Update: October 2018
Every modern woman wearing a baby’s heart knows
what is ultrasound. She goes to him for the first time
learning about an interesting situation, and throughout pregnancy
this diagnostic miracle will accompany it. Many are asked
question how necessary this procedure is. The answer lies in
the number of babies that the ultrasound helped in time
keep health and life.
Indications for ultrasound during pregnancy:
- На ранних timing
- First screening
- Second screening
- Third screening
УЗИ на ранних timing
Diagnosis of normal and ectopic pregnancy
Первый признак беременности на ранних timing – наличие в матке
gestational sac. It is already possible to detect it for a period of 5-6 weeks.
vaginal sensor, as the dimensions approach 1-2 cm. According to
The average diameter of the ovum can be determined with accuracy
up to 1 week.
Sometimes a fertilized egg does not attach to the endometrium,
and remains in the fallopian tube or even the abdominal cavity. As a result
developing ectopic pregnancy. It’s life threatening
condition, as the embryo develops thinning
and the rupture of the pipe wall begins bleeding, which without
surgery can lead to the death of a woman. Recognize such
ectopic pregnancy helps ultrasound in conjunction with the analysis
blood on hCG. If the level of this hormone has reached 1000 mIU / l, and in
the uterus of the ovum is not detected, then there is a large
probability of ectopic pregnancy.
Heartbeat эмбриона можно определить с помощью УЗИ уже через 4
weeks after conception (i.e. in 6 obstetric weeks). It is possible
make an internal, vaginal sensor. Up to
9-10 weeks the heart rate steadily increases, and
then decreases to 14 weeks.
If after 9-10 weeks of pregnancy the heart rate does not exceed 100 beats
per minute, the prognosis for such a pregnancy is unfavorable. This
criterion allows you to predict the risk of miscarriage with a high proportion
probabilities Аналогичные выwatersы можно сделать, если в 5-8 нед. Heart rate
less than 85 beats per minute.
Уже на ранних timing можно определить
two or more fetal eggs. This is far from a guarantee of multiple babies, so
how often embryo reduction occurs. This is the process by which
one or more embryos just dissolve, allowing
another to develop normally. Поэтому на очень ранних timing
you can not say the fact of multiple pregnancy.
Often there is a non-developing pregnancy. Usually
this happens in cases of anembryonic infection, when in the fetal egg is not
turns out to be an embryo. Sometimes it happens later when normal
e development suddenly stops, the embryo dies, but does not leave
the uterus. It is possible to diagnose such a condition using ultrasound. Doctor
увидит либо пустое плодное яйцо на timing, когда там уже должен
be a fetus, or will not register a heartbeat in an embryo,
lagging in size from gestational age.
Risk of miscarriage
Many women have bleeding early
varying intensity, from a few drops to heavy
secretions. Such symptoms are a direct indication for ultrasound. With his help
you can identify retrochorial hematoma – a collection of blood,
remaining after the threat of miscarriage. It should be noted that most
such pregnancies end safely, no treatment
required. Sometimes an ultrasound reveals a miscarriage that has already begun, when
the uterus ejects the embryo or it is already empty. This usually happens when
сильных кровотечениях, остановить этот процесс неpossibly.
Основной принцип УЗИ беременности на ранних timing: любые
сомнения в диагнозе – поwaters повторить исследование через 1-2
of the week.
First screening в 11-14 недель
Objectives of the first screening ultrasound:
- Confirmation of developing intrauterine pregnancy
- Determining the expected date of birth
- Detection of multiple babies
- Detection of early signs of fetal pathology (thickness of TBP,
length of the nasal bone)
- Evaluation of the remaining parameters of the fetus
Measurement of the neck area
This метод активно используется для выявления хромосомных
anomalies of the fetus, since the 90s of the last century.
The optimal time for its use – from 11 to 13 week, in more
Late terms of information is reduced. It is important to measure this
The parameter is as accurate as possible, which requires a high doctor
qualifications and work on modern devices. That is why
первое скрининговое УЗИ проwatersят на экспертном уровне.
Collar space is the gap between the outer
the surface of the soft tissues of the neck and the inner surface of the skin.
The upper limit of normal values of TVP is about 2.5-3 mm. Sometimes
false positive results are obtained if the surface of the skin
take amnion. In most cases, exceeding the TVP
suggests a higher risk of chromosomal disease, especially if
mother’s age is approaching 40. According to foreign studies
at TVP = 3 mm, the frequency of chromosomal abnormalities was 7%, at TVP = 9
mm and more, the probability of these pathologies reached 100%.
Most frequent pathology of the number of chromosomes, which mainly and
The first screening is directed, is Down syndrome. Combination
age risk with ultrasound and blood tests (for hCG and PAPP-A)
allows you to identify more than 90% of cases of this disease without invasive
procedures (chorion and amniocentesis).
The size of the embryo with ultrasound by week of pregnancy:
In addition to chromosomal aberrations, the deviation of the TVP from the norm allows
suspect fetal malformations. Many of them cannot be seen
before the second screening, whereas the enlarged collar
space helps form risk groups. So women
recommend undergoing ultrasound in dynamics to
identify defects as early as possible.
Evaluation of fetal parameters
Basic research includes measuring CTE�
(coccyx-parietal size), head circumference, abdomen, length
limbs, condition of the stomach, bladder, heart. All this
allows you to exclude severe anomalies and diseases of the child at the
Second screening в 18-24 недели
Objectives of the second screening:
- Confirmation of developing pregnancy
- Determining the place where the placenta is attached
- Examination of the fetus for developmental anomalies and serious
Examination of the fetus for developmental anomalies and serious
AT середине беременности проwatersят оценку всех органов и систем
Measure the size of the head (biparietal and fronto-parietal), length
hip bones, abdominal circumference. Assess the condition of the organs
abdominal cavity, heart, spine, brain. Measure speed
blood flow in the uterine arteries of the placenta, determine its
Is it possible to detect hypertonus of the uterus with ultrasound?
Many women return from ultrasound,
frightened by the term “hypertonus of the uterus on the back wall.” At the very
In fact, such a diagnosis is incompetent. The uterus is a muscular organ
which quite has the right to shrink. Intense Masterbatch
contractions start in the second trimester, but they can also be on
ранних timing. However, the woman does not experience any unpleasant
sensations, and the life of the fetus is not in danger.
Third screening в 28-31 неделю
Objectives of the third screening:
- Fetal development evaluation
- Measurement of uterine blood flow velocity
- Подсчет количества околоплодных waters
The first two parameters help to identify failure
blood circulation between the fetus and the mother. This is manifested by a delay.
growth of the baby, as well as a change in the speed of blood movement during
The placenta, or baby seat, is a very important organ that allows
малышу получать кислород, питательные вещества и выwatersить продукты
exchange. Therefore, the study of its structure and function is necessary
do every pregnant woman to choose tactics and time
Starting from week 14, the location and size of the placenta is easy
identify on ultrasound. It may be centered, right or
on the left as well as in the area of the uterus, on the front or back
Location of the placenta
- Normal (not adjacent to the uterine zone)
- Low attachment (close to internal throat)
- Regional presentation (edge overlaps the internal uterine
- Центральное (плацента полностью перекрывает mouth)
During the entire pregnancy, the location of the organ may vary
поэтому при выявлении патологии обычно проwatersят контроль через
few weeks. However, central presentation is rare.
corrected, and the chances that the regional arrangement will change
after 30 weeks are also extremely small.
The location of the placenta is crucial for choosing a method.
delivery, since the central attachment is absolute
indications for cesarean section.
The measurement of the thickness of an organ is not completely accurate, since
plays a big role subjective opinion of the doctor.
- резус-конфликт, watersянка плода
- diabetes in the mother (with compensated form)
- current or past maternal viral diseases
- thickening may occur with detachment
- diabetes mellitus (insulin-dependent, often
- fetal growth retardation
Intrauterine growth retardation
If fetal parameters do not reach the minimum values for
the specific period of gestation, then the doctor diagnoses the delay
intrauterine development (SVRP). The reasons for this condition may
be a lot (diabetes and hypertension of the mother,
smoking and infections), and the mechanism of occurrence is almost
always alone. This is placental insufficiency. At the base
such a state is a violation of blood flow between the fetus, the placenta
and mother. With the help of ultrasound and dopplerometry, FPI can be detected on
ранних стадиях и выбрать тактику и сроки delivery
The diagnosis of FPN and ZVRP, exhibited in the period up to 24 weeks – a big
rarity. Such children usually die in the womb or immediately after
birth, as they are not viable during delivery to
In the 24-28 weeks doppler ultrasound helps to identify early signs
placental insufficiency and delayed fetal growth. Such
situations are state-oriented pregnant, given CTG. Usually
have to give birth to a woman in the next 4 weeks, so
how FPI is not treated.
AT более поздние сроки диагностированный синдром ЗATРП — поwaters
start preparing the cervix for childbirth, since the fetus is
The link between the fetus and the placenta is the umbilical cord. Her
осмотр всегда проwatersится при УЗИ, так как любые нарушения могут
retard the development of the baby, complicate childbirth and represent
danger to life.
A normal umbilical cord contains one vein and two arteries. AT
in some cases, only one artery is visualized instead of two.
Такая патология может приwatersить к внутриутробной гибели и часто
combined with other malformations.
- Neural tube defects
- Spinal anomalies
- Cystic hygroma
- Heart defects
- Anomalies of the digestive tract
- Defects of the anterior abdominal wall
- Renal impairment
- Измененное количество околоплодных waters
Neural tube defects
- Anencephaly – the absence of the brain.
This is one of the most frequent types of nervous system defects. With
Pregnancy ultrasound at 12 weeks this defect is usually good
distinguishable. Almost always combined with higher levels
околоплодных waters и высоким значением биохимических маркеров (АФП).
Anencephaly is a direct indication for abortion, since
the fruit is absolutely not viable.
An increase in the amount of fluid in the brain cavities is recognized on
second screening, after 18 weeks. This phenomenon can be combined with
other developmental disabilities, so careful
ultrasound procedure. Read about hydrocephalus in children.
- Encephalomeningocele is essentially a cerebral hernia, that is
protrusion of brain tissue in the area of the bones of the skull. Like all vices
neural tube, hernia requires careful research, often – with
дополнительным УЗИ-контролем через 1-2 of the week.
Defects in the spinal column often occur in the cervical and lumbar
department, emerging at the second screening. Very well visible
severe spina bifida (spina bifida) stage when
elements of the spinal cord protrude outward. Lighter violations
can only be detected after delivery.
Anomaly of the lymphatic system, in which the back of the neck
find a cyst with partitions. With этом ни череп, ни спинной
the brain is not damaged. This is a non-lethal defect, except
cases in which the lymphatic system is completely disrupted.
ATыявление пороков сердечной мышцы – всегда очень тяжелая задача,
sometimes requiring the participation of high-class experts. Underdevelopment
one half of the body, anomalies of its location and defects
interventricular septum usually find themselves easily. Other
violations are harder to detect, so if you have any doubts in the maternity hospital
should be prepared to provide a specialized newborn
Anomalies of the digestive tract
Atresia (absence) of the duodenum is more common.
Sometimes бывают случаи непроходимости или отсутствия толстого
intestine. Many stomach and intestinal defects can be detected.
only in the third trimester of pregnancy.
Defects of the anterior abdominal wall
Omphalocele (abdominal wall defect in the midline) is one of
most common anomalies, usually combined with one or more
other vices. In fact, it is a hernia that may be different.
size, containing part of the intestine, liver, stomach,
Gastroschisis, in which the protrusion is not on average
lines, and sideways. Usually бывает единичной находкой и содержит только
The accumulation of fluid in the abdominal cavity of the fetus – a direct indication to
in-depth study on malformations. Often
ascitic fluid is represented by urine, which indicates
violation of the structure of the kidneys of the child. There is another term –
watersянка, при котором жидкость скапливается во всех полостях.
Withчиной такого явления может быть резус-конфликт матери и плода,
abnormalities of the heart and lymphatic system.
Some kidney abnormalities are incompatible with life and are
indications for abortion. Birth tactics also directly
depends on the condition of the urinary system of the fetus.
Bilateral agenesis (absence) of the kidneys is a lethal defect, but
unilateral agenesis is more common. This порок практически не
влияет на качества жизни baby
Hydronephrosis is an extension of the renal pelvis. It may be
transient, being a variant of the norm. Such случаях повторяют
study in a couple of weeks. If in two weeks the dynamics
negative, and hydronephrosis bilateral, combined with
малоwatersием – прогноз для жизни и здоровье ребенка становится
heavy. Read more about hydronephrosis.
Multicystosis – a change in the kidney, manifested by multiple
cavities. Since they do not function as kidney tissue,
bilateral multicystic is incompatible with life.
Изменение количества околоплодных waters
- Полигидрамнион (многоwatersие)
- obstruction of the upper intestine
- neural tube defects
- watersянка плода
- multiple fetus
- diabetes in pregnant
- Олигогидрамнион (малоwatersие)
- violation integrity of amniotic membrane, leakage
- bilateral abnormality of the urinary system (kidney,
- fetal growth retardation
- fetal fetal death
- violation integrity of amniotic membrane, leakage
A dangerous condition in the second trimester can be
cervical insufficiency. It is characterized
premature dilation of the cervical canal, which can lead to
rupture of the membranes, infection of the fetus and
Why ultrasound is necessary even with the well-being of pregnant
and the absence of risk factors
- 9 out of 10 malformations and mutations are detected in the absence of
family of a similar pathology earlier. That is to predict their appearance in
most pregnant is impossible.
- Even with a safe course of pregnancy are sometimes detected
serious and fatal malformations of the fetus
- It is impossible to determine the exact number of fruits without ultrasound
- Placenta previa which can be deadly in
childbirth, most often does not manifest itself
- Nearly half of all women claiming to know the exact date.
Conception and gestational age are mistaken for 1.5-2 weeks. These 14 days
may be critical in emergency delivery and affect
vitality of the fetus.
In our country, according to the standards, it is recommended to do three screenings
during the whole pregnancy. Additionally, a woman usually goes for an ultrasound scan.
first suspicion of an interesting position. But there are situations
at which a visit to the doctor of ultrasound diagnosis can be
- Intrauterine growth retardation
- Bleeding on any duration
- Previously detected fetal pathology
- Low location of the placenta – ultrasound control at late
- The discrepancy between the size of the uterus and the duration of pregnancy
- Lack of movement and other signs of fetal life
The effect of ultrasound on the fetus
The basis of this research method is mechanical
the impact of sound waves on the fabric. Depending on the density
the last waves are reflected differently, creating on the screen
image. There are two types of ultrasound interaction with
environment: mechanical and thermal.
The mechanical impact causes the gas bubbles to burst, which
in theory can cause a rapid rise in temperature. On practice
this effect is insignificant, since the lungs and intestines of the fetus are not
filled with air.
Heat effect occurs when the “accumulation” of sound waves
inside the tissue. To a small extent, it manifests itself during prolonged
effects of the sensor on the same place or when dopplerometry.
This can also be attributed to the 3D ultrasound due to the increase in time
With proper research, ultrasound does not have
no adverse effects on the course of pregnancy and
health of the baby, as evidenced by multicenter studies.
There are several principles for the rational use of this
- Исследование ультразвуком проwatersится в рамках скринингов,
which in our country are three.
- Unscheduled Ultrasound делаются по показаниям (кровотечение,
suspicion of vices, etc.)
- 3D ultrasound has clear indications (for example, recognition of complex
пороков лица или сердца), большинству женщин оно не проwatersится
- You can not do ultrasound “for yourself,” out of curiosity
- Sex determination is not an indication for an ultrasound
- Исследование должно проwatersиться грамотным специалистом на
modern equipment as fast as it is
The first ultrasound during pregnancy is not only a necessity,
but also a unique opportunity to meet a baby before his
of birth. Therefore, before the procedure, you need to tune in to the positive and
enjoy this chance!