When Will Doctor Schedule an Anatomy Scan of Baby

When and Why to Get Ultrasounds During Pregnancy

An ultrasound isn't simply a photograph 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 can feel unreal. How do y'all know the fetus is there when you tin't come across it or experience it moving yet? Then the first ultrasound motion-picture show can feel momentous: Finally, your whirring encephalon tin can be placated with straight proof. Only other than the visual prove that yous're not dreaming all this, you may not know what to wait from prenatal ultrasounds. We're here to walk you through it.

During an ultrasound exam, your health care provider will tape the fetus's movement, heartbeat, breathing and the amount of amniotic fluid surrounding your baby. Simply at that place'due south a lot more to know virtually the tests.

For this guide, I interviewed two obstetricians who specialize in ultrasounds — and a radiologist whose ascertainment led to a diagnostic breakthrough — to discover out what y'all need to know nearly prenatal ultrasounds.

Prepare yourself for testing.

Usually an ultrasound technician or your ob-gyn will perform an ultrasound. Become ultrasounds at an accredited facility, not at an unaccredited place at the mall. An unaccredited facility "tin can either miss something or find something that volition upset you that's not really in that location," 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. Yep, you will get pictures of the baby, but an ultrasound is not primarily a photograph shoot. It's O.K. if the upshot is a blurry picture of the baby's elbow, every bit long equally your health care provider gets the necessary medical data.

It's common to get a transabdominal ultrasound, meaning that the ultrasound wand, or transducer, is pressed upwards against the belly, lubricated with gel. Merely information technology'southward possible yous will 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 team has trouble seeing things with a transabdominal ultrasound. You can ask to insert the transducer yourself if that would brand you more comfortable, said Dr. Joshua Copel, a professor of obstetrics and gynecology at Yale, who offers this option.

You lot're usually told to drink water before a kickoff trimester transabdominal ultrasound because a full bladder makes information technology easier to run across structures nether or backside the float. This is non necessary for a transvaginal ultrasound or in late second or third trimester.

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

Know what to await at 12-14 weeks.

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

"The earlier yous do a scan in pregnancy, the more accuracy it has" for determining your due engagement, said Dr. Copel. If the 12-14 week ultrasound is your beginning, it volition give the about accurate due date compared to later scans. It'south often more than authentic than measuring from your last menstrual period, considering dating from the final menstrual flow assumes that every woman has 28-twenty-four hours menstrual cycles, and many do not. (Using in-vitro fertilization dates can be more than accurate than even very early ultrasounds if you lot know how many days after fertilization the embryos were transferred. Using records of when you had sexual activity can be accurate, if you lot kept accurate records and have regular cycles.)

Basic anatomy is visible on the 12-14 week ultrasound. Your medical provider can meet if the centre has 4 chambers; if the brain has two hemispheres; and if the infant 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 yous don't want to diagnose very subtle heart anomalies." The full anatomy scan will come later.

The 12-14 week ultrasound includes a screening test for Down syndrome and other chromosome abnormalities called the nuchal translucency test. Nuchal translucency is the thickness of the back of the baby's neck. The screening test also involves a blood depict, which is used to measure levels of a protein that is lower in Down syndrome pregnancies and a placental hormone that is higher in Down syndrome pregnancies. Dr. Benacerraf was amid the commencement in her field to annotation that neck thickness on ultrasound was correlated with Down's syndrome. "Babies with Down syndrome accept a fiddling scrap of a fat roll on the back of their neck. Pediatricians have 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 infant has Down's syndrome, only the chance or probability that he or she does. Even if you become a nuchal translucency test event showing a 90 pct hazard of Down Syndrome, y'all can't tell whether the baby has Down syndrome without an amniocentesis or chorionic villi sampling test.

Nuchal translucency tests also tell five percent of patients that they accept a college adventure of fetal chromosome abnormalities when their risk is actually normal, said Dr. Copel.

There'southward at present some other screening test for Down syndrome, called a cell-free Deoxyribonucleic acid examination, which involves only a blood draw from the mother, not an ultrasound. "Just because y'all've had the cell-free Deoxyribonucleic acid, exercise not forgo the ultrasound. They're not equivalent," Dr. Benacerraf advised. The jail cell-free Deoxyribonucleic acid test cannot find whatever of the basic anatomy problems that an ultrasound can, such as major eye defects, she said. (Dr. Benacerraf noted that many of her patients who receive the test experience pushback from their insurance companies, which turn down to pay for both the 12-14 calendar week ultrasound and the prison cell-free Deoxyribonucleic acid test. Cheque with your insurance provider if you plan to take the claret test in addition to the ultrasound.)

Know what to expect at 18-20 weeks.

The 18-20 week ultrasound is often called the "beefcake scan." "At that time the organs are already completely formed," said Dr. Bilardo. Medical providers check for center defects, brand certain all organs are nowadays and count the number of fingers and toes. They also keep an eye on the infant'south growth.

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

Your provider can to tell you the likely biological sex of the baby at the xviii-xx week ultrasound, if you want to know. If y'all don't desire to know, tell the ultrasound technician or ob-gyn before the ultrasound.

At the 18-twenty week ultrasound, your medical provider will also bank check the position of the placenta. If the placenta is low in the uterus, covering the neck, this is chosen placenta previa, and you volition demand a after ultrasound to see whether the placenta has moved. Almost twenty percent of patients accept "low-lying placentas" at some indicate, Dr. Benacerraf said, but less than one per centum end upwardly that style at the cease. If the placenta doesn't migrate and remains resting on your neck as you arroyo your due date, you lot will probably need a C-department, considering commitment through the cervix is impeded if the placenta is in the way.

[What to expect from a C-section ]

If y'all had a previous C-section, your medical provider will also check whether the placenta could have implanted inside the scar in your uterus from the surgery — a status called placenta accreta that tin can necessitate another C-department. If the placenta appears to be on the scar at your xviii-20 calendar week ultrasound, y'all do not necessarily have placenta accreta, because it can be hard to tell from imaging. Your md volition likely lodge an additional ultrasound to either dominion out or confirm placenta accreta later in your pregnancy.

Sympathize that you may need more ultrasounds.

An expectant parent might require prenatal ultrasounds across 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 non ectopic. An ectopic pregnancy is implanted outside the uterus, and needs to be removed or dissolved because it'south dangerous for the mother and non viable.

Later in pregnancy, ultrasounds may be needed to monitor the baby'south size if in that location is a risk of too much or too lilliputian growth, for instance, in some cases of gestational diabetes or pre-eclampsia (loftier blood pressure level during pregnancy). If y'all take a history of preterm birth, transvaginal ultrasounds can be used afterward in pregnancy to measure out the length of your cervix for early on warning signs that yous might go into labor prematurely.

If you lot are expecting twins, y'all will probably get more ultrasounds to check their growth. In the case of identical twins who share a placenta, Dr. Bilardo said, a pregnant woman will get ultrasounds every ii weeks during weeks 16-28 to monitor the babies' growth and ensure that 1 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 delivery or by lasering blood vessels in the placenta.

When to Worry

• If y'all don't understand something, it's ever O.Yard. to ask your medical provider what it means, what your options are or why he or she is recommending a detail follow-up.

• Waiting for test results is hard, and it'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.

• It's normal to experience upset or worried if y'all get examination results saying that your baby has a higher take chances for something. Seek out or ask your medical provider to connect yous with people who accept been in the aforementioned situation.

• If your medical provider has trouble explaining results in a fashion that you understand, yous may want to seek a second opinion.

[The vaccines yous need during pregnancy ]

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

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

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