When do you get a sonogram during pregnancy

Ultrasound during pregnancy | March of Dimes

A prenatal ultrasound uses sound waves and a computer screen to show a picture of your baby inside the womb.

Ultrasounds can help your health care provider see how your baby is growing and developing.

Your provider also may use ultrasounds to see if other tests need to be done to check on your baby’s health.

There are several types of ultrasounds and they are safe for you and your baby when done by a trained health care provider.

What is an ultrasound?

Ultrasound (also called sonogram) is a prenatal test offered to most pregnant women. It uses sound waves to show a picture of your baby in the uterus (womb). Ultrasound helps your health care provider check on your baby’s health and development.

Ultrasound can be a special part of pregnancy—it’s the first time you get to “see” your baby! Depending on when it’s done and your baby’s position, you may be able to see his hands, legs and other body parts. You may be able to tell if your baby’s a boy or a girl, so be sure to tell your provider if you don’t want to know!

Most women get an ultrasound in their second trimester at 18 to 20 weeks of pregnancy. Some also get a first-trimester ultrasound (also called an early ultrasound) before 14 weeks of pregnancy. The number of ultrasounds and timing may be different for women with certain health conditions like as asthma and obesity.

Talk to your provider about when an ultrasound is right for you.

What are some reasons for having an ultrasound?

Your provider uses ultrasound to do several things, including:

To confirm (make sure) you’re pregnant
To check your baby’s age and growth. This helps your provider figure out your due date.
To check your baby’s heartbeat, muscle tone, movement and overall development
To check to see if you’re pregnant with twins, triplets or more (also called multiples)
To check if your baby is in the heads-first position before birth
To examine your ovaries and uterus (womb). Ovaries are where eggs are stored in your body.

Your provider also uses ultrasound for screening and other testing. Screening means seeing if your baby is more likely than others to have a health condition; it doesn’t mean finding out for sure if your baby has the condition. Your provider may use ultrasound:

To screen for birth defects, like spina bifida or heart defects. After an ultrasound, your provider may want to do more tests, called diagnostic tests, to see for sure if your baby has a birth defect. Birth defects are health conditions that a baby has at birth. Birth defects change the shape or function of one or more parts of the body. They can cause problems in overall health, in how the body develops, or in how the body works.
To help with other prenatal tests, like chorionic villus sampling (also called CVS) or amniocentesis (also called amnio). CVS is when cells from the placenta are taken for testing. The placenta is tissue that provides nutrients for your baby. Amnio is a test where amniotic fluid and cells are taken from the sac around your baby.
To check for pregnancy complications, including ectopic pregnancy, molar pregnancy and miscarriage.

Are there different kinds of ultrasound?

Yes. The kind you get depends on what your provider is checking for and how far along you are in pregnancy. All ultrasounds use a tool called a transducer that uses sound waves to create pictures of your baby on a computer. The most common kinds of ultrasound are:

Transabdominal ultrasound. When you hear about ultrasound during pregnancy, it’s most likely this kind. You lay on your back on an exam table, and your provider covers your belly with a thin layer of gel. The gel helps the sound waves move more easily so you get a better picture. Then he moves the transducer across your belly. You may need to drink several glasses of water about 2 hours before the exam to have a full bladder during the test. A full bladder helps sound waves move more easily to get a better picture. Ultrasound is painless, but having a full bladder may be uncomfortable. The ultrasound takes about 20 minutes.
Transvaginal ultrasound. This kind of ultrasound is done through the vagina (birth canal). You lay on your back on an exam table with your feet in stirrups. Your provider moves a thin transducer shaped like a wand into your vagina. You may feel some pressure from the transducer, but it shouldn’t cause pain. Your bladder needs to be empty or just partly full. This kind of ultrasound also takes about 20 minutes.

In special cases, your provider may use these kinds of ultrasound to get more information about your baby:

Doppler ultrasound. This kind of ultrasound is used to check your baby’s blood flow if he’s not growing normally. Your provider uses a transducer to listen to your baby’s heartbeat and to measure the blood flow in the umbilical cord and in some of your baby’s blood vessels. You also may get a Doppler ultrasound if you have Rh disease. This is a blood condition that can cause serious problems for your baby if it’s not treated. Doppler ultrasound usually is used in the last trimester, but it may be done earlier.
3-D ultrasound. A 3-D ultrasound takes thousands of pictures at once. It makes a 3-D image that’s almost as clear as a photograph. Some providers use this kind of ultrasound to make sure your baby’s organs are growing and developing normally. It can also check for abnormalities in a baby’s face. You also may get a 3-D ultrasound to check for problems in the uterus.
4-D ultrasound. This is like a 3-D ultrasound, but it also shows your baby’s movements in a video.

Does ultrasound have any risks?

Ultrasound is safe for you and your baby when done by your health care provider. Because ultrasound uses sound waves instead of radiation, it’s safer than X-rays. Providers have used ultrasound for more than 30 years, and they have not found any dangerous risks.

If your pregnancy is healthy, ultrasound is good at ruling out problems, but it can’t find every problem. It may miss some birth defects. Sometimes, a routine ultrasound may suggest that there is a birth defect when there really isn’t one. While follow-up tests often show that the baby is healthy, false alarms can cause worry for parents.

You may know of some places, like stores in a mall, that aren’t run by doctors or other medical professionals that offer “keepsake” 3-D or 4-D ultrasound pictures or videos for parents. The American College of Obstetricians and Gynecologists (ACOG), the Food and Drug Administration (FDA) and the American Institute of Ultrasound in Medicine (AIUM) do not recommend these non-medical ultrasounds. The people doing them may not have medical training and may give you wrong or even harmful information.

What happens after an ultrasound?

For most women, ultrasound shows that the baby is growing normally. If your ultrasound is normal, just be sure to keep going to your prenatal checkups.

Sometimes, ultrasound may show that you and your baby need special care. For example, if the ultrasound shows your baby has spina bifida, he may be treated in the womb before birth. If the ultrasound shows that your baby is breech (feet-down instead of head-down), your provider may try to flip your baby’s position to head-down, or you may need to have a cesarean section (also called c-section). A c-section is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus.

No matter what an ultrasound shows, talk to your provider about the best care for you and your baby.

Last reviewed: October, 2019

What Every Mom-To-Be Needs to Know

Moms-to-be typically look forward to ultrasounds during pregnancy more than any other prenatal appointment. It’s easy to see why! It’s fun to get a sneak peek of your bundle of joy while your OBGYN looks for specific growth and development markers. Many women look forward to learning their baby’s sex as soon as possible and wait impatiently for their 20-week ultrasound. Others want to be surprised. Whether or not you intend to learn about your baby’s sex ASAP, it’s important to keep all your ultrasound appointments.

An ultrasound, also known as a sonogram, is typically performed by an ultrasound technician or sometimes by an OBGYN. It uses sound waves to create an image of the organs inside your body. (These sound waves are not harmful to you or your baby.) Ultrasounds during pregnancy help doctors diagnose many diseases and conditions, even those not related to pregnancy.

This article will cover why and how ultrasounds are used during your pregnancy, how many ultrasounds to expect while you’re pregnant, and what your OBGYN may be looking for at each ultrasound.

Most pregnant women typically only get two ultrasounds, one at the beginning of pregnancy and one about halfway through. Other women may have three or more ultrasounds done depending on a number of factors.

Your First Ultrasound

Your first ultrasound is called the “dating” or “viability” ultrasound. It’s typically done between 7 and 8 weeks to verify your due date, to look for a fetal heartbeat, and to measure the length of the baby from “crown to rump.” At this ultrasound, you’ll also learn whether you’re having one baby, pregnant with twins, or more! You may even get to see or hear your baby’s heartbeat during this appointment.

If you have irregular periods, or didn’t have a period after coming off birth control, this ultrasound will be especially helpful in determining a more accurate due date. Your due date is important because it helps your doctor know whether your baby’s development is on track each month.

We’ll perform this ultrasound at our Madison Women’s Health clinic.

What to Expect at Your First Ultrasound

When you’re just 7 or 8 weeks pregnant, your fetus is only about two centimeters long. In order to get a close enough view of your uterus and fetus, the dating ultrasound is done transvaginally. This means the ultrasound is done internally, literally “through the vagina. ” A transvaginal ultrasound can be a little uncomfortable, but it is not painful. Most would say it feels less invasive than a gynecological exam that uses a speculum.

To perform this ultrasound, your OBGYN or ultrasound tech will gently insert a narrow ultrasound wand just inside your vagina. The transvaginal ultrasound wand is also called a transducer. It’s about three centimeters around, a little larger than a tampon. It will be covered by a condom and lubricant. The wand will not reach your cervix and is safe for your baby.

You may be asked to arrive at your first ultrasound with a full bladder. Having a fuller bladder helps to put your uterus in a better position for the ultrasound.

What Your Doctor is Looking for at Your First Ultrasound

Viability of pregnancy
Fetal heartbeat
Fetal size
Single or multiple pregnancy

Genetic Screening Ultrasound

If you choose to have prenatal genetic testing done, you’ll have your next ultrasound at 12 to 13 weeks gestation. This ultrasound is also called nuchal translucency screening. It’s offered to everyone and is covered by most insurance plans. This genetic screening ultrasound is optional.

During this ultrasound, your doctor will look for indicators of chromosomal disorders. Chromosomal disorders mean that the baby received an extra chromosome at conception and could have moderate to extreme physical or mental challenges. These disorders include:

Trisomy 21, known as Down Syndrome
Trisomy 13
Trisomy 18

Read more about carrier screening and prenatal genetic testing.

What Your Doctor is Looking for at the Genetic Screening Ultrasound

This ultrasound will be an anatomical scan. Your doctor will look to see if all four limbs are present. They will also look for basic structures in the brain, the stomach, the bladder, the nasal bone, and last but not least, something called nuchal translucency. Nuchal translucency is a fluid sack at the back of the baby’s neck that is filled with lymphatic fluid. There are correlations between the size of that sack of fluid and the likelihood that the fetus could be affected by a major chromosomal disorder.

After the ultrasound has been performed, your OBGYN will interpret the results and share the information with you. You may also meet with a genetic counselor who could recommend having additional tests done to verify the ultrasound results.

Keep in mind that ultrasound screenings for other genetic disorders or anatomic abnormalities become more accurate further into the pregnancy.

We’ll perform this ultrasound at the Madison Women’s Health clinic.

Should you Get a Genetic Screening Ultrasound?

There’s no right or wrong answer to this question. Ultimately, the decision is up to you. Here are some good questions to ask yourself as you decide whether to have the genetic screening:

Is there a family history of these genetic birth disorders?
Would I terminate my pregnancy if there was a risk of Downs Syndrome, Trisomy 13, Trisomy 18, or other genetic disorder?
Would knowing about my pregnancy’s risk of genetic defect make it easier to emotionally or physically prepare for a baby with a birth defect?
Would it be easier for me to cope with and enjoy pregnancy if I focus on the more likely positive outcome rather than the chance of birth defects?

Whether you choose to have genetic screening done at this time is entirely your decision. Some women prefer to have as much information as possible as early as possible, while other women do not. If you’re still uncertain, you can discuss the pros and cons with your OBGYN.

Basic Anatomy Scan Ultrasound

This is the ultrasound that people look forward to the most! The full anatomy ultrasound is typically performed at about 20 weeks, or 5 months. As the name implies, this ultrasound will look at all the baby’s organ systems to make sure they’re present, are a normal size and shape, and are in the right location.

What to Expect at a Full Anatomy Scan Ultrasound

The full anatomy scan is a transabdominal ultrasound. It uses a transducer that looks a lot like a store checkout scanner. The ultrasound technician will put warm ultrasound gel on your stomach and then slide the transducer in the gel around your stomach. The gel helps the sound waves travel through your skin.

Tip: Come to your appointment with a relatively full bladder. This will make it easier for your ultrasound technician to get better images of your baby.

Because there are so many things to look for, this ultrasound will take at least 45 minutes—if your little one cooperates! If you’ve got an extra squirmy baby who is “camera shy,” it could take a few hours to get all the images that we need. Don’t worry, we have a lot of tricks to encourage your baby to change positions—everything from asking you to lay on one side and then the other, emptying your bladder or filling it, maybe even walking around. We’ll do whatever it takes to get the images we need to track your baby’s growth and development.

What Your OBGYN is Looking for at a Full Anatomy Scan

During the full anatomy, 20-week ultrasound, you can find out if your baby is male or female. If you want the sex to be a surprise, be sure to tell your technician know ahead of time so they don’t accidentally let it slip. When the scan is complete, Meriter will even send you a link to view some fun photos of your baby!

Your ultrasound technician will capture a large number images and measurements:

limbs: arms, legs, feet, hands
torso: chest, heart, kidneys, stomach, bladder, diaphragm, genitals
head and face
spine
umbilical cord
amount of amniotic fluid
location, size, and shape of your placenta
length of your cervix

After your ultrasound technician has captured all these images and measurements, your OBGYN will review the pictures and look for abnormalities such as congenital heart defects or cleft lip or palate. They’ll discuss their findings with you and help you understand what you’re looking at in the different images.

If everything looks normal and there are no other issues during your pregnancy, the next time you’ll see your baby is when he or she is in your arms! In the meantime, you can enjoy those 2D or 3D photos of your baby!

This ultrasound will be performed at UnityPoint Health – Meriter Hospital Center for Perinatal Care.

“Extra” Ultrasounds

Sometimes, women need additional ultrasounds during pregnancy. Your OBGYN may ask you to come in for additional ultrasounds to check your:

Cervical length: if your cervix is shorter than expected, you may need to have your cervix checked regularly to be sure it stays closed so that you can maintain your pregnancy. If the cervix continues to shorten or thin, you may need a cerclage to help strengthen it until it’s time to deliver your baby. Cervical length ultrasounds occur at 16, 18, 20 and 22 weeks and are done transvaginally.
Placental location and size: if your placenta is too small, if it is in an abnormal location or if it is an abnormal shape, then we will need to monitor it and the growth of your baby with regular ultrasounds. Your placenta is responsible for passing blood and nutrients to your baby, so it’s important thrat it is growing correctly.

You may need growth ultrasounds if you have:

hypertension
diabetes
high BMI (body mass index) going into pregnancy
preeclampsia
indicators that your placenta or uterus is not growing appropriately

Sometimes, growth ultrasounds are needed to check that your baby’s growth is continuing along the growth curve. They’re done at 28, 32, and 36 weeks. One way doctors estimate whether your baby is growing as expected is by measuring your fundal height. Fundal height is the number of centimeters from your pubic bone to the top of your uterus. This measurement typically increases about 1 cm each week. If your uterus has not grown appropriately in the last month, your OBGYN will surmise that your baby is also not growing and will want to perform monthly growth ultrasounds.

What to Expect at a Growth Ultrasound

These ultrasounds take less time than the full basic anatomy ultrasound because there are fewer measurements required. The ultrasound technician will measure the baby’s head circumference, bi-parietal diameter, abdominal circumference, and femur length.

What Your OBGYN is Looking for at Growth Ultrasounds

Your OBGYN is looking to see if your baby is staying on its growth curve. We will also use the measurements to estimate your baby’s weight. A large or extra large baby isn’t typically concerning. An extra-small baby or a baby who does not grow according to their growth curve could mean that the baby is not getting enough nourishment through the placenta and may need to be delivered early.

2D, 3D, and 4D Ultrasounds

2D ultrasounds are the black and white images that you’re probably used to seeing. To an untrained eye, they can look pretty fuzzy or obscure. However, they give the best definition of the structures of your growing peanut and are considered the “gold standard” of diagnostic imaging.

3D images are especially popular among parents-to-be who want to enjoy those cute baby pictures even before the baby is born! These pictures show facial features and look much more baby-like than the kind of obscure 2D images. 3D ultrasounds have usefulness beyond the cuteness factor, however! In the case of abnormalities of the spine or palate, 3D ultrasounds can help your OBGYN get a better idea of the severity.

4D images are like a 3D image, but show the baby moving around. They’re like getting to see a live action video of your little one. These are less commonly done because they don’t actually help with diagnoses. Depending on which perinatal center you go to, you might receive a link to view your ultrasound images or videos online.

While there are some stand-alone ultrasound centers offering to tell you your baby’s sex early on or to give you keepsake 3D or 4D images, these aren’t necessary and are rarely covered by insurance. You’ll find out everything you need to know during your appointments at the perinatal center — and those appointments will be covered by your insurance.

The best place to have an ultrasound performed is always at a clinic, where you will have access to a physician who has been trained in interpreting the images. At Madison Women’s Health, we’re happy to print off pictures for you to put in your baby’s scrapbook — or anywhere else you’d like to display those “coming soon” photos.

Final Thoughts

Ultrasounds during pregnancy are a fascinating way to get a glimpse of your developing baby. Don’t be afraid to ask your OBGYN for more details about genetic screening as you determine whether that is something you want done. And make sure you’ve set aside a good amount of time for your ultrasounds — especially the all-important full anatomy scan!

—

Dr. Beth Wiedel has been providing healthcare to women in Madison since 2002 and is a founding partner of Madison Women’s Health. She shares the vision of all the partners of being a strong healthcare advocate for her patients, emphasizing compassion and communication throughout her practice.

When to do the first ultrasound during pregnancy - "happy days" for screening of the 1st trimester

The world of a modern woman is always full of important events, meetings and an endless series of pre-planned things. When pregnancy occurs, many planned events can be moved from “expected” to “impossible” or simply postponed indefinitely. It is quite difficult to worry in advance and reschedule an important event at the most appropriate time, because planning events against the backdrop of pregnancy is a very difficult science.

Therefore, when pregnancy occurs, it is advisable to draw up at least an approximate “life plan for 9 months”. For example, it is known that maternity leave is most often preceded by unspent regular leave, and registration for pregnancy is preceded by the fact that a pregnancy has occurred and is developing normally.

Many events will now depend on how the new life develops. So, when a multiple pregnancy is diagnosed, not only the estimated due date will change, but maternity leave will come 14 days earlier, and the beginning of unspent leave will move with it. Therefore, one of the first steps in the event of a desired pregnancy is the passage of an ultrasound examination (ultrasound). Scientific and technological progress is rapidly changing the whole world, including the state of the prenatal ultrasound diagnostic service. Opportunities are changing, and with them the timing of the passage of research, which I would like to dwell on in more detail.

When to do an ultrasound scan during pregnancy

In 2012, the regulation “Decree of the Health Committee of the Government of St. Petersburg No. 39-r”1 came into force in St. Petersburg. Based on the above document, for a full-fledged ultrasound screening, it is desirable to undergo a study in “. .. the first trimester: 11 + 0-13 + 6 weeks; 18+0-20+6 weeks; and 32+0-34+6 weeks of pregnancy.” However, these terms apply only to uncomplicated singleton pregnancies. At the same time, early registration is limited to up to 12 weeks of pregnancy with the ensuing consequences (payment of a lump-sum allowance to women registered in medical institutions in the early stages of pregnancy, clause 2-c of Decree of the Government of the Russian Federation of October 15, 2001 N 727 (as amended on 04.09.2012).

Therefore, at 11 weeks, a pregnant woman can be registered when establishing the fact of a developing pregnancy , for which ultrasound "... in the first trimester" is recommended. Most doctors recommend doing it at terms 7-8 weeks of pregnancy , because it is at this time that the heartbeat of a developing embryo is always determined as a sign of the physiological development of pregnancy.

The next obligatory steps in the ultrasound are screening. The entire pregnancy is divided into three periods (trimesters) and ultrasound plays an important role in each.

What is the diagnostic window for ultrasound during pregnancy

The first screening study is carried out from 11 weeks 0 days of pregnancy to 13 weeks 6 days of pregnancy. These limits are adopted for the timely detection of pathological conditions that determine the prognosis for the health of the fetus. Theoretically, any pregnant woman can apply for an ultrasound both at the beginning of the eleventh and at the end of the thirteenth week - the entire period is screening. However, among doctors who have dedicated their lives to prenatal ultrasound diagnostics, there is an opinion about the most preferable period in each screening period - the so-called " diagnostic window" or "happy days" .

Terms of fetal ultrasound examination

Legally regulated period (order KZ SPb No. 39-r dated 02/01/12)	Optimal timing/happy days
-	7-8
11 weeks 0 days – 13 weeks 6 days	12 weeks 2 days - 12 weeks 4 days
18 weeks 0 days – 20 weeks 6 days	20 weeks 0 days - 20 weeks 6 days
32 weeks 0 days – 34 weeks 6 days	32 weeks 0 days - 33 weeks 3 days

Diagnostic window in the 1st trimester of pregnancy

For the first screening study, these days include the interval from 12 weeks to 12 weeks. 2 days to 12 weeks 4 days . It is in this interval that the fetus has already grown enough to evaluate the smallest organs (eye lenses, heart), and the probability of ascertaining the most important morphological changes is significantly higher than at 11 weeks 0 days. On the other hand, each day lived by the baby increases not only the height and weight of the body, but the quality of the picture on the ultrasound machine.

According to various authors, the frequency of congenital pathology reaches 5%, and for patients in this group it is especially important to identify the problem at an early stage. In such special cases, it may be necessary to expand the range of diagnostic procedures, including prenatal karyotyping (obtaining samples of fetal tissue or amniotic structures in order to determine its karyotype). It takes time to carry out these procedures, from preparing the necessary tests for a pregnant woman, ending with directly invasive diagnostics and obtaining results about the health of the fetus.

In some cases, the established disease of the fetus raises the question of the impossibility of prolonging the pregnancy. According to the current legislation of the Russian Federation, the procedure of medical termination of pregnancy by the decision of the woman can be performed ". .. no later than the end of the twelfth week of pregnancy", but "... not earlier than 48 hours from the moment the woman applied to the medical organization for artificial termination of pregnancy" (clause 3.1, clause 3-b of article 56. Federal Law No. 323 of November 21, 2012)2. In other words, if a patient goes for an ultrasound scan at 12 weeks 5 days, if a serious pathology is detected, she is no longer sent for an artificial medical abortion, but for an abortion, which is a more complex and traumatic procedure. Therefore, when asked about the best rock for the first screening, almost any practitioner will answer: "up to 12 weeks 4 days" .

Diagnostic window in the 2nd trimester of pregnancy

The second screening period occurs at 18 weeks. 0 days and ends at 20 weeks 6 days pregnant . "Lucky days" is considered the entire twentieth week: 20 weeks. 0 days - 20 weeks 6 days . Not all the subtleties of the architectonics of the main organs can be considered so successfully, especially in pregnant women with increased body weight at 18 weeks of pregnancy. If so-called "markers of chromosomal problems" are detected, it may be necessary to perform prenatal karyotyping (obtaining fetal blood or amniotic fluid), which may take some time.

The collection of the material itself takes several minutes, but the preparation of the pregnant woman (examination, obtaining the results of blood and urine tests, etc.), transporting the material to the laboratory, examination and obtaining the results can take several days. If serious deviations in the state of health of the fetus are detected, in order to resolve the issue of further management tactics, the pregnant woman is sent to undergo a prenatal consultation consisting of an ultrasound doctor, a specialist in the field to which the identified disease belongs (for example, a surgeon, neurosurgeon, cardiologist, etc. ) .

Prior to the new regulation, the second screening period ranged from 18-22 weeks, even earlier than 18-24 weeks of pregnancy. According to WHO recommendations, the fetus becomes viable from the 22nd week of pregnancy, therefore, before this period it is very important to obtain all possible information about its condition and form a prognosis for health and later life. That is why now there is a restriction regulated by law, so that if serious problems with the health of the fetus are detected, all additional diagnostic procedures should be carried out in a timely manner and, if necessary, terminate the pregnancy without violating the Legislation of the Russian Federation2.

Diagnostic window in the 3rd trimester of pregnancy

The third screening period (32 weeks 0 days - 34 weeks 6 days of pregnancy) has two main objectives: the exclusion of congenital malformations with late manifestation and assessment of the fetal condition. Issuance of a referral for the passage of the third ultrasound along with maternity leave of 30 weeks. 0 days of pregnancy potentiates untimely early appeal of pregnant women for the third screening ultrasound before the period of 32 weeks 0 days, which in turn may require a second planned ultrasound in the "scheduled time". A later turnout (after 34 weeks) reduces the quality of the ultrasound picture obtained by changing the relationship between the amount of amniotic fluid and the volume of the fetal body towards the latter. Therefore " happy days" the third trimester can be considered the period 32 weeks 0 days - 33 weeks 3 days of pregnancy .

Unscheduled ultrasound at any stage is required, as a rule, only in case of complicated pregnancy, therefore, it is prescribed only according to indications and is performed regardless of the gestational age.

Notes: 1 - Order of the Health Committee of the Government of St. Petersburg dated February 1, 2012 N 39-r "On measures to reduce hereditary and congenital diseases in children in St. Petersburg".
2- Article 56 "Artificial termination of pregnancy". Federal Law of the Russian Federation of November 21, 2011 N 323-FZ "On the basics of protecting the health of citizens in the Russian Federation", entered into force: November 22, 2011, published on November 23, 2011 in "RG" - Federal issue No. 5639

Ultrasound in early pregnancy: 3D and 4D, when to do, is it harmful, what shows

Ultrasound in early pregnancy: 3D and 4D, when to do, is it harmful, what shows - Juno

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An ultrasound is scheduled for every woman in an "interesting position". The expectant mother must undergo this procedure at least twice in 40 weeks. The study allows you to specify the gestational age, make measurements of the height and weight of the fetus. You will learn about the benefits and harms of ultrasound in our article.

Planned ultrasound during pregnancy

From 2021, the expectant mother will have to undergo at least two ultrasound examinations during pregnancy. The timing of the planned examination is determined by the Ministry of Health. These studies are called screening. Their task is to identify possible violations in the development of the fetus and the course of pregnancy and provide the woman with qualified medical care in time.

Until 2021, a pregnant woman underwent an ultrasound in trimesters - one in each specified period. But according to order N 1130n, now the expectant mother will be screened only twice - in the first and second trimester.

First trimester

The first screening ultrasound is performed at 11-14 weeks. At the same time, biochemical screening is done. The expectant mother donates blood for the determination of β-hCG and PAPP-A. The data obtained are evaluated together with the results of the first ultrasound screening. Together, these methods make it possible to identify disorders in the development of the fetus, such as Down syndrome and other chromosomal abnormalities.

In the first trimester, ultrasound can determine:

Gestational age. If the expectant mother does not remember when her last menstruation was or she has an irregular menstrual cycle, an ultrasound examination will help. The doctor will specify the gestational age by ultrasound. But you need to remember: these calculations will not be too accurate, and therefore, if possible, gynecologists are guided by the date of the last menstruation and calculate the due date from it.
Number of fruits. In a multiple pregnancy, the doctor examines the placenta (or chorion) and membranes in detail. The tactics of managing pregnancy and childbirth depend on their location and number.
Fetal malformations. For example, to diagnose Down syndrome, the doctor evaluates the thickness of the collar space and visualization and the length of the nasal bone, the length of the thigh. Ultrasound in early pregnancy can also reveal malformations of the internal organs and nervous system.
The condition of the cervix (cervicometry), uterine appendages and uterine wall are assessed.

Despite a thorough examination, it is impossible to completely exclude fetal malformations only by the results of ultrasound. If in doubt, your doctor may recommend an invasive test such as amniocentesis or cordocentesis. The second ultrasound screening also helps to clarify the diagnosis, in which it is possible to examine the organs and tissues of the fetus in more detail.

Second trimester

The second screening ultrasound is done at a period of 19-21 weeks. Here is what the doctor evaluates:

Correspondence of the size of the fetus to the gestational age. If they are less than normal, they talk about fetal growth retardation.
Structure of internal organs and nervous system. At this time, malformations of the heart, brain, digestive tract and other organs and systems can be detected.
The state of the placenta and umbilical cord, features of blood flow in them. If the blood flow is disturbed, the fetus will suffer from a lack of oxygen.
Volume of amniotic fluid. If there is too much amniotic fluid, they talk about polyhydramnios, a little - about oligohydramnios.

At the second ultrasound screening, the sex of the fetus can be determined. This is not necessary, and if the expectant mother wants a surprise, she can ask the doctor not to report the results.

The timing of the ultrasound and the interpretation of the results is done by a gynecologist observing a pregnant woman. The doctor will tell you when to do an ultrasound scan during pregnancy, and if necessary, he will prescribe an unscheduled examination.

Unscheduled ultrasound during pregnancy

Outside of screenings, ultrasound is prescribed in such situations:

Confirm pregnancy. This is necessary in order to make a correct diagnosis - after all, tests are sometimes wrong, and a delay in menstruation is not always associated with an interesting situation. Such an ultrasound is done in the early stages - at 4-6 weeks.
Determine the location of the gestational sac. This is necessary in order to exclude an ectopic pregnancy.
When bloody discharge from the genital tract appears, ultrasound is done on an emergency basis at any stage of pregnancy - it is necessary to exclude the development of complications.
In the later stages - if the fetus has stopped moving or, on the contrary, has become overly active. In addition to ultrasound, CTG (cardiotocography) is done from the 33rd week to assess the fetal heartbeat.
Before childbirth - if there is a risk of complications. With ultrasound, you can clarify the weight and position and presentation of the fetus, the condition of the placenta, umbilical cord and amniotic fluid.

With multiple and complicated pregnancies, ultrasound can be done more often. The terms are set by the attending physician individually for each woman.

Ultrasound features in early pregnancy

Many expectant mothers are wondering what week the ultrasound will show pregnancy. Modern devices allow this to be done at about 3-4 weeks if a vaginal sensor is used (transvaginal method). If a specialist conducts a study through the abdominal wall (transabdominal method), then he will be able to detect a fetal egg later, at 5-6 weeks.
Note

Knowing how long the ultrasound shows pregnancy, you can not run for an examination immediately after a missed period. For a very short time, the doctor may not see the fetal egg - and not because it is not there, but because the equipment is not perfect. There is no need to create a cause for alarm for yourself - it is better to wait until 5-6 weeks, when the fetal egg will be clearly visible.

In the early stages, ultrasound can detect serious problems such as ectopic or regressive (non-developing) pregnancy. The sooner the pathology is detected, the easier it will be to avoid complications.

Types of ultrasound during pregnancy

Modern equipment of ultrasound rooms allows for high-precision ultrasound examinations. In addition to the standard 2D ultrasound, three- and four-dimensional studies - 3D and 4D - have now become very popular. Let's consider them in detail.

2D is a study in which a black and white image is obtained in two dimensions - in height and length. This option is quite informative. The doctor can measure the growth and proportions of the fetus, as well as assess the condition of the placenta and amniotic fluid. 2d is the most common and "old" procedure among all ultrasound diagnostic formats.
3D is a more modern examination method. It gives a detailed and three-dimensional image of the object. 3D ultrasound during pregnancy allows not only to assess the condition of the fetus in detail, but also to take a photo of it. 3D ultrasound is not a mandatory procedure, it is carried out at the request of the baby's parents.
4D Pregnancy Ultrasound provides a video image of the fetus. Parents are given the opportunity to watch the child in real time: how he sleeps, eats or sucks his thumb. The video material, like the photo, is recorded on a disk and remains as a keepsake for mom and dad.

Experts say that all existing methods of ultrasound diagnostics are the same in terms of the impact on the fetus: the power of the ultrasound wave and its intensity are identical in all cases.
Many women are interested in seeing a pregnancy ultrasound photo by week. It is not necessary to do an ultrasound without indications so often, but you can find such photographs in scientific papers and see how a child develops in the mother's womb.

Is it harmful to do ultrasound for pregnant women

There is no consensus among experts: some believe that the study should be carried out without fail, others - that it is best to refuse the effect of ultrasound on the fetus. Russian and foreign specialists in the field of gynecology also do not find a compromise on this issue.

Meanwhile, according to statistics, not a single expectant mother or child in the womb suffered as a result of ultrasound diagnostics. So there are no scientific facts proving the harm of ultrasound to humans. In this regard, most experts who observe the pregnancy of their patients adhere to the principle of the "golden mean". They insist on carrying out two planned procedures, more - only according to indications.

Experts rightly believe that it is impossible to do without ultrasound. It allows you to control the development of the fetus and, if necessary, take timely measures to preserve the health of the baby.

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