At what time is it better to do an expert ultrasound. Expert ultrasound: reasons for conducting and principles for deciphering the results
According to the order of the Ministry of Health of Russia No. 572n dated November 12, 2012, screening ultrasound (ultrasound) of the fetus should be performed three times from 11 to 14, from 18 to 21 and from 30 to 34 weeks of pregnancy.
If necessary, an additional ultrasound examination can be carried out in any quantity and at any time during pregnancy, given the absolute safety of ultrasound for the fetus.
Ultrasound examination protocols at the European Medical Center are compiled depending on the timing of the examination itself and on the basis of the recommendations of the International Society for Ultrasound in Obstetrics and Gynecology (ISUOG), the Fetal Medicine Foundation (FMF) and the Russian Association of Ultrasound Diagnostics Physicians in Perinatology and Gynecology. If necessary, all studies are accompanied by the use of 3D/4D technologies. At the end of the ultrasound, the expert doctor issues a study protocol with an interpretation of the results.
Basic ultrasound examinations of the fetus during pregnancy
1. The first study to confirm the viability of the fetus.
This is an ultrasound examination, which is usually performed with a vaginal probe at 6-10 weeks of gestation. The purpose of this study is to determine the number of embryos and confirm the normal development of the fetus inside the uterus.
This study is especially indicated for pregnant women with lower abdominal pain and/or bleeding from the genital tract, as well as women who have a history of non-progressing pregnancies, spontaneous miscarriages or ectopic pregnancies.
2. Ultrasound examination for a period from 11 to 14 weeks.
It is usually performed transabdominally, but in some cases, if necessary, it can be performed transvaginally.
The purpose of the ultrasound in this period:
Accurately determine the gestational age. This is especially true for women who do not remember their last menstrual period, have irregular menstrual cycles, or who become pregnant while breastfeeding. By measuring the size of the fetus, we can accurately calculate the date of conception and the date of delivery.
Diagnosis of multiple pregnancy. Approximately 2% of independent pregnancies and 10% of pregnancies resulting from the use of assisted reproductive technologies are multiple. Ultrasound allows you to determine whether both fetuses are developing normally, to assess the condition of the placenta (it can be the same for both babies, or each baby can have its own placenta), which is fundamentally important in multiple pregnancies. In such cases, it is advisable to monitor pregnancy more closely.
Diagnostics of the main pathological conditions fetus. Some serious anomalies, malformations may be visible at this stage of pregnancy. However, it must be borne in mind that the main detailed ultrasound to exclude malformations is carried out for a period of 20 weeks.
Diagnostics early miscarriages. Unfortunately, in 2% of women who come for a planned ultrasound at 11-14 weeks, the fact of an undeveloped pregnancy is established. Couples receive information about the possible causes of miscarriages and additional examinations to plan future pregnancies.
Assessment of the risk of Down syndrome and other chromosomal abnormalities. Each woman is given an individual risk assessment. This indicator is calculated taking into account the age of the mother, the measurement of two hormones in the mother's blood and the results of the ultrasound measurement of the thickness of the collar space, as well as the measurement of the bones of the nose, the assessment of blood flow in the fetal heart and ductus venosus, and the assessment of fetal malformations. Parents will receive full advice on the significance of these risks and the need for more detailed studies - a non-invasive prenatal test or an invasive diagnosis - amniocentesis.
3. Ultrasound examination for a period of 20 - 24 weeks.
The doctor examines in detail each part of the fetal body, determines the position of the placenta, estimates the amount amniotic fluid and fetal growth. Particular attention is paid to the assessment of the state of the brain, face, spine, heart, stomach, intestines, kidneys and limbs.
4. Ultrasound to assess fetal development.
This ultrasound is usually performed between 30 and 34 weeks of pregnancy.
The purpose of this ultrasound examination:
Measurement of the fetal head, abdomen and femur and assessment of fetal weight.
Study of fetal movements.
Assessment of the position and condition of the placenta.
Measuring the amount of amniotic fluid.
Assessment of blood flow in the placenta, fetal head, uterine arteries using color Doppler mapping.
5. Ultrasound examination of the heart.
During the ultrasound for a period of 11-14 weeks, 20-24 weeks and 30-34 weeks, the doctor necessarily assesses the condition of the fetal heart and major vessels.
An expert detailed examination of the fetal heart is recommended:
women with a family history of congenital heart anomalies, patients with diabetes and those taking antiepileptic drugs;
in a fetus with suspected heart disease or in a fetus with an increase in the thickness of the nuchal space of the fetus, as well as in case of detection of other malformations in the fetus during routine ultrasound examinations.
The test is usually performed between 18 and 23 weeks of gestation, but may be done as early as 13 weeks if needed.
6. Ultrasound examination of the cervix.
This is an ultrasound to measure the length of the cervix. Recommended for women at high risk of preterm birth multiple pregnancy; pregnant women with a history of premature birth previous surgery on the uterus for malformations or surgery on the cervix.
This examination is usually carried out at 30-34 weeks, but if necessary, can be performed starting at 16 weeks.
You can go through all the studies during pregnancy in ours.
It makes sense to conduct an expert ultrasound during pregnancy if it is necessary for high-precision diagnostics, which is possible due to the high resolution of the devices and the high qualification of ultrasound specialists.
Modern science does not stand still. The geniuses of our time are doing everything to improve life. A successful start to life begins with the office of a gynecologist. The achievement of the 21st century in the field of prenatal diagnosis is expert ultrasound during pregnancy, what is it?
All modern medical centers have the ability to conduct expert ultrasound - a non-invasive study, the accuracy of information in which can be obtained an order of magnitude higher than that of a conventional ultrasound machine.
The main advantage lies in the new methodology and the latest equipment, which can be used by ultrasound specialists, and not just trained medical staff. The experience and skill of an ultrasound diagnostician is very important, because, otherwise, the diagnosis can be quite superficial and inaccurate, which is sometimes extremely important.
The value of expert ultrasound during pregnancy is difficult to overestimate. The choice of the type of sensor, its frequency, class, Dopplerography, as well as the ability to display a three-dimensional image - all these features are collected in one device. With the help of these data, it is possible to diagnose various pathologies of fetal development, including the smallest ones.
What is this examination
Due to the good resolving property at a high level, it is possible to detect abnormalities in the development of the heart and great vessels, the gastrointestinal tract, the musculoskeletal system, the brain and other organs of the fetus. It is worth remembering that with conventional ultrasound diagnostics it is impossible to exclude a medical error, and with an expert it is minimal.
What is the difference between expert and conventional ultrasound
Ultrasound devices of an expert class are devices that allow for all possible ultrasound examinations and are equipped with a full set of sensors, including Doppler attachments with all the functions. These digital devices also allow you to work in 3d-4d (HD) real-time mode.
Such devices are very expensive and not every polyclinic in Russia can purchase them, but nevertheless, the fleet of expert-class ultrasound devices is constantly growing due to their many more equipment capabilities than conventional ultrasound devices.
For example, in transplantation and various operations, the use of expert-class ultrasound devices is necessary, as well as in identifying various kinds of pathologies or necessary accurate studies during pregnancy at any time.
Under normal outpatient conditions, an expert ultrasound examination is not necessary.
Advantages of the technique
They can be explained by two possibilities:
- high quality and great capabilities of the equipment, doctor's qualification;
- the entire course of the study is recorded on removable media, in case of disputes, it is enough to re-view the record on disk.
Modern ultrasound machine for expert class diagnostics
In order to avoid late pathology of the fetus, ultrasound is best done several times at different stages of pregnancy.
In the first trimester, you can:
- establish the presence of a fetus;
- make sure the fetus is in the correct position in the womb;
- confirm multiple pregnancy;
- assess the amount of amniotic fluid and the location of the umbilical cord;
- exclude Edwards, Patau and Down syndromes.
For 10 weeks, a detailed assessment of the state of the organs and systems of the unborn child is carried out, in order to exclude severe pathology.
Additional Methods
Already in the second and third trimester, a color Doppler study is attributed, which is necessary to assess hemodynamics in the main vessels of the brain, heart, current through the vessels of the umbilical cord and uterus in order to predict possible complications. Already from the 3rd month of pregnancy, you can get indicators for calculating the mass-growth coefficient.
An ultrasound of an expert class can dispel doubts if possible anomalies in the development of the fetus are suspected (if there is information in the birth history). The examination is also carried out at the request of the woman, if future mom worries about the health of future offspring and wants to make sure that the pregnancy proceeds smoothly. Thanks to this opportunity, you can live in peace, as there will be no reason to worry. Future parents are advised to use the following rule: "Qualified help is the key to your child's health."
Expert ultrasound during pregnancy is an extended diagnostic examination of the fetus. The technique of such diagnostics has been developed by leading domestic and foreign diagnostic centers. This study is performed by highly qualified doctors to confirm or exclude many diseases of the mother and child.
Consider what is the difference between expert ultrasound during pregnancy, what it is, in what cases it is prescribed and what it shows.
Of course, this type of diagnosis includes an ultrasound examination. However, the patient additionally undergoes a study of such organs:
- brain;
- lungs;
- hearts;
- digestive organs;
- vessels;
- kidneys;
- bones and muscles;
- faces;
- Doppler mapping (color), with which you can determine the degree of functioning of the vessels of the child's brain.
The peculiarity of expert ultrasound during pregnancy is that it allows you to detect even minor changes in the structure of the fetus, as well as its pathology. During such an examination, only high-precision stationary ultrasound devices are used, which make it possible to most accurately determine the condition of the fetus. Be sure to apply the methods of three-dimensional and four-dimensional ultrasound (in the latter case, it is carried out in real time).
Many women, not knowing what an expert ultrasound is, are therefore afraid to do it because of the erroneous opinion that it will harm the unborn child. Such fears are completely unfounded and in vain: a stationary ultrasound machine will not bring the slightest harm to the mother and her child, since X-ray or other radiation is not used.
Differences of this survey
Expert-class devices can do all the necessary examinations of the organs of the human body. They are equipped with all possible sensors (including those used in Doppler studies). Expert ultrasound, unlike conventional ultrasound, provides data in digital format and of very high quality, in three-dimensional or four-dimensional mode.
These devices have a very high cost, but it suggests that the results of the study will be the most accurate of all possible.
Ordinary polyclinics do not have expert-class ultrasound machines, and there is no need for this either.
Unlike conventional devices, expert devices allow the doctor to record the results of the examination on a removable disk. The equipment with which this study is carried out has very high capabilities, so this diagnosis is carried out only by a very experienced doctor.
A woman should do such a survey in the following cases.
- If there is a suspicion of a malformation of the baby, and at any stage (when other diagnostic tests show it).
- When there are children with genetic abnormalities in the family.
- If pregnancy occurred during in vitro fertilization or through the use of modern reproductive technologies (in this case, careful monitoring of the pregnancy process and the health of the mother and child is shown).
- When a woman is diagnosed with a multiple pregnancy.
- If pregnancy occurs after the age of 35 years.
- If there are any, even the most minor complications in the process of bearing a child.
- If a woman wants to see the full information about the result of an ultrasound examination in real time (using the technologies of three-dimensional and four-dimensional ultrasound). Moreover, such results will be very accessible for understanding by everyone who does not have a special education.
When is a Doppler examination done?
With an expert ultrasound, the doctor may order a woman to undergo a Doppler study. This happens in such cases:
- arterial hypertension;
- diabetes;
- renal pathologies;
- risk of Rhesus conflict;
- active development of the child, or vice versa, his lagging behind normal indicators;
- if there is at least one bad gestation in the anamnesis.
Why is it necessary to conduct a study of the kidneys?
During pregnancy, the risk of kidney pathologies in a pregnant woman increases sharply. If a woman has abnormalities in kidney tests, she must be prescribed an ultrasound of this organ.
With the help of such an examination, it is possible to detect the risk of developing pyelonephritis, a dangerous disease that threatens the development of kidney failure. And if a woman has never suffered from urological diseases, this does not mean that she does not need to do an expert ultrasound. On the contrary, an inattentive attitude to one's own health can just have very adverse consequences for the baby.
What can be seen in such a study?
An extended examination of women is carried out with the same frequency as the usual one - that is, three times.
During the first trimester of pregnancy (the most responsible one), the doctor, with the help of an expert examination, can see how many embryos there are in the uterus, where the chorion is located, what condition the yolk sac and embryo membranes are in. In the first trimester of pregnancy, only with the help of an expert ultrasound can such severe genetic pathologies as Down syndrome, Edwards syndrome and others be excluded.
Such an examination is done in order to exclude the most severe anomalies of the fetus. The study is carried out only transvaginally. It is mandatory to conduct a detailed examination of the child's organs at the 10th week of pregnancy. It also helps to detect certain severe pathologies in time.
During the period of the second and third trimester, Doppler mapping is done (the capabilities of the equipment allow it to be done in full color). With the help of ultrasound, you can see the hemodynamics of the mother and fetus, assess the condition of the umbilical cord. Of course, such an examination can answer the question of whether the size of the fetus corresponds to the established parameters.
In addition, during the third trimester, a detailed ultrasound will give a complete and accurate picture of the fetus, exclude the presence of developmental pathologies and help determine the most accurate date of birth. An extended ultrasound must be performed each time to make sure the condition of the placenta, umbilical cord, presentation of the baby, and so on.
Doing an extended ultrasound examination is not prohibited even before the very birth. The expectant mother can see her baby in real time, what it looks like in the last weeks of its stay in the womb. This wonderful moment can be captured on video or on a hard drive. The doctor determines in detail the weight of the baby and his height.
Is a 3D or 4D examination harmful?
The usual three-dimensional examination shows the future baby in black and white and flat. On the contrary, a high-quality 3D image gives the doctor more opportunities to see the smallest details of the unborn child.
The device for conducting this type of study does not outwardly differ from two-dimensional ones. However, its sensitivity is much higher. The frequency of ultrasound is the same as during a conventional ultrasound examination. From this we can conclude that an expert ultrasound using three-dimensional and four-dimensional technologies does not harm either the baby or the woman. Doppler mapping of blood vessels is also absolutely harmless.
The duration of such an examination may be somewhat longer than usual. But let this fact not disturb future parents: this does not affect the child's condition in any way.
So, expert ultrasound is a modern and accurate diagnostic solution that allows you to determine the slightest pathology of the fetus at the earliest stages of pregnancy. At the same time, the doctor has very valuable information regarding the condition of the fetus. In no case should such examinations be ignored.
In addition to the standard screening ultrasound examinations that are carried out for pregnant women in each trimester of pregnancy, additional diagnostics of the fetal condition may be required. It is not advisable to perform such invasive (violating the integrity of the skin) procedures as cordocentesis or amniocentesis. Even modern medical technologies do not exclude the possibility of complications: infection; damage to the embryo, temporary organs of pregnancy, blood vessels in their atypical position, and so on. Therefore, invasive studies have strict indications.
For a more accurate assessment of the condition of the fetus and the course of pregnancy, it is recommended to undergo an expert ultrasound. This is an additional method of non-invasive diagnostics, which is carried out to clarify the results of screening. For healthy women or with a normal pregnancy, it makes no sense to prescribe such a study. It is important to note that additional ultrasound is completely safe, since all clinical studies have not revealed any effect (immediate and remote) of ultrasound on the mother and fetus.
Reasons for the appointment of an expert ultrasound:
- detection on screening of signs of congenital anomalies or hereditary defects;
- inconsistency of the fetus with its gestational age;
- impaired fetal activity (apparent lack of movement after the 8th week of gestation, rapid or slow heartbeat);
- the presence in the past of a woman of miscarriages, gestosis, intrauterine growth retardation of the fetus;
- burdened heredity of a woman carrying a pregnancy;
- age - over 30 years old;
- the need for complete visualization of the body of the embryo.
Private medical enterprises are currently offering "expert ultrasound" service to pregnant women to show a 3D image of their baby and satisfy their interest. This can be considered a psychological reason for this procedure.
Differences from screening ultrasound
The difference between an expert ultrasound and a standard examination lies in the equipment used and the methodology used. Typically, this class of diagnostics requires a high-resolution ultrasound scanner with 3D and 4D imaging capability. Unfortunately, district hospitals cannot afford this equipment, so for this procedure, you should contact private centers or regional budgetary diagnostic centers.
The examination technique involves not only scanning in 2D mode with an assessment of the morphological state of the fetus, but also a study using a 3D / 4D module. In this mode, superficial anatomical structures (facial skeleton, limb structure, etc.) are assessed in detail, and internal organs. The analysis of the vital activity of the fetus and the state of provisional (temporary) organs of a pregnant woman are of greater accuracy.
Evaluation of results
Such an ultrasound has a similar technique for interpreting the results, as in a screening study at different times. It is important to evaluate the following indicators:
- fetometric indicators of the fetus and their compliance with the gestational age;
- the anatomical structure of the internal organs of the embryo (brain, kidneys, heart, and so on);
- intrauterine life of the child (active movements and cardiac activity)
- condition of the provisional organs of pregnancy (placenta, umbilical cord, amount of amniotic fluid) and uterus.
Also, the detected signs of hereditary pathology must be studied in detail and the diagnosis suggested. The most common markers of a gene disease include:
- reduction in the length of the femur;
- thickening of the skin fold on the neck of the fetus;
- abundant amniotic fluid;
- deformity of the hands and feet of the embryo.
Various combinations of these anomalies in the structure of the fetus indicate Edwards or Down syndrome, the incidence of which is 1: 700 children. It directly depends on the age of the mother - the older the woman carrying the pregnancy, the higher the risk of genetic abnormalities. Therefore, after the age of 32, pregnant women are advised to perform an expert ultrasound, in addition to the screening study.
An expert ultrasound examination is an important diagnostic procedure that determines the indications for invasive interventions and allows us to assume the presence of pregnancy pathology with high accuracy. The level of equipment and qualifications of the specialist should be sufficient to determine the signs of intrauterine anomalies. Therefore, their implementation in district hospitals is often impossible, and in order to provide adequate medical care, you should contact the regional diagnostic centers.
Ultrasound examination (ultrasound) is one of the most informative, safe, and available methods research. At the REMEDI clinic, we offer an expert ultrasound during pregnancy using the Voluson E8 high-end device by a specialist doctor with ten years of experience in leading clinics in Moscow.
Expert class ultrasound
According to the order of the Ministry of Health of Russia, during pregnancy, every woman undergoes a planned ultrasound three times: at 11–14, 19–21 and 30–34 weeks. The number of studies depends on many factors and is determined individually by the obstetrician-gynecologist who is seeing the expectant mother. Ultrasound for pregnancy, along with blood tests, is included in routine screenings that help identify the risk of chromosomal, genetic and congenital disorders in the fetus. On early dates- at 4-7 weeks - ultrasound is used to diagnose pregnancy.
- Examine in detail the anatomy of the child
- Timely determine deviations in the development of the fetus
- Get complete information about the health and well-being of the baby
- Assess uteroplacental and fetal blood flow
- Determine the sex of the child from the 13th week of pregnancy
Expert ultrasound makes it possible in the first prenatal screening (11-13 weeks of pregnancy), according to the recommendations of the International Association of Obstetricians and Gynecologists in ultrasound diagnostics, to conduct an extended study of the anatomy of the fetus and already at this time to exclude most abnormalities in the structure and gross malformations, as well as determine the risk group for chromosomal abnormalities.
What are the types of ultrasound in obstetrics and gynecology?
Modern ultrasound diagnostic devices are equipped with additional functions that allow you to get the most detailed information about the state of the pelvic organs, the fetus during pregnancy:
- 2D ultrasound is the most common method for assessing the health of the fetus and is widely used throughout the world. This is the normal image you see on the screen.
- 3D ultrasound - volumetric image. Allows you to take 3D pictures. Thanks to this, the doctor can get more important information about the condition of the fetus, which makes it possible to exclude more complex malformations that are not available for diagnosis in the usual 2D mode, and the woman can see a three-dimensional image of her baby! If you decide to undergo an expert ultrasound scan in Moscow at the REMEDI Institute of Reproductive Medicine, our doctor will definitely print out pictures for you as a keepsake.
- 4D-ultrasound is a three-dimensional image in motion. The "fourth dimension" is the movements of the fetus, so on the screen of the device you can see how the baby moves his arms, legs, puts his finger in his mouth, breathes, hiccups.
Dopplerometry - the study of blood flow, it helps to judge the well-being of the baby. During pregnancy, dopplerometry involves the assessment of blood flow in the following vessels: the uterine arteries on the right and left, the umbilical arteries, the fetal middle cerebral artery. If necessary, assess the blood flow in the venous duct and aorta of the fetus. With identical twins, Dopplerography makes it possible to exclude feto-fetal transfusion syndrome - a serious complication when one of the fetuses "takes" most of the blood for itself, and the other is deficient. Dopplerometry also allows you to assess the anatomy of the fetal heart, exclude the most common defect - ventricular septal defect and, of course, hear the baby's heartbeat. Dopplerometry is necessarily used during the third planned ultrasound.
During the second screening study, this method is recommended to be carried out according to indications: burdened obstetric history with an unfavorable outcome in a previous pregnancy, severe gestosis in a previous pregnancy, edema, diabetes mellitus, impaired fat metabolism. The need for a study at an earlier date is determined by the attending physician.
How to prepare for a pregnancy ultrasound
No special training required. The study is carried out transabdominally (through the wall of the abdomen) on an emptied bladder. The duration of the study, as a rule, is 20-30 minutes.
It is advisable not to eat foods that cause bloating (cabbage, grapes, sour-milk products, etc.) on the eve of the study.
When is transvaginal access used?
- To assess the condition of the cervix and internal os during pregnancy
- Up to 10 weeks pregnant
- To determine the availability gestational sac in the uterine cavity and exclusion of ectopic pregnancy
- To determine multiple pregnancy
Prices
| Service | Cost, rub. |
|---|---|
| Ultrasound during pregnancy (includes assessment of anatomical structures, including the fetal heart and dopplerometry according to indications, in 2D and 4D mode) | 6000 |
| Ultrasound of the pelvic organs in women (including those with a gestational age of up to 10 weeks inclusive) | 3000 |
| Fetal Doppler | 2500 |
| Determination of the heartbeat of the embryo / fetus | 800 |
| Ultrasound during pregnancy with recording (includes assessment of anatomical structures, including the fetal heart and dopplerometry according to indications, in 2D and 4D mode) | 6800 |
| Cardiotocography (CTG) | 1000 |
