My Baby Look Pretty Excited on the Ultrasound

When and Why to Go Ultrasounds During Pregnancy

An ultrasound isn't just a photo shoot but an essential diagnostic tool.

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• April 17, 2020

This guide was originally published on May 15, 2019 in NYT Parenting.

Early pregnancy tin can feel unreal. How do you lot know the fetus is there when yous tin can't run into it or feel information technology moving nevertheless? So the first ultrasound moving picture tin feel momentous: Finally, your whirring brain can be placated with direct proof. Only other than the visual prove that you're not dreaming all this, yous may not know what to expect from prenatal ultrasounds. Nosotros're here to walk you through it.

During an ultrasound exam, your health care provider will record the fetus'due south movement, heartbeat, breathing and the amount of amniotic fluid surrounding your infant. Merely there's a lot more to know about the tests.

For this guide, I interviewed two obstetricians who specialize in ultrasounds — and a radiologist whose observation led to a diagnostic breakthrough — to find out what yous demand to know about prenatal ultrasounds.

Fix yourself for testing.

Usually an ultrasound technician or your ob-gyn will perform an ultrasound. Get ultrasounds at an accredited facility, not at an unaccredited identify at the mall. An unaccredited facility "can either miss something or find something that will upset you that'south not really there," said Dr. Beryl Benacerraf, professor of radiology and of obstetrics, gynecology and reproductive biology at Brigham and Women's Hospital and Harvard Medical School in Boston. Yes, you volition get pictures of the baby, only an ultrasound is not primarily a photograph shoot. It's O.Thousand. if the result is a blurry moving-picture show of the baby's elbow, as long as your wellness care provider gets the necessary medical information.

Information technology'due south common to go a transabdominal ultrasound, meaning that the ultrasound wand, or transducer, is pressed upwardly against the abdomen, lubricated with gel. But information technology's possible you volition need a transvaginal ultrasound, meaning that the transducer is placed inside your vagina. Transvaginal ultrasounds may be necessary in very early on pregnancy, to look at the shape of your uterus, if you're obese or if your medical squad has trouble seeing things with a transabdominal ultrasound. You can ask to insert the transducer yourself if that would make you more comfy, said Dr. Joshua Copel, a professor of obstetrics and gynecology at Yale, who offers this choice.

You're normally told to drinkable water before a first trimester transabdominal ultrasound because a total float makes information technology easier to see structures nether or backside the float. This is not necessary for a transvaginal ultrasound or in late 2d or third trimester.

Think about who you will want in the room for a medical test. "Sometimes you practise observe things that are upsetting, and you don't want to bring the whole family to something that you want to keep private," Dr. Benacerraf said.

Know what to expect at 12-14 weeks.

The 12-14 calendar week ultrasound browse has four main purposes: determining the due date; detecting multiple pregnancies; checking basic beefcake; and performing a nuchal translucency test, which is a screening test for Down syndrome and some rarer weather condition.

"The earlier y'all do a scan in pregnancy, the more accuracy it has" for determining your due date, said Dr. Copel. If the 12-fourteen week ultrasound is your outset, it will give the most authentic due date compared to later scans. It's often more accurate than measuring from your final menstrual period, considering dating from the last menstrual period assumes that every adult female has 28-day menstrual cycles, and many do not. (Using in-vitro fertilization dates can exist more accurate than fifty-fifty very early ultrasounds if yous know how many days subsequently fertilization the embryos were transferred. Using records of when you lot had sex can be accurate, if yous kept accurate records and take regular cycles.)

Bones anatomy is visible on the 12-14 calendar week ultrasound. Your medical provider tin can see if the center has four chambers; if the brain has 2 hemispheres; and if the baby has eyes, limbs, lungs, a spine and a bladder, said Dr. Caterina Bilardo, president of the International Society for Ultrasound in Obstetrics and Gynecology. But, she said, "at such an early stage you don't want to diagnose very subtle heart anomalies." The full anatomy browse will come afterward.

The 12-14 week ultrasound includes a screening test for Down syndrome and other chromosome abnormalities called the nuchal translucency exam. Nuchal translucency is the thickness of the back of the baby's neck. The screening test besides involves a blood describe, which is used to measure out levels of a protein that is lower in Down's syndrome pregnancies and a placental hormone that is college in Downwardly syndrome pregnancies. Dr. Benacerraf was amidst the first in her field to note that cervix thickness on ultrasound was correlated with Downward syndrome. "Babies with Down's syndrome have a niggling flake of a fat curl on the back of their neck. Pediatricians take known this for decades," she said. "We just noticed this in the fetus early on."

The nuchal translucency test does not tell yous whether the babe has Down's syndrome, only the chance or probability that he or she does. Even if you lot get a nuchal translucency test result showing a 90 percent take chances of Down's syndrome, you can't tell whether the baby has Down syndrome without an amniocentesis or chorionic villi sampling exam.

Nuchal translucency tests besides tell 5 per centum of patients that they have a college risk of fetal chromosome abnormalities when their risk is actually normal, said Dr. Copel.

There'due south now another screening test for Down's syndrome, chosen a cell-free Deoxyribonucleic acid test, which involves but a blood depict from the mother, not an ultrasound. "Just because y'all've had the cell-free Dna, do not forgo the ultrasound. They're not equivalent," Dr. Benacerraf advised. The cell-costless DNA test cannot detect any of the basic beefcake bug that an ultrasound can, such as major centre defects, she said. (Dr. Benacerraf noted that many of her patients who receive the exam experience pushback from their insurance companies, which reject to pay for both the 12-14 calendar week ultrasound and the prison cell-free DNA test. Check with your insurance provider if y'all plan to take the blood examination in add-on to the ultrasound.)

Know what to expect at 18-twenty weeks.

The 18-twenty week ultrasound is often called the "anatomy scan." "At that time the organs are already completely formed," said Dr. Bilardo. Medical providers bank check for centre defects, make sure all organs are nowadays and count the number of fingers and toes. They too keep an eye on the babe's growth.

"At that time the organs are already completely formed," Dr. Bilardo said.

Your provider tin can to tell you lot the likely biological sex of the babe at the 18-20 week ultrasound, if you desire to know. If yous don't want to know, tell the ultrasound technician or ob-gyn before the ultrasound.

At the eighteen-20 week ultrasound, your medical provider volition also cheque the position of the placenta. If the placenta is low in the uterus, covering the cervix, this is called placenta previa, and yous will need a after ultrasound to see whether the placenta has moved. About xx percent of patients have "low-lying placentas" at some signal, Dr. Benacerraf said, simply less than one percent end up that way at the end. If the placenta doesn't migrate and remains resting on your cervix as you arroyo your due date, you will probably need a C-department, because commitment through the cervix is impeded if the placenta is in the way.

[What to expect from a C-department ]

If yous had a previous C-section, your medical provider will too bank check whether the placenta could have implanted within the scar in your uterus from the surgery — a condition called placenta accreta that tin can necessitate another C-section. If the placenta appears to be on the scar at your 18-twenty week ultrasound, you lot do not necessarily have placenta accreta, considering it can be difficult to tell from imaging. Your doctor will likely guild an additional ultrasound to either rule out or confirm placenta accreta later in your pregnancy.

Understand that y'all may need more than ultrasounds.

An expectant parent might require prenatal ultrasounds beyond the two standard ones for many reasons. Early on in pregnancy, bleeding or cramping calls for an ultrasound, both Drs. Copel and Benacerraf said. An early ultrasound can ostend that the pregnancy is in the uterus and not ectopic. An ectopic pregnancy is implanted outside the uterus, and needs to be removed or dissolved because it's dangerous for the mother and not feasible.

Later in pregnancy, ultrasounds may be needed to monitor the infant's size if there is a risk of too much or also picayune growth, for example, in some cases of gestational diabetes or pre-eclampsia (loftier blood pressure during pregnancy). If you have a history of preterm birth, transvaginal ultrasounds can be used later in pregnancy to measure the length of your cervix for early alarm signs that you might go into labor prematurely.

If y'all are expecting twins, yous will probably get more ultrasounds to check their growth. In the example of identical twins who share a placenta, Dr. Bilardo said, a pregnant woman will get ultrasounds every two weeks during weeks xvi-28 to monitor the babies' growth and ensure that one of them isn't hogging an outsize portion of resources from their shared placenta. This condition is chosen twin-to-twin transfusion syndrome and is treatable either by early commitment or by lasering claret vessels in the placenta.

When to Worry

• If you lot don't understand something, it's ever O.K. to inquire your medical provider what it ways, what your options are or why he or she is recommending a particular follow-upwardly.

• Waiting for test results is hard, and information technology's normal for emotions to run high. Seek back up from people you trust to be validating and non-judgmental — perhaps other expectant parents or close friends or family unit.

• Information technology'due south normal to feel upset or worried if you become test results saying that your babe has a higher risk for something. Seek out or ask your medical provider to connect you with people who have been in the same situation.

• If your medical provider has problem explaining results in a way that you sympathize, yous may want to seek a 2d opinion.

[The vaccines you need during pregnancy ]

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Anna Nowogrodzki is a scientific discipline announcer and mom in the Boston surface area.

mooredoudiwome.blogspot.com

Source: https://www.nytimes.com/article/pregnancy-ultrasounds-guide.html

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