OBSTETRIC ULTRASOUND

Obstetric ultrasound 1st trimester of pregnancy

The obstetric ultrasound of the first trimester of pregnancy is usually performed between the 6th and the 10th week of gestation. The purpose of this ultrasound is to evaluate the correct course of pregnancy in its initial stage, in both the asymptomatic patient and in the one with particular risk factors (for example, abdominal pain, blood loss) by means of:

• Visualization of the gestational sac in the uterus to rule out ectopic pregnancy
• Visualization of the embryo/foetus, their number (to identify whether it is a single or twins pregnancy) and heart activity
• Dating of the pregnancy, which is fundamental for all those patients who do not remember with certainty the date of their last menstrual cycle, who have an irregular menstrual cycle or who have conceived while breastfeeding or after discontinuing birth control. Proper dating of pregnancy is very important to determine the delivery due date and to be able to plan the necessary check-ups during pregnancy such as extra ultrasounds and/or examinations to assess the risk of chromosomal anomaly.

The ultrasound examination is then immediately reported.

Early Morphology Ultrasound

This is an ultrasound performed around the 16th – 18th week of pregnancy by a doctor experienced in the study of foetal morphology (development of organs and systems of the foetus) that uses a state-of-the-art 3D – 4D instrument. The aim of this ultrasound is to anticipate the study of the foetus’ anatomy that is normally performed on the 20th week of pregnancy, thus allowing an early diagnosis of potential foetal malformations.

The ultrasound, that is totally harmless for the foetus, is usually performed transabdominally (a probe is placed on the mother’s abdomen after having spread gel over it). It is possible to use the transvaginal probe (the probe is covered by a latex sheath and is placed inside the vaginal cavity) for a more complete examination.

The ultrasound examinations is then immediately reported.

Morphology Ultrasound

it is an ultrasound performed around the 20th – 21st week of pregnancy by a doctor who is an expert in the study of foetal morphology (development of organs and systems of the foetus) that aims to identify any foetal malformations and the study of the uteroplacental function. This ultrasound is carried out by using a state-of-the-art 3D – 4D high resolution device. Both types of ultrasound are performed in this case; via the so-called transbdominal method (the prove is placed on the mother’s abdomen which was previously covered with gel) and via the transvaginal method (the probe is the probe is covered by a latex sheath and gel and is then placed inside the vaginal cavity in contact with the cervix) in case one wishes to evaluate the length of the cervix.
The study of the foetus is completed by evaluating the blood flow in the umbilical cord and in the maternal uterine vessels by means of a Doppler ultrasound and with the help of 3D-4D technique, which provides a more accurate assessment of the foetus’ face, spine and limbs.

Diagnostic possibilities

• It recognizes the biggest foetal malformations
• It selects, through the study of the blood flow at the uteroplacental level (blood-flow velocity recording by using ultrasonic and Doppler techniques), the patients are at risk of developing gestational hypertension and/or foetal growth restriction. Still today, these pathologies are the leading causes of both maternal and foetal mortality and morbidity.
• By measuring the length of the cervix, it identifies the patients at risk of preterm birth.
• It allows a non-definitive location of the placenta as it is “in movement” until the third trimester.
• It allows to evaluate a possible reduction or increase of the amniotic fluid.
• It indicates the patients with increased risk of chromosomal disorder, via marker evaluations (such as nuchal fold, nasal bone, echogenic bowel, dilation of the renal pelvis).

The ultrasound examinations is then immediately reported.

3rd Trimester Obstetric Ultrasound

Growth Ultrasound
The ultrasound of the 3rd trimester of pregnancy is usually performed between the 30th – 32nd week of gestation.
The purpose of this test is to evaluate foetal growth and well-being both in patients that show no risk factors whose pregnancy had a normal course but also, and above all, in those patients at risk for maternal and/or foetal diseases (such as diabetes mellitus or foetal growth defects) through:

• biometric measurements (measuring the size of the head, abdomen, femur and humerus) and
• estimated foetal weight
• evaluation of the placenta’s position
• measuring the amount of amniotic fluid
• evaluation of blood-flow in the umbilical cord

The ultrasound examination is then immediately reported.