Fetal Ultrasound

Early pregnancy scan is generally done for,

• Confirmation of intrauterine pregnancy
• Confirmation of viability
• Assessment of gestational age
• Confirmation of singleton/multiple pregnancy.

Nuchal Translucency Scan is performed between 11 – 13^{+6 Days} weeks of pregnancy.

Importance

• To date the pregnancy, we measure the size of the fetus and from this we calculate expected date of delivery.
• To diagnose multiple pregnancy
• To diagnose major fetal anomalies
• To assess the risk of Down’s Syndrome and other chromosomal abnormalities

The NT scan measure the clear fluid behind the neck of the baby. The NT scan is generally offered along with blood tests – double marker test

Down’s Syndrome Screening

Every women have a risk of having a baby with down syndrome. This risk either can be decreased or increased by this screening test. After this screening test if any women come under high risk for having downs syndrome she has to undergo a diagnostic test for confirmation.

 

Screening Tests for Down’s Syndrome

• Double marker test / combined 1^sttrimester screening (NT Scan + Double marker).
• Non Invasive cell free fetal DNA test (NIPT)
• Quadruple marker
• Genetic sonogram

This is a detailed scan at 18-22  week of pregnancy. During this scan, we examine each part of baby including brain, face, spine, heart, stomach, bowel, kidney, bladder, limbs, determine the position of placenta, assess the amount of amniotic fluid, and measures the fetal growth.

If any abnormalities detected the significance of  finding you can discuss with  our consultant fetal medicine at Palash – A Centre For Fetal Medicine.

Genetic sonogram is performed when some one is high risk on biochemical screening test. This scan is performed looking for specific ultrasound soft markers which suggestive of possibility of trisomy 21 like venticulomegaly, increased nuchal fold, absent/hypoplastic nasal bone, echogenic cardiac foci, aberrant right subclavian artery (ARSA), echogenic bowel, pyelectasis, short femur.

These soft markers are checked during this scan which either increases or decrease the risk of having trisomy 21 baby.

This scan usually performed between 17 to 22 week of gestation along with detailed anatomical evalution of baby.

Fetal ECHO is a specialised detailed scan of your baby’s heart. This scan generally look for heart defect, done between 18 to 24 week of pregnancy

Specific scan of fetal heart required in case of a patient having a history of congenital heart disease, diabetes mellitus, those who are on antiepileptic drug, increased NT in NT scan.

It includes detailed evalution of the fetal Central Nervous System. It requires specific expertise and a sophisticated ultrasound machine. This type of examination is indicated in pregnancies at increased risk of CNS anomalies.

Real-time 3D/4D sonography provides a three dimensional view of the fetus in motion and is one of the most important modern innovations in the field of ultrasound. The clear view of the baby from all angles allow doctors to detect any congenital abnormalities at an early stage. The image quality is so clear and sharp that one can get an accurate impression of how baby s features look on birth.

Preeclampsia screening is a pregnancy induced high blood pressure and is one of the most common life threatening condition during pregnancy.

This high blood pressure can affect the mother’s health and growth of the baby also. First trimester can identify the women at high risk for preeclampsia this can improve the pregnancy outcome by appropriate monitoring of fetus and mother and early detection of any affection of baby and timely delivery at appropriate place.

Ethnicity, first pregnancy, High  BMI any previous pregnancy or family history of preeclampsia all these factors affect your having risk of preeclampsia.

Preeclampsia screening include ultrasound measurement of placental blood flow at 11-13 week scan along with history, maternal mean arterial blood pressure with or without blood test.

Cervical Assessment

Cervical screening by transvaginal sonography done at  11-13^{+ 6}  day and during 19 -22 week anomaly scan. The length of the cervix is measured at midsagittal plane to assess the risk of preterm labour. Normally cervix measured more than 25 mm.

Preterm labour screening

Preterm labour is when u have started labour pains and open the cervix before 37 completed weeks gestation leads to premature delivery of baby.

There are many risk factors for preterm labour like poor nutrition, infection, smoking, previous pregnancy having h/o of preterm, cervical surgeries overdistention of uterus, low socioeconomic class etc…

Because of preterm labour when baby born before 34 week their lungs are still immature may having breathing problems and may require ICU. Also, this baby is high risk for infections and feeding problem also.