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With the constant need to pee, nausea, and cravings, you know something is going on inside of you. Nevertheless, sometimes it doesn’t feel entirely real until you get to see your baby for the first time during your prenatal ultrasound. Pregnancy ultrasounds are a standard part of prenatal care for all the curious and anxious moms out there.
What is an ultrasound?
It is a type of imaging technology that creates images using sound waves. During your prenatal doctor’s visit, a transducer or wand is placed in your vagina or on top of your belly and it emits sound waves that bounce off of your baby’s tissues, fluids, and bones. As the transducer picks up these echoes, it translates them into the image of your baby which you can see on the screen.
Ultrasounds are used to confirm the fetal heartbeat and location of your pregnancy early in pregnancy. Later, it screens for fetal growth, location of the placenta, and baby’s general health and anatomy.
Towards the end of your pregnancy, ultrasounds are useful to check any suspicions/symptoms that you may be in preterm labor, the length of your cervix, as well as to verify that your baby is in a heads-down position before giving birth.
When is an ultrasound during pregnancy done?
The American College of Obstetricians and Gynecologists (ACOG) suggests that women should get at least one sonogram done during their second trimester which is between 18 and 22 weeks of pregnancy. Additionally, in your first trimester which is before your 14th week of pregnancy, you may also receive an ultrasound. Although the time of your first ultrasound exam may vary as it depends on your health. If you have certain chronic conditions including asthma or obesity, you might be closely examined.
First-trimester Ultrasound
During the first trimester, having an early ultrasound is often a part of routine prenatal care, which happens between 6 to 9 weeks. However, a first-trimester ultrasound isn’t standard practice as it’s still too early to see your baby in detail.
Most doctors opt to wait until at least 6 weeks to perform a first pregnancy ultrasound. Nevertheless, you can see a gestational sac as early as 4 1/2 weeks after your last period and a fetal heartbeat can be detected at 5 to 6 weeks (remember, it doesn’t always happen). So, if your healthcare provider does decide to perform a first-trimester ultrasound, you’ll be able to have a first glance at your baby. You’ll be able to:
- Confirm your expected due date more accurately by measuring the fetus.
- Check your fetus’s heartbeat.
- Make sure you can rule out an ectopic pregnancy.
- Examine if you are going to have more than one baby.
Second-trimester ultrasound
During your second-trimester which is between week 18 and week 22, a detailed anatomy scan called a level 2 ultrasound will be performed by a trained sonographer. Your second-trimester ultrasound is reassuring, nerve-wracking, all in all, fun to watch. It also allows you and your practitioner a clear picture of the overall health of your baby and your pregnancy by:
- Checking your baby’s major organs and measuring their size.
- Assessing the amount of amniotic fluid found in your uterus to make sure the levels are as expected.
- Checking the position of the placenta.
- Telling you your baby’s sex, that is, only if you want to know.
- Giving you a sneak peek at your baby, just ask the sonographer to point out where your baby’s hands, feet, and face is.
Your routine second-trimester ultrasounds are usually 2D in nature. Most doctors reserve 3D and 4D ultrasounds ( which are more detailed) for when they are medically necessary. As they can closely examine a fetus for any suspected anomaly. While ultrasound is considered to be very safe, doctors prefer to be extra cautious and minimize intrusions into your womb.
Please interlink ‘Second Pregnancy Trimester’
Additional ultrasounds during pregnancy
There can be several reasons as to why you may have additional ultrasounds during your pregnancy, it includes:
- Any spotting during pregnancy to confirm everything is alright.
- If you’re carrying multiple babies. You can monitor their growth.
- Being at risk of preterm labor, you can check for changes in the cervix.
- Towards the end of your pregnancy, if your doctor wants to check whether your baby may be too large to deliver vaginally. For example, you have a very small pelvis, or due to gestational diabetes, your practitioner suspects your baby is very large.
- Your doctor wants to check if your baby’s in a heads-down position before birth.
In addition to that, ultrasounds are a part of several other tests which includes:
- Amniocentesis
- Biophysical profiles
- Chorionic villus sampling (CVS)
- Nuchal translucency screening
Your healthcare provider sometimes recommends a fetal echocardiogram, which is a detailed ultrasound of a baby’s heart that’s performed by a trained professional and analyzed by a pediatric cardiologist. Your doctor may recommend it if you have certain risk factors, which include:
- A family history of congenital heart defects.
- If your baby is diagnosed with a genetic abnormality (like Down’s syndrome).
- If you had an abnormal result during another pregnancy test.
- If you have certain health conditions like an autoimmune disease or diabetes.
- If your baby has an abnormal heart rhythm/rate.
- If you had certain infections during pregnancy like rubella or CMV.
Types of pregnancy ultrasounds
If your healthcare provider detected any problems during your traditional ultrasound, more advanced ultrasound techniques may be used as a more detailed image is required. These may give the doctor the information necessary to make a proper diagnosis.
1) Transvaginal ultrasound
A transvaginal ultrasound is done to get a clearer image. It is more likely to be done during the early days of pregnancy when capturing a clear image of your baby could be more difficult. For this test, a small probe will be inserted into the vagina and it rests against the back of your vagina while the images are being captured.
2) 3-D ultrasound
A 3-D ultrasound allows your healthcare provider to see the width, height, and depth of the fetus and your organs. It is especially helpful for diagnosing any suspected problems during your pregnancy. The procedure of this ultrasound is the same as a standard one. 3-D ultrasound uses a special probe and software to create the 3-D image. It may not be as widely available as it requires special training for the technician.
3) 4-D ultrasound
4-D ultrasound is also known as a dynamic 3-D ultrasound. This ultrasound creates a better image of the baby’s face and movements along with a moving video of the fetus. The captured highlights and shadows are better, too. It uses special equipment but the procedures are similar to others.
4) Fetal echocardiography
This procedure is done if your healthcare provider suspects your baby has congenital heart defects. It may be similar to a traditional pregnancy ultrasound, except it might take longer to finish. It captures an in-depth picture of the fetus’ heart, where you can see the heart’s size, shape, and structure. This ultrasound also allows your doctor to look at your baby’s heart clearly, which can help them diagnose heart problems better.
How to prepare for a pregnancy ultrasound?
You should arrive at your appointment with a full bladder if you’re getting a transabdominal ultrasound because this makes it easier for your healthcare provider to see around or through your bladder. However, some practitioners suggest emptying your bladder 90 minutes before your exam. Then drink 8-ounce of any beverage about an hour before your appointment.
There are no other specific preparations that are required and you can eat normally that day. Your job is to sit back and relax.
What to expect during your first pregnancy ultrasound?
During pregnancy, two types of ultrasounds are done: transvaginal ultrasound and transabdominal ultrasound. They are both painless and last for about 20 minutes. The type of ultrasound that you’ll get mainly depends on how far ahead you are.
1) Transvaginal ultrasound
Your doctor will likely perform a transvaginal ultrasound if you’re getting your first pregnancy ultrasound before 6 or 7 weeks. They insert a small, long transducer (or wand) that is wrapped in a sterile condom-like cover into the vagina and move it within the vaginal cavity to scan your uterus. Because of the sound waves, the transducer emits which bounce off of structures (your baby) to produce an image which you can see on a computer screen.
2) Transabdominal ultrasound
You’ll get a transabdominal ultrasound examination if your first ultrasound is after 6 to 7 weeks. After the gel is rubbed onto your belly (which helps the sound waves move more easily), the wand is also rubbed over your belly which produces images of your baby.
What is the difference between a sonogram and ultrasound?
Although the words sonogram and ultrasound are often interchangeable, there is a distinction. Ultrasound is an imaging test that uses sound to produce pictures whereas a sonogram is a picture produced by the said ultrasound technology.
Does ultrasound have any risks?
Ultrasound is safe for you and your baby when done by your healthcare provider. It uses sound waves instead of radiation, which makes it safer than X-rays.
Remember that the American College of Obstetricians and Gynecologists (ACOG), and the American Institute of Ultrasound in Medicine (AIUM) do not recommend non-medical ultrasounds. As the people doing these tests may not have medical training and may give you harmful or even wrong information.
What happens after an ultrasound?
Usually, ultrasound shows that the baby is growing normally. Sometimes, it might show that you and your baby need special care.
For instance, if the ultrasound shows that your baby has spina bifida, it can be treated in the womb. If the ultrasound reveals that your baby is breech (feet-down), your doctor might try to flip your baby’s position to head-down, or you might need to have a cesarean (c-section).
To Conclude:
For most women, ultrasound reveals that your baby is growing normally. Make sure to keep going to your prenatal checkups, even after your ultrasound is normal. Ultrasound is good at ruling out some of the problems. So, no matter what it shows, talk to your provider about the best care for you and your baby.
FAQs: Ultrasound During Pregnancy
1) How many ultrasounds are normal during pregnancy?
2) What month can you tell the gender?
3) In which month baby's lungs are fully developed?
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Reviewed By:
Esha Chainani - Obstetrician and Gynaecologist
Dr. Esha Chainani is an Obstetrician, Gynaecologist, and laparoscopic surgeon who aims to break the stigma around women’s health by advocating an inclusive and open practice of obstetrics and gynecology and an author of several internationally published research papers and health articles in the media like the Swaddle.
She also founded Premaa, a non-profit to reduce maternal morbidity and eventual maternal mortality by providing lower-income pregnant women living in urban areas with cell phone access through an app that can feature an entire section about contraception as well for a whole gamut of reproductive health.
A panel for multiple health sessions including with the UN, USAID, BMC, gender at work, and multiple non-profit organisations, and is on the advisory panel of the South Indian medical students association.
