A GUIDE TO YOUR ULTRASOUND EXAMINATION
PLEASE MAKE SURE YOU KNOW AND FOLLOW THE POINTS BELOW
So that we can record a complete history of your pregnancy, you need to bring with you all the tests you have had during the pregnancy. We are mainly interested in the nuchal translucency with the PAPP-A test and in the level II scan. You should also know the date of your last menstrual period (LMP) and your expected date of delivery (EDD), as calculated by your gynecologist from the first-trimester scan.
If the examination is an invasive one, you should also tell us your blood group and whether you are taking any anticoagulant medication (aspirin, heparin and so on).
For the first-trimester scan (nuchal translucency) it helps if your bladder is full. The fetus at this gestational age is still small (45–84 mm), and a full bladder gives us better visibility. As for the blood test (PAPP-A), you can eat normally, as this does not affect the result at all.
For the level II scan (the detailed scan) there is no blood test and a full bladder is not needed. It does help, however, if the mother has something sweet (chocolate, sweets with plenty of sugar, or a chocolate milk, for example) 15–20 minutes before the scan. For the third-trimester scan (growth and Doppler) it is enough to have a little urine in your bladder.
All the scans are done transabdominally. There are cases, however, where a transvaginal scan may also be needed, particularly for the early pregnancy scan and the nuchal translucency. Parents, children and friends are welcome at the clinic. In every case, though, you should be aware that in an examination of this kind the results may not be what you hoped for and that, instead of joy, they may have to face difficult news.
For amniocentesis and chorionic villus sampling no preparation is needed, unless your rhesus is negative or you are taking anticoagulants. When the rhesus is negative, an injection of immunoglobulin (Rhophylac) is given at the end of the procedure to protect the fetus from the mother's blood. You obtain the immunoglobulin yourself from a pharmacy. If you are taking anticoagulants you must stop them at least 24 hours before the procedure, and aspirin 5 days before. Finally, you are perfectly free to have eaten beforehand.
BEFORE THE EXAMINATION
When you arrive at the clinic you will be given a questionnaire to complete. This is how we gather information about you and your pregnancy.
If any question is unclear, our reception staff will gladly help. If you would rather not answer one of the questions, you can simply skip it. You will then be given an information leaflet describing in detail the examination you are about to have, what it can show and what its limitations are. The doctor will answer any question you have just before the examination begins. Each scan takes about 45 minutes, depending on particular factors (the position of the fetus, the possibility of a problem, the thickness of the mother's abdominal wall). It may take less time or more, so we ask for your understanding if you have to wait.
DURING THE EXAMINATION
Before the examination the doctor gathers information about your health, about previous pregnancies and about how this pregnancy has progressed. He will also explain the purpose of each scan and its limitations, and will tell you exactly what we are looking at and checking at each stage of the examination. If any question comes up, do not hesitate to ask. During the scan the doctor tries to image the various parts and organs of your baby in order to assess its structure properly. In some cases the position of the fetus does not allow us to obtain the right views. We then try changing the mother's position so that the fetus moves as well. Because that is not always effective, you may need to go for a short walk (15–20 minutes) so that we can get the result we need.
THREE-DIMENSIONAL 3D/4D ULTRASOUND
Many mothers-to-be believe that the whole level II scan (the detailed scan) is done in 3D. You should know that this is not possible, since two-dimensional images are needed to assess a baby's anatomy.
Three-dimensional imaging shows only the external features of a fetus, not the things we need to examine (bones, brain, kidneys and so on). The doctor will try to show you three-dimensional (3D) photographs of your baby, and four-dimensional video (4D) as well. You should understand, however, that besides not being necessary for assessing the baby's anatomy, these images are not possible if the fetus is not in a suitable position. A high maternal body weight can also reduce the sensitivity of the scan.
RESULTS — once the scan is complete, the doctor will tell you the result of the examination. If a problem or anything suspicious is found in the fetus, you will be given all the information about the problem and about the possible risks ahead.
Finally, you take home a folder containing a report and photographs of the examination performed on your baby (anatomy and 3D images), as well as the whole examination on DVD, so that you can watch it as many times as you like until your baby is born. Besides their great medical importance, these scans have great emotional value for mothers. They are done only once in a pregnancy, and for that reason we take care to give you the best service we can, so that you have no unanswered questions at the end of each examination and leave satisfied and happy.