#3d ultrasound in karol bagh | Explore Tumblr posts and blogs

drseemagupta-blog · 5 years ago

Text

Importance of Ultrasound in Pregnancy

Introduction

In pregnant women, tests that use radiation, such as x-rays and computerized tomography, should be avoided due to the obvious risks they bring to the baby. So, ultrasound in Delhi is the imaging test of choice for prenatal follow-up. Ultrasound is a cheap test, without risks for the fetus, which causes no side effects and has no contraindications.

In this article, we will briefly review the role of obstetric ultrasound scan in Delhi. We will address issues such as nuchal translucency, morphological ultrasound, estimating gestational age and 3D and 4D ultrasound.

WHEN MUST THE OBSTETRIC ULTRASOUND BE DONE?

Ultrasound can be performed several times during pregnancy, but it is not necessary in each consultation. In fact, many international Gynecology and Obstetrics societies agree that, if the patient is healthy, she has no complaints or risk factors, only one or two ultrasound evaluations, carried out between the 10th and 13th weeks and between the 16th and 20th weeks of gestation, they are really necessary during pregnancy.

However, since many obstetricians have an ultrasound device in their office, it is very common for the test to become part of many, if not all, prenatal consultations. It is good to make clear that, being pregnant well, there are no studies that indicate advantages in terms of health of the mother and the fetus when we compare pregnant women who did serial ultrasounds throughout pregnancy with pregnant women who made only a single ultrasound between the 16th and 20th week of gestation. Therefore, in places with structure and limited access to medical resources, there is nothing wrong with requesting only a single ultrasound during pregnancy.

In places with more resources, the obstetrician usually performs at least 3 or 4 prenatal ultrasound exams, divided during the 3 trimesters of pregnancy:

1- In the first or second prenatal consultation with the aim of confirming the existence of an embryo within the gestational sac and intrauterine pregnancy, visualize the heartbeat of the fetus, early identification of a twin pregnancy, estimate the gestational age and evaluate possible changes Anatomical aspects of the female gynecological tract, such as ovarian cysts, myomas, uterine malformations, etc.

2- In the second trimester of pregnancy, the pregnancy scan in Delhi should be performed, preferably, between the 18th and 24th week of pregnancy, to evaluate the formation of the fetal anatomy. This test is called morphological ultrasound (or morphological ultrasound) and is the most important ultrasound of pregnancy since it is capable of detecting fetal malformations.

Then in the beginning of the 2 trimester, around the 12th week of gestation, it is also very common to perform an ultrasound to measure the nuchal translucency, which is a test that evaluates the amount of fluid in the region of the nape of the fetus. An increased nuchal translucency suggests the possibility of a chromosomal alteration, such as Down syndrome.

3- In the third trimester, ultrasound is used to control the growth rate of the fetus, the placenta of the uterus, the amount of amniotic fluid, the vitality of the fetus, its position inside the uterus and the position of the umbilical cord.

FIRST ULTRASOUND OF THE BABY

Obstetric ultrasounds performed in the first 12 weeks of pregnancy are usually done through the transvaginal route. From the 12th week, the abdominal route is more indicated.

The first pregnancy ultrasound in Karol Bagh can be performed after the 5th week of pregnancy, when it is already possible to visualize the gestational sac, the first identifiable structure of a pregnancy. The gestational sac is usually visible after the 4th or 5th week of gestation. Before the 4th week it is useless to do the ultrasound since he is not able to identify any sign of gestation.

A few days after the beginning of the 5th week of pregnancy it is possible to identify, within the gestational sac, the vitelline vesicle, structure that provides nutrients to the embryo. The presence of the gestational sac and the vitelline vesicle inside the uterus confirms the existence of an intrauterine pregnancy, ruling out the possibility of an ectopic pregnancy, although the embryo is still incapable of being seen.

The embryo itself is usually visible from the 6th week and its heartbeat can be identified between the 6th and 7th week.

In general, we indicate the realization of the first ultrasound during the 7th week of pregnancy, when all the data referred to above will already be available to the obstetrician.

ESTIMATION OF THE GESTATIONAL AGE BY ULTRASOUND

In the first trimester of pregnancy, the human embryo presents a more or less stable and predictable growth and development rate, thus being possible to estimate the gestational age according to its ultrasonographic characteristics. From the second trimester, babies begin to grow at different speeds according to their genetic characteristics and pregnancy conditions, being it more difficult to estimate gestational age through ultrasound.

The estimate of the gestational age and the probable date of delivery (PPD) are made more accurately by the obstetric ultrasound in Delhi in the first trimester than by the date of the last menstruation (DUM), mainly in women who have a cycle Irregular menstrual or that are not remembered with certainty of the day of the beginning of the last menstruation. If the DPP calculated by the DUM is different from the DPP calculated by the ultrasound, the latter should be the one used by the obstetrician to assess the most accurate gestational age.

The size of the gestational sac and, mainly, a measure called head-buttock length (CCN), are the most used measures to estimate gestational age. Data, such as the presence of the heartbeat, the vitelline vesicle and an embryo visible inside the uterus, also help in the estimation of gestational age in still very early pregnancies.

From the 12th week of pregnancy, other measures allow to estimate the gestational age, such as the biparietal diameter (DBP), the cephalic circumference (CC) and the length of the femur (LF).

NUCAL TRANSLUCENCY

The evaluation of the nuchal translucency (TN), which some call morphological ultrasound of the first trimester, is an examination performed between the 11th and 13th week of pregnancy, whose objective is to identify the amount of fluid present in the nape of the fetus. Studies show that fetuses with chromosomal abnormalities, fetal malformations and genetic syndromes tend to have more fluid in this region, making the neck look wider.

As liquids create less echo than solid structures to ultrasound, they appear darker, that is, with greater translucency or increased nuchal translucency. The examination of the nuchal translucency only has value when performed on fetuses with head-buttock length between 45 and 84 mm and with less than 14 weeks of gestation

Normal values of the nuchal translucency are less than 2.5 mm. These values, however, must be evaluated according to the age of the pregnant woman. A nuchal translucency greater than 2.5 mm in a 22-year-old pregnant woman is less worrisome than the same value in a 40-year-old pregnant woman. The greater the value of the nuchal translucency, the greater the possibility of the fetus having some genetic alteration.

The increased nuchal translucency may be an indicator of several genetic diseases or malformations, with Down syndrome being the most important. About 75% of babies with Down syndrome have increased nuchal translucency.

It is necessary to reinforce that the nuchal translucency is only a screening test, and does not serve as a definitive diagnosis. The false positive rate is relatively high, around 5%. In the same way, a normal TN, below 2.5 mm, does not rule out the possibility of a chromosomal disease since around 20 to 25% of fetuses with Down present normal TN.

When we find an increased nuchal translucency, other ultrasonographic evaluations must be performed to obtain more data. Generally, the absence of nasal bone and an altered blood flow in the venous duct (communication between the umbilical vein and the inferior vena cava of the fetus) are alterations that reinforce the possibility of genetic problems.

When the tracing by the nuchal translucency, nasal bone or venous duct is altered, an investigation with blood analysis of the mother (beta hCG and Plasmatic Protein A (PAPP-A)) is necessary.

With the TN data and the results of the blood tests, the obstetrician can calculate the risk of chromosomal diseases of the fetus. If the value is much higher than expected for age, amniocentesis (collection of amniotic fluid) is usually indicated for the definitive diagnosis.

MORPHOLOGICAL ULTRASOUND

Fetal morphological ultrasound is the most important ultrasound examination of pregnancy. It should be done abdominally between the 18th and 24th weeks of pregnancy. In this stage, the fetus is already fully formed, being possible to identify present malformations with relative ease.

The morphological ultrasound is the slowest and most detailed of the pregnancy, being able to take more than half an hour, since the doctor at ultrasound centre in Delhi needs to individually evaluate different structures. In many cases, it is not your obstetrician who performs this test, but a radiologist in Delhi or another obstetrician specializing in fetal morphologic ultrasound.

In the morphological ultrasound it is possible to confirm the sex of the baby, verify its heart and its chambers, evaluate the formation of the brain, digestive organs, limbs, face and other systems of the fetus. The use of Doppler is used to check the blood flow in the placenta and uterus. In this ultrasound it is also possible to determine the location of the placenta to know if it may be blocking the exit of the uterus, a condition called placenta previa.

The morphological ultrasound also serves to measure the head of the baby, the femur and the abdominal circumference to know if its growth is adequate.

ULTRASOUND 3D

3D ultrasound has gained popularity in recent years due to the greater sharpness and beauty of its images. For parents, 3D ultrasound is much more interesting, because it shows the appearance of the fetus in more detail. For the doctor, however, in most cases, there is no indication for its realization because 3D ultrasound adds little information in relation to the common 2D ultrasound.

In some cases of suspected facial abnormality or neural tube defects seen by common ultrasound, 3D ultrasound seems to show the defects with a little more clarity. Except situations like this, there are few cases in which 3D ultrasound is really useful.

The 4D ultrasound is only a 3-D ultrasound in real time, capable of showing the movements of the fetus and its internal structures, such as the heart. It can be recorded as a video, which makes it even more attractive to parents.

#Radiologist in Delhi #Ultrasound in Delhi #Ultrasound Centre in Delhi #Ultrasound Scan in Delhi #Pregnancy Scan in Delhi #Ultrasound in Karol Bagh

1 note · View note