3D Baby - Ultrasounds by Dr. Nathan, M.D.

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Ultrasounds by Dr. Nathan, M.D.

Ultrasound uses sound waves that are above the range of human hearing to create an image of organs within the body. Sound waves are reflected off internal body structures and back to the ultrasound machine. The reflected sound waves are analyzed by computer and turned into pictures. This method of imaging results in less clear pictures than xrays, CAT scans or MR; however, there is no radiation risk with ultrasound and no confirmed adverse effects on the fetus or mother from diagnostic ultrasound examinations in pregnancy.

Different Types of Ultrasounds
There are different types of ultrasound exams. They are differentiated by the purpose for which they are done and the level of detail obtained.

Limited exams are focused studies used to answer specific questions about the fetus, mother, or both. This exam is often used when you go to your doctor or the hospital with an urgent problem related to your pregnancy.

Basic exams are performed to survey for obvious malformations of the fetus and to estimate fetal age, the amount of amniotic fluid present, location of the placenta, and for other concerns. These are the kind of exams you would likely receive in your doctor's office or in the hospital as a routine evaluation. They are typically performed at 18-20 weeks of pregnancy.

Comprehensive exams provide a more in-depth look at the fetus when there is reason to suspect something is wrong with the fetus or mother. They include a detailed examination that is often done as a response to an abnormal screening test such as the alpha-fetoprotein screen. In some areas of the country this is called a Level II or Level III ultrasound. Technical difficulties and the need to image many different areas of the fetus may extend the length of this exam to 30 or more minutes.

Who Should Receive One?
Controversy remains regarding the value of the routine prenatal ultrasound for all pregnant women. Many researchers have studied the benefit of routine ultrasounds for every pregnant woman. Some studies have suggest a benefit, and others do not. This contradictory evidence has resulted in conflicting recommendations from different physician groups. Prenatal ultrasounds are routinely recommended and offered to all pregnant patients in some European countries and in Canada. In the U.S. at this time, there is not an official recommendation to perform routine ultrasounds in all women; however, many physicians report situations where the routine ultrasound revealed important findings not otherwise suspected. Currently between 45 percent and 70 percent of women have an ultrasound some time during their pregnancies. Many U.S. doctors recommend that all pregnant patients receive at least one ultrasound examination usually at about 18-20 weeks.

Reliability of Ultrasounds
The accuracy of the ultrasound findings depends on the equipment used, the skill of the operator, fetal position, maternal weight, gestational age, and amniotic fluid volume. Ultrasound has become quite accurate in diagnosing many fetal problems. Up to 85 percent of fetuses with spina bifida, enlarged kidneys, or abdominal wall defects can be detected using ultrasound. Routine ultrasound is likely to miss other fetal problems such as heart defects and club foot. Even the best ultrasonographers have difficulties seeing all structures in some fetuses. The ultrasound can exclude or confirm that a serious problem is present. For example, an elevated maternal serum alpha-fetoprotein (MSAFP) screening test often leads to an ultrasound to examine for spina bifida or other problems associated with an elevated MSAFP. If the ultrasound is negative, it may be possible to avoid more invasive testing.

Plainly Speaking
Prenatal ultrasounds can give you and your doctor important information about you and your baby before delivery. They are safe and relatively easy to perform. The ultrasound can help you prevent or prepare for problems with your delivery or newborn baby.

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