Uzi decoding. Ultrasound of the uterus: how it is done, preparation and interpretation of the results

Our mothers had to go through 9 months of pregnancy with a very vague idea of how their body is changing and how the baby is developing. Modern medical technologies have made it possible to make the waiting period for a child more comfortable for a woman, relieving her of many worries.

Ultrasonography - the main method for studying the anatomical and functional state of the fetus throughout pregnancy. Ultrasound allows you to determine the presence and duration of pregnancy, find out the sex of the child, and most importantly, with the help of ultrasound scanning, doctors can monitor the development of the embryo and take timely measures if any trouble is detected.

In "MedicCity" patients have the opportunity to undergo ultrasound during pregnancy using premium equipment. The scanner is indispensable for diagnosing fetal development during pregnancy, identifying congenital pathologies and other potential dangers. Our highly professional with vast experience in this field, doctors and candidates of medical sciences, armed with first-class equipment, will do everything possible to ensure that the period of expectation of a child runs as smoothly as possible!

What does ultrasound screening show?

Ultrasound scanning is a highly informative, non-invasive and safe way to obtain data on the health of the future mother and fetus. The method is based on the analysis of differences in the reflection of ultrasonic waves from structures of unequal density.

The purpose of an ultrasound examination is to assess the condition of a woman and her unborn child, as well as to identify possible deviations from the norm in order to take the necessary measures (ultrasound for fetal pathology).

Ultrasound diagnostics allows you to confirm the fact of pregnancy, obtain data on the formation of the fetus, the structure of the uterus and appendages, as well as the state of the placenta, umbilical cord, amniotic fluid. The tactics of managing pregnancy and preparing for childbirth, as well as the choice of the method of delivery, largely depend on the results of ultrasound.

After confirming the fact of pregnancy, all subsequent ultrasounds are carried out according to the schedule drawn up by the attending gynecologist.

The reason for an unscheduled ultrasound in early pregnancy may be the following reasons:

discrepancy between the size of the uterus and the norms for the current period of pregnancy;
the presence of a woman bleeding (single or frequent);
pain and discomfort in the lower abdomen;
suspicion of a "frozen" pregnancy, ectopic pregnancy and other pathologies of early pregnancy;
the age of one or both future parents exceeding 35 years.

Timing of fetal ultrasound

At what terms (trimesters) of pregnancy do ultrasound is one of the main questions of interest to future parents.

According to the order of the Ministry of Health of the Russian Federation No. 457 dated December 28, 2000, the mandatory examination of pregnant women, along with biochemical screening (blood test for the content of specific proteins), includes ultrasound, which is performed for a period of 11-13 weeks, as well as 2 morphological ultrasounds during second and third trimesters. In total, a three-time screening ultrasound examination is performed during the pregnancy period.

Scheduled fetal ultrasound by weeks of pregnancy do the following:

screening of the 1st trimester - at 11-13 weeks;
2nd trimester screening - at 20-24 weeks;
3rd trimester screening at 32-34 weeks.

Additional (unscheduled) ultrasound examinations can be carried out on the recommendation of a doctor at any stage of pregnancy. This should not frighten the patient, since ultrasound does not have a harmful burden on the body. Repeated procedures can be prescribed to clarify the diagnosis or, if a particular pathology of pregnancy is detected, to take the necessary measures to improve the health of the woman and the fetus.

First fetal ultrasound helps to determine the exact gestational age, obtain data on the size and number of embryos, hear the fetal heartbeat, assess the degree of its development, and detect possible deviations.

Heart rate, nasal bone formation, thickness of the collar region and coccyx-parietal size (CTE) are extremely important parameters by which the formation of the fetus is judged. Significant deviations from the norm, coupled with the corresponding results of laboratory tests, will indicate the presence of a pregnancy pathology.

Important! Screening should be deciphered by a professional. Only in this way can you be sure that no pregnancy pathology has gone unnoticed. Attempts to independently evaluate the results of ultrasound will not give an objective picture of what is happening and will only add anxiety to an already emotionally difficult period for future parents.

On the second ultrasound during pregnancy checks if the size of the fetus corresponds to the current stage of pregnancy. The length of the child's limbs, the size of his head, internal organs, the volume of the chest and abdomen, etc. are estimated. It is equally important during this period to monitor whether internal organs, the spine, and the cardiovascular system are developing normally.

Also, during the ultrasound screening of the 2nd trimester, the condition of the walls and cervix, appendages, the location, thickness and structure of the placenta, the number of vessels in the umbilical cord are assessed.

Third fetal ultrasound - key. At this stage, the doctor carefully analyzes the compliance of the anatomical and functional state of the fetus with the screening standards for this period of pregnancy. It is extremely important to identify late malformations.

If the screening results of the 3rd trimester show some delay in the development of the fetus, the patient is assigned additional diagnostics (assessment of blood flow in the vessels of the uterus, embryo and umbilical cord). The doctor also analyzes the state of the "womb-placenta-fetus" system. At the same time, close attention is paid to the placenta - the zone of its attachment, the degree of maturity and thickness.

Determination of the sex of the child during the third planned screening reaches 90% in accuracy.

More information about prenatal screenings you can read .

Unscheduled ultrasound during pregnancy is performed if:

the patient experiences pain in the lower abdomen;
suffered an infectious disease;
does not feel fetal movement after the 20th week;
has bloody and other discharge;
premature labor began;
there were contractions for a period of 36-40 weeks;
there are other complications of pregnancy.

Ultrasound protocol during pregnancy

Deciphering ultrasound diagnostics during pregnancy reveals the parameters of fetal development in the womb at different times. Ultrasound indicators by week of pregnancy include the following data:

HC - circumference of the child's head;
FL - length of the thigh bone;
BPD - the size between the temples (biparietal diameter);
CRL - the length of the embryo from the crown to the coccyx (this parameter makes it possible to determine the gestational age by ultrasound).

When deciphering ultrasound by weeks of pregnancy, the following fetal malformations can be detected:

spinal cord herniation, which threatens the normal development of the spinal cord and brain;
heart disease;
accumulation of cerebrospinal fluid in the skull;
lack of a brain (this defect can lead to termination of pregnancy);
fusion of the duodenum;
mental retardation of the child (Down syndrome).

Types of fetal ultrasound

Familiar to everyone ultrasound picture - a black-and-white flat image with spots and dots that are understandable only to a specialist - this is the result of an ultrasound study conducted in two dimensions: in width and height ( 2D ultrasound ). Almost every antenatal clinic is equipped with such a device today.

3D fetal ultrasound or 3D ultrasound during pregnancy - a more informative and modern diagnostic method that provides a high-quality image of the fetus in volume and color. The picture obtained with 3D ultrasound is almost a photo of the fetus, in which you can see the features of the child's face and even his facial expressions.

The service of three-dimensional ultrasound is offered today by many paid medical centers. When choosing a clinic, you should pay attention to the qualifications of the doctor, because a competent interpretation of the results is the most important stage of screening. In "MedicCity" only highly qualified specialists with extensive practical experience are engaged in ultrasound diagnostics.

4D ultrasound during pregnancy image quality is similar to 3D. However, here, when receiving information, another factor is connected - real time. In the process of research, you can not only examine the fetus in detail and track its movements, but also record what you see on a disk or other medium. That is, parents will have not just a picture, but a video with the baby even before his birth.

Patients of MedicCity can undergo conventional, 3D and 4D ultrasound in our clinic - by appointment, at a convenient time, without queues.

Pregnancy is a special time in a woman's life, full of both joyful expectations and worries. Without a doubt, seek help from specialists - our highly professional doctors will help you in solving all medical issues!

The interpretation of ultrasound readings is carried out by two specialists - a doctor who conducts an ultrasound examination, and a leading gynecologist. The ultrasound doctor issues a conclusion with the established gestational age and information about the existing pathologies of fetal development or their absence. The gynecologist also assesses the degree of pathologies and decides what to do next for the pregnant woman.

Why do you need an ultrasound during pregnancy

Conducting an ultrasound analysis is caused by the need to examine the child in the womb for its pathologies or their absence.

Early ultrasound is carried out to determine the presence of pregnancy and its duration, the number of fetal eggs. This way of research is useful in that it can reveal an ectopic pregnancy - a dangerous condition that requires immediate medical intervention, up to surgical methods. If, with the help of ultrasound, this pathology is detected in the initial stages, the pregnant woman has the opportunity to avoid surgical intervention.

At the stage first screening (11-13 weeks) the walls of the uterus, the uterus itself and its appendages are studied, and the following indicators of the growth of the embryo are considered:

chorion - it contributes to the development of the placenta;
The yolk sac is an important component for the development of the embryo.

At the next ultrasound helps to identify existing pathologies, such as, the threat of miscarriage,. It is the timely diagnosis of deviations that helps to eliminate them and avoid subsequent complications.

At the second screening a number of indicators are examined, which then will need to be deciphered:

the uterus, fallopian tubes and the condition of the ovaries are examined;
fetometry is carried out, with the help of which the sizes of individual parts of the fetus are established and their compliance with the gestational age is assessed;
the state of the organs that connect the child with the mother (placenta, umbilical cord) is studied, the structure of the amniotic fluid is assessed;
the state of the internal organs of the child is analyzed.

On this ultrasound, some pathologies can be traced, such as oligohydramnios or too low attachment of the placenta. Thanks to ultrasound, it is possible to establish both curable and incurable fetal defects.

Third screening carried out for the following purposes:

identification of serious fetal malformations that cannot be detected in the early stages;
determination of fetal presentation (gluteal or head);
determination of the body weight of the child;
assessment of the risk of abnormal formation of the brain;
examination for a subject;
evaluation of the fetal heart rate - rapid or rare;
assessment of fetal growth;
assessment of the risk of developing heart defects in the fetus.

On ultrasound in the third trimester, you can already see the baby's lungs and their readiness to work in a normal environment in case of premature birth. In the last screening, great attention is paid to the skull, abnormalities such as cleft palate, cleft lip, etc. are monitored.

On the eve of the birth itself, ultrasound allows you to find out some of the nuances that may be important for the birth process itself. In particular, only thanks to ultrasound it is possible to see the entwined umbilical cord with 100% accuracy, and this is a very important aspect in the birth process, because it can become a threat both to the health of the baby and to his life.

Some pregnant women are prescribed Ultrasound more often than expected. These pregnant women include those who have: diabetes mellitus, blood and lymph diseases, negative Rh factor.

Deciphering fetal ultrasound

Already starting from the 11th week of pregnancy, the detection of fetal pathologies is allowed. In Russia, two main standard protocols are defined, according to which data is decrypted.

These studies are conducted at 11-13 weeks of pregnancy and at 19-22 weeks. In order to more accurately decipher the data, you need to know the norms of fetal development at different stages of gestation.

At this time, a detailed examination of the collar zone of the fetus is carried out - the area between the tissues and the skin in the neck area. The thickness of the collar zone is abbreviated as TVP. Normally, TVP should not exceed 2.7 mm.

The nasal ossicle is another parameter that is being investigated at this time. Normally, the bone should be visualized.

Another indicator that is measured at this stage is KTR (coccyx-parietal size of the fetus).

For a kid at 11 - At week 13, the KTR is considered to be within 45-80 mm.

In addition to KTR, the doctor evaluates the biparietal and fronto-occipital dimensions of the fetus. The first is the distance from one temple of the head to another and is normally up to 28 mm. The second - the distance from the frontal to the occipital bone - normally does not exceed 31 mm.

* Percentile is a descriptive statistics term. The average value is indicated in the "50th percentile" column, in the "5th percentile" and "95th percentile" columns - the minimum and maximum allowable values, respectively.

Separately, the doctor evaluates the diameter of the fetal egg ...

... and calculates the heart rate (HR).

If the indicators do not correspond to the norm, the pregnant woman is recommended to undergo a consultation with a geneticist and an additional examination.

Second fetal screening

The norms of fetal development in the second trimester are shown in the table:

If there are any changes in these indicators, deviations in the development of the child in the womb can be assumed. By the way, during the second screening, the fetus is seen much better than during the first one, so the doctor can judge not only about genetic abnormalities, but also about other defects (they are recorded separately in the examination protocol).

As part of the third screening, such baby parameters as height, weight, biparietal head size, hip and chest length are evaluated. The norms of the listed parameters are described in the table above. Below are the normal indicators of BDP and LZR.

During the 3rd screening, the doctor evaluates the condition of the placenta, its degree of maturity and thickness. The placenta is the link between a mother and her baby. It remains for the entire duration of pregnancy. It exists in order to nourish the child with the necessary nutrients.

IAI norms (amniotic fluid index)

Fetal size by week of pregnancy

Each trimester has its own research and measurements. The interpretation of ultrasound indicators helps to establish the size of the child at the time of its development.

Below is a table of the size and weight of the fetus by week. It is worth saying that the readings are average, may differ from reality. This is especially true in the last months of pregnancy.

A newborn can be born with a weight of 2300 grams, or it can be born with a weight of 4500 grams. And in fact, and in another case, he can be absolutely healthy.

Term in weeks	Height in cm	Weight in g
	6-9	11-16
	9-11	16-21
	10-12	20-30
	12-14	30-50
	14-16	50-75
	16-18	75-115
	18-20	115-160
	20-22	160-215
	22-24	215-270
	24-26	270-350
	26-28	350-410
	28-30	410-500
	30-32	500-600
	32-34	600-750
	34-36	750-850
	36-37,5	850-1000
	37-39,5	1000-1200
	38-40	1200-1350
	39-40	1350-1500
	40-41	1500-1650
	41-42,5	1650-1800
	43-44,5	1800-1950
	44,5-45	1950-2100
	44,5-46	2100-2250
	46-46,5	2250-2500
	46,5-48	2500-2600
	48-49	2600-2800
	49-50	2800-3000
	50-51	3000-3200
	51-54	3200-3500

Ultrasound examination of the placenta

Ultrasound of the placenta determines its size, echostructure, development.

When the placenta may be hyperthick:

at detachment;

with Rhesus conflict;

with dropsy of the embryo;

mild thickening may occur in women with diabetes mellitus;

if in the process of bearing a pregnant woman suffered an infectious disease.

The placenta has the same functions as the human body - it tends to be born, mature and fade. All these moments are absolutely natural. But if it happens, it is a pathology.

Exists 3 degrees of maturity of the placenta:

Idegree of maturity. Until the 30th week of pregnancy, the placenta is at the zero degree of maturity. At this time, it increases in size, nourishing the baby with all the useful elements. The structure is normally homogeneous, smooth. After 30 weeks, specks and waves may appear on the placenta, which indicate the beginning of the maturation of the placenta. If the appearance of these signs is detected earlier, then this process is called "premature aging of the placenta." In some cases, women are prescribed medication. The first degree should last up to 34 weeks.

IIdegree of maturity. This degree comes from 34 to 37 weeks. It already looks more prominent, wavy, the ultrasound shows an echostructure with speckles. If the second degree is indicated earlier than 34 weeks, then more detailed diagnostics and fetal CTG will need to be performed. All tests as a whole will show if there are any fetal pathologies. If the child suffers from hypoxia, outpatient treatment may be prescribed.

IIIdegree of maturity. This degree is established already at full-term pregnancy. The placenta is preparing for childbirth and its functions are reduced, its natural aging occurs. There are large waves and salt deposits all over the surface.

If the placenta does not correspond to its term, then there is a risk of premature birth.

Ultrasound of the umbilical cord of the fetus

An umbilical cord passes between the placenta and the fetus, which connects them together. Ultrasound examination determines the number of vessels in the umbilical cord, their condition, structure.

The umbilical cord has two arteries and one vein that feed the fetus. The vein saturates the fetus with oxygen, and the arteries serve as the output of processed products.

The length of the umbilical cord should normally be at least 40 cm.

Ultrasound allows you to see the entanglement of the umbilical cord, if any. Establishment of entanglement is not yet a reason for a caesarean section.

Ultrasound examination of amniotic fluid

In the process of ultrasound, the amniotic index is calculated, which indicates the amount of water. The index is measured according to a certain scheme:

the uterus is divided into two perpendicular strips, one goes along the navel line, the other longitudinally;

in each sector, measurements of the free distance between the fetus and the wall of the uterus are made;

indicators are summed up.

Normal values at week 28 will be AI readings of 12-20 cm. An increase in the value may indicate polyhydramnios, a decrease in indicators, respectively, of oligohydramnios.

* Percentile is a descriptive statistics term. The average value is indicated in the "50th percentile" column, in the remaining columns - the minimum and maximum allowable values, respectively.

In any case, this or that deviation indicates violations in the blood supply to the placenta.

Ultrasound of the uterus during pregnancy. The size of the uterus by week of pregnancy

When conducting an ultrasound of the uterus, its size is measured, its appearance is examined for the presence of myomatous nodes, muscle tone, and the thickness of the walls of the uterus is measured.

Before pregnancy, the thickness of the walls of the uterus is 4-5 cm, by the end of pregnancy, the uterus is stretched, its walls become thinner and are approximately 0.5-2 cm.

The normal length of the cervix is 3.5-4.5 cm.

Marianna Artemova, obstetrician-gynecologist, specially for site

The introduction of the ultrasound method has significantly expanded the diagnostic capabilities in modern gynecology. With the spread, the requirements for its implementation have also increased, in particular, ultrasound of the uterus. In the course of numerous studies and observations, the indications and possibilities of this method have been significantly expanded.

Existing research methods are quite simple and have no contraindications.

Ways

Pregnancy period, weeks	Length, mm	Width, mm	The height of the fundus of the uterus, cm
8	71-82	42-53	8
10	92-103	55-64	9
12	111-123	65-74	11
16	135-145	76-85	14
18	171-182	92-102	17
20	191-203	113-121	19
22	208-215	122-141	22-23
24	220-231	139-158	23-25
26	245-252	159-172	25-27
28	271-279	179-182	27-30
30	302-312	180-193	27-31
32	318-324	192-201	30-32
34	331-342	198-207	31-35
36	338-345	211-224	32-36
38	351-363	228-241	35-38
40	372-381	247-261	33-37

ovarian ultrasound

The study of the appendages, as a rule, is carried out in a complex examination of the female reproductive system. Preliminary preparation for ovarian ultrasound is not specific and is described in the section “How to prepare for uterine ultrasound”.

When choosing a research method, preference should be given, since visualization of the ovaries is not always possible with a transabdominal examination.

With regards to the timing of the diagnosis, ultrasound of the uterus and ovaries differs slightly.

The first phase of the cycle is considered the optimal period; it is also possible to make a diagnosis in the middle of the cycle (, control of the ovulatory process). If the study is carried out in the second phase of the cycle, the possibility of visualization of follicular cysts, which can be falsely mistaken for true cysts, should be considered.

Therefore, so that the decoding of the ultrasound is not erroneous, it should be repeated in the first half of the cycle.

Examination of the ovaries is done either for preventive purposes during the passage of a gynecological examination, or if any pathology is suspected

Ovarian sizes

It has already been mentioned that ultrasound of the ovaries in women can be performed by any of the methods presented, regardless of the day of the menstrual cycle. The size of the appendages is in a wide range and depends on the patient's age, history, day of the menstrual cycle, oral contraceptives.

Outwardly, the ovaries have an ovoid shape, smooth clear contours, the internal structure is significantly variable depending on the phase of the cycle. Follicles can be determined as early as 2-4 years of age in girls, their number also changes with age.

The volume of the ovaries is calculated by the formula:
V= a*b*c*0.5, where
a, b, c - length, width, thickness in centimeters, 0.5 - coefficient.

Girls

The sizes of the ovaries at a young age are as follows:

During the reproductive period

Postmenopausal

It should be borne in mind that the ovaries should be equal in size before the onset of menarche and during menopause, and an increase in the volume of one of the ovaries by more than twice compared to the second indicates malignancy and requires a more detailed examination.

Interpretation of ultrasound results

The ultrasound method has expanded non-invasive diagnostic capabilities for most diseases of the female reproductive system.

A properly conducted study and a correctly executed conclusion carry comprehensive information about the reproductive system.

The volume of detected pathology is extremely large, so let's consider the main ultrasound diagnostic criteria.

The causes of such a disease may be inflammatory diseases of the genital organs, adenomyosis, uterine fibroids, abortions, or a genetic predisposition

Enlargement of the uterus

In addition to the previously discussed physiological causes of an increase in the size of the uterus, there are a number of reasons for its pathological increase:

In this case, there is a slight increase in the uterus, an ectopically located fetal egg is visualized.

This method of examination is the only method for determining an ectopic pregnancy.

Almost always accompanied by an increase in the size of the uterus due to rounded heteroechoic formations of the myometrium.
On ultrasound, it has a similar picture with myoma, however, the nodes often have reduced echogenicity and cystic components in the structure of the node.
Internal endometriosis is characterized by an increase in the anteroposterior size, uneven wall thickness, and the presence of a hyperechoic formation in the myometrium.
Hyperplasia of the myometrium only in advanced cases leads to an increase in the linear dimensions of the uterus.

Reduction in the size of the uterus or its absence

Condition after surgical removal of the uterus
Aplasia or hypoplasia of an organ
Volumetric formations of the small pelvis, which lead to displacement of the uterus or atrophic processes in it.

Enlargement of appendages

The ovaries can increase while maintaining the internal structure, as well as with its violation:

Multifollicular ovaries. Bilateral increase due to numerous follicles (against the background of hormonal dysfunction).
Polycystic. More often a bilateral pathological process, ultrasound does not show a change in the structure of the appendages throughout the entire cycle.
Endometriosis. This disease is difficult to diagnose by ultrasound, the process is often bilateral.

gynecological disease. It can cause ovarian cysts, menstrual irregularities, and even infertility.

Oophoritis. The inflammatory process more often covers both appendages, echogenicity decreases, and the shape approaches spherical.
Ovarian pregnancy is a rare pathology, is unilateral.
Adnexal torsion is an acute unilateral process, the ultrasound picture is nonspecific. Requires laparoscopic follow-up examination followed by surgical treatment.
Tumors. All volumetric processes, both benign and malignant, lead to a unilateral significant increase in the volume of the appendage. The ultrasound picture is heterogeneous.

Lack of visualization of the ovaries can be observed after surgical removal of the organ from one or both sides, with agenesis or aplasia. In a transabdominal examination, visualization difficulties are often associated with insufficient filling of the bladder.

A large number of gynecological pathologies require the active use of modern diagnostic methods, including the ultrasound method, at all stages of diagnosis and treatment.

During pregnancy, any woman will have to do at least three ultrasounds. This is really necessary for the timely diagnosis of serious fetal lesions, developmental disorders and uterine pathology, for example:

chromosomal disease,
anomalies and malformations,
placental abruption,
chorion detachment,
frozen pregnancy,
fetoplacental insufficiency,
intrauterine hypoxia,
developmental delay,
increased tone of the uterus,
fibroids,
ectopic pregnancy.

When conducting an ultrasound examination, if there is any suspicion of a pathology in the field of gynecology, it is necessary to examine not only the cavity and cervix, but also the ovaries and their appendages.

The treatment and diagnostic center "Kutuzovsky" offers you to go for an ultrasound of the uterus and fetus with experienced qualified specialists in obstetrics and gynecology using modern equipment. This will allow timely identification of possible deviations in the development of the fetus or prerequisites for a possible complication of the course of pregnancy or the threat of its termination.

Fetal ultrasound by week

Almost all stages of fetal development can be seen using ultrasound. In the early stages, at 5-8 weeks, ultrasound is done in gynecology to confirm the very fact of pregnancy, the place of attachment of the fetal egg and the viability of the embryo.

At 10-12 weeks, the development of pregnancy is confirmed. At this time, you can determine the expected date of birth. Some chromosomal diseases and complications of the course of pregnancy from the uterus and placenta are also diagnosed.
At 17 weeks, ultrasound shows the rudiments of teeth, all organs and systems are fully formed. Examination shows coordinated fetal movements.
At 20 weeks, you can already determine the sex of the unborn child.
At 21 weeks, hearing is finally formed. Now your unborn child can fully hear the surrounding sounds, conversations and music. The size according to ultrasound from the crown to the heels is about 26.5-26.8 cm.
On ultrasound at 20-22 weeks, the location of the placenta and the presence or absence of its pathology are specified, the size of the fetus is measured, and malformations are diagnosed.
At 30-32 weeks, an additional study of fetoplacental blood flow is usually carried out using dopplerography, and the motor activity of the unborn child is assessed.

Ultrasound of the fetal heart

With ultrasound, the structure and functioning of the heart of the unborn baby is necessarily studied for the timely diagnosis of possible pathology, developmental anomalies and congenital malformations. The fetal heartbeat, its reaction to movement and any external influences are necessarily studied in each study. Especially exciting for many parents is the moment when they first see on the screen of the ultrasound machine how the heart of their child beats.

It is recognized as the most informative and absolutely safe method of monitoring the course of pregnancy. This procedure also allows for a period of 5 weeks - doctors see a formed fetal egg, and at 6 weeks - a full-fledged embryo.

Timing

Throughout the entire period of bearing a child, a woman is prescribed an ultrasound examination three times at exactly the agreed time:

10-14 weeks;
20-24 weeks;
30-34 weeks.

Despite the fact that the safety of ultrasound has been confirmed, gynecologists do not recommend "getting carried away" with this procedure - it is advisable for pregnant women to undergo it no more than 4 times during the entire period of pregnancy, although additional visits to an ultrasound diagnostician may be prescribed.

What does ultrasound show during early pregnancy?

Women can have two types of ultrasound:

transabdominal. In this case, the patient must prepare for the procedure - 30 minutes before it starts, you need to drink about half a liter of water (non-carbonated) and not go to the toilet. That is, the ultrasound procedure is performed with a full bladder.
. This type of examination is carried out without any preliminary preparation, the bladder must be empty. The sensor from the ultrasound machine is inserted into the vagina, after which a special cover or condom with a gel is put on it.

The ultrasound examination procedure in the 1st trimester of pregnancy lasts a maximum of 30 minutes, the doctor takes all the necessary measurements, records the data obtained in the protocol - this document will help the gynecologist determine how normal the pregnancy is and whether the fetus is developing correctly.

The considered diagnostic procedure in the first trimester of pregnancy is carried out for:

determining the location of the fetal egg - a normal pregnancy may develop, and perhaps the formation / fixation of the fetal egg in the fallopian tubes;
diagnosing a multiple pregnancy, if the doctor sees only the bottom of the fetal egg, then a singleton pregnancy is diagnosed;
assessment of the structure of the embryo, the size of the fetal egg;
identification of pregnancy problems - for example, a specialist will pay attention to, can diagnose reversible or irreversible spontaneous abortion or.

In addition, an ultrasound examination in early pregnancy allows not only to record the fact of conception, but also to identify various diseases of the internal genital organs - for example, it is with the help of ultrasound that tumor formations in the ovaries are most often diagnosed, a septum inside the uterus or the bicornuity of this hollow organ are detected.

Deciphering ultrasound of the 1st trimester: norms and deviations

Ultrasound diagnosis of uterine pregnancy

If a specialist conducts an ultrasound examination in the early stages of pregnancy, then he will be able to see the fetal egg in the upper part of the uterus, and it looks like an oval (in some cases rounded) dark spot. If the pregnancy is multiple, then the doctor, respectively, will see two / three and so on such dark spots.

The transabdominal type of the study under consideration makes it possible to establish the onset of uterine pregnancy at the earliest possible date - 5 weeks, when the absence of menstruation from the estimated start date lasts about 14 days. At this time, the size of the fetal egg will be at least 5 mm in diameter.

Transvaginal ultrasound examination of the uterus is more informative - the doctor can confirm the fact of pregnancy for a period of 4 weeks, that is, after 6 days of delayed menstruation. The diameter of the fetal egg in this case will be 3 mm in diameter, which is normal.

As for the visualization of the embryo, with transabdominal ultrasound this can be done for a period of 6 weeks, with transvaginal ultrasound - 5 weeks, moreover, the embryo will look like a white spot in the cavity of a dark formation. You can listen to clear contractions of the heart (beat) of the embryo for a period of 6 weeks.

If a woman has a normal menstrual cycle, that is, there are no usual delays or early onsets, then transvaginal ultrasound can be performed at 6 weeks of pregnancy. Such an examination does not belong to the “mandatory program” and is carried out only at the request of the patient. If the menstrual cycle is unstable and the delay in menstruation cannot be accurately determined, then the estimated gestational age is set by the uzist.

How to estimate the size and growth of the fetal egg / embryo

This data is based on two indicators:

coccygeal-parietal size;
mean internal diameter of the ovum.

For a specific gestational age, there are established indicators (conditional, of course) of the average internal diameter of the fetal egg, which are included in the program of ultrasound machines. These data automatically establish a practically exact gestational age, but an error of 6 days in the direction of increase and decrease is allowed.

The term "coccygeal-parietal size" means the length of the embryo's body from head to tailbone, and this indicator is measured very first. It is by this size that you can more accurately determine the gestational age - the error is only 3 days.

Note:if the average internal diameter of the fetal egg is 14 mm, but the doctor cannot visualize the embryo, then experts will talk about a pregnancy that has stopped its development.

The principle of assessing the vital activity of the fetus and embryo

Heartbeat and motor activity are the main indicators that allow a specialist to assess the vital activity of the embryo.

If a transvaginal ultrasound is performed, then already at a period of 6 weeks, the doctor sees the heartbeat of the embryo. If it is within the normal range, then there will be a clear rhythm of contractions, but for each period of pregnancy they have their own frequency:

6-8 weeks - 130-140 beats per minute;
9-10 weeks - 190 beats per minute;
the entire period before childbirth - 140-160 beats per minute.

Heart rate should be measured without fail, since it is this indicator that allows specialists to determine problems with bearing a child. For example, if the heart rate is sharply increased or reduced, then doctors will place the woman at risk for miscarriage.

Note:if the ultrasound confirmed that the length of the embryo in the coccygeal-parietal size is 8 mm, but heart contractions are not detected, then the specialist may suspect an undeveloped pregnancy. In this case, a re-examination is carried out after 7 days and only after that a final diagnosis is made.

As for the motor activity of the embryo, it can be seen already at 7-9 weeks of pregnancy. At first, the embryo simply moves the whole body (chaotically), a little later already types of flexion and extension of the body. Doctors are well aware that the embryo rests very often and therefore the indicator of motor activity cannot be the main criterion in assessing its vital activity.

Assessment of the structure of the embryo

The doctor should pay special attention to the structure (anatomy) of the fetus during the ultrasound examination in the 1st trimester of pregnancy. For example, already at a period of 12 weeks, a specialist can diagnose fetal pathologies that will not be compatible with life - for example, a hernia of the spinal cord, absence of a brain, and abnormal development of the skeleton.

The specialist will definitely evaluate the collar space and determine its thickness - according to this indicator, it will be possible to identify diseases of the fetus of a chromosomal nature. An increase in the collar space by 3 mm is allowed, but large indicators will indicate the presence of chromosomal pathology in 80% of cases.

Modern medicine has the latest generation of ultrasound equipment, which makes it possible to diagnose abnormalities in the structure of all systems and organs of the unborn child as early as 12 weeks of pregnancy. Such an accurate diagnosis allows parents to make a choice - to leave the pregnancy or terminate it for medical reasons.

Study of extraembryonic structures

When conducting an ultrasound examination in the 1st trimester, a specialist will examine the yolk sac, amnion and chorion, and their assessment is mandatory.

Yolk sac- a structure that performs important functions - hematopoietic and nutritional, moreover, throughout the entire period of pregnancy. It is possible to determine this sac as early as 5 weeks of pregnancy, by the 10th week of pregnancy its dimensions reach 7 mm, but after 12 weeks of pregnancy it is not possible to determine / identify / assess the state of the yolk sac even with the help of ultrasound - this is the norm.

Doctors have long noted a direct relationship between the size of the yolk sac and the outcome of pregnancy. The fact is that the wrong size of the sac, changes in its shape and walls in most cases are accompanied by a delay in the growth of the embryo.

Chorion- this is the shell of the fetal egg, which consists of villi. Its size (thickness) is equal to the gestational age in weeks, but this rule "works" only in the first trimester. If there is underdevelopment or changes in the structure of the chorion, then the death of the fetus can be accurately predicted. The fact is that the villi of the chorion are very tightly attached to the uterine cavity, and if its structure is changed, then it is simply impossible for the villi to “catch on” - a miscarriage begins.

Amnion- this is a water shell, a sac in which the embryo is located, surrounded by amniotic fluid. Conducting this type of study in the early stages of pregnancy allows the specialist to identify the small diameter of the amniotic cavity, and this will indicate its underdevelopment, which always leads to problems with the development of pregnancy. But an increase in size will indicate the presence of intrauterine infection.

Identification of pregnancy complications

In the 1st trimester of pregnancy, most often, of all possible pathologies, the threat of abortion is diagnosed. Moreover, it is with the help of the study in question that the doctor can diagnose this pathological condition at the very beginning of its development - the walls of the uterus will be thickened. Women very often feel themselves, as this condition is accompanied by. If the diagnosis has taken place, then doctors carry out therapeutic treatment, which is designed to preserve the pregnancy. But if there was a detachment of the fetal egg, the woman has from the vagina, then the diagnosis will be made "started spontaneous abortion."

Important! If the miscarriage has already taken place, then the patient must undergo an ultrasound examination to determine whether the remnants of the fetal egg remain in the uterine cavity. And if such remnants are revealed, then the woman is sent for the scraping procedure..

With the help of this study in the early stages of pregnancy, the doctor can diagnose:

Yellow body cyst. This is a fairly common formation, which will be characterized by the presence of thick walls, and its structure will be assessed as heterogeneous - in principle, this is considered the norm. The corpus luteum cyst is prone to self-resorption and completely disappears by the end of the first trimester.
bubble skid. This complication is extremely rare - 1 case per 2,000 - 3,000 pregnant women. A very dangerous condition, which is characterized by a pathological lesion of the chorion. Bubble skid always leads to the death of the fetus, since the chorion turns into vine-like formations that destroy the fetal egg.

An ultrasound examination in the first trimester of pregnancy allows you to identify any pathological changes in the fetal egg and embryo - for example, at a gestational age of 12 weeks, the doctor can diagnose a cleft lip and other facial defects in an unborn child. The problem is that the type of research under consideration in early pregnancy is carried out exclusively at the request of the woman, and therefore early identification of problems with the fetus, when it is still possible to make a decision about the advisability of carrying it, is not always possible.