Ultrasound

Gynecology /

What are Obstetric Ultrasound Scans?

Obstetric Ultrasound is the use of ultrasound scans in pregnancy. Since its introduction in the late 1950’s ultrasonography has become a very useful diagnostic tool in Obstetrics.

Currently used equipments are known as real-time scanners, with which a continuous picture of the moving fetus can be depicted on a monitor screen. Very high frequency sound waves of between 3.5 to 7.0 megahertz (i.e. 3.5 to 7 million cycles per second) are generally used for this purpose.

The main use of ultrasonography are in the following areas:

Diagnosis and confirmation of early pregnancy.

The gestational sac can be visualized as early as four and a half weeks of gestation and the yolk sac at about five weeks. The embryo can be observed and measured by about five and a half weeks. Ultrasound can also very importantly confirm the site of the pregnancy is within the cavity of the uterus.

Vaginal bleeding in early pregnancy.

The viability of the fetus can be documented in the presence of vaginal bleeding in early pregnancy. A visible heartbeat could be seen and detectable by pulsed doppler ultrasound by about 6 weeks and is usually clearly depictable by 7 weeks. If this is observed, the probability of a continued pregnancy is better than 95 percent. Missed abortions and blighted ovum will usually give typical pictures of a deformed gestational sac and absence of fetal poles or heart beat.

Fetal heart rate tends to vary with gestational age in the very early parts of pregnancy. Normal heart rate at 6 weeks is around 90-110 beats per minute (bpm) and at 9 weeks is 140-170 bpm. At 5-8 weeks a bradycardia (less than 90 bpm) is associated with a high risk of miscarriage.

Multiple pregnancies

In this situation, ultrasonography is invaluable in determining the number of fetuses, the chorionicity, fetal presentations, evidence of growth retardation and fetal anomaly, the presence of placenta previa, and any suggestion of twin-to-twin transfusion.

3-D and 4-D Ultrasound

3-D ultrasound can furnish us with a 3 dimensional image of what we are scanning. The transducer takes a series of images, thin slices, of the subject, and the computer processes these images and presents them as a 3 dimensional image. Using computer controls, the operator can obtain views that might not be available using ordinary 2-D ultrasound scan. 3-dimensional ultrasound is quickly moving out of the research and development stages and is now widely employed in a clinical setting. It too, is very much in the News. Faster and more advanced commercial models are coming into the market. The scans requires special probes and software to accumulate and render the images, and the rendering time has been reduced from minutes to fractions of a seconds.

More recently, 4-D or dynamic 3-D scanners are in the market and the attraction of being able to look at the face and movements of your baby before birth was also enthusiastically reported in parenting and health magazines. This is thought to have an important catalytic effect for mothers to bond to their babies before birth. What are known as 're-assurance scans' and the rather misnamed 'entertainment scans' have quickly become popular.

GYNECOLOGICAL ULTRASOUND
For gynecology patients, ultrasound is used to view internal organs including the uterus, ovaries, kidneys, and bladder and to scan for cysts and tumors. It is also used for guidance during biopsies.

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