age determined by ultrasound up to 12 full weeks is considered the most accurate)
- estimated due date
- major pathologies and deformities of the fetus, leading to its death or serious illnesses in the future. These include anomaly in the development of the neural tube, anencephaly, Down syndrome and others.
Since the most serious fetal malformations are detected early, the first screening should not be postponed for the following reasons:
- if the recommended time interval is not followed, the ultrasound results may be inaccurate.
- if an abortion is medically necessary, the woman will have more time to decide.
At 10-14 weeks in the pictures you can see the child for the first time, the structure of his body, and also determine the presence or absence of developmental defects
Second ultrasound
So, at what time is the ultrasound done during pregnancy for the second time?
At about 20-24 weeks of pregnancy, it is customary to conduct a second ultrasound scan.
Whatever the pregnancy, the doctor definitely recommends to undergo this diagnosis, because at this time, ultrasound will show:
- compliance of the fetus with the term and proportionality of its body parts
- anomalies in the development of internal organs, which may require correction and special management of pregnancy and childbirth
- baby gender
- which method of delivery is best for this woman and her baby
- the degree of maturity of the placenta,
- the nature of blood flow in the mother-fetus system
- the presence of high and low water
- condition of the uterus and appendages of a woman
In the interval from 20 to 24 weeks, you can determine the sex of the child and assess in more detail the state of his internal organs
Third study
It is also useful for expectant mothers to know at what time an ultrasound is done 3 times during pregnancy. The third trimester of pregnancy often becomes a big challenge for the expectant mother. But, despite all the difficulties, a quick meeting with the baby inspires awe and hope in women.
Ultrasound examination at this time is aimed not so much at the child as at assessing the condition of the pregnant woman, the degree of her body's readiness for childbirth and at looking for complications.
A timely screening of the third trimester will help the expectant mother not only calm down and tune in to childbirth, but can also prevent the development of premature birth and other late pregnancy complications.
At what stage of pregnancy this study is performed, the doctor decides. It is usually held from the 30th to the 34th week.
Here are just some of the indicators that are assessed during an ultrasound scan at this time:
- size and development of the fetus, its approximate weight,
- the exact sex of the fetus,
- the nature of the fetal heart rate and signs of its hypoxia,
- position and presentation of the fetus,
- the presence of an umbilical cord entanglement,
- the presence of low water and polyhydramnios,
- the nature of placental blood flow and the degree of maturity of the placenta,
- readiness of the cervix for childbirth,
- the final choice of the method of delivery and more.
For a period of 30 to 34 weeks, the research process helps to determine the state of the placenta and the location of the fetus in the uterus, and also allows you to determine whether the fetus has been entwined with the umbilical cord
Conclusion
Today, ultrasound diagnostics is the method of choice for assessing the condition of the fetus and the expectant mother. Patients and doctors appreciated the simplicity, safety and availability of the ultrasound method, and now such a study is performed everywhere and is recommended even for absolutely healthy women.
Every expectant mother is worried about the result of an ultrasound scan during pregnancy, no matter at what stages she is. Sonography can reveal a really wide range of important details about the fetus.
At what time does the ultrasound show pregnancy, when it is possible to determine the sex of the fetus by ultrasound, what indicators are assessed at the first, second and third perinatal screening - you will find the answers to these and many other questions in this article.
Echograms during gestation (image gallery)
The first ultrasound examination during pregnancy is always an exciting and important event in the life of an expectant mother. This is the first "meeting" of a woman with her child, who is still very small.
This examination is expected with a special feeling - impatience mixed with anxiety. How and when the first ultrasound scan is performed for women in an "interesting position", as well as what parameters are considered the norm, we will tell in this article.
Dates
The first scheduled ultrasound scan, which is recommended for all expectant mothers, is performed for a period of up to 13 weeks inclusive. This is an important and informative first prenatal screening for doctors and women. However, for many women, this compulsory examination will no longer be the first, since up to 10 weeks, they may have already undergone such a diagnosis.
Theoretically, the first ultrasound can be informative during pregnancy. already in 2.5-3 weeks after the expected day of ovulation. This corresponds to approximately the fifth obstetric week.
At this time, for the first time, there is a technical opportunity to see the fetal egg on the monitor of the ultrasound scanner, which will indicate the onset of pregnancy. But before 10-11 weeks, ultrasound diagnostics is not officially recommended without good evidence.
Why is a routine ultrasound performed?
The purpose of a planned study within a specified time frame is to identify the so-called markers of possible fetal pathologies. Until 10-13 weeks by obstetric calculus (this is approximately -15 weeks from conception), these markers cannot be evaluated.
The timing of the first prenatal screening was not chosen by chance, because in case anomalies are found, a woman will be able to have an abortion for medical reasons, without waiting for the deadlines to get big.
There are always more complications after long term abortion.
It is also no coincidence that the first ultrasound scan takes place on the same day with the delivery of a venous blood sample for biochemical examination. Ultrasound results are not evaluated separately from blood counts. If markers are found both hormonal and protein balance in the blood are disturbed in a certain way, the risk of having a child with chromosomal abnormalities is higher.
A planned examination within the time frame established by the Ministry of Health is aimed at finding women who are at risk for the likelihood of giving birth to babies with severe total lesions caused by genetic "failure".
A person has 23 pairs of chromosomes. They are all the same, except for the last pair, in which boys have XY and girls have XX. An extra chromosome or a lack of one in one of the 23 pairs causes irreversible pathologies.
So, if the number of chromosomes in 21 pairs is violated, the child is diagnosed with Down syndrome, and if there is an incorrect number of chromosomes in 13 pairs, Patau syndrome develops.
It cannot be said that the first screening in general and ultrasound examination in its framework in particular are capable of revealing all possible variants of genetic disorders, but the most rude ones, for the most part, can be detected precisely at the first planned examination with subsequent additional diagnostics. Such pathologies include: Down, Edwards, Patau, Turner, Cornelia de Lange, Smith-Lemli-Opitz syndromes, as well as signs of non-molar triplodia.
Gross defects of the neural tube, such as a decrease or complete absence of the brain, anomalies in the development of the spinal cord, can be detected only at the second antenatal screening, which takes place according to the plan only in the second trimester of pregnancy.
Going to the first scheduled ultrasound scan, a woman should understand that no one will diagnose her baby only on the basis of the ultrasound scanner seen on the monitor.
If the diagnostician has suspicions of pathology and developmental anomalies, he will definitely indicate this in the conclusion, and the woman will be sent for a consultation with a geneticist, who will decide on the need for more accurate diagnostic methods than ultrasound - invasive, during which doctors take particles of fetal tissue , blood from the umbilical cord, amniotic fluid for genetic analysis. The accuracy of invasive methods is almost 99%.
An excellent analogue is the non-invasive analysis of fetal DNA, which is absolutely safe for both the mother and the baby, since the pregnant woman only needs to donate venous blood to carry it out.
Among other tasks of the first screening ultrasound is to clarify the gestational age according to the size of the baby, to determine the state of female reproductive health, and to assess possible risks in the upcoming birth in six months.
Unscheduled research - what is it for?
Today, ultrasound examination is more than affordable, and therefore a woman can go on it without the knowledge of the doctor and his direction. Many do so, and after a home test shows two strips, they go to the nearest clinic to confirm the fact of pregnancy with such a scan.
However, in addition to the woman's desire to know for sure whether conception has taken place, there may be medical indications for the first ultrasound scan ahead of schedule. It happens that before screening a woman has time to do several such examinations.
Medical indications for which the study can be recommended previously established according to the recommendations of the Ministry of Health, the timing is diverse:
- Miscarriage of pregnancy.If a woman previously had two or more miscarriages at the very early stages of gestation, the first ultrasound scan is recommended when registering with an antenatal clinic to make sure that this time the fetus is developing.
- History of pregnancy stillness... If, before the current pregnancy, a woman had cases of non-developing pregnancy, anembryony (absence of an embryo in the ovum), then an early ultrasound scan is strongly recommended to find out if there is a relapse.
- History of ectopic pregnancyor suspected ectopic pregnancy. In this case, the task of early examination is to identify possible ectopic anchorage of the ovum as early as possible, while it does not pose a serious threat to the woman's life. Suspicion arises if the level of hCG in the woman's blood is significantly lower than the prescribed level, if there is pain, discharge that does not look like menstrual, delayed menstruation, while the uterus is not enlarged.
- History of trauma and surgery on the uterus.If, before the onset of pregnancy, the woman underwent surgical interventions affecting the main female reproductive organ, then the task of the first ultrasound at the earliest possible date will be to assess the place of attachment of the ovum. The further from the postoperative scars the baby is fixed, the more favorable the prognosis for normal gestation and childbirth.
- Suspected multiple pregnancy.In this case, an ultrasound study before the screening time is necessary to confirm the very fact of bearing two or more babies. The doctor can guess about this by exceeding the level of hCG in the blood of a pregnant woman by two or more times.
- Chronic diseases tumors, fibroids. Existing pathologies of the reproductive system can affect not only the ability to conceive a child, but also the ability to carry him out. Therefore, women with such ailments are shown an early examination for an ultrasound scan in order to assess the place of implantation and the growth rate of the ovum.
- Interruption threat. In the very early stages, there may also be a threat of miscarriage. Usually it is manifested by smearing discharge from the genitals, pulling (as with menstruation or a little stronger) pain in the lower abdomen and in the lumbar region, deterioration of the general condition of the woman. With such symptoms, an ultrasound scan is recommended with the mark "cito", which means "urgently, urgently."
- Questionable test results. For a variety of reasons, there may be "disagreements" between the test strips, a blood test to determine the hCG hormone characteristic of pregnancy and the results of a "manual" gynecological examination. If the disagreements are such that the obstetrician-gynecologist cannot say with certainty whether a woman is pregnant at all, he will definitely refer her for an ultrasound scan.
First diagnosis after IVF
If for some reason a couple cannot conceive a baby on their own, doctors can do it for them. The entire process of in vitro fertilization, from preparation for it, and ending with embryo replanting - "three days" or "five days", is controlled by means of ultrasound diagnostics.
After embryo transfer, the woman is assigned hormone therapyso that babies have more chances to gain a foothold and start growing in the uterus.
At this stage, the task of diagnosis is to make sure that the pregnancy has taken place, and the efforts of the doctors and spouses are crowned with success.
If ultrasound diagnostics shows the presence of a fetal egg (or several fetal eggs) in the uterus, then the next ultrasound examination is scheduled after another two weeks to make sure that the embryos are growing and developing. Then the woman is assigned, like all other pregnant women, a scheduled screening examination at 10-13 weeks of gestation.
What can be seen on the first ultrasound?
The expectant mother, no matter how long she goes to the ultrasound office, is interested in what can be seen at one time or another. Modern types of ultrasound diagnostics significantly expand the prospects, especially for such innovative types as 3D and 4D ultrasound, as well as 5D ultrasound, which make it possible to obtain not two-dimensional, but three-dimensional and even color images in real time.
However, one should not think that the very next day after the start of the delay on any, even the most modern apparatus, you can see at least something. The earliest period at which it is possible (again, only theoretically) to consider a fertilized egg is considered 5 obstetric week (this is three weeks after ovulation or a week after the start of the delay).
There is no need to do an expensive "volumetric" three-dimensional ultrasound at such a short time, because you can see only the point, which is the fertilized egg. Going to the first ultrasound, a woman should know what exactly she can be shown.
At 5-9 weeks
An early ultrasound scan, with or without indications, at the will of the expectant mother, will not be able to please a woman with impressive pictures and memorable pictures. At the earliest stages, only a rounded formation in the uterine cavity with a barely distinguishable inner nucleus - the embryo - is determined. In reality, there will not be such a beautiful detailed picture of a small embryo, as they are depicted using computer graphics.
Most women cannot really even consider the fertilized egg itself, especially if the diagnosis is not accompanied by detailed comments from the doctor. But there is also one nice nuance - at five obstetric weeks, a tiny baby begins to pound a small heart, or rather, there is a characteristic pulsation where the chest will soon form.
If the apparatus on which the examination is carried out has a sufficiently good resolution and a modern sensor, then the mother will be able to see how this happens. The main characteristic of the development of the baby at the initial stage is the size of the ovum. This is what the doctor will measure if a woman comes for a scan at 5-9 weeks of pregnancy.
CTE
The coccyx-parietal size allows you to judge the growth rate of the child from about 7-8 weeks of pregnancy. This dimension is laid by the diagnostician from the highest point of the head (crown) to the lowest point - coccyx at maximum extension of the embryo.
Height is measured from head to foot. On an ultrasound scan, this size is considered an important indicator, especially if an early study is done prior to a planned one. According to the CTE, they not only determine how the baby is growing, whether he feels well, but also the gestational age in order to clarify the expected date of birth.
At a later date, when the woman enters the second trimester, the CTE is no longer determined, since the baby becomes large enough to measure it from the head to the coccyx as a whole.
KTR is a size that causes serious worries for expectant mothers. His hesitation causes a storm of emotions.
In fact, you shouldn't look in tables for matches up to the millimeter. Not always slight deviations up or down may indicate anomalies, and not always deviations for 1-2 weeks have pathological reasons.
A decrease in CTE may be caused by the fact that the woman had late ovulation or the baby was "delayed" on the way to the uterine cavity after conception, that is, implantation occurred later than the woman thinks.
Among the possible adverse consequences of a decrease in CTE are infections, including intrauterine ones, as well as gross genetic pathologies that prevent the crumbs from developing at the physical level at a pace set by nature.
An increase in CTE can also indicate inaccuracies in determining the gestational age, that is, early ovulation, as well as a tendency towards a large fetus.
CTE norm table (average)
TVP
This is the first indicator of possible chromosomal abnormalities. The thickness of the collar space is measured by the segment that is laid from the inner surface of the skin to the border of the dark anechoic area on the back of the baby's neck.
Some gross developmental anomalies associated with errors in the genetic code cause general edema in the child, but it can be determined during this period only by one study area - the collar space. After 13 weeks of pregnancy, this indicator is not measured, it is no longer considered diagnostically important.
About this size, expectant mothers undergoing the first prenatal screening worry the most.
You should not panic, because this size, like all the others determined on ultrasound scanning, does not speak with an accuracy of 100% about the presence of pathology. A slight deviation from the norms does not always indicate the presence of a disease.
Statistics show that disappointing diagnoses in children with increased TVP are confirmed only in 10% of cases. Among sick babies, TVP above 3.0 mm was found only in a few, usually true malformations correspond to an excess of 3-8 mm from the norm.
TVP table (average)
Length of the bones of the nose
As in the case of the thickness of the collar space, the bones of the nose can also indicate the likelihood of pathology of chromosomal origin. In children with Down's syndrome, for example, the nasal bones may not be detected at all, and in babies with Patau's syndrome, the nasal bone may be severely shortened. But again, as with TVP, it all depends not only on the state of health of the baby.
Very often, doctors do not see the nasal bone due to the fact that the ultrasound machine in the consultation is outdated ten years ago. Sometimes the reason for the detection of an alarming marker is the lack of experience of the diagnostician. If the result of the examination of this marker is disappointing, then the woman is assigned a control ultrasound on an expert-class apparatus and a consultation with a medical geneticist.
Table of norms for the length of the nasal bone (average)
Technique
Many women are interested in how the first ultrasound examination is performed. Most often, doctors use a vaginal probe for examination, which is inserted into the vagina in a condom. It is possible to examine the uterine cavity with this method through the vaginal wall. It is quite subtle and the visualization is good. therefore intravaginal ultrasound is considered one of the most accurate.
It is theoretically possible during pregnancy in the first trimester to examine a woman transabdominally - with an external sensor, which is applied to the anterior abdominal wall, however, at a short time, a subcutaneous fat layer, which even fairly tiny girls have on the stomach, can interfere with a tiny embryo.
The examination is carried out on a couch on which the woman is asked to sit in a supine position with legs bent at the knees. Also, the doctor can examine the vaginal probe on the gynecological chair.
If a woman comes to an appointment at the ultrasound office before the scheduled screening, which happens when an examination is prescribed for possible complications of pregnancy, the doctor will scan exclusively with a vaginal sensor, since it allows a detailed study of the condition of the cervix and cervical canal, which is very important in suspicion of a threat of miscarriage, an ectopic pregnancy, an undeveloped pregnancy.
How to prepare for the examination?
Early ultrasound results can be affected by an insufficient amount of fluid through which the ultrasound waves pass better. That is why, before going to the doctor, the expectant mother it is recommended to drink about half a liter of water, thereby filling your bladder.
In the later stages of pregnancy, there will be enough amniotic fluid in the uterine cavity, which will serve as an ideal environment for conducting ultrasound waves.
While the embryo is very tiny, any factor can distort the real picture of what is happening. So, the intestines overflowing with feces, the intestines, the loops of which are swollen from gas, can squeeze the pelvic organs of a woman.
In order to better prepare for the first ultrasound scan, the expectant mother is advised not to eat foods that can cause fermentation and the formation of intestinal gases two to three days before visiting the diagnostic room.
It is better to exclude peas, white cabbage, baked goods, rye bread, sweets, carbonated drinks from the diet. On the day of the examination, the intestines should be emptied, and 2-3 hours before the ultrasound, take a drug that "collapses" the intestinal gas bubbles, preventing bloating. Such funds allowed for pregnant women include Espumisan or "Simethicone".
With you for the first ultrasound, you need to take an exchange card, if it is already wound up, a passport, a policy of compulsory medical insurance, a clean diaper that can be placed on a couch or a gynecological chair, as well as removable shoes. There is no need to starve, go for an ultrasound scan on an empty stomach.
Error probability
Errors of doctors of ultrasound diagnostics are a subject of wide discussion among expectant mothers. Indeed, ultrasound scanning is not considered a highly accurate method. Its accuracy is estimated at only 75-90%. Much in the veracity of the results depends on the quality of the apparatus, the qualifications of the doctor and the timeliness of the examination.
If a woman asks the doctor for an answer to the question of what gender is her child at 11-12 weeks of pregnancy, then the accuracy of such a "prediction" will not be higher than 70%, however after 18 weeks, the accuracy in determining gender will approach 90%.
The same pattern is observed with the confirmation of the pregnancy itself. If a woman came to do an ultrasound scan too early, then the doctor may not see anything and write in the conclusion that there were no signs of pregnancy.
If you resolve issues as they become available, within the recommended time frame, ultrasound can be considered a fairly accurate and informative way. And in cases where the results of an ultrasound scan cannot be unambiguously interpreted, if there are alarming markers or doubts at the doctor, he will definitely advise more accurate diagnostic methods - amniocentesis, chorionic biopsy, and a little later - cordocentesis.
If you wish, you can do non-invasive analysis of fetal DNA, which is an excellent alternative to invasive tests, and is absolutely safe for the baby.
In addition, in most cases, ultrasound again helps to dispel doubts, but of a different class - expert. Such devices are at the disposal of perinatal centers, medical genetic centers and clinics.
Does ultrasound harm a child?
There is no consensus on this score. Modern medicine has no evidence of the harm of this diagnostic procedure for the developing fetus in the womb. However, there is no evidence of the complete harmlessness of ultrasound. The point is that science cannot study the long-term consequences. No one knows how the effect of ultrasound in the embryonic period affects a person when he turns 30, 40, 50 years old.
It is the lack of information that is fertile food for pseudo-scientific reasoning about the influence of ultrasound waves on human DNA. Existing experience shows that children who were born to women who did not do ultrasound during pregnancy at all, and children who were born to women who underwent such a diagnosis more than 6 times during the gestation period, did not differ in any way in terms of health from each other.
To do an ultrasound or not is a woman's choice. The Ministry of Health only recommends three routine examinations for the entire pregnancy period, but they are not mandatory either. If a woman does not want, then no one will force her.
But before giving up screening or unscheduled ultrasound scanning, a woman should weigh all the risks well, because many pathologies during gestation and childbirth can be avoided if doctors are able to consider alarming symptoms in time.
An interesting and exciting procedure for the expectant mother is an ultrasound scan, which allows you to see the future baby. In the course of ultrasound diagnostics, the doctor evaluates the woman's blood flow, the condition of the fetus, and its development.
When is the first ultrasound done during pregnancy? Routine research is performed three times throughout the gestation period. An ultrasound is done in the first (10-14 weeks), second (18-21 weeks) and third trimesters (32-34 weeks). At what time it is better to undergo the procedure, the woman herself should decide together with the doctor who supervises her.
- pulling pain in the lower abdomen;
- minor bleeding, which may indicate an ectopic pregnancy, increased uterine tone and cervical dilatation;
- poorly developing pregnancy;
- diseases - cyst, endometriosis, fibroids;
- conception occurred when the spiral was installed;
- a woman, when talking with a gynecologist, reported previous miscarriages;
- cases of detection of pathologies in the fetus have occurred earlier.
- The fact of pregnancy.
- The exact position of the ovum.
- The presence of one embryo or several.
- What is the condition of the ovaries and uterus, is there any inflammation.
- How the placenta develops, the amount of amniotic fluid, is there a threat of miscarriage.
- How chronic diseases of the mother affect the baby's health, does he suffer from a lack of oxygen?
- Whether the fetus is getting enough nutrition for normal development.
- 1. Down syndrome.
- 2. Edwards disease.
- A woman should stop smoking tobacco, taking alcohol and any medications;
- For a period of 12 weeks, it's time to get registered with an antenatal clinic;
- On the advice of a doctor, you can undergo the first screening;
- Excessive physical activity is prohibited;
- Stress, intense excitement are excluded;
- It is advisable to wait with intimate relationships, as they can provoke a threat of miscarriage. But in the absence of contraindications and with the permission of the doctor, sex during this period is permissible.
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How many times is an ultrasound scan allowed?
You can do an ultrasound scan several times during pregnancy. Some people manage to undergo the procedure twice or three times during the first three months. Seeing two coveted red stripes on the test, some immediately try to sign up for an ultrasound examination.
But there is no need to rush. What do doctors say about this? When is it better to go for the first ultrasound during pregnancy?
From a medical point of view, the optimal period when you can conduct the first examination is 10 weeks, plus or minus 6 days. You can also do research at an earlier date. It will help determine the presence of a fertilized egg, where it is located - inside the uterus or outside (ectopic), the fetus is developing or not.
When is the procedure needed?
You should not rush into this, even at 10-11 weeks you need to do an ultrasound scan if there are strict indications. If you are feeling well, it is better to wait a little.
At a period of 10-13 weeks, the exact duration of pregnancy, the number of fetuses inside the uterus, abnormalities in the set of chromosomes, which can cause gross defects in the development of the fetus, are established. Among the pathologies, the absence of bone covering of the skull, cerebral hemispheres, extremities, soft tissues, and the presence of a heart defect are distinguished.
The first ultrasound scan during pregnancy is an important and crucial moment. Screening ("sifting") is designed to identify the belonging of the fetus to a risk group, to show a tendency to genetic abnormalities and congenital malformations. Detecting deficiencies at an early stage allows you to take any action to correct the situation.
Sometimes the procedure for a pregnant woman is simply necessary, because the doctor insists on carrying it out. It is imperative to do an ultrasound if there are the following indications:
Features of ultrasound examination
The specialist looks at how the pregnancy proceeds, whether it is single or multiple, and measures the size of the collar space - the amount of fluid accumulated under the skin near the fetus's neck. If the norm is exceeded, then this is indirect evidence of anatomical anomalies.
For a more accurate diagnosis, a biochemical blood test is performed for the content of certain types of proteins in the placenta (hCG and PAPP-A). Each clinic uses its own standards and reagents for analyzes, so it is impossible to specify specific values. In addition, the protein content changes at different stages of pregnancy.
The results obtained during the examination are tested using the PRISCA prenatal screening computer program.
Additional procedures
Based on numerous observations of pregnant women in different countries, scientists are convinced that the birth of a baby with genetic diseases is directly related to the biological characteristics of the mother's body. Therefore, the degree of risk of genetic changes is calculated taking into account the characteristics of a particular woman - weight, age data, the presence of hereditary and acquired chronic diseases. If the likelihood of developing a pathology is high, then amniocentesis or biopsy is additionally prescribed. They help to confirm or deny the preliminary diagnosis.
During amniocentesis, a puncture (puncture in the fetal membrane) is done in order to obtain amniotic fluid for examination in the laboratory. Chorionic villus sampling is a procedure in which a piece of tissue from the outer shell (chorion) of the embryo that forms the placenta is taken through the cervical canal or the abdominal wall with a special instrument. This is considered dangerous, as it is fraught with bleeding and then miscarriage.
The principle of the device
A hardware sensor emits high-frequency sound waves into the amniotic fluid. Oscillations spread in ripples, spreading throughout the interior of the shell of the fetus. The body of the embryo has a denser structure than water, therefore it reflects part of the waves that collide with it. The wave, like a balloon, bounces off the fetus and, having changed the direction of movement, returns back to the sensor. Another part of the waves, bending around the baby, reaches the placenta, umbilical cord, are reflected from them and are also sent to the signal receiver.
The sensor receives the received vibrations, quickly processes them and displays a 2D image on the screen. After examining it, the doctor assesses the condition of the baby.
Modern ultrasound machines can display three-dimensional moving pictures in 3D and 4D formats on the monitor, but they are already interesting only for parents - they help to examine the embryo in the smallest detail. Doctors, on the other hand, observe how the umbilical cord is located, how tightly it has wrapped around the baby's body, whether the limbs and facial features develop normally.
Is ultrasound dangerous for the embryo?
Sound waves cannot harm an adult. They are identical to those that are formed during conversation or singing. They differ only in frequency and length. But for a baby 3-5 cm in size, such fluctuations are very sensitive. They make his tiny body shake, scare. It was noted that during the procedure, babies begin to actively move and turn away from disturbing waves.
At later stages of development (15-16 weeks), when active growth begins, the formation of organs, any insignificant influence can disrupt this process, provoke the appearance of congenital malformations. Extreme caution is required in the first trimester. By 4-5 months, when the fetus grows up, it will no longer be afraid of ultrasounds.
Advantages and disadvantages
Research types
The procedure is carried out in two ways, depending on which sensor is used - external (abdominal) or internal (transvaginal).
When using an external sensor, its wide working surface is pressed against the abdominal skin. The doctor moves it gradually to examine the embryo from all sides. To make the sound waves better pass, a special anti-allergenic gel is applied to the skin. Then it is removed with a napkin. To improve the quality of the image of certain areas, the patient may be asked to turn to one side, to bend the leg.
The internal method is used only during the first trimester. It gives much more information for diagnosis in the early stages of pregnancy, because the sensor is separated from the maternal organs only by the vaginal wall.
How to prepare for the examination?
With the external method, in the first trimester, the procedure is performed with a full bladder. At this time, the uterus is almost at the bottom of the small pelvis and it is difficult to see it, and due to the liquid it rises. Patients are asked to start drinking mineral or sweetened water 1-2 hours before the event. On the eve of dinner, it is not allowed to eat fatty, salty foods, smoked meats, vegetable fiber and other foods that have a diuretic effect on the body. The same properties are typical for birch sap, cranberry juice, lingonberry broth. Black bread, pears, cabbage cause the accumulation of gases, which also interferes with the procedure.
With the internal method, special preparation is not required. On the contrary, the bladder should be empty. A vaginal probe with a miniature head is applied to the uterine wall or vaginal fornix. With its help, the doctor examines the state of the uterus, appendages, embryo.
What does the device show?
When to go to the first ultrasound scan at the antenatal clinic, the young mother decides on her own. But a mandatory examination awaits her after the 11th week of pregnancy. At this time, the baby's head circumference, chest, tummy, legs are already visible. You can calculate the estimated date of birth based on observations, as well as the expectant mother's own calculations about the time of conception.
If the toddler looks younger for a certain period of time, it means that there is a delay in development. The doctor will try to determine the cause, as this will affect the further management of the pregnancy.
The main thing that ultrasound shows:
Can I refuse the procedure?
By law, all pregnant women must have an ultrasound scan. However, the doctor has no right to force a woman to undergo the procedure. This should be her conscious, voluntary decision. Many mothers consider the procedure only unnecessary anxiety for the baby. Excitement and nervous tension of a woman, the action of ultrasonic waves has a bad effect on his condition.
If doctors diagnosed gross defects in the fetus, then the mother has two options - termination of pregnancy or the birth of a disabled child. There are violations incompatible with life. The choice is made by the woman herself together with the doctor. An ultrasound scan can only indicate the upcoming difficulties, so that after the birth of the baby, his shortcomings do not come as a surprise. Different situations happen in life. Often, with positive screening results, children with disabilities are born, and vice versa.
Diagnosis of diseases during the first ultrasound
The first step is to measure the size of the body of the fetus. If the distance from the crown to the tailbone is more than the established norm, then the child will be large. A small body indicates developmental abnormalities - genetic or abnormalities caused by an infection, a lack of hormones in the mother's body, or the presence of diseases in her. In a living embryo, heartbeats are already heard. The absence of toxicosis in a woman during the first trimester and well-being is considered normal. Such mothers, during the ultrasound, are convinced that everything is in order with their baby and there is nothing to worry about.
Another thing is when the heart rhythms are not audible. This means that the embryo died for some reason. The increased thickness of the collar space warns of chromosomal abnormalities. Deviation from the norm is not a sentence, because each child develops individually. An ultrasound examines the presence of a nasal bone in the fetus. Its absence also becomes a warning about a change in the composition of chromosomes.
Common genetic abnormalities in babies
The pathology, named after the physician John Down, is characterized by congenital disorders in the mental and physical development of the child. Diagnosis is based on external signs and chromosomal tests. Children have a narrow eye shape, underdeveloped auricles, flat facial features, shortened arms and legs, a crooked little finger and a slightly open mouth due to decreased muscle tone.
With such children, you will have to do a lot according to an individual program, try to involve them in ordinary life by communicating with loved ones, peers, practicing in sports sections and circles. Downyats can attend school or kindergarten, where they are taught according to an individually drawn up plan.
It occurs most often in girls. The reason is the extra 18th chromosome. Newborns suffer from profound mental retardation, as well as numerous congenital defects of external and internal organs. Babies are not viable, therefore they die during the first year of life. Pregnancy can result in a miscarriage or stillbirth. The disease cannot be prevented, its exact causes are not yet fully understood. For prevention, women should avoid alcohol, contact with cigarette smoke, exposure to radioactive radiation, toxic substances, and certain medications even before conception. The syndrome is rare - 1% of cases. Doctors can detect some of its signs, but you should not worry ahead of time. The diagnosis must be confirmed by genetic testing (today it has 99% accuracy), ultrasound results, blood tests, hormonal levels of the patient.
In order for the baby to be born healthy and the pregnancy to be easy, you must adhere to the following recommendations:
Ultrasound examination of the embryo in the first trimester of pregnancy is an indispensable diagnostic method that helps to understand how early pregnancy develops and to choose the correct method of its management. Screening helps a woman avoid complications during pregnancy and get the necessary medical care on time.
