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Second-trimester fetal ultrasonography: what is the test?

Second-trimester fetal ultrasonography: what is the test?

Second-trimester fetal ultrasonography is the one performed between 20 and 24 weeks of gestational age (or the beginning of the 21st to the end of the 24th week) of pregnancy. It is an ultrasound examination that consists of evaluating the structures of each segment of the fetus (head, neck, spine, chest, abdomen, external genitalia and extremities) and of the amniotic fluid, umbilical cord and placenta with color Doppler .

Color Doppler is a feature used to measure blood flow in certain maternal and / or fetal vessels. Uterine arteries and the umbilical artery are analyzed in the second trimester ultrasound.

Indications

Every pregnant woman must perform the first and second trimester ultrasound ultrasound. This is a right that you are assured, regardless of age, how many children she has had, whether all are healthy or not, or any other personal or family factor.

In the second trimester of pregnancy, ultrasound can be done to :

  • Monitor the growth of the fetus
  • Determine the sex of the baby
  • Look at the placenta to check for problems such as low insertion placenta and placenta detachment
  • Examine the fetus for malformations or flow problems blood
  • Monitor amniotic fluid levels
  • Determine if the fetus is receiving sufficient oxygen
  • Diagnose problems with the ovaries or uterus, such as tumors of pregnancy
  • Measure the length of the cervix
  • Orient other exams, such as amniocentesis
  • Confirm a possible intrauterine death

Contraindications

The performance of Doppler morphologic USG has no contraindication. Ultrasonography is a non-invasive examination that is part of the prenatal routine, offering no risk to the patient and the baby.

In cases of gestational age less than 18 weeks, there is a decrease in the sensitivity of the test.

Exam Preparation

There is no special care to take the exam. There is a protection of the clothes of the patient so as not to get dirty with the contact gel, and ideally she is fed, to present greater fetal movement.

How it is done

Arriving at the laboratory, the patient is oriented to lie down with the belly facing up and the back raised (approximately 45 degrees). The doctor will then spread a clear, water-based gel on the pregnant woman's belly and pelvis. This gel is used to facilitate the transmission of sound waves.

A hand-held probe is used on the patient's belly and pelvis, which will emit and pick up sound waves and create images on the ultrasound machine. The ultrasound device picks up the sound waves that are emitted by all parts of the uterus, including baby's movements. These echoes are imaged and displayed on a monitor, allowing the physician to examine all the characteristics of the fetus, in addition to the uterus, ovaries and cervix.

Ultrasonography images show the baby moving, as well as being able to hear your heart rate.

In the second trimester, the transvaginal assessment of the cervix is ​​also done. This is a measure of uterine cervix length through transvaginal USG examination. At this time of the examination, a probe is inserted into the vaginal canal of the pregnant woman, so that parameters of the cervix that indicate risk of prematurity are evaluated. The lower the cervix, the greater the risk.

Examination duration

The duration of the examination is 30 to 50 minutes, depending on the degree of difficulty of the examination. The duration of the second trimester morphological ultrasonography is always influenced by several factors, such as the fetal position and the patient's biotype.Post-examination recommendations

There is no special recommendation after second trimester morphological ultrasonography. The patient may return to normal activities.

Examination frequency

Second trimester ultrasonography is usually done once during pregnancy. All women should be tested at least once per pregnancy.

Risks

Because it is a non-invasive test, second-trimester ultrasonography does not harm the mother or baby in any way.

Results

After the second trimester ultrasound examination, the information obtained will be interpreted and a written report will be issued, accompanied by photographic documentation of the images obtained. In the report all the findings in the USG are described, such as:

Information on fetal structures analyzed

  • Biometrics
  • Fetal weight
  • Doppler values ​​
  • Gestational age
  • Presence or not of structural abnormalities
  • Fetal growth
  • The result can be delivered after 48 hours of the examination. However, in cases where the pregnant woman needs the results urgently, they can be available in about 30 minutes.

Normal results

Information collected on second trimester ultrasonography is interpreted according to specific reference values ​​of the "

Fetal Medicine Foundation " for single-fetus pregnancies. Other specifications will be evaluated according to clinical gestation data, since reference curves are standards that do not fit all populations. Regarding the analyzed structures, the normal results will indicate the absence of malformations. The risk of prematurity is also shown in the second trimester USG, based on the length of the cervix - if it is greater than 25 mm the risk of preterm birth is low.

Abnormal results

An altered outcome is presence of fetal malformation (deviation from normal fetal anatomy). The patient and her doctor are aware of the outcome and discuss the best course of action - whether more specific tests need to be done and what follow up is required.

In cases of change in the length of the neck (short neck), there is a greater risk for prematurity. Patient and physician should define what the follow-up will be.


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