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Who does ultrasounds for pregnancy


OB/GYN – The Ultrasound Tech’s Role in Pregnancy

Editor: Samantha Callis, MHA, RDMS, RDCS, RVT

For parents expecting a child, one of the most exciting moments during pregnancy is that first, prenatal ultrasound. It can also be a scary time for mothers that have higher-risk pregnancies. Obstetric ultrasounds are performed for many reasons including confirming pregnancy and assisting with determining the date of conception. Sonograms may also be used to detect multiple births (i.e. twins) and even ectopic pregnancies (abnormal pregnancies where the fetus is developing outside the womb). Obstetric sonographers may perform ultrasounds on pregnant women to detect abnormalities or signs of congenital diseases, particularly if the female is high risk due to age or medical history.

These highly skilled professionals obtain joint certification from the ARDMS (American Registry for Diagnostic Medical Sonography) by passing both the Sonography Principles and Instrumentation (SPI) exam and the OB/GYN exam.   The OB/GYN exam must be attempted and passed within five years of taking the SPI exam.

For uncomplicated pregnancies, ultrasound technologists are there to monitor the growth and development of the fetus until birth. For women who are not at risk, they will typically get an ultrasound once during the first trimester and again at the 18th to 20th week stage, according to the March of Dimes. Women who are at higher may have more ultrasounds ordered by their provider.

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Job Duties for Obstetric Sonographers

– Obtain pertinent patient history
– Perform gynecologic ultrasounds
– Perform routine first trimester ultrasounds
– Perform routine second trimester ultrasounds
– Perform routine third trimester ultrasounds
– Perform advanced obstetric ultrasounds*
– Assist with ultrasound guided procedures
– Prepare preliminary reports for interpreting physicians
– Disinfect and maintain ultrasound equipment to department standards
– Other administrative or clinical duties as outlined by the medical director

First Trimester (Week 1 – Week 13)
According to the American Pregnancy Association, several aspects or criteria
may be assessed during a first trimester ultrasound. First trimester ultrasound
is an excellent way to evaluate maternal anatomy, determine the likely
presence of an intrauterine pregnancy, number of pregnancies, perform
measurements to estimate gestational age by measuring the length of the
fetal pole (crown-rump length).

During the first trimester, a sonographer can also confirm that there is a
cardiac activity by visualizing a fetal heartbeat and determine if the pregnancy
is ectopic (implanted outside of the uterus) or molar (when a non-viable egg is
fertilized). Transvaginal ultrasounds may be performed to complete more
detailed, high-resolution images of small/early structures. During a
transvaginal ultrasound, a specialized transducer is placed within the vaginal
canal. This differs from a transabdominal ultrasound in which a transducer is
utilized over the lower abdomen.

Second Trimester (Week 14 – Week 27)
The most standard ultrasound for women who are not at risk takes place
during the second trimester, halfway through the pregnancy, between the
18 th  to 20 th  week. Sonographers often perform a routine fetal anatomic survey, obtaining images of fetal anatomy of the head, chest, abdomen, extremities, various measurements as well as the documenting maternal structures. At this stage, sonographers can visualize external genitalia and identify the sex of the fetus. This mid-pregnancy ultrasound serves to evaluate the health and development of the fetus. At this stage, the ultrasound technologist can also confirm if there is more than one fetus growing inside the mother’s uterus (multiple gestation).

Abnormalities and signs of diseases may also be detected at this stage such as the presence of congenital defects, the incorrect amount of amniotic fluid or miscarriages (which usually happen during the first three months of pregnancy) and stillbirths (which occur after week 20). Signs of Down syndrome may be detected between the 13th and 14th week, according to the American Pregnancy Association.

Third Trimester (Week 28 – Birth)

Women who are at a higher risk, such as those who had problems with previous pregnancies, or women who are carrying multiple babies will most likely go in for an ultrasound during the third trimester.

Aside from monitoring fetal development and health, one purpose for an ultrasound at this stage is to determine if the placenta is located too close to the cervix (placenta previa) which may warrant a caesarian section for the birthing process.

A third trimester ultrasound will also be ordered if the OB/GYN suspects the fetus is in a breech position (where the baby’s head is farthest away from the cervix), which also may call for a Cesarean section.

Advancements in Ultrasound Technology

Sonography is a rapidly advancing profession due to technological changes. Sonographers must be prepared to continue their education and adapt to new practice standards and guidelines. Advancements in sonography include three-dimensional/four-dimensional ultrasound. While cute pictures of babies often come to mind initially, this provides the interpreting physician with additional information for gynecologic and obstetric patients! It can be used to further characterize uterine shape abnormalities, detailed fetal cardiac assessment, and fetal structural abnormalities.

The ultrasound technologist’s role is essential throughout an entire pregnancy. If you would like to work in this field of sonography, you can complete an ultrasound degree and complete courses and clinical rotations related to obstetrics or the joint OB/GYN field.


Sam Callis is the clinical coordinator for the DMS program at the University of Southern Indiana in Evansville, IN. In addition to clinical coordinating duties, she teaches didactic and laboratory coursework in cardiac and general sonography.

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 examination (ultrasound) during pregnancy

Gynecological ultrasound of the pelvic organs is a painless and safe research method that allows you to quickly assess the condition of the pelvic organs, determine the pathological process and choose treatment tactics.
To improve visualization, as a rule, a special gynecological sensor is used, which allows for an examination with increased accuracy.
Ultrasound is also a necessary study in obstetrics: as a rule, during pregnancy, ultrasound is performed 3-4 times and is the main source of information about the development of the fetus.
Ultrasound allows you to reliably assess the course of pregnancy, determine the sex of the unborn child.
In our hospital, it is possible to conduct 3D-4D ultrasound on a modern Siemens Acuson S2000 device, screening ultrasound, ultrasound of the pelvic organs. The class of the device allows you to conduct an expert-level ultrasound examination, obtain a three-dimensional color image of the child, his movements, and also helps in the diagnosis of some developmental anomalies.
Screening ultrasound during pregnancy is the easiest, fastest and safest way to monitor the growth and development of the fetus, as well as to exclude or confirm malformations.

1st trimester ultrasound
This examination is recommended to take place at 11-13 weeks of pregnancy.
Ultrasound screening of the 1st trimester makes it possible to:
• Determine the duration of pregnancy and the expected date of birth of the child.
• Make sure your baby is growing and developing properly.
• Consider the place of attachment of the placenta, the correctness of its structure.
• Exclude gross malformations of the fetus.
• Measure the thickness of the collar space and the length of the nasal bone (the earliest markers of Down's syndrome).
• Exclude pathology from the uterus and appendages.


II trimester ultrasound
Second trimester ultrasound is best done between 18 and 22 weeks. Survey objectives:
• Determine if the development of the fetus corresponds to the expected gestational age.
• Identify or eliminate congenital malformations and anomalies in the development of all major organs and systems of the unborn child. At this time, it is possible to examine in detail the structure of the heart, kidneys, digestive system, brain and spinal cord, as well as other important organs of the growing fetus.
• Determination of the quantity and quality of amniotic fluid, a detailed examination of the structure of the placenta.
• Ultrasound in the second trimester allows you to accurately determine the sex of your baby.


III trimester ultrasound
Ultrasound of the third trimester is recommended to take place in the period of 32-34 weeks of pregnancy. At this time, the doctor once again looks at all the organs of your unborn baby in order to exclude malformations. The degree of development of the child is also determined (growth retardation, signs of intrauterine hypoxia are excluded), the volume of amniotic fluid is measured (oligohydramnios and polyhydramnios are excluded), the umbilical cord is examined (if there is an entanglement). In the third trimester, we also perform Doppler ultrasound, i.e. with the study of blood flow in the vessels of the uterus, umbilical cord and fetal brain. Doppler ultrasound during pregnancy helps to identify disorders of the uteroplacental blood flow at an early stage in order to take measures, if necessary, to prevent the development of fetal oxygen starvation and growth retardation.
Upon completion of the study conducted at any stage of pregnancy, you will receive a medical report with a detailed description of all the necessary parameters. And having made a three-dimensional and four-dimensional ultrasound of the fetus, you will also receive the first photos and videos with your baby.
In our hospital we can offer you:
• Get a fetal ultrasound not only at the screening time, but at any time if something bothers you or you just want to make sure that the baby is growing and developing normally.
• Do an ultrasound with dopplerography on an expert-class device.
• Get tested the day before the birth to determine how the baby is lying and if there is any entanglement in the umbilical cord.
• Use the service of 3D and 4D ultrasound. Such a study will provide an opportunity not only to see your unborn child on the monitor screen, but also to obtain high-quality photographs and video recording of fetal movements in real time.

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