Obstetric
Ultrasound Services
An obstetric ultrasound can provide insight into your baby’s health and growth. For a more in-depth look at your baby’s development, at Valley Perinatal we offer both 3D and 4D state-of-the-art obstetric imaging. Every screening is completed by ARDMS certified sonographers who are highly specialized and fully trained using the latest digital ultrasound technology. Your results will be reviewed immediately on-site by one of our board certified physicians.
What Happens During An Ultrasound?
No special preparation is needed. The pregnant mom lies on a table. The room is usually dark so the images can be seen clearly on the computer screen. A technician (sonographer) trained in ultrasound imaging will spread a clear gel on the abdomen. This gel helps with the transmission of the sound waves.
The sonographer will move a small “wand” (a transducer) over the gel. The transducer emits high-frequency sound waves and a computer measures how the sound waves bounce back from the body. The computer changes those sound waves into images.
The prenatal ultrasound is painless. A slight pressure on the belly may be felt as the transducer is moved over the abdomen. If pain or lightheadedness is felt, the sonographer should be informed, and a change in position or taking a short break may help.
Sometimes an ultrasound test done through the vagina (called a transvaginal ultrasound) provides better imaging, such as early in the pregnancy when the uterus and ovaries are better seen from that angle, or to improve imaging of the baby’s anatomy, or the maternal cervix.
Some ultrasounds can show the fetus in three dimensions, like a photograph (a 3D ultrasound), and sometimes show movement (a 4D ultrasound). 3D/4D ultrasound is routinely done at Valley Perinatal to provide the optimal images. 3D/4D ultrasound is very helpful in checking for birth defects.
Sometimes one of our physicians will request additional images or come in during the ultrasound. Consultations are frequently arranged after the ultrasound to discuss ultrasound results or medical problems.
Ultrasounds may be done to check the size of the fetus, the fetal heart activity, features of anatomy after 10 weeks, and the mother’s uterus and ovaries. The ultrasound may be done by a vaginal approach called “transvaginal”, especially for pregnancies under 10 weeks, or an abdominal approach later in the first trimester. Both methods may be used depending on the technical needs for good imaging.
A nuchal translucency (“NT”) ultrasounds screens for fetal genetic or chromosomal abnormality. This is typically done between 11 and 13 weeks, and may be done in conjunction with a maternal blood test for fetal chromosomal abnormality, also known as the first trimester genetic screen.
A uterine artery doppler screen may be done after 10 weeks to asses a pregnant patient for risk of developing high blood pressure problems later during the pregnancy.
Ultrasounds used for a detailed anatomy survey of the baby are typically done between 18 and 22 weeks of pregnancy, but may be done as early as 16 weeks, or at any time after 16 weeks when there is an need to examine the baby’s development. This ultrasound looks at the development of the baby from “head to toe”, and may take between 30 minutes to 60 minutes to complete.
When the ultrasound is conducted during mid-pregnancy, the cervical length is also assessed with through a “universal cervical screening” for assessing the risk of preterm labor or delivery. When the cervix is “long”, it provides some reassurance that the cervix will not prematurely open. A “short” cervix is associated with increased risk for preterm delivery, and may be treated with medications or surgery in an effort to avoid delivering too early in the pregnancy. The cervical length is optimally measured with a vaginal approach during the ultrasound, which has been shown to be safe. In some cases abdominal ultrasounds can obtain the same information when there is a full bladder and good visualization of the cervix deep in the pelvis.
Ultrasounds may be needed to check the baby’s growth periodically, or to recheck growth and anatomy. These ultrasounds are usually of shorter duration. The length of time between ultrasounds varies according to the medical problems.
Fetal well-being testing may involve ultrasounds to asses the amount of amniotic fluid in conjunction with a nonstress test (NST) which monitors the fetal heart rate. These results can also be achieved through an ultrasounds to assess the biophysical profile once a week in addition to a weekly NST.
The biophysical profile (BPP) involves an ultrasound assessment and searches for fetal movement, fetal breathing movements of the diaphragm, and measures the amount of amniotic fluid.
3D Obstetric Ultrasound
3D Obstetric Ultrasound
Like a 2D ultrasound or sonogram, a 3D ultrasound involves taking three-dimensional digital images of your baby in utero. These images can be used to monitor fetal growth, organ development, and learn the baby’s sex. Facial features, umbilical cord, placenta, and other features, can be more clearly examined, giving your doctor a better picture of your baby’s development. This type of procedure is painless and does not require any special preparation by the patient.
While a 3D ultrasound may be medically necessary for diagnostic purposes, you should always talk to your doctor or perinatologist to find out if a 3D ultrasound is necessary. The best time to have a 3D ultrasound is in your third trimester, between 24 and 34 weeks. A 3D ultrasound can be performed at any time during pregnancy, but the images produced will be clearer during the third trimester of pregnancy.
3D ultrasounds follow the same procedures as standard 2D ultrasounds. A transducer placed on top of the belly sends out sound waves that get interpreted into images by a computer. A specific 3D ultrasound probe, special software, and more specialized technician training are required. 3D ultrasounds are safe for mom and baby just like 2D ultrasounds.
For an abdominal ultrasound, you’ll lie down and a technician will put a certain gel on your belly. This helps carry the sound waves. Then the technician will hold a probe against your belly and move it around to get an image. A 3D ultrasound takes multiple two-dimensional images of your baby from various angles. These images are combined using a computer program to create a three-dimensional image.
4D Obstetric Ultrasound
4D Obstetric Ultrasound
Most mothers will have at least one ultrasound performed in a medical setting during the course of their pregnancy. What’s also true of most mothers is that a two-dimensional ultrasound is the standard. This test provides outlines and flat images that give doctors and families views of the baby’s internal organs, like the heart or kidneys, to make sure that everything is developing properly. As imaging technology becomes more advanced and widely available, ultrasounds in three and four dimensions are possible. In most cases, 4D ultrasounds are considered optional and not medically necessary. For some high-risk pregnancies, however, a 4D ultrasound could be recommended. If you have the type of pregnancy that would benefit from the level of detail that a 4D ultrasound can provide, Valley Perinatal Services in can help.
A 4D ultrasound is essentially a 3D ultrasound, but with time as the fourth dimension. This means that the images that are taken to form a 3D ultrasound are continuously updated to the point where it’s possible to see the baby moving. The test is performed in the same way that a 2D ultrasound is, with the exception of some differences in equipment, and they have similar levels of safety. Ultrasounds of all types work by using sound waves to form images that are interpreted by a computer. The mother’s belly is coated in a layer of conductive gel, and a sonographer moves a transducer along the skin. The transducer emits ultrasound waves that are reflected off of the structures they encounter, and the strength of the waves and time they take to return to the probe form the basis of the images.
2D, 3D, and 4D ultrasounds are all used for similar functions. All of the tests will capture images that allow doctors to assess the baby’s growth and well-being, see and hear a heartbeat, and locate and assess the placenta if necessary. 3D ultrasounds additionally provide a clearer picture of certain potential anomalies of the face, heart, limbs, neural tube, and skeleton. The addition of video in the 4D ultrasound allows doctors to assess internal movement to detect even further problems. With a moving image, the fetal heart wall or valves can be examined along with the blood flow in various vessels going to and from the heart. 4D ultrasounds are not typically used to diagnose problems, but are used to confirm an unusual occurrence in another test.
While 4D “keepsake ultrasounds” are popular, we recommend that you not get any scans that aren’t medically necessary. Ultrasounds are a safe test with low levels of risk, but ultrasounds should only be performed by trained professionals, especially in high-risk pregnancies, in order to keep the time and intensity of ultrasound exposure to a minimum. The best time to get 3D images of your baby, as well as 4D videos, is between 26 and 30 weeks. Before week 26, there isn’t enough growth under the skin to get a good image of the face; after 30 weeks, the baby is moving into position for delivery, so his or her head might not be visible on images.
It might be the case that an expectant high-risk mother requires a 4D ultrasound for medical purposes. We have seven locations that can assist you with the care and management of your pregnancy. We are ranked in the top one percent of perinatologists in the nation and have specially-trained ultrasound sonographers who focus on the best possible outcome for your pregnancy.
Birth Defects Screening
Birth Defects Screening
Our expert health care providers assess the health of your baby by reviewing results from an ultrasound scan, including low and high-risk birth defects. Early detection of any anomalies can help you become better prepared for the birth of your baby. Our healthcare professionals will work with you to assess or inform you of suspected or known anomalies associated with pregnancy.
1st Trimester (9-13 weeks) - While this test cannot give a definitive answer, it looks at the likelihood of whether your baby might be born with Down’s Syndrome. If the baby is at a high risk, a diagnostic test can then be performed for further information.
Abnormal Biochemical Test
Abnormal Biochemical Test
“AFP”, “Triple”, “Quad” Screen - This procedure screens for different proteins, or biochemical markers, which have been linked to birth defects and abnormalities. This screening tool helps to identify pregnancies that are at a higher risk.
There is no treatment for genetic abnormalities. There is, however, a lot of value in getting testing done to learn about your baby’s potential risk for chromosome abnormalities. Knowledge can do a lot for a family, and perinatologists and other high-risk pregnancy experts like the ones at Valley have a variety of ways to keep parents informed about what could lead to health problems.
Counseling is a good first step for a young family to take prior to any further testing. A genetic counselor will help you figure out what anomalies your baby might be at risk for based on factors in your family and will be able to help make information about those anomalies clear to you. They are experts in inheritance patterns and other risk factors that could lead to early detection and even treatment of some problems. When combined with a blood serum screening, this could give a mother-to-be peace of mind.
If you have a high-risk for genetic disorders, whether because of a family history, a previous child born with a chromosomal anomaly, age, or abnormal ultrasound results, you might opt to get an amniocentesis test. This test takes a small amount of amniotic fluid from the sac surrounding your baby in the womb, and this fluid gets sent to a lab for analysis. The fluid contains fetal cells that can be tested for birth defects connected to chromosomal abnormalities, such as Down syndrome, or neural tube defects
Chorionic Villus Sampling (CVS) is another test that collects samples of genetic material around your baby for lab testing. The difference is where this material comes from. This test takes cells from the placenta where it’s attached to the uterine wall, either through the cervix or abdominal wall. These cells, called chorionic villi, are placental tissue that share the fetus’ genetic makeup, which helps to detect chromosome abnormalities.
Fetal Dating & Growth Scans
Fetal Dating & Growth Scans
A fetal dating scan can help determine the gestational age, or how far along you are during the pregnancy. The fetal growth scan is also used to determine how well your baby is growing and the position in which he or she is in the uterus. During the scan, different measurements of your baby are taken along with observations of their activity inside the womb.
Genetic Screening
Genetic Screening
2nd Trimester (16-22 weeks) - This examination includes an assessment of your developing baby, the uterus, placenta, cervix, and the regions of the ovaries.
Fetal Echocardiography
Fetal Echocardiography
This procedure is similar to the ultrasound as it allows us to have a better look at the structure and function of your baby’s heart while still in the womb. Similar to the ultrasound, the echocardiography uses sound waves to create a picture of the heart that can be analyzed for anomalies.
A fetal echocardiogram (also called a fetal echo) is an ultrasound study of the baby’s heart before birth. A transducer placed on gel applied to the mother’s abdomen is used to send and receive sound waves that create pictures of an unborn baby’s heart. This painless ultrasound test shows the structures of the heart, including chambers, valves, and blood vessels to and from the heart, and how well the heart is pumping blood. The fetal echocardiogram is typically done in the second or third trimester, and more rarely at the end of the first trimester, depending on the indication.
The person doing the ultrasound is a highly trained sonographer who will move the transducer or “wand” around to get pictures of the heart from different angles. The ultrasound typically is scheduled for 60 minutes for one baby, and more time if twins or higher order multiples. Sometimes, the position of the baby can make it hard to see the heart, and the test may take longer or necessitate a followup ultrasound appointment. The results are typically provided in a consultation following the ultrasound, and a report provided to the primary obstetrician.
A fetal echocardiogram is primarily used to diagnose two types of conditions:
- Congenital heart defects: “Congenital” means the defect is present at birth. Heart defects are the most common congenital defects. These defects affect the structure of a baby’s heart and can change how it works. There are hundreds of types of congenital heart defects. The majority of serious structural heart defects can be detected before birth. The detection of heart defects before birth may lead to early lifesaving care in the newborn.
- Heart rhythm abnormalities: A heart rhythm abnormality (medical term arrhythmia) is an abnormal heartbeat pattern. A baby’s heartbeat can be too fast, too slow, or it may be irregular. An arrhythmia can cause the heart to pump less blood to the rest of the body than it should. Some arrhythmias are harmless and others can damage the heart. In some cases treatment is done with medications before birth when a serious arrhythmia is found.
- Family history of childhood heart problems
- Mother has a medical condition such as diabetes that may affect the baby’s heart development.
- The baby has a genetic disorder which is associated with increased chance of a heart defect, such as Down syndrome.
- An abnormality of the baby’s heart is suspected on fetal anatomy ultrasound during the pregnancy
- The baby’s heart is not seen well on fetal anatomy ultrasound.
The fetal heart is small, and still developing, so some holes in the heart walls, minor valve abnormalities, and narrowing of a small area of the aorta may go undetected. Fortunately most of these abnormalities that are difficult to find will not result in difficulties at birth.
A fetal echocardiogram is a safe procedure without any known significant risks for pregnant mom and her growing baby.
Doppler Studies (All Types)
Doppler Studies (All Types)
Doppler ultrasound is used to look at the blood flow of your baby to check on his or her health. Different types of doppler tests are used based on medical indications and status of the pregnancy.
