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Ultrasound

Doctors can deduce a lot of information on the progress of the pregnancy with a simple Ultrasound Scan. Using ultrasound waves, any abnormalities in the fetus can be determined. Depending on the procedure, the testing may be transabdominal (performed by passing through the abdominal wall) or transvaginal (performed by passing across the vaginal wall). We recommend two major ultrasound examinations during the pregnancy period - First Trimester Nuchal Translucency Scan and Detailed Anatomy Ultrasound or Detailed Scan (which might include Fetal Echocardiography).

  • First trimester nuchal translucency scan
  • Second Trimester detailed scan
  • Fetal echocardiography

Performed between 11 weeks and one day until 14 weeks of pregnancy, the first trimester includes nuchal translucency scan which uses special ultrasound waves to check the accumulation of fluid in the baby’s neck and this also includes the assessment of the fetal nasal bone and the blood flow.
The NT can be an indicator for the risk of cardiac defect, chromosomal abnormality or other genetic disorder in the fetus. The test also requires blood samples to measure the levels of plasma protein and human chorionic gonadotropin (HCG), and two maternal hormones called pregnancy-associated plasma protein A (PAPPA).

Our physicians and sonographers are certified NT specialists in Fetal medicine Foundation

https://fetalmedicine.org/lists/map/certified/NT-specialist

The first trimester ultrasound (NT Scan) provides more clarity on the following details:
The size of the fetus is a good indicator of the estimated date of delivery. Women with an irregular menstrual cycle can, therefore, accurately predict their delivery date with this scan.
If confirmed, a first trimester ultrasound (NT scan) can ensure that multiple babies develop normally in their placentas. An inadequate share of the placenta means that either of the babies may fall short of proper nutrition from the mother. This defect can be accurately detected using an NT scan.
Major defects in a baby’s growth can be detected during this gestation period as well as major structural abnormalities. Examples of abnormalities that can be detected using the scan include Down Syndrome (trisomy 21), Edwards Syndrome (trisomy 18) and Patau Syndrome (trisomy 13). However, further ultrasound or tests may be required to accurately pinpoint the defects with the fetus.
Miscarriage: As in a few cases, the unforeseen and unfortunate
death of the foetus can be discerned with a nuchal translucency test.
Based on the mother’s age, specific hormone levels in the maternal blood, the thickness of the nuchal fold and blood flow through the fetal heart, mothers receive the estimate of the risk of fetal abnormalities.

The sonographer will look at your baby’s organs and body structures in more detail compared to the basic ultrasound scan done in the first trimester. A detailed scan is best performed when you are in 18 to 24 weeks of pregnancy. During this scan, we look in detail at the baby’s brain, face, spine heart, lungs, diaphragm, anterior abdominal wall, kidneys, liver, stomach, bowels, urinary bladder, and lower and upper limbs. Fetal weight, placenta and amniotic fluid, as well as the cervix, are also evaluated during this scan.

In case abnormalities are detected during this scan, it is advisable to go for further tests, particularly a genetic amniocentesis to diagnose or rule out the increased risk of chromosomal abnormalities, and to seek additional expert medical or surgical consultations like a pediatric cardiologist, geneticist, neonatologist surgeon, to learn more about the condition and its optimal plan of management after delivery.

The test uses waves similar to ultrasound to see the structure and function of the baby’s heart. Any abnormalities in the blood flow or heartbeat of the unborn can be detected with fetal echocardiography.
The test is recommended by doctors for the following reasons:
Fetal factors
Fetal echocardiography is indicated if there is:
  • Suspected cardiac structural anomaly
  • Suspected abnormality in cardiac function
  • Hydrops fetalis
  • Persistent fetal tachycardia (heart rate >180 beats per minute)
  • Persistent fetal bradycardia (heart rate <120 beats per minute) or a suspected heart block
  • A Frequent episode or a persistently irregular cardiac rhythm
  • Major fetal extracardiac anomaly
  • Nuchal translucency of 3 mm or greater or at above the 95th percentile for gestational age
  • Chromosomal abnormality by invasive genetic testing or with cell-free fetal DNA screening
  • Monochorionic twinning

 

Maternal or Familial Disease or Maternal environmental exposure
Fetal echocardiography is indicated if there is:
  • Pregestational diabetes regardless of the hemoglobin A1c level
  • Gestational diabetes diagnosed in the first or early second trimester
  • In vitro fertilization (IVF), including intracystoplasmic sperm injection
  • Phenylketonuria (unknown status or a periconceptional phenylalanine level >10mg/dl)
  • Autoimmune disease with anti-Sjogren syndrome-related antigen A antibodies and with a prior affected fetus
  • First-degree relative of a fetus with CHD (parents, siblings, or prior pregnancy)
  • First or second-degree relative with disease of Mendelian inheritance and a history of childhood cardiac manifestations
  • Retinoid exposure
  • First-trimester rubella infection

 

Genetic Screening

Genetic screening can reveal vital information about a baby’s genetic makeup in the womb.

Learn More

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