Obstetric ultrasound: A guide for medical students

Having this information in advance of the birth means that healthcare staff as well as parents can better prepare themselves for the delivery of a child with a health problem. For example, Down Syndrome is associated with cardiac defects that may need intervention immediately upon birth. Many expectant parents would like to know the sex of their baby before birth. Methods include amniocentesis with karyotyping , and prenatal ultrasound. In some countries, health care providers are expected to withhold this information from parents, while in other countries they are expected to give this information. Since screening tests yield a risk score which represents the chance that the baby has the birth defect, the most common threshold for high-risk is 1: A risk score of 1: However, the trade-off between risk of birth defect and risk of complications from invasive testing is relative and subjective; some parents may decide that even a 1: ACOG guidelines currently recommend that all pregnant women, regardless of age, be offered invasive testing to obtain a definitive diagnosis of certain birth defects.

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What will you do with your scan photos? When will I have my dating scan? You’ll have a dating scan, also known as a week scan between about 10 weeks and 14 weeks of pregnancy.

The dating scan serves to assess viability of pregnancy (confirmed upon visualisation of fetal heart pulsation), estimate the gestational age (by measuring the crown-rump length), as well as diagnosing multiple pregnancies, ectopic and molar pregnancies.

All women regardless of age have a small risk of giving birth to a baby with a chromosomal abnormality. The FTS test assesses whether your risk is less than, equal to, or greater than the average risk for your age. Why should I have a nuchal translucency scan? The nuchal translucency test is part of a non-invasive ultrasound study that provides information for your doctor about the relative risk of your baby having a chromosomal abnormality. Additional benefits of the ultrasound study include confirmation that the fetus is alive, accurate dating of the pregnancy, early diagnosis of major physical defects and the detection of a multiple pregnancy.

Is there any special preparation? You will need to have a full bladder for the ultrasound examination. Empty your bladder one hour prior to the appointment, and then drink mls of fluid, finishing 30 minutes before your appointment time. If you know the date of your last period or have had an earlier dating scan, please inform the sonographer when you are taken in for your scan.

How is the test performed?

Obstetric ultrasonography

Will I be given a risk level for any other abnormalities? What is nuchal translucency? Nuchal translucency is a collection of fluid under the skin at the back of your baby’s neck. The amount of fluid is measured during a nuchal translucency NT ultrasound scan: That’s why the NT scan is used to help screen for Down’s syndrome.

A dating scan is one that is performed in order to establish the gestational age of the pregnancy, and also reveal important information such as; the presence of a heart beat, the number of fetuses and gestation sacs as well as any unusual features.

A maximum vertical pocket of centimeters is normal Doppler scan As indicated Not recommended without an indication e. Am J Obstet Gynecol ; 5: Nutrition A woman carrying twins has unique nutritional needs, especially for additional calories. Because the patient most often experiences early satiety and loss of appetite, we recommend a consult with a nutritionist to address this and other issues.

She must increase her daily dietary intake by about calories per day, calories more than a woman carrying a singleton gestation. High-protein shakes are recommended given the high nutritional value. Because women carrying twins are at an increased risk of developing anemia, the Society of Maternal-Fetal Medicine recommends 30 milligrams of iron during the first trimester and 60 milligrams of iron until delivery.

The Society of Maternal-Fetal Medicine also recommends that they take 1 mg of folic acid to prevent neural tube defects most prenatal vitamins have 0. For dizygotic twins, there is a higher probability that one or more of the fetuses will have a trisomy, resulting in a higher overall risk to the pregnancy. We recommend that all women carrying twins have integrated serum screening with a first trimester nuchal translucency measurement. Invasive diagnostic testing with chorionic villus sampling CVS or amniocentesis are available options.

However, understanding the higher risk of false positives and false negatives associated with the use of cell-free fetal DNA in twin pregnancies, this test can be offered to patients who are over the age of 33 or 35 depending on the kind of twins. The incidence of congenital anomalies is fold higher in monozygotic twins than in singletons or dizygotic twins; thus, we stress the importance of an early anatomy ultrasound.

Preterm Labor The use FFN as a screening method for risk of preterm labor in asymptomatic women is not recommended.

Obstetric Ultrasound

Ultrasound Scans Dublin Some Common Questions If you are wondering why you should have an early pregnancy scan , why not take a look at this video where one of our consultants, Dr. Shane Higgins, explains clearly the reasons for attending an early pregnancy scan — just click on: Especially if this is your first pregnancy, you may also be unsure as to when is the earliest you could have your first scan. Normally this 1st trimester scan is undertaken from 6 to 12 weeks.

medical physicists in the United States. The College is a nonprofit professional society whose primary purposes are to advance the science of radiology, A limited obstetric ultrasound examination is performed to answer a specific, acute clinical question when an or detailed scan, some will only need limited scans, whereas others will.

Prenatal Ultrasound Page Content Ultrasound scans offer a non-invasive, accurate diagnostic tool for dating a pregnancy, checking for any problems, and obtaining information about the fetus. It does not use X-rays or other types of radiation that could harm a fetus, and may be used as early as the fifth week of pregnancy. We also have the capability to perform 4D ultrasound, which allows moving 3D images. A radiologist or perinatologist reviews all results.

Ultrasound Schedule The following schedule describes the ultrasounds that women experiencing a typical pregnancy may receive. Your care provider may recommend a different schedule. You may receive an ultrasound scan in your provider’s office to:

Nuchal translucency

HCG Levels for normal Pregnancy. The quantitative maternal serum beta HCG peaks at approximately 10 weeks and then reduces. It will be difficult to see if the mother has a retroverted uterus or fibroids. The GS is an echogenic ring surrounding an anechoic centre. An ectopic pregnancy will appear the smae but it will not be within the endometrial cavity.

Gestational sac size should be determined by measuring the mean of three diameters.

Nuchal translucency is the normal fluid-filled subcutaneous space identified at the back of the fetal neck during the late first trimester and early second trimester ( weeks).. It should not be confused with the nuchal fold, which is seen in the second trimester.

The scan is usually done transabdominally, but occasionally it may be necessary to do the scan transvaginally: The purpose of the week scan: To date the pregnancy accurately. This is particularly relevant for women who cannot recall the date of their last period, have an irregular menstrual cycle, or who have conceived whilst breastfeeding or soon after stopping the pill. We measure the size of the fetus and from this we calculate the expected date of delivery.

To diagnose multiple pregnancy. Ultrasound scanning can determine if both babies are developing normally and if the babies share the same placenta which can lead to problems in the pregnancy. In such cases it would be advisable to monitor the pregnancy more closely. To diagnose certain major fetal abnormalities. Some major abnormalities may be visible at this gestation, but a follow up scan at weeks remains essential.

Not all anomalies are detected at weeks. Risk assessment for Downs syndrome and other more rare chromosomal abnormalities Edward syndrome, Patau syndrome, Turner Syndrome and Triploidy with nuchal translucency measurement.

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Senior Sonogropher Obstetric and Gynaecology Ultrasound Department We provide pregnancy and gynaecology ultrasound examinations. To achieve this we apply a clear gel to the skin to allow a small hand-held probe to slide over your abdomen to produce images via sound reflected from the internal structures. It is safe to use in pregnancy and from any age from birth to the elderly. We welcome one adult to accompany you during your ultrasound examination.

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Ultrasound About us QA has approximately 12 ultrasound scanning rooms. There is a large dedicated team to providing one to one individual care with the patient during their scan. You may be seen by a sonographer or radiologist depending on the type of scan requested by your referrer. There are a large range of scans performed that may identify the clinical question asked by the referrer, however just like other imaging modalities, it has its benefits and limitations.

In some circumstances you may be referred for further diagnostic imaging. Ultrasound, like x-ray, is a quick dynamic imaging technique that is usually the first port of call for assessing the underlying question. It uses sound waves to produce images of the particular region in question. It is a safer form of imaging compared to those that use ionizing radiation, such as X-ray and CT.

What is ultrasound used for? Ultrasound Scans can be separated between obstetric and non-obstetric. Obstetric scans are performed mostly by sonographers or Obstetricians within the Antenatal Clinic on B-level. This is where you will be seen by the specialist team dedicated in assessing mums-to-be wellbeing as well as the unborn baby.

There is also an Early Pregnancy Unit on A level. Talk to your midwife, GP or obstetrician about any concerns you have.

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Contact Us Assessing your baby This scan well assess the health of your baby during your first trimester, and identify any issues early in the pregnancy. What is a nuchal translucency scan? The nuchal translucency scan is a non-invasive ultrasound procedure usually performed on the abdomen area, although it may also be performed vaginally. This assessment is important as it allows the diagnosis of potential fetal complications including Down syndrome. If our specialists detect any abnormalities using our state-of-the-art ultrasound technology, we will notify you of the risks and discuss your options.

Counselling and recommendations for non-invasive prenatal testing or definitive tests such as amniocentesis or CVS invasive confirmation of chromosomal complications can be offered. When is it recommended and how is my risk factor calculated? The nuchal translucency scan is recommended between 12 and 14 weeks of pregnancy as this is the stage of the pregnancy when the thickness of the nuchal translucency fluid layer is seen differently from chromosomally normal fetuses.

When determining your risk of chromosomal complications there are three main independent risk factors used in the assessment, including:

12 WEEKS PREGNANT