Mandatory ultrasound during pregnancy. 3D ultrasound examination. Does ultrasound harm during pregnancy

22.07.2019

For every girl, the waiting time for the birth of her beloved child is the happiest and most exciting. I would like to know what he is, how he develops, what happens to him even at the earliest stage of pregnancy. Every pregnant woman worries about her baby being healthy and developing correctly. It is ultrasound that allows you to monitor the process of fetal development throughout all 9 months.

What is ultrasound

Ultrasound has been known for its special capabilities for a long time and longer than X-ray. Their properties and capabilities are different, but in the field of obstetrics, ultrasound has become just a panacea for solving many problems and provided answers to the most common questions. In addition, ultrasound allows you to diagnose a variety of congenital diseases or pathologies in the early stages with an accuracy of 95-100%. It began to be applied in the middle of the twentieth century and since then every pregnant woman has the opportunity to see her unborn child. What is the essence of the operation of this device?

The device consists of a sensor and a receiver. The sensor sends invisible ultrasonic waves, which, when entering the body, are converted, and the receiver decodes them and creates a picture. Modern equipment allows ultrasound examination at the highest level of quality and opens up many opportunities for doctors and future parents to monitor the process of fetal development.

Today, obstetricians-gynecologists are required to perform several ultrasound sessions during pregnancy. And to be precise, three. Why do you need to do this research? How long should this be done?

Ultrasound in the first trimester

The first ultrasound examination is performed at 9-14 weeks of fetal development. Already on this to see if the baby is growing and forming correctly and in a timely manner. It is during this period that the first deviations and pathologies can be determined (all organs have already been formed in these weeks), and timely actions can be taken to solve such problems. Ultrasound in the first trimester allows you to get answers to the following questions:

The most accurate period of pregnancy is established;
Single or multiple pregnancy;
Ectopic pregnancy;
Risk of miscarriage;
The condition of the uterus and placenta;
The size of the fetus is measured;
It is possible to determine the sex of the child;
The most accurate due date is calculated.

In addition, an ultrasound scan in the first trimester is also performed in order to determine the size of the collar zone - the correctness of chromosomal development is also very important. If this zone exceeds 2.7 mm, then doctors can talk about the presence of pathologies such as Down syndrome. If the ultrasound finds such a deviation, then additional studies and blood tests can confirm the diagnosis. The main thing is to identify the threat in time already at an early stage of development. Unfortunately, modern medicine cannot treat Down syndrome. But its timely determination makes it possible for the mother to prepare for this kind of responsibility.

An ultrasound scan in the first trimester is extremely important and should not be missed by a pregnant woman. Thanks to him, your doctor will be able to establish the correct and most accurate observation of the development of your child. Also, after the study, you can get the first photo of your baby - the uzist doctor can do a screening for you.

It should be noted that it is not recommended to conduct research at an earlier date. While there are many benefits to ultrasound, it can have some side effects. If you are not concerned about lower back or lower abdominal pain, then postpone the first test until the deadline for the first trimester. Early research can only be carried out on the recommendation of a doctor and for good reasons.

The second ultrasound examination is carried out for a period of 20-24 weeks. During this period, you can learn a lot more about the baby. The doctor measures the size of the fetus: the circumference of the abdomen, the head, and the length of the femur. These parameters will help determine developmental deviations. In addition, it is possible to determine how well developed the blood flow inside the placenta, as well as the uterus, the level of their maturity, as well as where and how they are located. The condition of the placenta can tell a lot. If there are seals in it, then this is a harbinger of various infections, and its detachment can lead to miscarriage or premature birth. Therefore, it is necessary to prevent such situations.

In addition, it is on the second ultrasound that the sex of the child is determined with 100% accuracy. The genitals become larger and more pronounced. It is during these weeks that you can talk about who you will be - a boy or a girl.

The second ultrasound examines the amniotic fluid and the cervix. This allows you to prevent a number of pathologies. Timely therapy or timely hospitalization will help normalize the development of the fetus and lead to the threat of miscarriage or premature birth.

Unlike the first trimester test, the screening this time will allow you to have a more accurate picture of your baby.

This ultrasound procedure is performed at 32-34 weeks. By this time, the intrauterine development of the fetus comes to an end, and the fetus itself unfolds with its head down. An ultrasound scan can confirm or deny this fact. And then the obstetrician-gynecologist can plan in advance a strategy for how the birth will take place. If the baby has not turned over by this time, the doctor can take a number of actions to correct his position. The cephalic presentation is very important for the correct and normal course of the labor process. At this stage, thanks to an ultrasound scan, you can find out how much the child weighs and how tall he is. The latest research will also help determine when to give birth. This is especially important if you are scheduled to have a cesarean section.

During these weeks, the position and condition of the placenta is also examined. It is this fact that can tell about whether a woman can give birth herself - in the event that the placenta is attached to the very top of the uterus. If it is displaced to the cervix, then such a placenta previa is an indication for a cesarean section. The maturity of the placenta indicates a woman's readiness for childbirth. If the placenta matures ahead of schedule, then this suggests that childbirth should be carried out ahead of schedule in order to avoid fetal transfer.

At the final ultrasound, you have the opportunity to see your baby the way he is born.

Is it harmful to do an ultrasound

Many women are very worried about whether the ultrasound study done will harm the baby. Medicine does not give unambiguous answers to this question, but no obvious threats to the baby have been identified. It is precisely because of this ambiguity that the number of sessions has been reduced to a minimum - 3 for clearly specified periods. On the territory of our country, the maximum number of ultrasounds can reach 10. But they are carried out exclusively for good reasons and the urgent recommendation of a doctor. This will allow you to secure the development of your baby and make it as correct as possible in the presence of various kinds of threats.

Also today there is an opportunity to conduct 3D research. It makes it possible to get a three-dimensional picture and examine the child from all sides. 3D ultrasound is a real joy for the expectant mother. Thanks to him, you can quite accurately examine the baby's face, especially in the weeks of the last trimester, see how he moves and breathes.

Thanks to modern equipment, we can see our baby in the womb. Ultrasound during pregnancy at various times provides you with the opportunity to take care of your baby even when you cannot touch him.

At what stage of pregnancy is ultrasound done to pregnant women and fetal diagnostics? It is better to consult your doctor about this.

This study allows you to answer numerous questions that arise from the doctor and the patient throughout the gestation period.

Scanning is designed to identify defects, as well as assess the development of the fetus. Every woman who was registered on time is given an ultrasound scan at least three times. But it is not necessary to customize all cases to the standard conditions. Each situation is considered individually. There are women in labor and successful mothers who have never visited the ultrasound diagnostic room for the entire period.

Many expectant mothers have an interest: Even the most experienced obstetrician-gynecologist cannot give you the answer. Everything is very individual. Doctors do not recommend that expectant mothers visit the scan room every week in order to once again assess the condition of the fetus and find out how many millimeters its size has increased. At the same time, a large number of studies can be carried out for certain indications for pregnancy.

There is a misconception that such a diagnosis can harm an unborn child. Doctors say that this is exactly what people who do not understand anything about medicine think. In fact, doing an ultrasound is not so much harmful as useful, but again - according to indications.

If the doctor has doubts and grounds for diagnosing, then he prescribes an unscheduled study. Such monitoring can provide a lot of important information and prevent disastrous consequences. Ultrasound examination for expectant mothers and their children is not at all dangerous. During the procedure, no radiation occurs, but it is this that inexperienced future parents are afraid of. The picture is delivered to the monitor of the device using ultrasonic reflection.

Number of ultrasounds

How often should the expectant mother visit the ultrasound diagnostic room? As you can already understand, there is no definite and unified answer. There are at least three scans performed throughout the pregnancy. These are routine and are called first, second, or third trimester screening. For their implementation, the doctor sets a certain range of weeks (usually from 2 to 4).

In this period, the expectant mother must meet: visit the specialist's office and receive a scan protocol. A woman has the right to refuse diagnostics. It is then that an official document is signed, which indicates the reason for this decision. All responsibility for possible congenital defects and complications of pregnancy falls on the patient's shoulders.

Often during the period you have to do not three, but several more studies. There are certain indications for emergency and unscheduled diagnostics. The number of monitoring cannot be limited by any parameter. If it is necessary and important, then an ultrasound scan is performed almost every two weeks.

Scheduled examinations

How many times to do an ultrasound during pregnancy? There are three planned examinations - three important screenings. With their help, the child's condition, his development and parameters are assessed. In addition, the woman takes a blood test, the results of which make it possible to more accurately interpret the readings obtained during the scan.

The first study is performed from week 10. Doctors recommend staying within 12-14 weeks. During this period, you can get a lot of important information about the embryo, establish its size and gestational age. The estimated due date at this point is considered to be as accurate as possible. Major birth defects are also found during this period. It is very important not to miss the first screening.
The second study is equally important. If everything went well the first time, then it is carried out for up to 24 weeks. It is permissible to visit the ultrasound office as early as 20 weeks. This examination draws attention to defects and malformations of vital organs.
The third diagnosis is performed in the final pregnant trimester. The deadline for its implementation is set from 32 to 35 weeks. Then the condition of the fetus is assessed, its readiness for an early birth. The doctor pays attention to the work of the placenta, studies the blood flow. All this is very important, since a banal lack of nutrition and oxygen can result in a serious injury for the baby.

How many times are ultrasound done during pregnancy, according to the established plan? Three times.

When can the first ultrasound be done?

For the first trimester? Often, it is during this period that a woman has to repeatedly visit the diagnostic room. There can be many reasons for conducting an unscheduled examination.

The first ultrasound is often assigned to the expectant mother to establish the very fact of pregnancy.... This is necessary in case of an irregular cycle, suspicion of ectopic attachment of the ovum, in order to treat inflammation (you need to make sure that there is no pregnancy). The first scan can be done within a week after the delay. At the same time, a modern apparatus will show not only the presence of an embryo, but also fix its heartbeat.

Transabdominal ultrasound

It may be necessary to carry out diagnostics up to 10 weeks due to suspicion of the threat of termination of pregnancy. A scan is prescribed for the following symptoms: bleeding, abdominal pain, lower back aches. If the threat is confirmed, then therapy is carried out. After treatment, it is imperative to do another ultrasound, which will show the result of the use of medications. If you count, then we can say that during the first trimester a woman can visit the ultrasound office three times or more.

Special cases

An ultrasound scan during pregnancy may be prescribed on an emergency basis. In the first and second trimester, diagnosis is often carried out due to the threat of termination of pregnancy. In the third trimester, we are talking about premature birth. Additional research can be carried out after a viral illness, such as influenza. Diagnostics is necessary in order to make sure of the normal development of the baby and the absence of a negative effect of the drugs used on him.

If a woman has an ICI or other problems with the cervix, the test may be repeated several times. Scanning is often required in the second trimester. Moreover, it can be carried out every 7-10 days. So often, an ultrasound scan is needed to track the behavior of the cervix and prevent it from opening in time.

How many ultrasound scans during pregnancy are performed in the third trimester? At the end of the term, diagnostics are often needed by expectant mothers with a history of cesarean section. With the help of ultrasound, gynecologists monitor the condition of the scar. If he allows, then the woman can give birth herself: in a natural way. When the scar is deemed insolvent, another cesarean section is prescribed. However, it may be premature with the risk of seam divergence.

After childbirth: ultrasound diagnostics of the baby

A newborn baby needs ultrasound diagnostics no less than when he was in the womb. Now the actions of doctors are aimed at assessing the development of the baby. There are several important studies that all children undergo. Remember that refusing to do this can have bad consequences.

Study of the hip joints. This ultrasound allows you to assess how the joints have developed, whether there are any defects. In this way, dysplasia can be detected in time.
Neurosonography. This examination of the brain is performed through the unretched fontanelle. With its help, a neurologist can establish pathologies such as intracranial pressure, cysts, and insufficient blood circulation.
Examination of the abdominal cavity. This ultrasound is assigned to all babies. It studies the work of the digestive system and identifies its pathologies.
Ultrasound of the heart is prescribed solely according to indications. If there is no reason for the examination of the newborn, then it is carried out as planned at 12 months.
Ultrasound of the cervical spine is necessary to establish a birth injury or torticollis. Appointed if there is any suspicion of such.

Many parents are afraid of doing an ultrasound scan for a baby. In fact, there is nothing wrong with this manipulation. On the contrary, diagnostics helps to identify pathologies in time and eliminate them without serious consequences. For the first six months of a baby's life, he should undergo at least 4 ultrasounds.

Finally

If you are interested in the permissible amount of ultrasound during pregnancy (how many times it is performed), then you should ask your gynecologist this question. Only a doctor will be able to assess your condition individually and suggest whether additional scans will be needed. No one is immune from the need for an emergency ultrasound scan. Even an experienced gynecologist will not be able to reliably say whether you need it or not. How much ultrasound can be done during the entire pregnancy? As much as you like, but only according to indications!

The first ultrasound examination during pregnancy is always an exciting and important event in the life of an expectant mother. This is the first "meeting" of a woman with her child, who is still very small.

This examination is expected with a special feeling - impatience mixed with anxiety. How and when the first ultrasound scan is performed for women in an "interesting position", as well as what parameters are considered the norm, we will tell in this article.

Dates of the

The first scheduled ultrasound scan, which is recommended for all expectant mothers, is performed for a period from 10 to 13 weeks inclusive. This is an important and informative first prenatal screening for doctors and women. However, for many women, this mandatory examination will no longer be the first, since before 10 weeks, they may have already undergone such a diagnosis.

Theoretically, the first ultrasound can be informative during pregnancy. already 2.5-3 weeks after the expected day of ovulation. This corresponds to approximately the fifth obstetric week.

At this time, for the first time, there is a technical opportunity to see the fetal egg on the monitor of the ultrasound scanner, which will indicate the onset of pregnancy. But until 10-11 weeks, ultrasound diagnostics is not officially recommended without good evidence.

Why is a routine ultrasound performed?

The purpose of a planned study within a specified time frame is to identify the so-called markers of possible fetal pathologies. Until 10-13 weeks by obstetric calculus (this is approximately 12-15 weeks from conception), these markers cannot be evaluated.

The timing of the first prenatal screening was not chosen by chance, because in case anomalies are detected, a woman will be able to have an abortion for medical reasons, without waiting for the deadlines to get big.

There are always more complications after long term abortion.

It is no coincidence that the first ultrasound scan takes place on the same day with the delivery of a venous blood sample for biochemical examination. Ultrasound results are not evaluated separately from blood counts. If markers are found both hormonal and protein balance in the blood are disturbed in a certain way, the risk of having a child with chromosomal abnormalities is higher.

A planned examination within the time frame established by the Ministry of Health is aimed at finding women who are at risk for the likelihood of giving birth to babies with severe total lesions caused by genetic "failure".

A person has 23 pairs of chromosomes. They are all the same, except for the last pair, in which the boys have XY and the girls have XX. An extra chromosome or a lack of one in one of the 23 pairs causes irreversible pathologies.

So, if the number of chromosomes in 21 pairs is violated, the child is diagnosed with Down's syndrome, and if there is an incorrect number of chromosomes in 13 pairs, Patau's syndrome develops.

It cannot be said that the first screening in general and ultrasound examination in its framework in particular are capable of revealing all possible variants of genetic disorders, but the most rude ones, for the most part, can be detected precisely at the first planned study with subsequent additional diagnostics. These pathologies include: Down, Edwards, Patau, Turner, Cornelia de Lange, Smith-Lemli-Opitz syndromes, as well as signs of non-molar triplodia.

Gross defects of the neural tube, such as a decrease or complete absence of the brain, anomalies in the development of the spinal cord, can be detected only at the second antenatal screening, which takes place according to the plan only in the second trimester of pregnancy.

Going to the first scheduled ultrasound scan, a woman should understand that no one will diagnose her baby only on the basis of the ultrasound scanner seen on the monitor.

If the diagnostician has suspicions of pathology and developmental anomalies, he will definitely indicate this in the conclusion, and the woman will be sent for a consultation with a geneticist, who will decide on the need for more accurate diagnostic methods than ultrasound - invasive, during which doctors take particles of fetal tissue , blood from the umbilical cord, amniotic fluid for genetic analysis. The accuracy of invasive methods is almost 99%.

An excellent analogue is the non-invasive analysis of fetal DNA, which is absolutely safe for both the mother and the baby, since to carry it out, the pregnant woman only needs to donate venous blood.

Among other tasks of the first screening ultrasound is to clarify the gestational age according to the size of the baby, to determine the state of female reproductive health, and to assess possible risks in the forthcoming birth in six months.

Unscheduled research - what is it for?

Today, ultrasound examination is more than affordable, and therefore a woman can go on it without the knowledge of the doctor and his direction. Many people do this, and after a home test shows two strips, they go to the nearest clinic to confirm the fact of pregnancy using such a scan.

However, in addition to the woman's desire to know for sure whether conception has taken place, there may be medical indications for the first ultrasound scan ahead of schedule. It happens that before screening a woman has time to do several such examinations.

Medical indications for which the study can be recommended previously established according to the recommendations of the Ministry of Health, the deadlines are diverse:

Miscarriage. If a woman previously had two or more miscarriages at the very early stages of gestation, it is recommended to undergo the first ultrasound scan when registering with an antenatal clinic to make sure that this time the fetus is developing.
History of pregnancy stillness... If, before the current pregnancy, a woman had cases of non-developing pregnancy, anembryonia (absence of an embryo in the ovum), then an early ultrasound scan is strongly recommended to find out if there is a relapse.

History of ectopic pregnancy or suspected ectopic pregnancy. In this case, the task of early examination is to identify possible ectopic anchorage of the ovum as early as possible, while it does not pose a serious threat to the woman's life. Suspicion arises if the level of hCG in the woman's blood is significantly lower than the prescribed level, if there is pain, discharge that does not resemble menstrual discharge, delay in menstruation, while the uterus is not enlarged.
History of trauma and surgery on the uterus. If, before the onset of pregnancy, the woman underwent surgical interventions affecting the main female reproductive organ, then the task of the first ultrasound at the earliest possible date will be to assess the place of attachment of the ovum. The further from the postoperative scars the baby is fixed, the more favorable the prognosis for normal gestation and childbirth.

Suspected multiple pregnancy. In this case, an ultrasound study earlier than the screening dates is necessary to confirm the very fact of bearing two or more babies. The doctor can guess about this by exceeding the level of hCG in the blood of a pregnant woman by two or more times.
Chronic diseases tumors, fibroids. Existing pathologies of the reproductive system can affect not only the ability to conceive a child, but also the ability to carry him out. Therefore, women with such ailments are shown an early examination for an ultrasound scan in order to assess the place of implantation and the growth rate of the ovum.

The threat of interruption. In the very early stages, there may also be a threat of miscarriage. Usually it is manifested by smearing discharge from the genitals, pulling (as with menstruation or a little stronger) pain in the lower abdomen and in the lumbar region, a deterioration in the general condition of the woman. With such symptoms, an ultrasound scan is recommended with the mark "cito", which means "urgently, urgently."
Questionable test results. For a variety of reasons, there may be "disagreements" between the test strips, a blood test to determine the hCG hormone characteristic of pregnancy, and the results of a "manual" gynecological examination. If the disagreements are such that the obstetrician-gynecologist cannot say with certainty whether a woman is pregnant at all, he will definitely refer her for an ultrasound scan.

First diagnosis after IVF

If for some reason a couple cannot conceive a baby on their own, doctors can do it for them. The entire process of in vitro fertilization, from preparation for it, and ending with embryo replanting - "three days" or "five days", is controlled by means of ultrasound diagnostics.

After embryo transfer, the woman is assigned hormone therapy so that babies have a better chance of gaining a foothold and starting to grow in the uterus.

Signs of pregnancy after IVF before hCG

At this stage, the diagnostic task is to make sure that the pregnancy has taken place, and the efforts of the doctors and spouses are crowned with success.

If ultrasound diagnostics shows the presence of a fetal egg (or several fetal eggs) in the uterus, then the next ultrasound examination is scheduled after another two weeks to make sure that the embryos are growing and developing. Then the woman is assigned, like all other pregnant women, a scheduled screening examination at 10-13 weeks of gestation.

What can be seen on the first ultrasound?

The expectant mother, no matter how long she goes to the ultrasound office, is interested in what can be seen at one time or another. Modern types of ultrasound diagnostics significantly expand the prospects, especially for such innovative types as 3D and 4D ultrasound, as well as 5D ultrasound, which make it possible to obtain not two-dimensional, but three-dimensional and even color images in real time.

However, one should not think that the very next day after the start of the delay on any, even the most modern apparatus, you can see at least something. The earliest period at which it is possible (again, only theoretically) to consider a fertilized egg is considered 5 obstetric week(this is three weeks after ovulation or a week after the start of the delay).

There is no need to do an expensive "volumetric" three-dimensional ultrasound at such a short time, because so far you can see only the point, which is the fertilized egg. Going to the first ultrasound, a woman should know what exactly she can be shown.

At 5-9 weeks

An early ultrasound scan, with or without indications, at the will of the expectant mother, will not be able to please a woman with impressive pictures and memorable pictures. At the earliest stages, only a rounded formation in the uterine cavity with a barely distinguishable inner nucleus - the embryo - is determined. In reality, there will not be such a beautiful detailed picture of a small embryo, as they are depicted using computer graphics.

Most women cannot even really consider the ovum itself, especially if the diagnosis is not accompanied by detailed comments from the doctor. But there is also one pleasant nuance - at five obstetric weeks, a tiny baby begins to pound a small heart, or rather, there is a characteristic pulsation where the chest will soon form.

If the apparatus on which the examination is carried out has a sufficiently good resolution and a modern sensor, then the mother will be able to see how this is happening. The main characteristic of the development of the baby at the initial stage is the size of the ovum. This is what the doctor will measure if a woman comes for a scan at 5-9 weeks of pregnancy.

If the first ultrasound occurs at 7 weeks according to obstetric calculation of the gestational age (approximately 5 weeks from the day of ovulation), then the woman will most likely be able to show her baby. The embryo at this time has a disproportionately large head and tail.

At 9 weeks old, the baby will already acquire human forms that are more understandable to the mother, although both the tail and the large head will still be observed. The heart of a child at 8-9 weeks can already be heard if the ultrasound machine is equipped with acoustic speakers.

At 10-13 weeks

By the time of the first screening, the baby is changing dramatically. At the first scheduled ultrasound scan, a woman will most likely show such a baby.

He already has clearly distinguishable pens, if you're lucky, you can even see the fingers on them. We can also distinguish the facial profile, tummy, chest. The heart of the crumbs beats rhythmically and loudly, they will let you listen to it.

In the baby at this time, the distance from the coccyx to the crown is measured ( coccygeal-parietal size or CTE), the distance between the temporal bones is the biparietal head size (BPD), sometimes they continue to measure the size of the ovum, but this size is no longer of great diagnostic value.

The main goal is to find, if any, the markers for the chromosomal abnormalities discussed above. These include two sizes - the length of the nasal bones and the distance from the inner surface of the baby's skin to the outer surface of the soft tissues of the neck.

Some pathologies are characterized by the accumulation of excess fluid in this area, due to which the TVP ( collar space thickness) increases. Many chromosomal "failures" are accompanied by various deformations of the facial bones, which is why the nasal bones are also trying to see, and, if possible, measure.

The external genitals are almost formed, and they can also theoretically be considered at 12-13 weeks, but doctors at this time cannot talk about the sex of the baby with certainty, because the differences still look minimal. The diagnostician will be able to more accurately answer the mother's question about the gender of the child after the 18th week of pregnancy, when she comes for the second scheduled ultrasound scan.

Decoding and norms

A doctor should be involved in the interpretation of the ultrasound results. Everyone knows about this, but the understandable curiosity and anxiety inherent in expectant mothers make women thoroughly approach the study of complex terminology in order to figure it out on their own. This is not unusual our task is to help pregnant women understand what is written in the conclusion.

SVD

This three-digit abbreviation hides the main indicator of the development of a baby for a period of up to 9-10 weeks. Since the embryo itself is still very small, and it is very difficult to measure the embryonic parts, the state, development and gestational age at the initial stage are determined by the size of the ovum.

The shape and size of the ovum can even tell about the baby's trouble, for example, deformation and some "compression" of the outlines of the fetal membrane may indicate that a woman has begun a miscarriage, and its simultaneous decrease in size indicates an undeveloped pregnancy and the death of the embryo.

Determination of the gestational age by SVD in the early stages is considered quite reliable.

After all, so far babies are not divided into large and small, thick and thin - all embryos in the first trimester grow at about the same rate, but they begin to show hereditary features of appearance a little later.

The average inner diameter of the ovum increases simultaneously with term, and the fetal membrane grows not even by week, but by day, so it will not be difficult to establish the day of conception, provided that the pregnancy develops normally.

SVD norms table (average)

Average inner diameter of the ovum (mm)	Compliance with gestational age (week + day)

CTE

The coccygeal-parietal size allows one to judge the growth rate of the child from about 7-8 weeks of pregnancy. This dimension is laid by the diagnostician from the highest point of the head (crown) to the lowest point - the coccyx at maximum extension of the embryo.

Height is measured from head to foot. On ultrasound, this size is considered an important indicator, especially if an early study is done prior to the planned one. According to the CTE, they not only determine how the baby is growing, whether he feels well, but also the gestational age in order to clarify the expected date of birth.

At a later date, when the woman enters the second trimester, the CTE is no longer determined, since the baby becomes large enough to measure it from the head to the coccyx as a whole.

KTR is a size that causes serious worries for expectant mothers. His hesitation causes a storm of emotions.

In fact, you shouldn't look in tables for coincidences down to the millimeter. Not always insignificant deviations up or down may indicate anomalies, and not always deviations for 1-2 weeks have pathological reasons.

A decrease in CTE may be caused by the fact that the woman had late ovulation or the baby was "delayed" on the way to the uterine cavity after conception, that is, implantation occurred later than the woman thinks.

Among the possible adverse consequences of a decrease in CTE are infections, including intrauterine ones, as well as gross genetic pathologies that prevent the baby from developing at the physical level at a pace set by nature.

An increase in CTE may also indicate inaccuracies in determining the gestational age, that is, early ovulation, as well as a tendency towards a large fetus.

CTE rate table (average)

TVP

This is the first indicator of possible chromosomal abnormalities. The thickness of the collar space is measured by the segment that is laid from the inner surface of the skin to the border of the dark anechoic area on the back of the baby's neck.

Some gross developmental anomalies associated with errors in the genetic code cause general edema in the child, but it can be determined during this period only by one study area - the collar space. After 13 weeks of pregnancy, this indicator is not measured, it is no longer considered diagnostically important.

About this size, expectant mothers undergoing the first prenatal screening experience the most.

Do not panic, because this size, like all the others determined on ultrasound scanning, does not speak with an accuracy of 100% about the presence of pathology. A slight deviation from the norms does not always indicate the presence of a disease.

Statistics show that disappointing diagnoses in children with increased TVP are confirmed only in 10% of cases. Among sick babies, TVP above 3.0 mm was found only in a few, usually true malformations correspond to an excess of 3-8 mm from the norm.

TVP table (average)

Length of the bones of the nose

As in the case of the thickness of the collar space, the bones of the nose can also indicate the likelihood of pathology of chromosomal origin. In children with Down syndrome, for example, the nasal bones may not be detected at all, and in babies with Patau's syndrome, the nasal bone may be greatly shortened. But again, as with TVP, it all depends not only on the state of health of the baby.

Very often, doctors do not see the nasal bone due to the fact that the ultrasound machine in the consultation is outdated ten years ago. Sometimes the reason for the detection of an alarming marker is the lack of experience of the diagnostician. If the result of the examination of this marker is disappointing, then the woman is assigned a control ultrasound on an expert class apparatus and a consultation with a medical geneticist.

Table of norms for the length of the nasal bone (average)

Technique

Many women are interested in how the first ultrasound examination is performed. Most often, doctors use a vaginal probe for examination, which is inserted into the vagina in a condom. It is possible to examine the uterine cavity with this method through the vaginal wall. It is quite subtle and the visualization is good. That's why intravaginal ultrasound is considered one of the most accurate.

It is theoretically possible to examine a woman during pregnancy in the first trimester and transabdominally - with an external sensor, which is applied to the anterior abdominal wall, however, at short periods of time, the subcutaneous fat layer, which even rather tiny girls have on the belly, can interfere with viewing a tiny embryo.

The examination is carried out on a couch, on which the woman is asked to sit in a supine position with legs bent at the knees. Also, the doctor can examine the vaginal probe on the gynecological chair.

If a woman comes to an appointment at the ultrasound office before the scheduled screening, which happens when an examination is prescribed for possible complications of pregnancy, the doctor will scan exclusively with a vaginal sensor, since it allows a detailed study of the state of the cervix and cervical canal, which is very important in suspicion of a threat of miscarriage, an ectopic pregnancy, an undeveloped pregnancy.

How to prepare for the examination?

Early ultrasound results can be affected by an insufficient amount of fluid through which the ultrasound waves pass better. That is why, before going to the doctor, the expectant mother it is recommended to drink about half a liter of water, thereby filling your bladder.

In the later stages of pregnancy, there will be enough amniotic fluid in the uterine cavity, which will serve as an ideal environment for conducting ultrasound waves.

While the embryo is very tiny, any factor can distort the real picture of what is happening. So, the intestines overflowing with feces, the intestines, the loops of which are swollen from gas, can squeeze the pelvic organs of a woman.

In order to better prepare for the first ultrasound scan, the expectant mother is advised not to eat foods that can cause fermentation and the formation of intestinal gases two to three days before visiting the diagnostic room.

It is better to exclude peas, white cabbage, baked goods, rye bread, sweets, carbonated drinks from the diet. On the day of the examination, the intestines should be emptied, and 2-3 hours before the ultrasound, take a drug that "collapses" the intestinal gas bubbles, preventing swelling. Such funds allowed for pregnant women include Espumisan or "Simethicone".

With you for the first ultrasound, you need to take an exchange card, if it has already been wound up, a passport, a policy of compulsory medical insurance, a clean diaper that can be placed on a couch or a gynecological chair, as well as removable shoes. There is no need to starve, go for an ultrasound scan on an empty stomach.

Probability of errors

Errors of doctors of ultrasound diagnostics are a subject of wide discussion among expectant mothers. Indeed, ultrasound scanning is not considered a highly accurate method. Its accuracy is estimated at only 75-90%. Much in the veracity of the results depends on the quality of the apparatus, the qualifications of the doctor and the timeliness of the examination.

If you resolve issues as they become available, within the recommended time frame, ultrasound can be considered a fairly accurate and informative way. And in cases where the results of an ultrasound scan cannot be unambiguously interpreted, if there are alarming markers or doubts at the doctor, then he will definitely advise more accurate diagnostic methods - amniocentesis, chorionic biopsy, and a little later - cordocentesis.

If you wish, you can do non-invasive analysis of fetal DNA, which is an excellent alternative to invasive tests, and is absolutely safe for the baby.

In addition, in most cases, ultrasound again helps to dispel doubts, but of a different class - expert. Such devices are at the disposal of perinatal centers, medical genetic centers and clinics.

Does ultrasound harm a child?

There is no consensus on this matter. Modern medicine has no evidence of the harm of this diagnostic procedure for the developing fetus in the womb. However, there is no evidence of the complete harmlessness of ultrasound. The point is that science cannot study the long-term consequences. No one knows how the effect of ultrasound in the embryonic period affects a person when he turns 30, 40, 50 years old.

It is the lack of information that is fertile food for pseudo-scientific reasoning about the influence of ultrasound waves on human DNA. Existing experience shows that children who were born to women who did not undergo ultrasound during pregnancy at all, and children who were born to women who underwent such diagnostics more than 6 times during the gestation period, did not differ in any way in terms of health from each other.

To do an ultrasound or not is a woman's choice. The Ministry of Health only recommends three routine examinations for the entire pregnancy period, but they are not mandatory either. If a woman does not want, then no one will force her.

But before giving up screening or an unscheduled ultrasound scan, a woman should weigh all the risks well, because many pathologies during gestation and childbirth can be avoided if doctors are able to consider alarming symptoms in time.

You have been planning to become parents for a long time, but still doubt whether an ultrasound scan will show early pregnancy, even if a blood test confirmed a positive result? How is ultrasound done and what are the limitations? We will try to provide qualified answers to these questions.

Is it not dangerous for the future of the baby?

Numerous studies unanimously confirm the high efficiency and safety of ultrasound examination during pregnancy. And although there are rumors among expectant mothers, their elderly relatives and even sometimes the old schooling staff from antenatal clinics and maternity hospitals about the dangers of manipulating the sensor and the harmful effects of ultrasonic waves, these experiences are groundless.

As a rule, in the absence of pathologies of the condition of the pregnant woman and the fetus, an ultrasound examination is prescribed four times. Many people miss the first ultrasound scan in the early stages of pregnancy because of the fears described above, which can be fraught with overlooking the baby's developmental abnormalities and serious complications in the mother, up to the development of tubal pregnancy.

To find inner balance and peace of mind, it is very important for future parents to know whether an ultrasound scan can be done in early pregnancy or not.

Types of ultrasound examination

Ultrasound is a kind of diagnostic measures, the principle of which is to transmit ultrasonic waves through soft tissues. What kind of ultrasound is done in early pregnancy?

2D - two-dimensional image of the fetus (height-width) allows doctors to detect an attached fertilized egg in the uterine cavity, assess the condition and development of the unborn child, its growth and size. 2D is the most inexpensive type of manipulation, widely used in antenatal clinics and state maternity hospitals. The whole procedure takes 10 to 20 minutes.
3D - three-dimensional color three-dimensional ultrasound, in which the image is displayed on the monitor screen. Parents-to-be will be able to look at the fetus and see its first movements and even facial expressions! The quality of the research result is an order of magnitude higher than two-dimensional, while the radiation level is the same. The duration is from 30 to 50 minutes, which is associated with the constant movement of the baby and the need to measure many important parameters.
4D - the same three-dimensional image, but the movements of the unborn child are displayed on the screen of the device in real time. For many mothers, babies wave their palm from the screen, rub their eyes and even suck their thumb. With 4D diagnostics, it is possible to create a video recording.

Is ultrasound harmful in early pregnancy? Definitely not.

The three-dimensional and four-dimensional type of research is recommended to be carried out for a period of 11 weeks or more, since at this time it is already possible to examine the baby's arms and legs and even determine its gender.

Varieties of ultrasound machine sensors

A conventional ultrasound machine has two transducers: transvaginal and transabdominal

Transabdominal ultrasound during pregnancy

Superficial, or transabdominal, ultrasound is widely used in the diagnosis of many diseases.

It is done as follows:

a pregnant woman lies on her back, exposes her belly and lower abdomen;
a small amount of a universal contact gel is applied to the skin near the navel, which ensures maximum contact of the sensor with the epidermis surface;
the doctor drives the device over the abdomen, pressing lightly; an image of the uterus with the fetus is displayed on the monitor screen.

Transvaginal ultrasound

The transvaginal probe is a small tube with a rounded end; often used with ultrasound to detect early pregnancy.

To carry out this examination, a woman lies on her back, strips herself below the waist and spreads her legs bent at the knees to the sides. An ordinary thin condom is put on the sensor of the device for reasons of hygiene. It is then gently inserted into the vagina for examination.

Transvaginal ultrasound is more likely to show early pregnancy than a classical study. It has a number of advantages:

allows you to detect an ectopic pregnancy in time (a fertilized egg can be fixed in the ovary, in the fallopian tube and even on the cervix) and prevent the development of peritonitis and internal bleeding;
will be able to determine the low attachment of the ovum;
will detect serious pathologies of fetal development at a time frame that allows an abortion.

Do I need to prepare for the procedure?

So, you've signed up for an exhilarating procedure and want to know if any prior preparation is needed.

When examining the pelvic organs with a transvaginal transducer, special preparation is not required, except perhaps for basic hygiene. You must be calm and in the mood for a positive result, then the baby will not flounder too actively and will allow the doctor to conduct a thorough examination.

Transabdominal ultrasound may sometimes require a full bladder. This nuance must be clarified during the appointment for the procedure. Take with you a bottle of clean drinking water and a chocolate bar. Cocoa will help to stir the baby up and get him into a comfortable position for examination.

When to do an ultrasound scan in early pregnancy?

Experienced obstetricians advise to undergo ultrasound at least four times during the gestation period. Sometimes the number of preventive studies increases, which is associated with new complications and features of the course of pregnancy (abnormal position of the fetus in the uterus, entanglement, placenta previa or its short length).

First ultrasound

The first ultrasound of the fetus in early pregnancy is usually performed after a delay and suspicion of fertilization to confirm it.

First screening

The first screening is carried out as standard in the period from the 11th to the 13th week and may additionally include the collection of venous blood for genetic studies. The first screening assesses the anatomy of the unborn baby, identifying the most formidable developmental anomalies (Down's syndrome).

Second screening

Doctors prescribe a second examination for a period of 20-23 weeks to identify malformations of the fetus and placenta. An examination of the already formed internal organs of the fetus, ultrasound of the heart and brain is carried out.

Third screening

At the 30-32th week of pregnancy, the woman goes to the third scheduled screening. Uzist diagnoses possible late anomalies in the structure of internal organs, assesses the size of the crumbs, its weight and the compliance of these parameters with the expected date. The correct position of the fetus in the uterus is checked, recommendations are given on the method of delivery (cesarean section or natural childbirth). It is possible that a woman will have to undergo ultrasound diagnostics of the fetus before hospitalization and in the maternity hospital itself.

Is ultrasound done during early pregnancy, is it mandatory?

It is the very first ultrasound procedure that causes such a stir and a flurry of doubts. If you are still in doubt about whether to do an ultrasound in early pregnancy (3-5 weeks, immediately after a missed period), we suggest considering all its benefits:

Diagnosing pregnancy, detecting the ovum in the uterine cavity, assessing the place of its attachment (relevant for multiparous after cesarean section).
Timely diagnosis of ectopic pregnancy, its location and size. When a fertilized egg is anchored in an ovary or fallopian tube, there is a high likelihood of rupture of the organ and the occurrence of internal bleeding, and surgical intervention is likely to be required.
Diagnostics of the so-called false pregnancy associated with the growth of neoplasms in the uterine cavity. The delay in menstruation in this case is symptomatic, its cause is hormonal imbalance.
The exact setting of the gestational age, the estimated date of conception, the date of birth.
Checking the heartbeat of the embryo.
Diagnosis of multiple pregnancies (the number of fertilized eggs that have taken root in the uterus).
Early diagnosis of the threat of miscarriage. The most striking symptom of possible interruption, visible on ultrasound examination, is uterine hypertonicity.

If you doubt the need to manipulate the sensor, but want to be sure of the onset of conception, you can donate blood for hCG - this test is also highly informative.

Horror stories about ultrasound

Many of the most controversial myths are circulating among the people about the ultrasound procedure. The most striking thing is that most of them are distributed by doctors themselves.

The first myth. The effect of the ultrasound machine on the fetus is not fully understood and may contribute to anomalies and malformations.

In fact, every second of life, any modern person is affected by a huge spectrum of different rays, from a microwave oven to a home wi-fi network. And we didn’t take into account the constant radiation background of large and small cities!

The second myth. Transvaginal sensors can trigger short term abortion.

Nature has taken care of our survival, which is why it is not so easy to get rid of the baby. During gestation, many continue to exercise, carry weights and have sex. Non-aggressive penetration of a rounded, smooth object into the vaginal cavity will not create any discomfort for the fetus.

The third myth. Ultrasound affects the embryo's brain, heating it up and leading to irreversible mental illness.

Let's start with the fact that for a period of 3-4 weeks the embryo does not yet have a brain, and so far it itself is a clot of uncontrollably dividing cells. And there can be no heating, purely physically: ultrasonic waves affect human tissues in a different way.

When asked whether it is possible to do an ultrasound scan in the early stages, we give an unambiguous answer: it is necessary!

Any girl who finds out about an interesting situation wants to do the first ultrasound as soon as possible, see her baby and find out about his state of health.

Many parents also do an ultrasound scan to find out the sex of the unborn child. This information will be useful when choosing the interior of a children's room, buying children's things and furniture.

I note right away that you shouldn't trust the results 100%. For example, they promised me a boy, but I gave birth to a daughter.

Why do an ultrasound scan during pregnancy

Several decades ago, people could not even imagine that there would be an opportunity to see their child, to find out how he develops and grows even before his birth. And now ultrasound is available to every pregnant woman. Not only 2D ultrasound is carried out, but also 3D and even 4d (that is, video). But many do not understand the importance of this procedure.

During an ultrasound examination, they find out:

exact gestational age;
expected due date;
singleton pregnancy or several embryos - multiple pregnancy is much more difficult and requires more attention;
the presence of abnormalities in the fetus - the sooner pathologies are found, the more likely they are to be eliminated;
the location of the placenta and the amount of amniotic fluid: improper location of the placenta, oligohydramnios or polyhydramnios is fraught with the death of the embryo and miscarriage (it is important to diagnose it on time and bring the condition of the woman and the fetus back to normal);
how the fetus develops, its size and gender.

In the presence of symptoms such as pain in the lower abdomen and / or spotting, the gynecologist directs the patient for an emergency ultrasound to exclude the possibility of an ectopic pregnancy and the threat of miscarriage.

How long does an ultrasound take?

During pregnancy, a girl undergoes three main ultrasound examinations.

They are held (usually free of charge) at the end of each trimester, that is, at 11-14, 18-21 and 30-34 weeks.

The first scheduled ultrasound

For 1 planned ultrasound, the doctor directs the pregnant patient at the end of the first trimester.

On it, the uzist checks:

The presence of pathologies in the fetus. Some defects mean that the child is born with a disability, others lead to the death of the fetus. If such pathologies are found during the study, then the girl is prescribed an additional analysis of amniotic fluid or a chorionic biopsy to confirm or deny the diagnosis.
Embryo size... Particular attention is paid to the size of the neck-collar space. Non-compliance with its norms indicates the presence of chromosomal abnormalities in the child - for example, Down's syndrome.
Bone sizes, in particular the shoulder, femoral, tubular, forearm and lower leg of the child.
Are the internal organs of the embryo correctly positioned?- and whether their size corresponds to the deadline.
What size is the heart with vessels and abdomen of the embryo.

There are cases in which the first ultrasound is performed ahead of schedule:

bloody vaginal discharge;
painful sensations in the lower abdomen;
suspicion of a frozen pregnancy;
previously suffered miscarriage;
fertilization did not occur naturally (IVF, test tube, etc.);
fetal pathology in other pregnancies;
suspicion of multiple pregnancy.

Second planned ultrasound

At around week 19, the pregnant woman undergoes a second ultrasound scan. This period was chosen because during this period the fetus already has well-formed organs and it will be possible to explore what could not be studied the first time.

In a second study, the doctor examines:

How many fruits and how they are located.
Parts of the body and internal organs of the fetus: the limbs are examined carefully, up to the number of fingers.
Of all the organs, the brain of a child is the most thoroughly studied.
Amniotic fluid.
The appearance and structure of the placenta and umbilical cord.
The degree of maturity of the placenta - the inadequacy of its term has a detrimental effect on the child.

Third planned ultrasound

On the third ultrasound, the same indicators are examined and measured as on the first two. The uzist pays the most close attention to the state of the placenta.

There are several reasons for this particular interest:

during childbirth, especially if it is a cesarean section, the obstetrician-gynecologist must know to which wall of the uterus the placenta is attached, and this is clearly visible on ultrasound;
if the indicator of the ratio of the cervical opening to the lower edge of the placenta does not correspond to the norms, there is a possibility of bleeding before or during delivery;
too large or, on the contrary, a small width of the placenta at the point of attachment to the umbilical cord means placental insufficiency, that is, the mother's body does not interact correctly with the fetus;
the degree of maturity is determined by the internal structure of the placenta - it depends on this indicator whether the girl's birth canal is ready for childbirth or any difficulties may arise.

All these indicators, which are of great importance, are studied by a specialist during the third ultrasound of the future woman in labor.

How is the examination going?

Ultrasound during pregnancy differs from other ultrasound studies in that special preparation is not required before the procedure. You just need to take a sheet and napkins with you. The sheet is required to lie on it, and not on the bare couch. Wipes will be needed to wipe off the gel from the abdomen, without which no examination is complete.

When conducting the first ultrasound, according to indications ahead of schedule, a transvaginal transducer is used. The doctor inserts it into the vagina. With the help of such a device, it is easier to identify an interesting position in a short time.

Three planned examinations are performed using an abdominal probe. They are being driven over their belly. Before starting the procedure, a special gel is applied to the abdomen. It is needed so that there is no air between the stomach and the device, as it greatly distorts the displayed image.

The sensor is connected to a monitor that displays the organs under study. Using a special keyboard, the doctor listens to the baby's heart, takes the necessary measurements and enters them into the examination card.

It is very important that the child is calm at the time of the examination. When the baby is constantly moving, the doctor simply will not be able to conduct an examination and will prescribe a re-examination. The behavior of the fetus depends on the emotional state of the mother and you should prepare in advance for the procedure.

Remember: the doctor wants only the best for both the mother and the baby and conducts the examination for your benefit.

It is recommended that you listen to soft music, read your favorite book, and talk to your child about something enjoyable just before the examination. During the procedure, you need to relax as much as possible, breathe evenly and ask the doctor everything that interests you.

Why you may need an unscheduled ultrasound

The number of ultrasound examinations primarily depends on the condition of the expectant mother. If she has pain or discomfort in the lower abdomen, blood from the vagina, then it is important for the doctor to exclude the threat of termination or ectopic pregnancy. It is possible to understand this only during an ultrasound scan, so the gynecologist appoints it unscheduled.

Also, a woman can undergo an additional examination if the baby behaved too actively during the study and the uzist was not able to examine all the necessary parts of the body and make the required measurements.

I had this situation on the second ultrasound. The doctor said that there is an acrobat in my stomach and it is simply impossible to conduct a normal examination.

The procedure had to be repeated a few days later. I have already prepared for it in the ways described above. Therefore, the emotional attitude should not be neglected. Remember that all the emotions of the mother are transmitted to the child, and try to think only about the good.

Contraindications to the procedure

There are no specific contraindications for ultrasound.

However, there are a number of complications in which the procedure is prohibited:

Acute fatty hepastosis... This is the process by which the liver converts its cells into fat cells or stores them. The reason for this complication is a large load on the liver while waiting for the child, since in addition to the main waste, it is also necessary to filter the waste of the fetus.
Strong gestosis. With such a complication, the expectant mother's blood pressure rises, significant swelling and protein in the urine appear. The liver and circulatory system are affected. A severe complication of gestosis is called HELLP syndrome.
Profuse vaginal hemorrhage.
Eclampsia or late toxicosis... This process is characterized by prohibitively high blood pressure. Possibility of loss of consciousness, seizures, difficulty or lack of breathing, and foam at the mouth.

Each of these complications is extremely dangerous for the life of the mother and child. If they occur, an emergency delivery is performed. In extremely severe cases, it is necessary for the delivery to occur within the next 30 minutes. For such patients, intensive care wards in the adult and pediatric wards are prepared in advance, in which they spend the first time after childbirth.

Is it dangerous to do an ultrasound during pregnancy

The opinions of scientists about ultrasound during pregnancy are divided. One half believes that this examination can and should be done, while the other is sure that it is better not to do an ultrasound at all, or at least be examined as rarely as possible.

It has not been scientifically proven that ultrasound negatively affects the human fetus. Research in this area has not been carried out, but according to statistics, there are no cases of a negative effect of ultrasound on a child.

It is much more dangerous not to do an ultrasound. Indeed, during this procedure, many vital moments come to light. However, it is better not to do the examination too often. Three scheduled inspections are enough. And the rest will be prescribed by the doctor.

Why is an ultrasound scan necessary even if a pregnant woman is feeling well?

An ultrasound scan is performed primarily to make sure that the baby is healthy, growing and developing. When diagnosing, measure the growth of the fetus, the size of its bones, the state of internal organs, etc. The inconsistency of these indicators with the norms does not in any way affect the well-being of the mother. She can feel great even when a child with serious pathologies develops in the womb.

There are a number of complications that are completely asymptomatic. For example, an ectopic pregnancy. Most girls do not even suspect about her until a certain moment. And this is a very serious pathology. If you do not detect an ectopic pregnancy in time and do not interrupt it, then you can lose the fallopian tubes and reproductive function in general.

Therefore, in order to identify all deviations and assess possible risks, ultrasound should be performed when the doctor requires it, regardless of the mother's well-being.

About the procedure in video format:

Conclusion

The best friend of the expectant mother throughout her pregnancy is her gynecologist.

He always wishes his patients only the best and does everything possible to make the pregnancy easy and the baby is born healthy and on time. Therefore, you should completely trust your doctor and undergo any procedures that he directs you to, including an ultrasound scan. After all, there is much more benefit from this research than harm.