PREGNANCY ULTRASOUND: EARLY PREGNANCY ASSESSMENT
The Diagnostics and imaging center is able to provide rapid access to diagnostic tests for women with complications of early pregnancy (i.e. from conception to 14 weeks of pregnancy). We provide scanning facilities immediately at the time of consultation and interpretation of serum levels of the pregnancy hormone hCG and progesterone. The nature of these problems is such that they tend to occur without warning. Hence we run 7 day a week service.
Common reasons for assessment: Pregnancy Test in Dwarka
- Unexplained bleeding in early pregnancy
- Lower abdominal pain in early pregnancy
- Severe nausea and vomiting in early pregnancy
- Possible miscarriage or ectopic pregnancy (tubal pregnancy)
- Reassurance following a previous miscarriage or ectopic pregnancy
- To date a pregnancy and check for the presence of a heartbeat
- To determine the number of foetuses
Information we would like you to bring
- The date of the first day of your last menstrual period and whether it was unusually light or heavy
- Whether you are pregnant. The commercially available urinary pregnancy tests you can buy from chemists are suitable.
- Whether you have had any significant medical problems in the past and the nature of these.
What does an early pregnancy assessment involve?
At our clinics we assess early pregnancies using transvaginal ultrasonography and on occasion to use measurements of a hormone produced in pregnancy (HCG).
We will ask you to give a brief outline of the problem, the day of your last period and whether you have had any significant gynaecological or other medical problems in the past. If you have not had a pregnancy test, you will be asked to provide a sample of urine for this to be done. You will then probably have a transvaginal ultrasound carried out.
In the majority of cases, following the scan you will be told what the situation is in relation to your pregnancy, and whether or not any treatment is needed. If the situation is still unclear you may be asked to provide a blood sample in order to measure the pregnancy hormone level in your blood. We may ask you to come back after a few days or 1 week to repeat either the scan or a blood test or both.
All results of Pregnancy Test in Dwarka will be given to you immediately at the time of your visit. A written report of the consultation will be for your referring doctor the same day. In the unfortunate event of an abnormal result we will contact your gynaecologist or GP. If you do not have a gynaecologist we can give you advice about what to do and arrange any care that may be appropriate.
Will I need to drink lots of water and have a full bladder for my appointment?
No – an empty bladder makes the examination easier for us.
What do you mean by ‘transvaginal ultrasound’?
Ultrasound works by sending out sound waves at a target (in this case your womb) and then analysing the pattern produced by the echoes that are bounced back. You will probably be familiar with scans carried out during pregnancy – these are performed by passing a probe over the stomach.
These often require the bladder to be very full. In early pregnancy or when scanning for gynaecological problems it is better to place the probe in the vaginal closer to the area of interest. In this way clearer images can be obtained (and for example in pregnancy the heartbeat of the embryo can be seen at least a week earlier).
The vaginal probe is about the size of a tampon and for most women the examination is not uncomfortable. If it is the examination will be stopped. A further advantage of this approach is that the bladder does not need to be full which should make both waiting and the examination more comfortable.
What do they do to the probe between examinations?
During the examination the probe is covered with a thick latex sheath rather like a condom. Between scans the probe is cleaned with an alcohol based cleaner.
What is the point of the blood test?
The blood test measures the level of a hormone called HCG in the bloodstream. This hormone is produced from the outset of a pregnancy. We know what the level of this hormone should be for any particular stage of an early pregnancy and also the rate at which it should rise or fall. This is useful in diagnosing either en ectopic pregnancy or a failing pregnancy.
THE NUCHAL SCAN (11 WEEKS – 14 WEEKS)
The majority of babies are born normal. However all women have a risk of carrying a baby with a physical or mental handicap. One cause of this may be a chromosomal abnormality, such as Down’s syndrome.
The risk of having a baby with such an abnormality can be calculated on the basis of maternal age, the amount of fluid behind the baby’s neck, the length of the baby and 2 hormones in your blood. You and your partner can then decide if the risk of the baby having Down’s syndrome is acceptable or if you would like to have an invasive test such as a CVS or amniocentesis. These two tests carry a miscarriage rate of 1 %.
The scan is performed between 11 weeks and 13 weeks and 6 days. An ultrasound transducer is placed on your abdomen and the procedure takes around 20 minutes. You should drink normally before the arriving but do not empty your bladder 30 minutes before the scan.
During the scan, several measurements are taken
- The crown rump length (CRL) from the top of baby’s head the bottom
of the spine
- This will enable us to accurately calculate how pregnant you are and the estimated date of delivery
- The fetal heart rate
- The nuchal translucency measurement (NT). This is the fluid filled space behind the neck that is present in all fetuses.
The fetal anatomy will also be examined, as there are some physical abnormalities that can be diagnosed at this stage of pregnancy. We will examine the skull and brain, the nasal bone the arms, the legs, the stomach, the spine, the abdomen and the bladder.
The accuracy of this test is increased by measuring the level of two hormones in the mother’s blood (Beta HCG & Papp-A)
After the scan you will be fully counselled about the results and the role of any invasive tests that can be done. The only way to know for certain if a chromosomal abnormality affects the baby is to have a CVS or amniocentesis.
FETAL ANOMALY SCAN 18-22 WEEKS
A detailed examination is performed of the baby from top to toe to exclude any chromosome abnormality. We will examine in detail, the head and brain, face, spine, chest, abdomen, kidneys, arms, hands, legs and feet.
The baby will also be examined for any minor variations of normal anatomy that may be found in babies with a chromosomal abnormality. At the same time measurements will be taken to assess the baby’s growth and the position of the placenta.
Fetal Cardiac ECHO
This scan can be performed from 18 weeks. A consultant fetal echo cardiographer will examine the heart and the connecting vessels in detail. This is normally recommended for those women who have a family history of cardiac abnormality or where the measurement of nuchal translucency has been increased at 12 weeks.
What does the procedure involve?
The scan is performed by placing an ultrasound transducer on you abdomen and takes around 30 minutes.
What can I do prior to the scan?
Your bladder does not need to be full but it is advisable to drink normally & not empty your bladder 30 minutes prior to the scan.
4-D SCAN (22-28 WEEKS)
What is the difference between a 2D, 3D and 4D scan?
Like all ultrasound studies, the 3D / 4D uses high frequency sound waves to create images that can be viewed on a monitor screen.
In 3D / 4D scans you will see your baby in a 3D – life like image, instead of the familiar flat, grainy 2D pictures associated with traditional ultrasound scans.
The 4th dimension is real time movement. This means that you may be able to see your baby stretching, kicking, yawning or sucking his or her thumb.
Is it safe?
Since its introduction over 40 years ago there have been no documented harmful effects to either mother or child caused by ultrasound scanning be it 2D, 3D or 4D.
In fact, 3D or 4D scans use the same type and intensity of ultrasound as with conventional ultrasound scanning and because you can store and view the images on a computer, the actual scanning time can often less than that of conventional 2D scans.
When is best time to perform a 3D or 4D scan?
This depends on what you want to see. With the 3D/4D technology currently available, we are able to image your baby at different stages during your pregnancy. We can successfully scan your baby at any time after 20 weeks. In our experience, the best images are generally obtained between 26-32 weeks. This ensures there is enough amniotic fluid present in the womb for the ultrasound scanner to properly image your baby, while ensuring the baby’s facial features have developed to the point where they are clear and easily recognisable.
If you are having twins, the best images will be obtained before 28 weeks.
Who will be performing my scan?
Dr HarshitaSurange who has been specially trained in 3D/4D prenatal scanning.
Will I always get a clear scan? Can you always see a beautiful picture of my baby?
The quality of your 3D images or 4D movie will be affected by the baby’s time of gestation, position, the amount of amniotic fluid surrounding the baby, and the amount of skin, fat and muscle around the baby.
The position however, will be the strongest factor in determining the quality of image that you see. But rest assured, it is our aim that no client leaves without the chance to be introduced to their little one. If your baby is lying in the wrong position, we will first have you go for a short walk to try and encourage the baby to change positions.
If this is still unsuccessful, we will invite you back for another appointment at no extra charge because your satisfaction is what matters to us most.
In order to maximise your chances of getting a great image, we recommend that you drink at least 8 glasses of water for 1-2 weeks prior to your scan.
How much time should I allow for my appointment?
The appointment length for your scan is generally 45 minutes from beginning to end. Actual scanning time is between 20 – 30 minutes depending on your baby’s movements. If your little one is not in the ideal position on arrival, your appointment might be lengthened to allow time for your baby to change positions.
FETAL GROWTH SCAN AND ASSESSMENT (22 – 40 WEEKS)
This scan is performed to assess the growth and well being of the baby.
What’s involved in a Fetal Growth Scan?
The scan is performed by placing an ultrasound transducer on your abdomen and takes around 20 minutes. Your bladder does not need to be full but it is advisable to drink normally & not empty your bladder 30 minutes prior to the scan.
During the scan we take look at a number of areas:
- Measuring the baby’s head, abdomen and thigh bone
- Assessing the amount of amniotic fluid around the baby
- Observing the baby’s activity
- Measuring the blood flow in the umbilical cord using Doppler ultrasound
- Recording the position of the placenta
If we are concerned regarding the findings of this scan, you will have the opportunity to discuss these and their implications with one of the fetal medicine consultants.