Ultrasound is an ultrasound examination, a method of prenatal diagnosis, the most informative of all existing ones, publicly available, and does not require special preparation.

One of the advantages of the procedure is that it is carried out in real time and results are instantly provided.

Why is ultrasound necessary during pregnancy?

An ultrasound scan is prescribed to a woman three to four times during pregnancy, but in some cases an additional procedure is required.

The research is carried out for the following purposes:

• confirm pregnancy;
• set an exact date and determine the date of birth;
• determine the location of the embryonic egg;
• detect multiple pregnancy;
• identify pathologies.

Before the method appeared ultrasound examination There were frequent cases of various complications, including the birth of children with disabilities or stillborn children, even in healthy parents. Diagnosing the course of pregnancy was very difficult.

Doctors' opinions on the need for research can be heard in the video: specialists answer questions about whether the procedure is harmful, why and how many times it is performed.

How the results are deciphered

Despite the fact that during the procedure the doctor tells in detail and explains everything that happens on the screen, every mother then looks at the conclusion. And he gets scared when he sees unfamiliar words, abbreviations and numbers. But deciphering indicators is a matter for professionals.

• 11-14 weeks – 1st trimester;
• 18-21 weeks – 2nd trimester;
• 30-34 weeks – 3rd trimester.

In case of bleeding or other possible complications, additional research is prescribed.

At each stage, the doctor performing the procedure faces certain tasks, and the results will differ. But first of all, ultrasound scanning is necessary to diagnose the condition of the fetus and identify the features of its development.

Fetal dimensions according to ultrasound

All indications can be deciphered using special size tables used by doctors.

To do this, record the following indicators and decipher them:

1. Heart rate. This is often a contraction of the fetal heart muscle, that is, a heartbeat. The normal heart rate in all trimesters is 120-160 beats per minute.
2. Fruit size. These indicators are recorded during the first screening. Using them, the exact duration of pregnancy is determined. Measure the diameter ovum(DPR) and the distance from the crown to the coccyx (KTR).
3. During the second and third screening, the following indicators are measured: the size between the temporal bones (biparietal size - BPD, can be written as BPD), the volume of the child's head (CG), the abdominal circumference (AC). If these indicators are not normal and are too low, then IUGR is recorded - intrauterine growth retardation.

Development of the placenta

The placenta is an organ that ensures the vital functions of the fetus during pregnancy. Ultrasound can show the condition of an organ at all stages.

When researching, pay attention to the following indicators:

1. Location. The formation of the placenta closer to the fundus of the uterus along one of the walls is a normal location. A deviation is considered if the organ is localized in the lower part of the uterus at a distance from its internal os of no more than 6 cm. Then a low location is recorded. Ultrasound allows you to identify such pathology and prescribe appropriate treatment, determine the method of childbirth. There are cases when the organ migrates towards the due date. An ultrasound can show a complete presentation - an organ blocking the exit from the uterus. The presence of such a diagnosis is a threat to the life of mother and child.
2. Degree of maturity. As the baby grows, the placenta also matures. Indicators of the degree of maturity are also provided by ultrasound. During the entire period of pregnancy, the placenta has 4 degrees of development. If the indicators are higher than normal, then premature aging is recorded. The placenta does not perform its functions, which is why the baby experiences a lack of nutrition and air. In some cases, emergency delivery is necessary.
3. Thickness. A thin or, conversely, thick baby's place indicates problems during pregnancy. It is important to determine the original source of the problem in order to continue treatment.
4. Diagnosis of various pathologies, such as cysts, tumors, placental abruption is one of the most important tasks of the study.

When the placenta may be hyperthickened

The placenta is considered thickened when it is more than 4 cm.

Pathology develops for the following reasons:

• Rhesus conflict;
• maternal diabetes;
• Availability infectious disease at the mother's;
• inflammatory processes children's place;
• inflammation in the genitals;
• detachment.

Having studied all the indicators of the functioning of the placenta, the doctor diagnoses its condition. This helps determine methods for monitoring a pregnant woman and the method of delivery. Ultrasound scanning also helps to identify pathologies in time and prescribe appropriate treatment.

Based on the results of the procedure, if certain complications are present, laboratory tests are prescribed to determine hormone levels. Another type of study is CTG (cardiotachography). CTG records the baby's heart rate and the number of uterine contractions. Doppler ultrasound helps to assess the state of blood circulation in the uterus, placenta, and umbilical cord.

What does an ultrasound tell you about the umbilical cord?

Development of the umbilical cord begins at 4 weeks of pregnancy.

The most important parts of the umbilical cord:

• vein that provides breathing and nutrition to the child;
• two arteries with excretory functions.

Average dimensions of the umbilical cord: length – 50-60 cm, diameter – 1.5-2 cm.

During an ultrasound examination, the size of the umbilical cord, its correspondence to the gestational age, its attachment to the placenta and the baby’s tummy, and the presence of blood vessels in the umbilical cord are carefully studied. The procedure allows you to see the umbilical cord already at 7 weeks and trace the movement of blood in it.

The attachment of the umbilical cord to the placenta under normal conditions has a U or V shape. The umbilical cord is attached to the center of the organ.

Deviations from the norm are recorded if:

• the umbilical organ is attached to the edge of the child's seat;
• the umbilical cord is located between one of the edges and the center of the placenta;
• formation of the umbilical cord at the internal os of the uterus.

The latter case poses a serious threat to the fetus.

Deviation from size indicators is also considered a pathology. The optimal length is no lower than 30 cm, no higher than 80 cm. In rare cases, the absence of a cord or its elongation to 3 meters is observed. Excessive elongation can lead to the umbilical cord entwining around the fetus and the formation of knots.

Entwining the fetus with the umbilical cord is a common occurrence. In itself, it does not pose any danger, since the child is not able to breathe through the lungs. The threat occurs when blood circulation in the umbilical cord is disrupted due to compression or a tight knot. In addition, being in constant motion, the child can get rid of the entanglement himself.

This phenomenon is also observed when the umbilical cord is close to the baby’s neck.

Studying the umbilical cord during scanning allows you to diagnose the condition of the fetus, as well as determine actions during the birth process if entanglement is observed.

Study of amniotic fluid

The study of amniotic fluid includes the following characteristics:

• quantity
• transparency
• compound.

The condition of the amniotic fluid is determined by various research methods, and one of them is ultrasound. An ultrasound procedure shows the amount and clarity of water. If the liquid is opaque and there are some flakes in it, this indicates deviations.

An experienced doctor can visually assess the amount of amniotic fluid during scanning. The area between the fetus and the inner wall of the woman's abdomen is studied. With polyhydramnios there is a large number of fluids, with oligohydramnios – the presence of free spaces.

An accurate conclusion is given based on the following indicators of AFI (amniotic fluid index):

• 0-5 cm with severe oligohydramnios;
• 5. -8 cm with moderate oligohydramnios;
• 8.1-18 – with a normal amount;
• more than 18 cm with polyhydramnios.

If deviations from the norm are detected, the pregnant woman is prescribed additional procedures for studying the amniotic fluid: amnioscopy or amniocentesis.

What does an ultrasound scan tell you about the uterus?

Ultrasound of the uterus and ovaries of a pregnant woman is considered one of the most important gynecological examinations. This procedure allows you to diagnose the presence of various pathologies to exclude relapses.

There are two ways to study the uterus and appendages:

1. Transvaginal ultrasound OMT(pelvic organs). The procedure is performed by inserting a sensor into the vagina. The research process is absolutely painless.
2. Transabdominal. This is a scan of the genitals using a sensor through the abdominal cavity.

During pregnancy, an OMT ultrasound examination is carried out to examine the condition of the reproductive organ and tone. On early stages Transvaginal ultrasound is prescribed for women at risk. In addition, the procedure is aimed at identifying possible diseases of the female organs.

During a normal pregnancy, the uterus is elastic and soft. During tone, the abdomen hardens, which threatens premature discharge of amniotic fluid and difficulty breathing for the fetus. Particular attention is paid to women who gave birth by caesarean section. In this case, there is a scar on the uterus that can rupture when stretched. This, in turn, can cause infertility.

Normal uterine indicators:

• length – 70 cm;
• width – 60 mm;
• anterior-posterior size – 42 mm.

Indicators may deviate slightly in different directions.

Despite the fact that ultrasound is an absolutely safe procedure, it is performed only when necessary and as prescribed by a doctor.

Conclusion

For a woman, screening is a very exciting procedure. After all, this is a great opportunity to see your unborn baby for the first time. And photographic photographs of its development will become a good memory of the most pleasant period in life.

After each ultrasound examination, the pregnant woman receives a special protocol containing important data on the development of the fetus. The main indicators include the biparietal size of the fetal head (abbreviated BPR), which, unlike other indices, can “tell” as accurately as possible about the gestation period. You will learn about what BPD is on ultrasound during pregnancy from today’s material.

The concept of BPR

During the ultrasound procedure, doctors pay special attention to the baby’s head. And this is not surprising, since the brain is one of the most important organs of the body, and its (brain) development has a direct impact on the state of the embryo. And the BDP just determines the size of the head and, consequently, the degree of brain development.

This index denotes the “width” of the skull, so to speak, which is measured between the temples, i.e. along the minor axis.

Note! Together with the BPR, the LZR is usually measured - the distance between the forehead and the back of the head, i.e. the measurement is performed along the major axis. Note that the values ​​of both indices can be obtained with maximum accuracy only between the 12th and 28th weeks of pregnancy.

The BDP index is important in determining the possibility of natural childbirth. If the circumference of the birth canal is smaller than the circumference of the baby's head, then doctors decide to resort to a caesarean section.

What is the BPR norm?

To evaluate this index week by week, a special table was created, which indicates the norms of the embryo’s BDP, as well as permissible deviations.

BRGP(BPR) - biparietal head size. DB - thigh length. DGrK - chest diameter. Weight - in grams, height - in centimeters, other indicators in millimeters

The fetal BDP exceeds the norm - what does this mean?

In some cases, the index exceeds the permissible norms. In this case, the attending physician is obliged to determine other parameters of the embryo (such as abdominal circumference, thigh length, etc.) in order to make sure that there are no pathologies. And if other parameters exceed the norm by at least one or two weeks, it means that the expectant mother has a large fetus. But if these indicators are within acceptable limits, then it is likely that the child is simply developing in leaps and bounds, and all parameters will soon level out.

As for significant deviations of the BPD from the norm, they often indicate serious problems in development. For example, an increased index may occur with a tumor of the cranial bones or the brain itself, as well as with hydrocephalus and cerebral hernia. In each of the listed cases (the exception is hydrocephalus), women are advised to immediately terminate the pregnancy, since such pathologies are, unfortunately, incompatible with life. But hydrocephalus is treated with antibiotics or (if treatment does not produce any results) an abortion is performed.

Note! If the BPD in the embryo is too low, nothing good should be expected either - this often indicates underdevelopment of the brain or the absence of certain of its components (right, left hemispheres, or both at once, the cerebellum, etc.). In such cases, the fetus is aborted regardless of the gestational age.

In the last trimester of pregnancy, low biparietal size indicates delayed fetal development. This syndrome is treated with special drugs (such as Actovegin, Chimes, etc.), which stimulate blood flow in the uterine cavity and placenta.

Average fetal fetometry values

Based on the results of an ultrasound scan during pregnancy, one can reliably judge the condition of the fetus and all possible pathologies of its development.

Ultrasound is considered a mandatory diagnostic method in each trimester of pregnancy. The result of its decoding in the early stages of pregnancy also makes it possible to determine the sex of the unborn child.

During pregnancy, it is extremely important to monitor the development of the embryo. In this case, Doppler ultrasound is the method that allows you to reliably establish the whole picture happening inside the woman’s abdomen.

Doppler ultrasound of a pregnant woman must be performed in every trimester, especially in the early stages. This diagnosis is considered routine and is prescribed by a doctor at various stages of the pregnancy process.

The first Doppler ultrasound examination must be carried out in the first trimester, or more precisely, no later than the 14th week.

The readings obtained allow the doctor to determine the exact date of conception, as well as to assess the overall course of the pregnancy itself.

In the early stages, the main location of the fertilized egg itself is checked, as well as the normal heart rate of the embryo.

The first Doppler ultrasound allows you to fully assess the general condition of the placenta and uterus.

The first ultrasound during pregnancy shows the general condition of all organs in the pelvic area, making it possible to timely detect multiple pregnancy and the presence of ectopic conception.

An ultrasound at the 14th week of pregnancy also shows all the main dimensions of the so-called collar zone.

The result obtained in this case makes it possible to establish with a high probability all possible diseases of the fetus already at this stage.

Doppler ultrasound must also be performed in the second trimester, when the fetus is actively developing and growing.

In this case, using this type of diagnosis, disorders that can occur during the development and growth of the fetus are identified.

In the second trimester, it is already possible to obtain results with high accuracy about the presence of various types of chromosomal pathologies that can affect the further development of the embryo.

It is in this trimester that, using Doppler ultrasound, the doctor takes measurements of all the internal organs of the embryo.

During this period, vital systems are assessed, the amount of amniotic fluid is determined, and the structure of the placenta is checked.

In the last trimester, Doppler ultrasound is necessary to prepare the patient for childbirth. This ultrasound makes it possible to fully assess the condition of the child’s organs and systems.

The result of this diagnosis allows you to assess the position of the fetus, as well as the placenta at a given time.

An ultrasound in the last trimester of pregnancy is necessary to accurately determine the total amount of amniotic fluid, as well as possible disorders in both the mother and the child. At this moment, you can reliably determine the gender of the unborn baby.

Deciphering an ultrasound during pregnancy allows a young mother to find out everything about the health status of her unborn baby.

The obtained result allows specialists to assess the progress and course of pregnancy, as well as timely identify possible pathologies.

If desired, young parents can already see the arms and legs of their future baby. When undergoing an ultrasound, you can get a picture of the fetus.

Decryption procedure

Currently, Doppler ultrasound during pregnancy is performed using several different methods. Despite this, decryption of all received data is performed using the same algorithm.

After the study, a protocol must be drawn up in which some individual data are entered.

In addition to personal information, it must indicate the end date of the last menstruation, as well as the estimated time of conception.

The protocol must also contain information about the number of fruits. When performing a Doppler ultrasound, the presentation of the fetus is necessarily determined, which is included in the same report.

Coccygeal-parietal size - KTR

The actual heart rate must be indicated. In this case, indicators ranging from 110 to 180 contractions per unit of time are considered the norm.

During pregnancy, the true diameter of the fetal egg, as well as the characteristics of the collar zone, are of great importance.

During an ultrasound, it is necessary to determine the real state of uterine contraction, since premature birth may depend on this indicator.

An ultrasound should show the true position of the fetus, which tends to change in each trimester.

Bipariental size (between the temporal bones) – BPR or BRGP; Thigh length – Dlb; Chest diameter - DGrK

The examination is required to assess the size of the embryo's head, which must correspond to the norm.

Ultrasound during pregnancy is of great importance, especially in the second trimester. It is at this moment that all the internal organs of the fetus are formed, as well as the formation of internal systems.

It is already possible to determine the exact gender of the unborn child, as well as see the outline.

During the examination, a medical specialist displays an image of the fetus on the screen, and it is already possible to notice the formed arms, as well as legs and other parts of the body.

The procedure helps to accurately determine the child’s condition and the functioning of all its organs.

It should be noted that each woman has her own individual physiological characteristics, so the results of studies in the same case may vary.

There may be some deviations from the norm in the development of the embryo, which are associated with the fact that each fetus develops individually.

If there are no serious pathologies during the examination, then they can be ignored, since they do not have a serious impact on the results of the ultrasound.

In the event that an ultrasound reveals some abnormalities, the conclusion drawn up must necessarily contain an item indicating one or another type of pathology.

Ultrasound can also show various kinds asymmetrical disorders, which mean a certain discrepancy between the main dimensions of the fetus and the norm.

The informative nature of ultrasound during pregnancy makes it possible to obtain timely information about the presence of pathologies in the fetus, and the doctor will be able to make the right decision.

Additional examination

If a medical specialist suspects that the fetus itself is developing with any pathology, an ultrasound examination in the third trimester should be carried out in conjunction with Doppler testing.

This study allows us to fully assess the total blood flow that occurs in the vessels of the embryo, as well as in the umbilical cord and in the uterus.

In addition, this method of examination makes it possible to fully determine the deficiency in the body of the unborn baby of all the essential nutrients that it needs to maintain overall development.

After a complete transcript of the ultrasound has been completed, it will be possible to find out the exact amount of amniotic fluid, as well as the exact condition of the placenta.

An important parameter that is taken into account after this type of examination is also the amount of oxygen entering directly through the placenta.

The examination data collected together makes it possible to determine the most accurate picture of all pathologies that can threaten the life of the fetus even in late pregnancy.

The decoding itself must be carried out by a specialist who thoroughly understands all the intricacies and nuances of conducting this particular type of research.

He must necessarily advise the woman about the possible consequences of the identified pathologies.

In some cases, the results of an ultrasound scan may have some slight deviations from established standards.

It is worth noting that this may not always be a reason for serious worries, since the body of each unborn child is almost always individual.

The medical professional must compare all data obtained from ultrasound with similar studies, as well as previously conducted laboratory tests and the internal state of the pregnant woman.

It should be remembered that ultrasound diagnostics during pregnancy is not only important, but also a necessary examination, allowing you to get the clearest picture of the general condition of the fetus.

When prescribing an ultrasound, in order for the result to be as accurate as possible, it is necessary to carry out a number of preparatory measures.

Immediately before the ultrasound examination, the doctor must inform the patient of all recommendations for preparing for the ultrasound itself.

The essence of these measures is to follow a simple diet, which should exclude the consumption of foods that can affect gas formation in the stomach.

Doppler ultrasound is considered the most effective and informative method of modern diagnosis, but only if the woman strictly follows all instructions.

It is recognized as the most informative and absolutely safe method of monitoring the course of pregnancy. This procedure allows even at a period of 5 weeks - doctors see a formed fertilized egg, and at 6 weeks - a full-fledged embryo.

Deadlines

Throughout the entire period of bearing a child, a woman is prescribed an ultrasound examination three times at precisely specified times:

• 10-14 weeks;
• 20-24 weeks;
• 30-34 weeks.

Despite the fact that the safety of ultrasound examination has been confirmed, gynecologists do not recommend getting carried away with this procedure - it is advisable for pregnant women to undergo it no more than 4 times during the entire period of pregnancy, although additional visits to an ultrasound diagnostician may be prescribed.

What does ultrasound show during early pregnancy?

Women can undergo two types of ultrasound:

1. Transabdominal. In this case, the patient must prepare for the procedure - 30 minutes before it begins, she must drink about half a liter of water (still) and not visit the toilet. That is, the ultrasound examination procedure is performed with a full bladder.
2. . This type of examination is carried out without any preliminary preparation; the bladder must be empty. The sensor from the ultrasound machine is inserted into the vagina, after which a special cover or condom with gel is applied to it.

The ultrasound examination procedure in the 1st trimester of pregnancy lasts a maximum of 30 minutes, the doctor takes all the necessary measurements, records the data obtained in a protocol - this document will help the gynecologist determine how normal the pregnancy is and whether the fetus is developing correctly.

The diagnostic procedure in question in the first trimester of pregnancy is carried out for:

• determining the location of the fertilized egg - a normal pregnancy may develop, or there may be formation/fixation of the fertilized egg in the fallopian tubes;
• diagnosing a multiple pregnancy, if the doctor sees only the bottom of the ovum, then a singleton pregnancy is diagnosed;
• assessing the structure of the embryo, the size of the fertilized egg;
• identifying pregnancy problems - for example, a specialist will pay attention to, can diagnose reversible or irreversible spontaneous abortion or.

In addition, ultrasound examination in the early stages of pregnancy allows not only to record the fact of conception, but also to identify various diseases of the internal genital organs - for example, it is with the help of ultrasound that tumor formations in the ovaries are most often diagnosed, a septum inside the uterus or the bicornuity of this hollow organ is detected.

Interpretation of ultrasound of the 1st trimester: norms and deviations

Ultrasound diagnosis of intrauterine pregnancy

If a specialist conducts an ultrasound examination in the early stages of pregnancy, he will be able to see the fertilized egg in the upper part of the uterus, and it looks like an oval (in some cases, round) dark spot. If the pregnancy is multiple, then the doctor will see two/three and so on such dark spots.

The transabdominal type of the study under consideration makes it possible to establish the onset of intrauterine pregnancy at the earliest stage - 5 weeks, when the absence of menstruation from the expected start date lasts about 14 days. At this stage, the size of the fertilized egg will be at least 5 mm in diameter.

Transvaginal ultrasound examination of the uterus is more informative - the doctor can confirm the fact of pregnancy even at 4 weeks, that is, after 6 days of missed menstruation. The diameter of the fertilized egg in this case will be 3 mm in diameter, which corresponds to the norm.

As for visualizing the embryo, with a transabdominal ultrasound this can be done at 6 weeks, with a transvaginal ultrasound - 5 weeks, and the embryo will look like a white spot in the cavity of a dark formation. You can listen to the clear contractions of the heart (beat) of the embryo at 6 weeks.

If a woman has a normal menstrual cycle, that is, there are no usual delays or early onsets, then a transvaginal ultrasound can be performed at 6 weeks of pregnancy. Such an examination does not belong to the “mandatory program” and is carried out only at the request of the patient. If the menstrual cycle is inconsistent and the period of delay of menstruation cannot be accurately determined, then the estimated duration of pregnancy is determined by an ultrasound specialist.

How to estimate the size and growth of the fertilized egg/embryo

This data is determined by two indicators:

• coccygeal-parietal size;
• the average internal diameter of the fertilized egg.

For a specific period of pregnancy, there are established indicators (conditional, of course) of the average internal diameter of the ovum, which are included in the program of ultrasound machines. These data automatically establish an almost exact gestational age, but an error of 6 days is allowed in the direction of increase and decrease.

The term “coccygeal-parietal size” means the length of the embryo’s body from the head to the coccyx, and this indicator is measured first. It is by this size that you can more accurately determine the gestational age - the error is only 3 days.

Note:if the average internal diameter of the ovum is 14 mm, but the doctor cannot visualize the embryo, then experts will talk about a pregnancy that has stopped its development.

The principle of assessing the vital activity of the fetus and embryo

Heartbeat and motor activity are the main indicators that allow a specialist to assess the vital activity of the embryo.

If a transvaginal ultrasound examination is performed, then already at 6 weeks the doctor sees the heartbeat of the embryo. If it is within normal limits, then a clear rhythmicity of contractions will be noted, but for each stage of pregnancy they have their own frequency:

• 6-8 weeks – 130-140 beats per minute;
• 9-10 weeks – 190 beats per minute;
• the entire period before birth - 140-160 beats per minute.

Heart rate must be measured without fail, since it is this indicator that allows specialists to identify problems with bearing a child. For example, if the heart rate is sharply increased or decreased, then doctors will place the woman at risk for miscarriage.

Note:if an ultrasound confirmed that the length of the embryo along the coccygeal-parietal dimension is 8 mm, but heartbeats are not detected, then the specialist may suspect a non-developing pregnancy. In this case, a repeat examination is carried out after 7 days and only after that a final diagnosis is made.

As for the motor activity of the embryo, it can be seen already at 7-9 weeks of pregnancy. At first, the embryo simply moves its whole body (chaotically), a little later there are types of flexion and extension of the body. Doctors know very well that the embryo rests very often and therefore the indicator of motor activity cannot be the main criterion in assessing its vital activity.

Assessment of embryo structure

The doctor should pay special attention to the structure (anatomy) of the fetus when conducting an ultrasound examination in the 1st trimester of pregnancy. For example, already at 12 weeks a specialist can diagnose fetal pathologies that will not be compatible with life - for example, spinal cord herniation, absence of the brain, abnormal skeletal development.

The specialist will definitely evaluate the collar space and determine its thickness - using this indicator it will be possible to identify fetal diseases of a chromosomal nature. An increase in the collar space by 3 mm is allowed, but higher values ​​will indicate the presence of chromosomal pathology in 80% of cases.

Modern medicine has the latest generation of ultrasound equipment, which makes it possible to diagnose anomalies in the structure of all systems and organs of the unborn child as early as 12 weeks of pregnancy. Such an accurate diagnosis allows parents to make a choice - to continue the pregnancy or terminate it for medical reasons.

Study of extraembryonic structures

When conducting an ultrasound examination in the 1st trimester, the specialist will examine the yolk sac, amnion and chorion, and their assessment is mandatory.

Yolk sac- a structure that performs important functions - hematopoietic and nutritional, and throughout the entire period of pregnancy. This sac can be identified as early as 5 weeks of pregnancy; by 10 weeks its size reaches 7 mm, but after 12 weeks of pregnancy, even with the help of an ultrasound examination, it is not possible to determine/identify/assess the condition of the yolk sac - this is the norm.

Doctors have long noted a direct connection between the size of the yolk sac and the outcome of pregnancy. The fact is that the incorrect size of the sac, changes in its shape and walls in most cases are accompanied by a delay in the growth of the embryo.

Chorion- This is the membrane of the fertilized egg, which consists of villi. Its size (thickness) is equal to the gestational age in weeks, but this rule “works” only in the first trimester. If there is underdevelopment or changes in the structure of the chorion, then the death of the fetus can be accurately predicted. The fact is that the chorionic villi are very tightly attached to the uterine cavity and if its structure is changed, then it is simply impossible for the villi to “catch on” - a miscarriage begins.

Amnion- this is a water membrane, a sac in which the embryo is located surrounded by amniotic fluid. Carrying out this type of study in the early stages of pregnancy allows the specialist to identify the small diameter of the amniotic cavity, and this will indicate its underdevelopment, which always leads to problems with the development of pregnancy. But an increase in size will indicate the presence of intrauterine infection.

Identifying pregnancy complications

In the 1st trimester of pregnancy, most often, of all possible pathologies, the threat of miscarriage is diagnosed. Moreover, it is with the help of the study in question that the doctor can diagnose this pathological condition at the very beginning of its development - the walls of the uterus will be thickened. Women very often feel it themselves, as this condition is accompanied by. If the diagnosis has taken place, then doctors carry out therapeutic treatment, which is designed to preserve the pregnancy. But if there is a detachment of the fertilized egg, the woman has some from the vagina, then a diagnosis of “incipient spontaneous abortion” will be made.

Important! If a miscarriage has already occurred, the patient must undergo an ultrasound examination to determine whether there are remains of the fertilized egg in the uterine cavity. And if such residues are identified, then the woman is sent for a curettage procedure.

With the help of this study in the early stages of pregnancy, a doctor can diagnose:

1. Cyst corpus luteum . This is a fairly common formation, which will be characterized by the presence of thick walls, and its structure will be assessed as heterogeneous - in principle, this is considered the norm. The corpus luteum cyst tends to resolve on its own and completely disappears by the end of the first trimester.
2. Hydatidiform mole. This complication is detected extremely rarely - 1 case in 2,000 - 3,000 pregnant women. A very dangerous condition, which is characterized by pathological damage to the chorion. Hydatidiform mole always leads to the death of the fetus, as the chorion turns into grape-shaped formations that destroy the fertilized egg.

An ultrasound examination in the first trimester of pregnancy makes it possible to identify any pathological changes in the ovum and embryo - for example, at 12 weeks of pregnancy, a doctor can diagnose a cleft lip and other facial defects in the unborn child. The problem is that this type of research in the early stages of pregnancy is carried out solely at the request of the woman and therefore early detection of problems with the fetus, when it is still possible to make a decision about the advisability of carrying it, is not always possible.

Waiting for the birth of a baby for any woman is a time of the brightest hopes and at the same time worries for the health of the child.

There are various methods for studying the functional and anatomical state of the fetus during pregnancy, fetal ultrasound is rightfully considered the leading one among them. Thanks to an ultrasound examination, it is possible to confirm the fact of pregnancy, determine its duration and determine the sex of the child. But the main thing is that ultrasound allows you to monitor the development of the embryo in the womb and timely diagnose fetal malformations.

Ultrasound during pregnancy gives a woman the opportunity to see the facial features of her unborn baby, examine his legs and arms, and hear his heart beat. By the way, the fetal heartbeat can be heard on ultrasound as early as 5-6 weeks of pregnancy.

According to the order of the Ministry of Health of the Russian Federation No. 457 of December 28, 2000, the mandatory examination of pregnant women, along with biochemical screening (blood test for the content of specific proteins), includes an ultrasound, which is carried out at 11-13 weeks, as well as 2 morphological ultrasounds during second and third trimesters. A total of three screening ultrasound examinations are performed during pregnancy.

In addition, the doctor who is treating your case may prescribe an ultrasound for other indications. The first combined screening is aimed at identifying fetal malformations using ultrasound in early pregnancy.

When is a fetal ultrasound performed?

Routine ultrasound during pregnancy is carried out at the following times:

• first fetal ultrasound carried out at 11-13 weeks;
• second ultrasound during pregnancy - at 20-24 weeks;
• third - at 32-34 weeks.

First fetal ultrasound gives the attending physician initial information about the intrauterine development of the child (its viability, the likelihood of fetal malformations, the mother’s ability to bear a child).

Particular attention is paid to such parameters as the thickness of the nuchal region, the formation of the nasal bone, heart rate and coccygeal-parietal size (CPR). Significant deviations in numerical indicators, along with the results of a blood test, allow us to draw conclusions about the presence of an abnormality in fetal development. For example, with Down Syndrome, in most cases the nasal bone is not visible in the fetus at 10-14 weeks, or a thickening of the “neck fold” is noticeable. With Edwards Syndrome, there is a tendency for the heart rate to slow down, the nasal bones are not visible, and instead of 2 umbilical cord arteries, only one is visualized.

If serious fetal malformations occur before 14 weeks, medical termination of pregnancy is used.

Second ultrasound during pregnancy carried out to exclude fetal malformations. The second prenatal ultrasound examination checks whether the gestational age corresponds to the size of the fetus. The length of the child’s limbs on both sides, the volume of the head, chest, abdomen, the size of internal organs, etc. are assessed. During this period, it is also important not to miss anomalies in the development of the cardiovascular system, kidneys and Bladder, stomach, intestines, spine.

Moreover, during Ultrasound screening during pregnancy The condition of the cervix and uterine walls, appendages, the location of the placenta, its thickness, structure, the number of vessels in the umbilical cord, etc. are assessed.

Third ultrasound during pregnancy is key. It is during this period that the degree of fetal development and its compliance with physical and functional standards for a given period of pregnancy are assessed. It is extremely important to identify late fetal malformations.

Deviations from the norm of 1-2 weeks are not always a sign of fetal developmental delay. Therefore, expectant mothers should under no circumstances interpret the ultrasound results on their own and panic if the baby falls slightly short of the generally accepted indicators. Trust the specialists who monitor your pregnancy throughout. If an ultrasound reveals intrauterine growth retardation, additional studies are carried out (determining the fetal heartbeat and blood flow in the uterus, in the vessels of the embryo, and the umbilical cord).

An analysis of the state of the unified “uterus-placenta-fetus” system is also carried out. Particular attention is paid to the development of the placenta - its place of attachment, thickness and degree of maturity.

After the twentieth week of pregnancy, at the third scheduled screening, sometimes earlier, it becomes possible to determine the sex by ultrasound of the fetus. Accuracy in determining sex is about 90%.

Ultrasound protocol during pregnancy

Deciphering ultrasound diagnostics during pregnancy reveals the parameters of fetal development in the womb at different stages. Ultrasound indicators by week of pregnancy include the following data:

• H.C. - the circumference of the child's head;
• FL - length of the thigh bone;
• BPD - size between the temples (biparietal diameter);
• CRL - the length of the embryo from the crown to the coccyx (this parameter makes it possible to determine the gestational age by ultrasound).

When deciphering an ultrasound by week of pregnancy, the following fetal malformations can be identified:

• spinal cord herniation, which threatens the normal development of the spinal cord and brain;
• heart disease;
• accumulation of cerebrospinal fluid in the skull;
• absence of the brain (this defect can lead to termination of pregnancy);
• fusion of the duodenum;
• delayed mental development of the child (Down syndrome).

In what cases is it necessary to undergo additional fetal ultrasound:

• when pain appears in the lower abdomen;
• after a bacterial or viral infection;
• if a woman does not feel fetal movement after the 20th week;
• with bloody and other discharge from the genital tract;
• if premature labor has begun;
• if contractions appeared at 36-40 weeks, and a fetal ultrasound was performed in the 1st or 2nd trimester.

• short cervix;
• placenta previa or low placenta;
• (: swelling, cramps, protein in urine);
• retroplacental hematoma (the appearance of hemorrhage during detachment of the ovum from the placenta in late pregnancy, after 16 weeks).

Ultrasound is also performed more often during pregnancy when the internal os is open. The internal os is located on the border of the uterus and the cervical canal; if it is open, premature birth may occur. To avoid this, stitches or staples are placed on the cervix.

- modern highly informative diagnostics, allowing to obtain a detailed image of the fetus in 3 projections.

Using 3D ultrasound, you can examine intrauterine malformations of the fetus, for example, defects of the spine, the formation of limbs, and facial bones. This diagnosis is used using an ultrasound scanner that creates a 3D ultrasound image.

Like traditional ultrasound, 3D ultrasound during pregnancy allows you to determine the gestational age, the number of embryos, the amount of amniotic fluid, the thickness and attachment site of the placenta, etc. However, 3D ultrasound gives future parents an additional opportunity to get the first photos of their baby, examine his head, arms, legs, and evaluate who the baby looks more like - mom or dad.

4D ultrasound during pregnancy - this is an even more sophisticated type of diagnosis, providing a three-dimensional picture of the fetus in motion in real time. In essence, this study can be compared to video recording of the fetus made through the mother’s abdominal wall using ultrasound. Thanks to 4D ultrasound of the fetus, you can see how the baby moves, yawns, and smiles.

Ultrasound screening during pregnancy

The standard examination includes only routine ultrasound examinations of the fetus; screening examinations are carried out as prescribed by a doctor, in the presence of chromosomal pathology (as well as other serious malformations of the fetus) or at the insistence expectant mother who wants to know more about the health of her child.

Unscheduled or frequent ultrasounds are indicated for those women who are in the so-called “risk group” for the following reasons:

• taking drugs dangerous to the fetus;
• miscarriages, “frozen” pregnancies or stillbirths in the past;
• viral or infectious diseases in the first trimester;
• the age of the future mother is over 35 years old, and the father is over 40 years old;
• the presence in the family of hereditary anomalies of fetal development.

The first combined screening includes 2 stages: laboratory blood test and ultrasound of the fetus. The remaining 2 screenings are aimed at assessing the morphological anatomy of the fetus, and therefore this examination is called morphological ultrasound.

“MedicCity” presents expert-class diagnostic equipment. The latest Voluson 10 ultrasound scanner is a real breakthrough in . allows you to accurately diagnose congenital anomalies and fetal malformations (such as Down syndrome, heart defects, cleft lip, etc.). carried out with extensive experience in this field.