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Many pregnant women have one or more ultrasounds during their pregnancy. Also known as scans or sonograms, ultrasounds use high-frequency sound waves to create a visual image. These images are black and white with gray shading. The sound waves can’t be felt. Ultrasounds are considered safe and do not use x-rays or radiation.
In the first 12 weeks, many women have an ultrasound to determine the baby’s age and establish a due date. Some other reasons for ultrasound are to:
In the 1st trimester the baby is so small and protected behind the mother’s pubic bone, that an external, abdominal ultrasound doesn’t yield as clear a picture as a vaginal ultrasound. Though they sound scary, these types of ultrasounds are safe and rarely cause pain or discomfort. The benefit is more accurate measurements of the baby.
Another type of ultrasound that may be recommended between 11 – 14 weeks is one that measures the baby’s neck (nuchal) fold thickness. A nuchal translucency scan screens for Down Syndrome. The estimated accuracy is 60 to 80%.
In the 2nd trimester (weeks 12-28), ultrasounds are performed for a variety of reasons. Many women will have a “Level 2 Scan.” This type of ultrasound is performed after 18 weeks. In this ultrasound, the baby’s development is evaluated from head to toe, as is the placenta, cord, and amniotic fluid. Level 2 scans can detect many abnormalities and can provide reassurance to both the parents and the health care providers, however they aren’t able to detect every possible problem. Many times the baby’s sex can also be determined.
Other reasons for ultrasounds in the 2nd and 3rd trimester are to:
Some high-risk moms with diabetes, high blood pressure, or other complications will need a specific type of ultrasound and monitoring known as a biophysical profile. In this case, the baby’s heart rate is monitored and then an ultrasound is done to look at the amount of amniotic fluid, the baby’s movement, and the baby’s breathing movements. Biophysical profiles may be recommended once or twice each week in the 3rd trimester to help monitor the baby’s well-being.
Other Concerns with Ultrasounds in Pregnancy
Some health care providers recommend routine screening ultrasounds for all their patients. Others order ultrasounds only when they are concerned about the growth of the baby or a possible abnormality. Be sure to discuss what’s best for you with your provider.
Currently, the standard of care in pregnancy is to use 2 dimensional or 2-D ultrasounds to best visualize the baby’s internal anatomy, growth, and development. These provide black and white images and allow clinicians to peek inside the baby to assess the growth of the bones, the development of organs such as the kidneys, brain, stomach, even see the 4 chambers of the heart. If certain problems are detected, or suspected with the 2-D ultrasound, a 3-D or 4-D ultrasound may be recommended by to look at the baby’s external features and their development. The use of 3-D and 4-D ultrasound is still being developed, and 2 D is still the best way to visualize the baby’s growth and development. Though many experts, including the FDA, caution against using 3-D and 4-D ultrasounds unless medically necessary, many parents enjoy the experience of seeing their baby’s features before birth.
Barb Dehn, RN, MS, NP is a nationally recognized women's health expert and nurse practitioner, conference speaker, and national Media regular. In 2004 she founded Blue Orchid Press, an innovative publishing company that provides Health Guides for Women. To date, over 3 million guides have been distributed to women across the country in partnerships with pharmaceutical and biomedical companies, and she was given National Inspiration in Women’s Health Award from the National Association of Nurse Practitioners for her work on the guides, making her an award-winning author as well. Barb is an expert at connecting with women both through their health care providers and direct to consumer. Barb is married and has a 12 year old son.
3-D Image courtesy National Geographic Channel