Physicians regularly need to investigate what is going on inside the patient when he or she is suffering from discomfort that is not necessarily caused by pathology, such as pregnancy, then it’s necessary to make an ultrasound.
And all radiological equipment such as ultrasound (US) and other laboratory studies are used in these situations.
What is ultrasound?
Ultrasound, also known as sonography, is a supportive tool widely used in medicine to investigate and diagnose whatever is affecting the patient inside.
It is the study of first choice to detect and study pregnancies up to the day of birth.
Unlike conventional radiology equipment such as X-rays, computed tomography or magnetic resonance imaging.
Ultrasound does not use ionizing radiation to operate, so in addition to being effective, it is considered safe.
The reason for this is that ultrasound implements high-frequency sound waves capable of providing visual structures belonging to the human organism. These waves are represented in the ultrasound machine as dotted images in movement, whether they are two-dimensional, three-dimensional or even in 4D.
Ultrasound as the study of choice during pregnancy
Obstetric ultrasound is a totally safe, painless and non-invasive procedure, so it will not affect the health of the mother or the baby.
Complementing the above, its simplicity, functionality and cost makes it accessible to the medical service.
Ultrasound-mediated monitoring and follow-up of pregnancy
The most common routine finding during the first trimester is the confirmation of pregnancy.
This is followed by the other studies that are necessary throughout intrauterine life and that are discovered via ultrasound.
- First trimester: confirmed pregnancy, features of multiple pregnancy, determining gestational age and estimated date of delivery, nuchal translucency test, normal study of the anatomical development of the fetus, examination of the woman’s uterus, ovaries and cervix.
- Second trimester: thorough study of the anatomical development of the fetus, monitor the position of the fetus in the uterus, determine the sex of the baby, examine the position of the placenta.
- Third trimester: determine that the fetus has developed correctly, diagnose any problems of the woman during pregnancy.
During each trimester it is essential to reaffirm that the fetus is alive and also to diagnose any life-threatening genetic malformations.
Types of ultrasound scans used in pregnant women
Being trained to use and interpret the ultrasound is essential when performing the different techniques.
In order to find and analyze what we are investigating at that time.
Each of these techniques allows the physician to observe different angles of the fetus and in different resolutions, so it benefits the timely attention in case of presenting any complication, abnormality or inconclusive diagnosis.
Fetal ultrasound examinations, Ultrasound:
- Transabdominal ultrasound: it is the most used technique due to its simplicity and efficiency, it is only placed over the abdomen to start reflecting the ultrasound.
- Transvaginal Ultrasound: used during early stages of pregnancy, a transducer is introduced through the vagina capable of transmitting the waves reflected in the ultrasound, it is usually used as a backup when the transabdominal US does not transmit enough information.
- 3D application: unlike traditional methods, 3D ultrasound provides volumetric data of both the fetus and its organs, it also helps detect neural tube defects or any other suspicion.
- Doppler ultrasound: when you need to check the blood flow of the fetus, the Doppler US is able to calculate the circulating blood by means of its sound waves, which is useful during pregnancy.
- Fetal echocardiography: this study provides a detailed image of the fetal heart, which is routinely helpful to verify the correct functioning or to rule out any heart defect.
Necessary care for the fetus and the mother in pregnancy
When ultrasounds show the perfect condition and growth of the baby, it is largely due to the care that the mother maintained during the months of gestation.
Although there are more factors that harm fetal development, maternal care is undoubtedly transcendental for the fetus.
Drugs and food
The essential before and during pregnancy is to consume folic acid in quantities of around 400 mg daily.
Since it has been proven that ingesting it potentially reduces any risk of genetic mutations in the fetus.
Similarly, it is suggested to suspend certain medications, because some drugs are highly lethal to the fetus, and it is necessary to avoid any complications.
Currently, the FDA has a classification of drugs in 5 different categories in order to ensure whether your drug is acceptable or should be restricted during pregnancy.
Also restricting alcohol, cigarettes and any other addictive products is necessary for pregnancy care.
Complementary laboratory studies
Although ultrasound serves its purpose in pregnancy, it is not a 100% accurate study.
Therefore, additional tests may be required to confirm or rule out genetic alterations.
Some of them are chorionic villus sampling, amniocentesis or conventional blood and serum tests to determine the health status of the fetus.
Chorionic villus sampling is obtained by removing a tiny piece of tissue from the placenta.
It is used to analyze the presence of chromosomal defects and is recommended to be performed between 10 and 12 weeks of gestation.
As for amniocentesis, this test is performed weeks after the villus sampling and consists of extracting amniotic fluid from the woman’s uterus.
If the fluid contains two of the most important proteins produced in the fetus, alpha-fetoprotein (AFP) and acetylcholinesterase (ACE), it indicates a developmental defect.
In the case of blood and serum tests, they are done in the mother to check the levels of human chorionic gonadotropin (hCG) and pregnancy-associated plasma protein A. If they are found to be altered in the mother, the mother’s levels of hCG and pregnancy-associated plasma protein A may be altered.
If they are found to be altered in the mother, they indicate a possible chromosomal abnormality.
Complications during pregnancy found by ultrasonography
Congenital anomalies are not seen very often and are usually associated with:
- poor cell division
- age and health of the mother
- environment of the fetus as well as the pregnant woman
Many genetic diseases can be discovered as a result of an ultrasound, and the most common are those related to neural tube defects (NTDs) involving the brain, spine and spinal cord.
Among the most commonly seen NTDs are:
- spina bifida
- anencephaly
- encephaloceleAlthough there is also a risk of hydrocephalus, microcephaly, myelomeningocele or Dandy-Walker syndrome.
On the other hand, they are also caused by cardiovascular defects.
Such as the development of a single ventricle or atrium, hypoplasia syndrome of left or right cavities, and cardiac tumors.
The digestive system defects found by US are duodenal atresia, gastroschisis and omphalocele.
While in the renal ones, unilateral or bilateral renal hydronephrosis and polycystic kidneys predominate.
What else can ultrasound be used for?
Unlike pregnancies, ultrasound is very useful in finding cancerous processes, for example:
When studying a possible case of breast cancer, both mammography and US Doppler are the mostly implemented examinations.
Both facilitate the search for abnormal masses in the breast areas.
Differentiating the large amount of tumor tissue and discovering new blood vessels that irrigate it, which favors a timely diagnosis.
In addition to this, it also has many other uses in medicine, such as guidance during aspiration biopsies, so that on the ultrasound you can observe the needle in the extraction area.
As mentioned above, it provides support for performing an echocardiogram that is not necessarily fetal.
Pathologies such as coronary artery disease and heart failure are found by means of ultrasound.
Other tasks of ultrasound are to discover causes of infections, visceral pain, renal organs and affections in the thyroid and parathyroid glands.
References:
Wikipedia Obstetric ultrasound.
