When is an ultrasound of the abdominal cavity prescribed during pregnancy: preparation and how is the examination performed? Preparing for an ultrasound for pregnant women

Ultrasound diagnostics is one of the most important studies during pregnancy.

In modern medicine, this method is considered almost universal, since it is with its help that the course, development and characteristics of pregnancy are monitored.

Having learned about motherhood, a woman, as a rule, goes to antenatal clinic for registration. While carrying a child, she will have to undergo a number of planned mandatory examinations and pass all the necessary tests. The ultrasound doctor's office will need to be visited at least three times for the ultrasound procedure.

Planned studies are done in the first and trimesters, however, the doctor may have any indications for additional diagnostics, and expectant mothers often insist on unscheduled procedures.

Ultrasound diagnostics has been used in prenatal practice for decades, so pregnant women should not be afraid of the mythical negative impact of ultrasound on the child and the course of pregnancy. Today, this type of research is one of the safest and most highly informative.

However, many women manage to do several studies before this time.

Why is ultrasound diagnostics needed in the first trimester of pregnancy?

Thanks to medical advances, the doctor will be able to see a tiny embryo as early as 3-4 weeks of pregnancy.

And in another week, you will even be able to listen to his heartbeat.

Of course, you shouldn’t run to the doctor literally the next day of your delay or go for an ultrasound on a whim. However, in order not to wait for a planned procedure, there are objective reasons:

• if you have reason to suspect, it is better to conduct a diagnosis and make sure that the localization of the fertilized egg is correct;
• If it occurs, an ultrasound examination is recommended to see if it is present. If this problem is detected in time, doctors will be able to minimize the high risk of miscarriage;
• An ultrasound can also be prescribed for;
• doctors often recommend unscheduled examinations for those women who have any abnormalities in the development of the genital organs (for example, with a double uterus, or with a septum in the uterus);
• some want to make sure if there are doubts about the reliability;
• sometimes the procedure helps determine the presence of inflammatory processes and tumors, which can give false positive test results and prevent a woman from becoming pregnant;
• if you have an irregular menstrual cycle or disruptions, then diagnostics are prescribed to;
• seeing it on ultrasound motor activity embryo and you will know that your pregnancy is progressing.

First Ultrasound examination as part of a “double test”

On first routine diagnostics The specialist will already assess the primary formation of the child, watch how his organs and systems develop.

During the procedure, the doctor must exclude the presence of any gross defects or anomalies in the baby’s development (absence of cerebral hemispheres, cranial vault bones and soft tissues).

The second significant point of the study will be that for the first time, a planned ultrasound is always performed as part (in addition, blood from a vein is donated for biochemical analysis).

Of course, such diagnostics should be done only in special institutions where there is high-precision modern equipment and doctors with good qualifications and sufficient experience. Based on the research results, the doctor will be able to draw conclusions whether the child is developing correctly and whether the pregnancy is proceeding normally.

In addition to establishing the exact date and determining the number of fetuses (twins, triplets), screening includes determining the norms:

• coccygeal-parietal size (CTP);
• biparietal head size of the child (BPR);
• the size of the neck fold or the thickness of the collar space (TVP);
• length of the nose bone;
• heart rate (HR).

The screening study protocol includes data on extraembryonic structures (chorion, yolk sac and amnion), and an assessment of the general vital activity of the fetus (what motor and cardiac activity it has, how other organs and parts of its body develop).

If any pathologies or developmental anomalies are suspected, the woman will be prescribed more detailed examinations to confirm the diagnosis, because with the risk of having children with chromosomal abnormalities, the question arises: artificial interruption pregnancy.

How is an ultrasound performed at 12 weeks?

The first planned ultrasound can be performed either transabdominally (the sensor is placed along the anterior wall of the pregnant woman’s abdomen) or transvaginally (the sensor is inserted into the vagina). Sometimes the doctor is forced to combine two types of studies to get a complete picture of the diagnosis.

The first screening ultrasound using the transvaginal method is considered more accurate, but there is a risk of infection, injury to the vagina, cervix, etc.

Ultrasound at week 12 is more often performed using the transabdominal method, and the sensor is inserted inside only if the uterus is too deep in the pelvic cavity or is overweight (the doctor cannot determine important points and developmental indicators through the abdominal wall).

The appointment may take from 10 minutes to half an hour.

How to prepare for screening?

1. If you are being examined at a government institution, then it is worth taking with you a pair of replacement shoes (slippers or shoe covers); a diaper that needs to be laid on the couch, a towel or napkins will also be useful to wipe off the gel applied to the stomach.

For a transvaginal ultrasound, you are usually asked to bring 1-2 condoms. In private clinics and medical centers, as a rule, the cost of an appointment already includes all these accessories.

1. Be sure to perform hygiene of the external genitalia before the procedure;
2. Usually, the doctor recommends a day or two before the test to start following a diet that will exclude foods that cause gas formation.

The fact is that gas bubbles can create interference or an unnecessary background in the image. Therefore, you can play it safe and take anti-flatulence medication in the evening, as well as in the morning before the procedure (Espumizan or Smecta).

You can eat before the procedure, but you should not overeat.

1. For a routine ultrasound, you need to come with a full bladder, so drink 1-1.5 liters of water approximately an hour before the procedure. For a transvaginal ultrasound, on the contrary, you will have to go to the toilet before the procedure.

If you have already had an ultrasound before this point, be sure to keep their results and bring them with you to subsequent procedures. This way, the doctor will have the opportunity to objectively assess the dynamics of the child’s development and growth and monitor how the pregnancy is progressing.

Importance of procedure timing

The deadline for the first planned examination is not vague numbers, but a strictly regulated norm, legally supported by special obstetric orders approved by the Ministry of Health.

Doctors try to carefully ensure that women are diagnosed on time.

More extended time frames include from 1 day of the 10th week to 6 days of the 13th.

It is at this time that gross fetal malformations and markers can be diagnosed chromosomal pathology(within two weeks after the above period, almost all the unique features that enable doctors to identify Down syndrome or other diseases and defects usually disappear).

In the first trimester, the baby’s gestational age is usually determined (with an accuracy of 2-3 days) and. Also at this stage, the doctor will judge the health status of the placenta, the quantity and nature of the placenta. amniotic fluid etc.

Well, you can look at the little man on the screen, listen to his heartbeat, observe his behavior and ask for a photo or video as a souvenir.

Ultrasound standards at 12 weeks: what will the screening study show?

All indicators obtained during the diagnosis can be deciphered and explained to you only by a highly qualified specialist. There are special tables that indicate the norms for all the required parameters of a child. The doctor will compare the results of your research with tabular data and evaluate them.

KTR norms

When measuring the coccyx-parietal size, only the length of the legs is not taken into account.

If the child’s CTE is greater than the specified norm, this means that he is developing rapidly, which means there is a risk of being overweight ().

A deviation in the smaller direction may indicate some kind of genetic pathology, developmental delay (no heartbeat), or simply an incorrectly determined gestational age.

Gestational age (in weeks and days)	Average standard value of CTE, mm	Minimum and maximum permissible regulatory values ​​of KTE, mm
10 weeks	31	24-38
10 weeks and 1 day	33	25-41
10 weeks and 2 days	34	26-42
10 weeks and 3 days	35	27-43
10 weeks and 4 days	37	29-45
10 weeks and 5 days	39	31-47
10 weeks and 6 days	41	33-49
11 weeks	42	34-50
11 weeks and 1 day	43	35-51
11 weeks and 2 days	44	36-52
11 weeks and 3 days	45	37-54
11 weeks and 4 days	47	38-56
11 weeks and 5 days	48	39-57
11 weeks and 6 days	49	40-58
12 weeks	51	42-59
12 weeks and 1 day	53	44-62
12 weeks and 2 days	55	45-65
12 weeks and 3 days	57	47-67
12 weeks and 4 days	59	49-69
12 weeks and 5 days	61	50-72
12 weeks and 6 days	62	51-73
13 weeks	63	51-75
13 weeks and 1 day	65	53-77
13 weeks and 2 days	66	54-78
13 weeks and 3 days	68	56-80
13 weeks and 4 days	70	58-82
13 weeks and 5 days	72	59-85
13 weeks and 6 days	74	61-87
14 weeks	76	63-89
14 weeks and 1 day	78	64-92

Norms of BPD of a child's head

Using these indicators, brain development is assessed. The doctor measures the distance from temple to temple. If the parameters do not reach the norm, then we can even talk about insufficient development (underdevelopment) of the organ, the absence of any of its sections.

If the numbers exceed the norm, then this may indicate certain intrauterine diseases or pathologies (cerebral hernia, tumor, hydrocephalus), as well as that the fetus is too large or is developing very quickly.

The size of the “neck fold” or TVP

Based on this indicator, doctors judge the presence of chromosomal abnormalities (Edwards or Down syndrome, etc.). However, the thickness of the collar space itself is not a direct verdict, but indicates a high degree of risk.

To confirm or refute fears, you will need to donate blood for hormones and undergo a re-examination (the TVL of a healthy baby cannot be more than 3 mm with a transabdominal ultrasound).

Norms for nose length (nasal bone)

If the child has any chromosomal abnormality, then ossification of the nasal bone will occur later than the time of examination. That is, it may be completely absent or very small. But if all other indicators correspond to the norm, then most often this may indicate individual characteristics baby (snub nose or simply small nose size).

Heart rate norms

To assess general vital activity, indicators of the child’s motor and cardiac activity are important. However, his movements during this period are still very difficult to distinguish, so for diagnosis, heart rate indicators are taken (motor activity is simply determined).

If the heart rate is significantly lower or higher than normal, then the woman will be prescribed an additional examination, as this may serve a worrying sign the child's poor health.

Gender of the child

Modern ultrasound machines are indeed a way to show the sex of a child, which makes future parents very happy.

Even if an expert ultrasound does not involve determining the sex of the fetus (in a government institution), you can ask your doctor about this. Usually they rarely refuse.

If you undergo your first routine ultrasound in a private clinic, the sex of the baby is announced right away.

However, it should be remembered that in short periods there is a high risk of error.

Even if the procedure is performed by a highly qualified specialist. Therefore, many parents prefer to wait for the second ultrasound, where the probability of determining the gender of the fetus is 90%.

Standards for the study of embryonic structures

After the anatomy has been studied and physiological characteristics child (internal organs, systems, tissue formation, etc.), the doctor will evaluate the chorion, yolk sac, appendages and uterine walls.

The yolk sac is a very important organ of the embryo. It is he who bears the most important functions, because until the end of the first trimester he performs the role of many vital and necessary for the child organs, working like the primary germ cells, the primary liver and the circulatory system.

When the need for it disappears (the baby forms and develops independent systems and organs), the yolk sac begins to shrink, and then completely takes the form of a small yolk stalk.

The doctor will measure the inner diameter of the bag and see what shape it is. Based on these indicators, it will be possible to judge the likelihood of developing pathologies (if more than the norm), that the pregnancy is not developing or is simply not enough (if the indicators are less than the norm).

Doctors also determine how the chorion is located, which is then transformed into the placenta (, along the back, etc.). It may be discovered, which means the doctor will have to develop special tactics for managing your pregnancy. During the study, its structure will be assessed (it must be homogeneous).

In addition, the amnion (the amount and nature of amniotic fluid) is also monitored. Features of the structure or anomalies of the uterus, as well as information about possible tone, are also recorded in the study protocol.

Personal experience

Almost every young mother is looking forward to her first child. I was also looking forward to my first baby. For some reason, everyone wants the boy to be first. But I didn’t care, the main thing was that the child was born healthy.

Now, in the first stages of pregnancy, they are required to undergo an ultrasound. Some mothers are in favor, others are not in a hurry, justifying this by the fact that it is harmful for the child and for herself. You can talk a lot about this topic, because before everything happened without an ultrasound, the children were born healthy, and everything seemed to be normal. But our time dictates new rules.

Poor ecology, nutrition, and lifestyle negatively affect human health. Very often children are born with pathologies or the mothers themselves may become ill with something. I believe that in our time an ultrasound must be performed, but not often, as some pregnant women do.

The doctor prescribes certain dates when you need to go and that’s it. Naturally, if there are any deviations, you will have to go and get checked more often.

As for me, during my first pregnancy I was sent for an ultrasound, when I first became registered, that is, at 12 weeks. I decided to undergo the procedure in a paid clinic, there was a modern device and an experienced doctor. I was waiting for this moment with trepidation, and what a joy it was to see my own little lump on the monitor!

Of course, the gender cannot be determined at this time, and I didn’t really insist on it. There were no abnormalities, the fetus developed normally. The second time the local doctor referred me at the end of pregnancy, at 33 weeks. What a pleasure it was to see a healthy baby, weighing about 3 kilos, the doctor himself said that the boy was 100% and everything should be fine. How much joy my husband, relatives, and myself had!

I believe that the ultrasound did not affect my health and the condition of the baby in any way. A healthy boy was born, calm, and raged only when his tummy hurt. Dear mothers, everyone has the right to make a choice. But I think that you should not categorically refuse an examination if the doctor advises, because this can prevent the appearance of any abnormalities or, even more, save the life of a child or mother...

Conclusion

Remember that if some parameters deviate from the norm at the first ultrasound, this does not mean that your child will necessarily be born defective. More research will be conducted to confirm suspicions. Therefore, do not panic and do not get upset ahead of time. Basically, the first planned ultrasound is an opportunity to see with your own eyes the little life inside yourself.

This is the basic principle of ultrasound examination. An accurate diagnostic method during pregnancy allows you to identify various anomalies and defects intrauterine development fetus It is difficult to imagine that just a few decades ago doctors could do without this unique research method. It is with its help that you can carry out diagnostics, determine the gestational age, weight and height of the child. When sending a mother for examination, each specialist will explain to her what measures need to be taken to ensure that preparation for an ultrasound scan during pregnancy is successful and the result is accurate.

Reliable data from the research allows us to:

• Detect placenta previa or the threat of miscarriage and bleeding;
• Get data on multiple pregnancies;
• Learn about ectopic pregnancy;
• Put exact date pregnancy;
• Calculate the number of days remaining until labor begins.

Necessary preparation.

Preparation for ultrasound examination at the initial stage of pregnancy and at a later stage have a number of differences. Transabdominal examination requires standard preparation. That is, on the eve of the procedure, the woman will need to take a drug that eliminates gas formation in the intestines. And an hour before the manipulation, she needs to drink about one liter of liquid. A full bladder will put pressure on the uterus and it will move out of the pelvic cavity. In the second half of pregnancy and later, the examination is carried out, more often, transvaginally. It does not require any special preparation. The only recommendation for pregnant women can be a list of foods that are undesirable to eat on the eve of the test.

Increased gas formation can cause poor-quality and incomplete results of the manipulation. The clarity of the images is lost, and it is quite difficult for the doctor to see a good image of the fetus.

What to be afraid of?

Some pregnant women refuse to undergo the procedure, citing the fact that the study could harm the health of the unborn baby. The human body is not capable of perceiving this frequency of waves. Many years of research confirm the safety of this method. No abnormalities, neither physical nor mental state No children were born from the control group. On the contrary, the high information content of the method makes it possible to identify fetal malformations already at early stages. After all, according to statistics, children with developmental anomalies are born to completely healthy parents. Therefore, when a doctor prescribes an ultrasound scan for you during pregnancy, your main task is to fully prepare for it and wait for the message that everything is fine with your baby.

How an ultrasound scan is performed during pregnancy, what you need to remember when preparing for routine diagnostics, what questions to ask the doctor based on the examination results - read our article 10 important rules for performing ultrasound during pregnancy.

Ultrasound during pregnancy: important rules

Keep an eye on deadlines

First of all, carefully monitor your gestational age and go for an ultrasound examination exactly when it was prescribed by the doctor leading your pregnancy. Because as a result of each of the three planned ultrasounds, the doctor excludes certain pathologies of the child’s development.

Choose a clinic for ultrasound

Spare no expense and get an ultrasound done in a good clinic using a modern machine. To do this, take the time to find out reviews about the clinic, equipment and doctors who perform ultrasounds during pregnancy.

Think over timing issues for ultrasound during pregnancy

First of all, coordinate the time with your husband if he also wants to be present during the procedure. Plan your time so that you get to the clinic 10-15 minutes before the appointed time, because most likely you will have to fill out a card or some other documents.

Think through the organizational issues of ultrasound during pregnancy

Check with the clinic for directions, as well as what things and documents you need to take with you. Prepare your money. Dress comfortably so that you can quickly expose your tummy. Just in case, take paper tissues with you to wipe off the gel. And also a disposable diaper if you are going for an ultrasound not to a private clinic, but to a regular local clinic.

Don't forget about hygiene before going for an ultrasound

A shower, clean underwear and socks, as well as neat clothes are natural hygiene standards for visiting any doctor. Ultrasound during pregnancy is no exception.

Don't forget your pregnant woman's exchange card

Also, take copies of previous ultrasounds with you, if you had any. The doctor will likely want to review these documents, compare ultrasound results during pregnancy, and make recommendations if necessary.

Prepare answers to questions

During your pregnancy ultrasound, your doctor will likely ask you several questions. Be ready to call

• first day of last menstruation,
• duration of menstruation,
• what kind of births are there?
• how previous pregnancies ended,
• how much the child/children weighed at birth,
• Are there any congenital pathologies in the family, for example, heart defects?

Prepare not to panic

Be calm and take care of yourself and your child under any circumstances. During an ultrasound, they can (but very rarely!) reveal pathologies in the development of a child. Your task is not to panic and double-check everything carefully. How to double check?

Yes, it’s very simple: undergo an ultrasound again from another specialist, a more specialized one, specializing specifically in your problems. As a rule, in cases of suspicion of any pathology, the expectant mother is sent for further examination either to the PAH or to OKHMATDIT.

According to the law, a private clinic cannot refute a serious diagnosis. It is also necessary to find out what tests and when to take to refute the diagnosis. These questions can be answered either by your local doctor or by the person who performed the ultrasound examination.

Find out more research

Find out what additional tests the clinic offers during your time period. In the early and middle stages of pregnancy, ultrasound is recommended to be done synchronously with genetic blood screenings - at 14-16 weeks and at 18-20 weeks - the so-called PRISCA of the first and second trimesters.

Comparison of data obtained from ultrasound and blood biochemistry data makes it possible to exclude major genetic pathologies with almost one hundred percent probability.

In the third trimester, along with ultrasound, Doppler measurements are also performed - the speed of blood flow in the vessels of the fetus and mother is determined, and the functionality of the umbilical cord is monitored. And during cardiotocography, the baby’s heart rate is recorded.

Ultrasound during pregnancy: a good doctor will tell the truth

Victoria Maksimova, obstetrician-gynecologist, deputy chief physician for outpatient work at the ISIDA clinic, comments:

“The obstetrician-gynecologist has a double responsibility: both for the life of the mother and for the life of the child. This is the specificity of our profession.
Such a doctor must be a “professional squared away.” And along with this also good psychologist- so that the patient trusts him. This means being able to listen, be compassionate, and be merciful.
Of course, midwifery is more about positive emotions. However, situations are different.
I believe that a doctor should always tell the truth. But this should be done gently, tactfully, perhaps through relatives. In each specific case, an individual approach is important, because all people are different.
As a doctor with extensive experience, I always know how to behave with a patient - as soon as she crosses the threshold. I try to convey information in an accessible way, because it is very important that my interlocutor understands everything correctly. This result can be achieved if a woman sees that the doctor is not indifferent to her problem.”

Three ultrasound examinations are required during pregnancy.

The following standards are accepted worldwide:

• The first ultrasound is at the onset of 11-13 weeks.
• Second ultrasound – within 21-23 weeks.
• The third ultrasound is at 30-32 weeks.

Today we will talk about the second ultrasound examination. It is considered the most important. It is the second ultrasound that makes it possible to find out the sex of the child and identify possible pathologies.

Reasons for performing a second ultrasound during pregnancy

The first and main reason is the globally established rules. Every pregnant woman must undergo a second planned examination, regardless of her health and other circumstances. And this is not without reason.

Proven: Around the twentieth week, the baby’s internal organs begin to form.

As soon as it becomes possible to get a good look at them, it’s time to go for an ultrasound!

Every parent strives to find out the sex of the child as quickly as possible. The second ultrasound provides just such an opportunity. There is a more important task of the procedure - to check the baby’s health.

The second ultrasound examination provides answers to the questions: is everything okay with the child? Are there developmental deviations - and if so, what are they? How can this be fixed?

The second ultrasound also determines:

• Exact date pregnancy and expected date of birth (accurate to three days).
• Risk of miscarriage and ways to prevent it.
• Multiple births. It is believed that twins can be detected already on the first ultrasound - however, the procedure often does not give an accurate answer.

Timing of the second ultrasound

We have already found out: the body expectant mother and her baby is ready for a second ultrasound around the twentieth week.

The procedure is carried out some time later - by the 23rd week you can be sure that the fetus is already sufficiently formed.

Usually the second ultrasound is done between 21-23 weeks. However, as you know, everything is individual. The exact date of the ultrasound examination is determined by the doctor.

Stages of the second screening

The procedure is carried out as follows:

• Future mom enters the ultrasound room, lies down on the couch and reveals his stomach. It is not necessary to undress.
• The doctor applies a special gel is applied to the surface of the abdomen. The substance is used so that there is no air left between the sensor and the skin.
• Doctor drives sensor on the abdomen to see the baby and the surrounding maternal organs in as much detail as possible.
• Doctor carefully looks at the monitor and explains what is clear from the ultrasound. He can show individual images to his mother. If necessary, the doctor will take a photo.
• At the end procedures, the pregnant woman is given a protocol where the objective results of the ultrasound examination are recorded.

  A photograph can be attached to the document in which the baby can be clearly seen.

Interpretation of the second ultrasound

The expectant mother got up from the couch, and the doctor turned off the machine. What's next? The pregnant woman is given a printout with many numbers.

Table normal indicators Ultrasound at 20-22 weeks looks like this:

The list of results of the second ultrasound does not end there. The doctor will have a rather large table of characteristics of the child’s internal systems.

Everything is being investigated: each organ, its location, size, shape, anatomy, structure.

The brain, genitals, digestive systems, face and limbs are subject to the most detailed examination.

Also Special attention pay attention to indicators related to maternal organs:

Organ and its indicator	Normal values ​​for the period of the second ultrasound
Placenta	Thickness - from 16.7 to 28.6 mm at 20 weeks, from 19.6 to 33 millimeters at 24 weeks. Maturity – 0. Location – no lower than 7 centimeters from the exit of the uterus
Amniotic fluid	Their number is assessed by the so-called amniotic fluid index. Week 20 – 86-230. Week 24 – 90-238
Umbilical cord	A normal umbilical cord contains one vein and two arteries. It should not wrap around the baby's neck. If ultrasound reveals this feature, additional research is necessary - Doppler
Cervix	Her channel must definitely be closed. The cervix itself is normally no shorter than 30 mm
Uterine walls	Normal – relaxed

How to prepare properly?

The first stage of research is traditionally considered to be preparation. Expectant mothers can breathe a sigh of relief: it is practically not needed.

Careful washing internal organs will not need.

The second ultrasound is transabdominal - which means that the sensor during the procedure is located on the surface of the abdomen, and not inside the vagina.

Amniotic fluid acts as a window, which the bladder used to be - now you can leave it alone without drinking liters of water.

There is no need to carry a condom or diaper with you either. It’s better to double check that you have taken all the documents.

The second ultrasound examination is an extremely important and responsible event for future parents.

Treat approach it not as a verdict, but as a planned procedure. Be calm - tune in to the birth of a healthy and strong baby!

Useful video

Related Posts

Any obstetrician will tell you how much necessary and sometimes vital information can be obtained with the help of Ultrasound (ultrasound examination). Before this diagnostic method began to be used in medicine, the size of the fetus remained a mystery, and it was also impossible to identify genetic abnormalities and monitor the condition of the placenta. In rare cases, x-rays have been used to identify genetic abnormalities. But X-rays have an extremely adverse effect on the development of the fetus. Therefore, this method was considered emergency. Thus, ultrasound revolutionized obstetrics.

Some expectant mothers doubt the need to attend an ultrasound scan. To this, any gynecologist will say that even with an apparently favorable course of pregnancy, it is impossible to determine, for example, genetic deformities, aging of the placenta and many other anomalies that can cause the death of the fetus or the birth of a sick baby.

• You should know that children with defects are born in ninety percent of cases to completely healthy mothers and fathers. Thus, only ultrasound can detect them,
• Many defects can be detected only using this method, which is done during a screening examination,
• It is not always possible to detect by probing and listening multiple pregnancy, it is only possible to further monitor how the twins develop using ultrasound,
• Only with this method can placenta previa or its low location be detected ( threat of bleeding and miscarriage),
• About half of expectant mothers are not able to correctly calculate the due date. Most often the error is 14 days. This deadline can be vital. Using ultrasound, you can calculate the due date with an accuracy of several days.

How many times can an ultrasound be done during pregnancy?

All indications for ultrasound examination are divided into screening and selective.
Screening ultrasounds are performed on all pregnant women at the prescribed time. They are aimed at detecting developmental defects. Such studies provide information about the size of the fetus, its compliance with developmental standards, as well as the condition of the placenta and uterus. There are usually 3–4 screening examinations.
Selective examinations are prescribed if the pregnancy is complicated or the doctor has doubts about normal development fetus Due to the fact that such examinations are prescribed in connection with a disease or pathology, their number may vary depending on the condition. In special cases, ultrasound is performed even twice a week.

Examination dates by week of pregnancy

Screening obstetric ultrasound is prescribed at the following times:

• 10 – 14 weeks,
• 20 – 24 weeks,
• 30 – 32 weeks,
• 36 – 37 weeks.

Early examination (4 weeks)

Transvaginal examination can detect the presence of a fertilized egg as early as three weeks after conception. After four weeks, you can already “see” some details of its structure.
A four-week embryo reaches 5 millimeters in length. It is still impossible to detect where his head is, but after a couple of weeks the limbs, head and body stand out. At this time he begins to move.

The main purpose of this examination is to ensure that pregnancy exists and ovum is located in the uterus. And also examine the state of the chorion ( placenta in the future) and amniotic fluid. It is advisable to undergo such an examination by a very qualified specialist. Sometimes the doctor has doubts, in which case another study is carried out a week later.

Examination at 10 – 14 weeks

The first examination at 10–14 weeks reveals the location of the fertilized egg, diagnosing an uterine or ectopic pregnancy. During the same examination, the thickness of the collar zone, a place located on the back surface of the neck, is necessarily studied. If this zone is larger than normal, this indicates a genetic abnormality. And the expectant mother will be sent for a genetic consultation. It is at 12–13 weeks that ultrasound can be used to identify Down syndrome, then the fetus develops, and these disorders will no longer be noticeable.

The diameter of the fetal egg is determined, as well as its length from the tailbone to the crown. An important parameter of well-being is the size of the uterus. It is this size that indicates the duration of pregnancy, because the fetus increases in size as standard, in contrast to later periods. In the transcript for ultrasound, sometimes it does not appear obstetric term, that is, from the first day of the last menstruation, and the embryonic period is the period from conception itself. Usually the difference between these periods is no more than 14 days. On the screen you can see how it moves little man how he moves his arms and legs and even opens his mouth.

The placenta is formed only at 16 weeks. At the first examination, they study where exactly it is attached to the uterus, how close the cervix is ​​( norm - at least 6 centimeters). If the placenta is found on the pharynx, a diagnosis of placenta previa is made, leading to complications during childbirth. Sometimes during the first examination a low location of the placenta is detected, but subsequently it rises to a normal level.

The structure of the placenta and its thickness are also important.
During the examination, the number of vessels in the umbilical cord is checked. There should be three of them.

The condition of amniotic fluid is another important indicator of the well-being of pregnancy. The volume of amniotic fluid is calculated through the amniotic index. If the index is increased, this indicates polyhydramnios, but if it is reduced compared to the norm, this indicates oligohydramnios. A strong deviation of this indicator indicates a violation of blood circulation in the placenta - fetoplacental insufficiency.
Cloudy amniotic fluid may indicate an infection.
The uterus is also examined: the presence of myomatous nodes, the tone of the uterus, and the thickness of its walls is determined.

Second examination at 20 – 24 weeks

The main purpose of this examination is to identify disturbances in the development of the internal organs of the fetus: liver, kidneys, heart, brain, digestive organs, and also to detect symptoms of infection of the fetus. Now the facial features of the fetus are clearly visible and defects such as a cleft lip or cleft palate can also be detected. Even a violation of the formation of teeth is detected at this time. Now it is already possible to determine the gender of the unborn baby, although these data may still be subject to adjustment. You can very accurately study the structure of the heart, down to the chambers and valves, and also calculate the heart rhythm.

At this stage, it is already possible to accurately determine the location of the placenta and diagnose its presentation.
In eight out of ten pregnancies, the umbilical cord loops are in close proximity to the cervix or legs of the fetus. However, this does not indicate the presence of umbilical cord entanglement. This diagnosis is made on the basis of Doppler ultrasound and it indicates that the fetus is suffering from a lack of oxygen and nutrients. But even in the presence of entanglement, doctors do not always resort to surgical intervention during childbirth.

Examination at 30 – 32 weeks

At this time, it is possible to identify developmental delay syndrome and detect a number of developmental disorders ( for example, heart defects), which cannot be detected earlier. This examination also traces the position of the placenta and fetus, it can be detected early aging placenta. According to the norms, up to 32 weeks the placenta should be of the second degree of maturity.
The amniotic index at this stage should be 10–20 cm.
At this time, it is possible to determine how much the weight and height of the fetus corresponds to age norms.

Examination at 36 – 37 weeks

The size and weight of the fetus is determined. Important at this stage is also given to the position of the fetus. Although, before giving birth, he can still roll over.
From this date, the degree of aging of the placenta is 3. Its thickness is 26 - 45 mm. Any deviation from the norm is a reason for additional Doppler examination, and possibly tests. It is very important that it is during these last weeks the baby did not suffer from a lack of oxygen and nutrients.

Fetal heart examination

Ultrasound examination of the fetal heart during intrauterine development is a very difficult task, requiring high professionalism from doctors. Such research is new in medicine. According to statistics, heart defects occupy the first place among all defects in newborns. Often the baby leaves the maternity hospital home, and his parents believe that everything is fine with the baby and a heart problem is discovered only at two or three years of age.
With the help of an expert ultrasound of the heart, almost all life-threatening defects can be detected in the fetus, leading either to death or requiring urgent surgical intervention immediately after the birth of the child.

Such studies can be started no earlier than 18 or 20 weeks of gestation. During the study, the valves, ventricles, and vessels are examined in great detail, and the blood flow rate is calculated. Defects of the septa are also detected.

Indications for expert ultrasound of the fetal heart:

• Insulin-dependent form of diabetes mellitus in the mother,
• Fetal heart rhythm disturbances
• Genetic predisposition to congenital defects hearts,
• The use of certain medications by a pregnant woman in the first weeks of pregnancy,
• The likelihood of a defect identified during a routine ultrasound examination.

Preparing for an ultrasound

If your pregnancy is less than 12 weeks and a transabdominal examination is being performed, your doctor will ask you to drink about a liter of water an hour before the procedure. A filled bladder will “squeeze” the uterus out of the pelvic cavity and make it possible to see it better. For more later, and also when conducting a transvaginal examination, no preparation is required.

Interpretation of examination results

The first points in the ultrasound protocol will be the last name, first name, patronymic of the subject, then the first day of the last menstrual cycle, as well as the probable duration of pregnancy.
Most information will be about the fetus.

So:
1. The presence of fetuses and their number, condition.
2. Presence of presentation ( oblique, transverse, pelvic, cephalic or variable). In the first and second trimesters, the fetus can take any position. But after thirty weeks the position should normally be cephalopresenting. But there is a possibility breech presentation. Sometimes in such cases a caesarean section is prescribed. Although a few hours are enough for the baby to take the “correct” position.
3. Fetometry of the fetus: size of the head, abdomen, hip, heart and cerebellum, height and weight, term, as well as growth parameters: normal, slow, accelerated or not at all. Presence of malnutrition.
4. Width of the collar area. U is correct developing fetus at 12 weeks the width should be within 3 mm.
5. Presence of congenital defects.
6. The presence of an umbilical cord entwined around the neck. Its presence should not immediately frighten you.
7. Heart rate ( Heart rate) should be between 110 and 180 beats per minute. The “older” the fetus, the lower this figure - by the end of pregnancy from 120 to 160 beats per minute.

Transvaginal examination

Transvaginal ultrasound examination is prescribed from three weeks and is done only at early stages. Such an examination allows you to clearly see the fertilized egg and fetus and determine the gestational age with an error of one day. The examination reveals ectopic pregnancy, as well as some malformations noticeable already at such early stages of development.

Ultrasound 3d and 4d

If most devices operating in 2D clinics show a black and white flat image, then a 3D device makes it possible to see the baby in volume. Such a device shows a clearer picture, allowing parents to independently determine whether they are expecting a son or a daughter. It turns out something like a holographic photograph.
The device for volumetric ultrasound examination is no different in appearance from its predecessors. Ultrasound frequency is similar to 2d analogues. Thus, the procedure is no more dangerous than a regular test.

A three-dimensional examination can be carried out at the same time as a regular one. But it is best to do it before 24 weeks, since at this “age” the baby can still fit entirely on the screen. Interestingly, after 30 weeks, some babies even resemble one of their parents.

The duration of a three-dimensional examination is slightly longer than a usual one. Since first a two-dimensional image is made, and then a special function is turned on and a three-dimensional image appears on the monitor.
During a three-dimensional examination, you can very clearly see the blood supply system, as well as identify some defects that are invisible during a two-dimensional examination.

4D is already a whole color film about a baby that you can watch and film.
The image can be immediately downloaded to disk and kept in the family archive.
Due to the fact that the equipment for this type of examination is expensive, and the medical information obtained from 3D or 4D differs little from the already known two-dimensional image, public clinics rarely purchase such equipment.

Doppler

Using Doppler ultrasound, you can determine the state of the circulatory system of the fetus and placenta.
This is very important information, which is required if a pregnant woman has problems with blood clotting.

Indications for Doppler testing.