When is a routine ultrasound done during pregnancy? Do I need to prepare for the procedure? Condition of female reproductive organs
During pregnancy, any woman needs to undergo 3 scheduled ultrasounds, plus additional ones on the recommendation of an obstetrician-gynecologist. When they do the latter ultrasound scanning? The duration of the study may vary. According to the law, the third screening (comprehensive study) must be completed at 30-34 weeks, and a planned ultrasound earlier - at 30-32 weeks.
But the third scan is not always the last: sometimes the doctor prescribes another procedure just before the birth.
Why do you need the latest ultrasound?
The main task of ultrasound during pregnancy 30-34 weeks is to determine the readiness of mother and baby for childbirth and determine the tactics for childbirth.
As with previous ultrasounds, one of the main functions of the analysis is to identify the presence/absence of serious developmental defects in the child. Most pathologies are shown by the second ultrasound, but some abnormalities can only be seen in the third trimester. These include renal hydronephrosis (fluid accumulation in children's kidneys), megaureter (enlargement of the ureter).
If pathology is detected, the final scan will decide whether the baby needs surgery immediately after birth or if there is a possibility of delay. Surgery can be postponed if the anomaly does not threaten the baby’s life. If a defect is diagnosed that is incompatible with life, the doctor may recommend artificial birth (up to the 40th week).
Objectives of the last ultrasound Regardless of which week of the third trimester the last ultrasound is performed, its tasks are the same. On latest dates
- Pregnancy ultrasound is designed to evaluate:
- Fetoplacental and uteroplacental blood flow (deviations may indicate developmental delay);
- The size of the baby, their correspondence to the gestational age;
- Localization of the placenta and the degree of its maturity;
Position of the baby in the uterus (cephalic, pelvic or transverse). The last two points directly influence the choice of birth tactics - natural or C-section
. At the same time, the position of the baby in the uterus is not always the determining factor. When scanning is done at 33 weeks or earlier, there is still a risk that the baby will turn over.
The last ultrasound during pregnancy is always done using the transabdominal method (through the outer wall of the abdomen).
First, the doctor assesses the number of fetuses and their location, then the anatomical structures of the fetus, and clarifies the condition of the placenta and amniotic (amniotic) fluid.
- During the last ultrasound you can determine:
- number of fruits and their position;
- difference in the size of the embryos (if twins or triplets are expected);
- some child developmental defects;
- changes in the cerebral cortex in the fetus;
- infection of the embryo due to diseases that the mother suffered during 9 months of gestation;
- position, structure and thickness of the placenta;
- distance from the edge of the placenta to the internal os of the cervix;
the amount of amniotic fluid, its color and purity (heterogeneous composition may indicate fetal hypoxia).
Norms of the latest ultrasound
For ultrasound at 30-34 weeks of pregnancy, there are certain standards recorded in special plates. Do not be afraid of minor deviations in indicators from standard figures: this extremely rarely indicates any developmental disorders. If the mother has any doubts about the baby’s condition, the attending physician will explain the ultrasound results in detail and allay all concerns.
- Standards for the last ultrasound during pregnancy include the following parameters:
- fetal presentation;
- fetometry indicators (child’s circumference and length of tubular bones);
- internal organs;
- biophysical profile (assessment of the baby’s posture, breathing, movement);
- placenta indicators;
- amniotic fluid;
mother's pelvic organs.
Indicators of fetal fetometry on the third ultrasound are biparietal diameter (BPD), head circumference (GC), abdominal circumference (AC), fronto-occipital size (FOR). The length of the femur, shoulder and overall weight of the child are also assessed.
During the final ultrasound, the doctor examines the child’s internal organs and skeleton: brain structures, spine, face, lungs, heart and tummy. To assess the condition of the mother and her readiness for childbirth, placenta indicators are of great importance. First of all is the location. It is optimal if the placenta is attached to back wall
uterus, but other localization is also allowed. The only pathology is previa, when the placenta is too close to the cervix and practically blocks the exit from the uterus. The specialist also looks at the thickness of the placenta at the site of attachment and maturity.
When it comes time for the last ultrasound, in most cases, doctors prescribe prenatal screening for the patient. This is the name of a comprehensive analysis for the most complete assessment of the condition of both the expectant mother and the baby. The final screening during pregnancy includes:
- ultrasound diagnostics;
- dopplerometry:
- cardiotocogram;
- "triple screening" ( biochemical analysis blood).
Doppler is an assessment of the speed of blood flow in the vessels of the child, as well as the uterus and placenta. In the third trimester, such an analysis makes it possible to recognize possible fetal hypoxia and evaluate the functioning of the child’s central nervous system and cardiovascular system. A Doppler ultrasound is performed in the same way as a regular scan.
Cardiotocography is a study of the baby's heartbeat, which also allows you to find out whether the baby is suffering from a lack of oxygen. Cardiotocography is done using an ultrasound machine, but it is not the image of the child that is displayed on the screen, but his cardiogram.
A planned ultrasound at the 30-34th week of pregnancy is not always the last. In some cases, a final scan may be needed just before delivery, after the 37th week. This is required to clarify the presentation of the fetus, the speed of blood flow in the uterus and placenta, and the condition of the fetus itself. The last ultrasound at 37 weeks is required if multiple pregnancy
. Often, the doctor advises carrying out the procedure for overweight patients. If gestation occurs with normal indicators , then the first ultrasound during pregnancy is always scheduled at the beginning of the 2nd trimester. If a pathological process is suspected, ultrasound examination can be used for more early stages
, in this case, transvaginal ultrasound is most often used.
When and how to do the first ultrasound for pregnant women First scheduled ultrasoundduring gestation, it is done at 11-13 weeks. It is during this period that the child reaches sufficient size to evaluate anatomical parameters and compare them with generally accepted standards. Most often, at this stage, ultrasound is performed in the abdominal way, when the sensor is moved across the abdomen, thus, the ultrasound waves penetrate through the abdominal wall. If the doctor suspects the formation, then the first ultrasound during pregnancy is done at an earlier stage. In this case, a transvaginal examination method is prescribed, which involves inserting an ultrasound sensor into the pregnant woman’s vagina. The method allows you to establish the date and fact of conception already in the first weeks, and see the dynamics of embryo development.
Ultrasound of a pregnant woman using the transvaginal method is considered the most harmless and is not at all dangerous for intrauterine development. If you need to determine the location of the attachment of the fertilized egg, then this method will show the exact location. If an ectopic pregnancy is diagnosed, appropriate therapy will be prescribed.
1 ultrasound after IVF in most cases is prescribed in the third week after embryo transfer, and the next study is already in the 5th, in order to determine the fetal heartbeat.
What does the first ultrasound during pregnancy show?
First of all, during the first ultrasound examination they look at and confirm the fact of conception, and then evaluate the parameters of embryo development:- at 1-3 weeks, the first ultrasound during pregnancy shows the attachment site of the fertilized egg, the size of which is about 3-4 mm, and also eliminates the risk of ectopic fetal formation;
- at 3-4 weeks the embryo reaches 4-5 mm, you can consider the initial stage of the formation of limbs and the umbilical cord;
- starting from 5-7 weeks you can hear the fetal heart rate;
- period from 8-11 weeks of gestation, ossification points and bones appear.
Explanation of the first screening
Initially, the number of embryos is entered into the protocol for ultrasound examination of a pregnant woman. If there is a multiple conception, each fetus will be assessed individually.Subsequently, during decoding, the coccygeal-parietal size (KTP - the distance from the beginning of the head to the coccyx) and heart rate (HR) are determined. These parameters must comply with the norms; any deviation indicates a functional pathology in the development of the baby.
Additionally, an analysis is used for the presence of chromosomal abnormalities (Down syndrome, Edwards syndrome and others), which is carried out by studying three markers. For this purpose, the thickness of the collar space is assessed using ultrasound, and blood is taken at the same time to determine hCG level and protein A.
Among other indicators, the location, condition and location of the chorion is studied, the heterogeneous structure of which may indicate an infectious process inside the womb.
During prenatal diagnostics condition is also assessed internal organs women. The uterine cavity, appendages and genitourinary system are subjected to a particularly thorough examination, which, with the active growth of the baby, will experience significant stress.
During the early screening process, after studying all the parameters, the doctor will definitely show the woman her baby inside the womb. In some clinics you can record your first ultrasound on video.
Video of what is shown at the first ultrasound during pregnancy
Ultrasound diagnostics is an important tool for doctors when managing any pregnancy. This method allows you to obtain a large amount of information about the baby’s condition, his development and growth, make sure that he has no pathologies, and also find out whether everything is in order with the mother’s reproductive health.
For expectant mothers, according to experienced obstetricians, ultrasound is the best medicine, because each such “meeting” with the baby lifts the mood and even improves well-being.
We will tell you in this article how often you can do an ultrasound during pregnancy.
The essence of the method
Ultrasound, also called sonography, is a gentle, non-invasive examination method in which ultrasonic waves help to examine the internal organs of the human body.
The devices used for research are equipped with ultrasound wave generators. These waves pass through tissues and liquids of different densities and consistencies at different speeds. Fabrics tend to prevent the penetration of ultrasound.
Waves, colliding with liquids, easily pass through them, and when they encounter tissues and organs, they are reflected at different speeds, which depend on the density of the tissues. So the signal sent by the sensor returns back to the sensor and is transformed into a picture. This is exactly how the image appears on the scanner monitor.
The devices themselves are different - both entry-level and expert class. There are also different kinds of diagnostic doctors, whose task is to decipher and measure the image seen on the monitor. Ultrasound diagnostics today is no longer considered an exotic method; it is carried out everywhere. During pregnancy, ultrasound helps in solving a variety of medical problems.
Types of ultrasound during pregnancy
There are different types of ultrasound diagnostics used in pregnancy management. It all depends on the specific purpose of the study and the circumstances.
Here are the main types of research:
Intravaginal (transvaginal)
This method of obtaining information is popularly called simply internal ultrasound. For examination, a vaginal oblong sensor is used. The examination is carried out through the relatively thin vaginal wall. This study is used when it is necessary to examine a woman’s pelvic organs., identify any gynecological problems.
During pregnancy, diagnostic examinations are carried out in this way “ interesting situation"in the early stages and in case of threat of miscarriage, in order to better assess the condition of the internal genital organs of the expectant mother.
Transvaginal ultrasound will also be performed on women who have excess weight and fatty deposits on the abdomen of different volumes, making visualization difficult, more later pregnancy.
Transabdominal
Doctors use this method in the second and third trimester of pregnancy, as well as before and after childbirth. An ultrasonic wave sensor is placed on the outer wall of the peritoneum, having previously lubricated the abdomen with a special gel, which ensures tighter contact between the sensor and the skin at the molecular level.
In the early stages, such an examination is impractical, since the uterus is not filled with fluid that conducts waves well; it is much easier to assess the condition through the vaginal wall.
As the child grows, the amount of amniotic fluid increases, which is an excellent medium for conducting ultrasound waves.
3D
This modern method, which has gained wide popularity among doctors, and especially among future parents, who such research makes it possible to see the unborn baby in all its glory and even understand who he is more like - mom or dad.
In fact, such an ultrasound does not differ from a standard two-dimensional one, the only difference is the sensor, which forms on the screen not a flat two-dimensional, but a three-dimensional three-dimensional image.
It is best to carry out such an ultrasound from the 20th week, since it is after this period that the child is clearly visible, his facial features are formed, and there are no difficulties in determining his gender.
4D
This is an even more modern method, which allows you not only to obtain an image, as with a two-dimensional equivalent, and not just to obtain it in volume, as is done in 3D diagnostics, but also see not just a static picture, but the baby in real time. That is, to all the characteristics of ultrasound diagnostics, another important parameter is added - time.
As a result parents can receive not only a beautiful photo of the baby for the family album, but also a video recording- a small film about the intrauterine life of a son or daughter.
There will be such a “movie” a good gift to the child himself, for example, on his coming of age.
5D
This innovative development, which is already beginning to be actively introduced into medical practice. Special scanners with 5D support can perform research in any format - two-dimensional, three-dimensional, four-dimensional. The difference is that the image will not only be 3D with real-time motion, but the program itself will measure the main indicators - bone length, TVP, etc.
This is convenient for clarifying data and for diagnosis if the baby is located in the uterus in such a way that a conventional two-dimensional sensor cannot show some parts of his body. 5 D in this case it will show and measure with great accuracy.
USDG
This is a conventional two-dimensional or three-dimensional ultrasound, which determines the speed of blood flow through the uterine vessels, measuring the placenta and studying its structure. Popularly, this diagnosis is called “ultrasound with Doppler,” and such a study is prescribed from approximately 20-22 weeks of pregnancy, when the placenta is already well developed. The study is carried out as usual, two-dimensional; there are no differences in the execution technique.
Ultrasound ultrasound is used when there are suspicions of disturbances in uteroplacental blood flow, malformations of the baby, hypoxia, fetoplacental insufficiency or developmental delay of the baby.
To all women such an examination is prescribed at least once during pregnancy. Some people do it more often if the pregnancy is problematic and there are concerns about the condition of the child.
Deadlines for mandatory diagnostics
Ultrasounds during pregnancy can be considered mandatory only conditionally. The Russian Ministry of Health recommended that expectant mothers conduct such studies, and therefore they are considered planned.
A woman has the right to refuse to undergo an ultrasound scan at any time without giving reasons. But before making such a decision, you should weigh everything carefully possible risks, because refusing an ultrasound means it is impossible to determine whether the baby is developing correctly and whether he has gross anomalies.
During the period of bearing a child, a healthy woman with an uncomplicated anamnesis is shown three planned examinations.
In the first trimester
Ultrasound is performed as part of the first prenatal screening, aimed at identifying the risks of giving birth to a child with gross genetic and chromosomal abnormalities. In addition to scanning, the woman will have to donate blood from a vein for biochemical analysis.
Ultrasound scanning carried out from 10 to 13 weeks. It allows you to see some signs (doctors call them “markers”) of possible defects, such as Down syndrome, Patau disease, Turner disease, Cornelia de Lange syndrome and various pathologies of the brain and spinal cord (neural tube).
In the second trimester
A mid-pregnancy ultrasound is part of the second prenatal screening, which also includes blood tests and ultrasound. The objectives of screening are the same - searching for markers of probable pathologies.
In addition, the second planned study evaluates the rate of development of the baby and the characteristics of pregnancy. Such an examination is carried out from 18 to 21 weeks.
In the third trimester
The third scheduled ultrasound is the last prenatal screening that is performed from 30 to 34 weeks of pregnancy. It also evaluates the development and growth of the child, his expected weight, position in the uterine cavity relative to the exit from it, because childbirth is just around the corner, and doctors need to decide on delivery tactics.
Indications for unscheduled ultrasound
If necessary, ultrasound diagnostics can be used at any time. For example, at the very beginning - to establish the fact of pregnancy itself, to establish the fact of multiple pregnancy, when two or three babies grow under a woman’s heart.
During ultrasound, women often go to at will- find out the sex of the child, see how he has grown. Doctors have certain indications for conducting unscheduled ultrasound examinations.
Among them:
- Clarification of gestational age. If a woman does not remember the start date of her last menstrual period, or if she has an irregular cycle, then the obstetrician will need an ultrasound specialist's opinion to determine the expected date of birth.
- Threat of interruption. If a woman complains of pain, discharge from the genitals, which should not be normal, abdominal tension, tone, if a manual examination on a gynecological chair reveals smoothness and shortening of the cervix, opening of its external pharynx, then an ultrasound is done urgently.
- Suspicion of delayed development of the baby, intrauterine death. The referral in this case is issued by the obstetrician based on the difference between the size of the uterus, the height of its fundus, which are determined at the appointment, and the actual gestational age. Also, pregnant women whose nature of the baby’s movements suddenly changed for an ultrasound scan are sent out of schedule - they have become more aggressive and frequent, infrequent and apathetic, or the movements of the baby in the mother’s womb have stopped completely.
- ECO. Women who are able to become pregnant through in vitro fertilization need constant monitoring of their pregnancy. They may be prescribed ultrasounds much more often, just to make sure that everything is going well.
- Assessing the consequences of diseases and treatment. If a woman has suffered from some kind of infectious disease during the period of bearing a child, if she received treatment prescribed by a doctor, a control ultrasound is done to assess whether the baby has suffered and whether everything is fine with him. If a woman has undergone any operations, for example, suturing the cervix, periodic ultrasound control is indicated almost until the very birth.
How to prepare for the examination?
As such, preparation for an ultrasound is needed only in the early stages of pregnancy, up to 10-12 weeks. As already mentioned, ultrasound penetrates liquid better, and therefore, when preparing for an external examination performed in a transabdominal manner, this should be taken into account.
A woman needs to drink about half a liter of water about an hour before the test to fill her bladder. At a later date, this will not be necessary, since there will be more than enough amniotic fluid to conduct an ultrasound signal.
In the early stages, regardless of what type of examination is to be done - external or vaginal - care should be taken to ensure that the intestines are not overfilled with feces and intestinal gases.
Swollen intestinal loops can compress the pelvic organs, distorting the true size of the latter. Therefore, before an ultrasound, a couple of days before an ultrasound, it is not recommended to eat foods that contribute to increased gas formation. These include legumes and peas, beans, baked goods, brown bread, any sweets, especially factory-made ones, sparkling water, dairy products a lot.
On the morning of the scheduled examination, you need to have a bowel movement. if there is no urge to defecate, you should use a microenema, for example, Microlax, and also drink activated charcoal or Smecta (Espumizan and Simethicone are also suitable) to free the intestines from gas bubbles.
Such preliminary preparation will not be necessary in the second trimester and in the later stages of pregnancy, when the uterus grows so large that it itself will push the intestines. Then no gases will be able to distort the true picture of what is happening to the baby.
If you have an ultrasound scan, if it is performed as planned, you should definitely take an exchange card, passport, medical insurance card, paper napkins to remove excess diagnostic gel from the abdomen, as well as a condom if the examination is carried out using the transvaginal method.
For any type of ultrasound scanning You should take a clean diaper with you, which can be placed on a gynecological chair (for transvaginal examination at an early stage), on a couch (for other types of ultrasound at other stages). It is advisable to have replacement shoes and some money with you in case the printing of photographs of the baby in this office is carried out on a paid basis.
Routine ultrasounds and unscheduled examinations prescribed by a doctor are performed free of charge. But some services are not included in the insurance cases provided for by the medical policy. So, gender determination during screening is a paid service, as well as printing a photo or copying a video file from the device to an electronic medium.
You can find out the prices for these ultrasound opportunities, which are important for expectant mothers, at the specific medical institution where she will be examined.
When can pregnancy be detected?
This question interests all women who dream of having a child and are planning one. Two weeks after ovulation the level of the specific hormone hCG in the woman’s blood is already increasing, and pharmacy tests and laboratory blood tests for human chorionic gonadotropic hormone begin to give positive results. However Ultrasound does not show anything at this time, even if the test showed a double stripe.
The size of the baby at this stage is only about 1 millimeter, and not a single modern device or doctor of the highest category can see it. But in a week such an opportunity theoretically appears However, much of this depends on the quality of the scanner and the level of preparedness of the diagnostician.
The baby grows up to 4 millimeters, his heart begins to beat. On an ultrasound, a heartbeat in the full sense of the word cannot yet be heard, but the pulsation should not escape the gaze of an experienced doctor.
Thus, the earliest time at which pregnancy can be seen is 7-10 days after the delay or three weeks after ovulation, of course, if it occurred on time and the implantation of the baby into the uterine cavity was not delayed.
Usually, an ultrasound examination shows the presence of a fertilized egg in the uterine cavity from 4 weeks after the delay, from 5-6 obstetric weeks.
In addition to the usual female curiosity, which, as is known, can be stronger common sense, in the first weeks of pregnancy, an ultrasound may be needed for well-founded medical reasons.
Such the need arises if the delay is accompanied by bleeding, which are not related to the next menstruation, pain. After conception accomplished through IVF, ultrasound monitoring is also necessary in the first weeks.
Make sure that pregnancy has occurred and ovum descended into the uterus, as prescribed by the laws of nature, is also necessary if the woman has previously had early miscarriages, ectopic pregnancies, frozen pregnancies at the very beginning of gestation, as well as surgical interventions, tumors and other gynecological problems that may affect the normal development of pregnancy.
Baby development by week
If the expectant mother did an ultrasound every week, starting from 1 week of pregnancy, when the baby is not yet conceived, she would be able to see the entire evolution of humanity through the example of one baby.
Before ovulation, an ultrasound shows how the follicle matures, after it - how the corpus luteum is formed in the ovary - a temporary gland, the task of which is to help the embryo in the very first weeks of its development with a shock hormonal background.
You can determine the fertilized egg from the 5th week of pregnancy. The baby's heartbeat can be heard already 3 weeks after conception. At this time, the formation of internal organs begins, but they will not be visible yet. At 5-6-7 weeks of pregnancy, an ultrasound shows only the fertilized egg - one or two, if there are several babies. The doctor can measure it and assess its viability.
At 8 weeks During pregnancy, the baby already looks like a little man, although he is only the size of a grape. He has a big head and his embryonic tail will soon fall off. The face and ears are actively forming, the formation of the genital organs is beginning, but it will not be possible to see them on an ultrasound yet, since for now we are only talking about the formation of the internal sex glands.
At 9 weeks the baby has all the organs, although they are in their infancy. During an ultrasound examination at this stage it is still quite difficult to examine them in detail, but in general terms it already becomes clear that the baby has two arms, two legs, a head, big belly, there is a fairly well-formed heart, liver, kidneys, and lungs.
At 10 weeks The ultrasound scanner detects the baby's movements well. They are still chaotic, sometimes involuntary, but a good sensor already allows you to “peep” what the baby is doing in the womb.
At 11 weeks The baby still has pronounced disproportions of the body and head - the head is large, and the body looks small and very thin in comparison. A good device with a highly detailed image will allow you to see the baby’s face at this stage with eyes still widely spaced, ears lowered below the level familiar to our perception. Every day the baby's facial features are changing, and soon the ears and eyes will fall back into place.
At 12 weeks The baby is already the size of an average lemon. He is no longer an embryo, but a fetus. Now the baby can please the doctor and the expectant mother, who is looking at him through the monitor of the ultrasound machine, with more active facial expressions, more “conscious” and precise movements. If the scanner is good, then you can count the baby’s fingers.
At 13 weeks the child begins to acquire sexual characteristics. The genital tubercle, which up to this point was exactly the same in both boys and girls, becomes either the penis or the labia. In theory During this period, it is quite possible to determine the sex of the baby using ultrasound diagnostics, but the gender differences still look too small, and it is not always possible to accurately recognize a boy or a girl.
At 14 weeks, if a pregnant woman comes for an ultrasound, her baby can show everything he has already learned. And he can do a lot of things - suck his finger, play with the umbilical cord, react to loud sounds, unfamiliar voices. Moreover, it is already possible to determine the character of the baby. Some of the little ones begin to move animatedly at the sound of the doctor’s voice, which is alien to him, while the other one freezes, trying to hide.
At 15 weeks The formation of the cerebral cortex begins, grooves and convolutions appear. Now every day the little ones will “get smarter”. In the meantime, the baby is busy actively training his lungs - inhaling and spitting out amniotic fluid. At the same time, he “trains” and digestive system, the baby drinks, pees, and the formation of original feces in the intestines begins.
At 16 weeks The baby reaches an impressive size - his height is now almost 11 centimeters. When undergoing an ultrasound scan, the doctor may clearly examine all the internal organs of the child, evaluate them and detect some malformations, if any.
Mom will be able to see how the baby turns his head and makes swimming movements. His skeletal and muscular systems are almost formed and neural connections are now being established between the muscles and the brain. Soon the baby will be able to coordinate its movements.
At 17-18 weeks pregnancy is already possible Determine the sex of the child using ultrasound. Moreover, the accuracy of such a determination will be higher than ever.. At an earlier stage, the genital organs were almost invisible; at a later stage, the baby will become cramped, and he will take a pose with his legs tucked to his stomach or sit down, and it will be even more difficult to discern gender differences.
At 19 weeks During pregnancy, the baby begins to become covered with a protective lubricant, which will protect his skin until birth and in the first hours after birth. His hair is growing, his fingernails and toenails have already grown. He hears, dreams, smiles, yawns, hiccups, plays with his feet or umbilical cord when he is not sleeping. Parents will be able to see any of these actions for themselves if they do an ultrasound at this time.
At 20-21 weeks The baby is fully formed and is already beginning to resemble a newborn. Now all his organs and body parts will only grow, no new ones will be formed. The baby is growing quickly, already now it reaches 25 centimeters from crown to toe.
Ultrasound diagnostics during this period almost accurately determines the sex of the baby. If you do a three-dimensional color ultrasound, you can see the child’s rich facial expressions, amazing in its manifestations - he knows so many grimaces that you can admire them for a very long time.
At 22-23 weeks the child may demonstrate a brain that is ten times larger in size. Its formation has been completed, and now the “debugging” of the central nervous system will be in full swing.
The baby begins to gradually accumulate subcutaneous fat, but still looks quite thin. This should not frighten the expectant mother; very soon both “cheeks” and “dimples” will appear.
At 24-25 weeks Pregnancy on ultrasound can be seen as fully developed, big baby, whose weight is approaching a kilogram. At this stage it is determined who the child will be - left-handed or right-handed, since he already gives preference to one handle when making his movements.
An ultrasound shows how the baby clenches his fists and puts them under his cheek in a dream; at this time, doctors are already more carefully studying the structure of the placenta in order to recognize its early aging, if it occurs.
At 26-27 weeks The baby is actively growing and gaining weight. It works almost autonomously endocrine system,immunity begins to develop. During the ultrasound scan, the child will no longer demonstrate somersaults and somersaults, since he becomes cramped in the uterus.
At 28-30 weeks For the first time, the baby can please his mother with chubby cheeks, because he has already accumulated a sufficient amount of subcutaneous fat. You can enjoy this spectacle with a regular, two-dimensional ultrasound, but the impressions received from a three-dimensional one cannot be compared. The baby has grown, his weight is more than a kilogram, and his height is already about 40 centimeters.
At 30-33 weeks It’s worth visiting a color ultrasound to see how the baby’s skin has changed. It stopped being red, the wrinkles were smoothed out due to the subcutaneous fatty tissue. Research at this time is of great importance, because by the 33rd week most babies already occupy the position in the uterine cavity from which they will soon be born.
At 34-37 weeks The baby sleeps more, gathers his strength, and soon he will have an important event - his own birth. Externally, the child at this stage changes little, his growth slows down, only weight gain remains intense. An ultrasound evaluates the placenta and umbilical cord; a lot depends on their condition in the last weeks of pregnancy.
At 38-40 weeks the baby looks exactly the same as at birth. Many mothers save photos from 3D ultrasound at this stage and compare them with photos in the first days after the birth of the baby.
Motor activity There is no need to wait on the baby during the examination; he is very cramped. But facial expressions and grimaces literally save the situation - if they can be captured in a photograph, it will be one of the best pictures in the family album.
Interpretation of ultrasound - basic rules and terms
Questions about decoding the results of an ultrasound examination concern all pregnant women without exception. You always want to be sure that the child is developing according to the deadline, that everything is fine with him.
To understand the ultrasound protocol, you do not need to have much knowledge in the field of medicine. It is enough to understand what terms the diagnostician uses and what they mean. We publish all the data presented for informational purposes only; it is not recommended for the expectant mother to diagnose herself. Ultrasound should only be deciphered by a doctor.
In the first trimester
In the first third of gestation, the ultrasound protocol plays a special role in the location and size of the ovum. It is its development in the early stages that gives the most accurate idea of the course of pregnancy.
To characterize this parameter, a certain value is used - SVD (average internal diameter of the fertilized egg). It is measured until about the 10th week of pregnancy; after this period, the main parameter is another size - CTE.
SVD is very important in the diagnosis of non-developing pregnancy, anembryonia, when the baby, for some reason, died in the very initial stages of pregnancy, if there is no embryo in the fertilized egg at all, as well as when there is a threat of miscarriage or an incipient miscarriage.
Coccyx-parietal size the fetus is a segment from the coccyx to the crown. It is the main parameter indicating the growth rate of the baby up to 15-16 weeks. In the early stages, the diameter of the yolk sac, which serves as a food storehouse for the baby, is also measured.
In the first third of gestation The main task of ultrasound scanning is to identify possible problems in the formation and development of the baby, so that the woman has a choice - to keep the child or have an abortion for medical reasons if pathologies are detected in the baby.
To do this, measure the length of the nasal bones (DNA) and the thickness of the nuchal space (TN). These are the very markers that can indicate the risk of developing pathologies.
In the second and third trimesters
From the second trimester, the ultrasound protocol includes new concepts and abbreviations that are unclear at first glance - BPR, DBK, etc. These abbreviations indicate the main sizes, because the baby has grown up, and the doctor no longer measures his entire height from the tailbone to the crown. You can get an idea of the proportions of the baby’s body by looking at its individual parts.
The main parameters are the longitudinal and transverse dimensions of the head. Using them, pregnancy dates are checked, the date of expected birth is specified, their proportions can indicate possible problems with the child's health.
The longitudinal dimension from the frontal to the occipital bone is called fronto-occipital (FOR), and the transverse dimension - from temple to temple - is called bipariental (BPR). They cannot be considered separately; when deciphering the ultrasound protocol, both sizes are taken into account collectively.
Paired bones are also subject to measurement - these are the femoral bones (FB), shin bones (DKG), as well as the humerus (HB) and the forearm bone (DKP). The baby's development can be indirectly indicated by the circumference of the baby's tummy and the diameter of his chest.
All these dimensions together allow the program embedded in the scanner to calculate the estimated weight of the fetus, which can be indicated in the protocol under the abbreviation PMP.
The thickness of the placenta, index amniotic fluid- amount of water (IAW). In the seventh month, using ultrasound, the blood flow in the uterine vessels and placenta is examined.
Closer to childbirth, these parameters become crucial, as do the anatomical features of a woman - features of the pubic symphysis, the size of the small pelvis.
How is the norm determined?
Whether or not the baby’s size meets the standards is determined using special diagnostic tables that are used by all diagnosticians. In most modern scanners, this information is embedded in the program, so it itself indicates which values correspond to the deadline and which do not.
Small deviations from the specified values usually have no diagnostic weight. In order to say that the baby’s growth rate lags behind the average statistical parameters, the lag must be significant - two or more weeks. Therefore, if the baby is a week behind according to ultrasound, no one will sound the alarm, and expectant mothers are recommended to do this.
Identified deviations and defects necessarily need confirmation; diagnoses are not made on the basis of ultrasound alone. If the doctor suspects hypoplasia of the nasal bones in the baby, a consultation with a geneticist and more accurate, for example, invasive diagnostic procedures will be required.
If the study showed different lengths shin bones or double contour of the head, you will definitely need one more - expert ultrasound to eliminate the human factor and banal errors of outdated technology.
When determining whether a child corresponds to the norm, its possible hereditary appearance traits are taken into account, because there are large and miniature parents, with long or snub noses, respectively, and the children are all different, and this difference becomes especially noticeable in the 2nd and 3rd trimester of pregnancy.
Therefore, a long or short nose, long or short legs are an individual trait, the main thing is that the baby’s body is proportional, and the internal organs work without interruption. The tables themselves, which compare the data, are presented below.
Parameter norms by week in the table
Duration, weeks | BPR, mm | LZR, mm | DBK, mm | DKG, mm | Humerus, mm | Forearm bone, mm | Coolant, mm | Head circumference, mm |
Not defined | ||||||||
Not defined | ||||||||
 Length of nasal bones and TVP in the first trimesterAbout harm and complicationsThere have been debates about the dangers of ultrasound examinations for pregnant women for decades. It must be said that official evidence of the harm or harmlessness of this diagnostic method does not exist in nature. Doctors long years They monitor pregnant women who undergo such procedures, and so far it has not been possible to establish evidence of a negative impact on the development of the child. Therefore, it is believed that ultrasound can be done as many times as the situation requires. However, to this day the influence of ultrasonic waves on the further development of the child, on his condition 20, 30, 50 years after birth, remains unstudied. There is no way to verify this using scientific methods; it is precisely this fact that opponents of ultrasound diagnostics during pregnancy refer to.
Numerous reviews and questions from expectant mothers on women's and parenting forums on the Internet concern the problems of complications after undergoing this type of diagnosis. Transabdominal ultrasound usually no negative impacts does not affect the condition of the woman and her baby. Rarely, after an external examination, a slight and short-lived increased tone of the uterus occurs, which passes quickly. Experts are not inclined to associate it specifically with ultrasound; most often, the reason for the increased tone is the excitement and nervous feelings with which the expectant mother went for the examination. Transvaginal ultrasound may cause some side effects. Usually expectant mothers complain that their stomach hurts after the examination, appear brown discharge , as well as scanty pink and transparent discharge.
It is difficult to answer with any certainty what such “consequences” may be associated with. Experts tend to believe that pregnancy itself is mostly to blame. Under the influence of the hormone progesterone, the mucous membranes of the vagina become more loose and vulnerable. Even an ultrasonic sensor can cause microtrauma. It would be wrong to blame ultrasound for a miscarriage or threat occurring after the study if bloody issues do not stop for two or more days after undergoing diagnostic measures. If this happened, then, according to most doctors, the ultrasound diagnosis simply coincided with the onset of pathological changes in the pregnant woman’s body. On women's forums, a frightened pregnant woman will, of course, immediately begin to tell horror stories about real and fictional characters, and also cite as an example articles found on the Internet about how ultrasound has a detrimental effect on DNA. Such data is not known to official science. Therefore, to draw a parallel between pain and discharge and what was done the day before ultrasound examination not worth it.
Diagnostic accuracyUltrasound, although considered one of the most informative methods for examining pregnant women, is not considered a highly accurate diagnostic method. Its accuracy, depending on the quality of the device and the qualifications of the diagnostician, ranges between 70 and 90%. You should not assume that such a diagnosis will answer all the questions that may arise. Is fetal hypoxia visible, is cerebral palsy or diabetic fetopathy visible on ultrasound - all these are questions that have nothing to do with the real goals of the study. Ultrasound does not make diagnoses. The technique only allows you to detect some alarming signs that may indicate the presence of disorders, pathologies, and anomalies. And it is not at all a fact that the suspicions will be confirmed.
IN next video More information about ultrasound awaits you.
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