How to find out if the fetus is developing correctly, are there any deviations, how are the internal organs of the crumb formed? Answers can be given (when the period your pregnancy has reached is 12 weeks) Ultrasound. Screening allows you to evaluate the development of the fetus, gives a clear picture of the genetic and chromosomal features of the unborn baby. This makes it possible to determine the presence or absence of anomalies.
Ultrasound on a 12-week period
Basically, the procedure is performed in two ways: transvaginally (through the vagina using a special sensor) and transabdominally (through the skin of the abdomen). The latter is more common, and the first is prescribed not to all women in the situation, but only to some of them, in cases:
- if the placenta (or chorion) is low attached;
- if there is isthmic-cervical insufficiency, and its degree must be assessed;
- if there are signs of inflammation of the cysts and appendages (in order to accurately establish the diagnosis), or the nodes of the uterine fibroids are very specifically located, and method No. 2 showed little information;
- when evaluating the child’s collar zone or measurements of the right size, which are difficult to make because the fetus is not located as it should, or the subcutaneous tissue of the abdomen is very thick.
The study is conducted as follows: a woman lies bending her legs in her knees; the doctor inserts an ultrasound probe into the vagina , onto which a disposable condom is put on. Usually everything is done with great accuracy, so the pregnant woman does not feel pain.
Transabdominal examination is done in the same position. All air between the sensor and the skin will not be forced out, so incorrect results are possible. To reduce the likelihood of error as much as possible, use a special gel that is applied to the stomach. Gradually move the sensor along the stomach so that you can see the organs of the baby, as well as the uterus and placenta of the mother. Ultrasound is completely safe for the fetus and does not cause him any damage.
How to prepare for an ultrasound
Preparation depends on the method. If transvaginal is used, it is recommended not to use those products that can cause fermentation 1 day before the study: white bread, legumes, cabbage, peas. The intestines must be emptied, otherwise the gases therein will interfere with the examination of the uterus and fetus. If you get a feeling that the stomach is pouting, you can drink the drug Espumisan, which is harmless to the fetus.
Before a transabdominal examination, drink half a liter of water 30 minutes before the start. This is necessary so that there is a full bladder, which will allow you to examine the fetus and evaluate its condition.
12-week baby development
Many of the main organs of the crumbs have already developed, and some small structures continue their formation. On average, a child’s height is 80 mm and weight is about 20 grams. Doctors also note that the fetus eats such features:
- heart contractions are more frequent than in the third trimester, and can be approximately 170 beats per minute;
- the face of the child no longer looks like a tadpole, but acquires human features;
- you can see the eyelids, lobes, a bit of fluffy hair (at the site of the formation of eyebrows and eyelashes);
- most of the muscles have almost already developed, so the fetus moves all the time, and the movements are mostly involuntary and rather chaotic;
- the baby grimaces and squeezes its handles into fists, on the fingers you can see the nails;
- the child has already developed kidneys and an intestine is almost formed, red and white blood cells are observed in the blood;
- both hemispheres of the brain are fully formed, however, “commands” while the spinal cord;
- you can see who it is: a boy or a girl, but since the fetus does not always lie in the way mother and doctors want, you can make a mistake, that's why they talk more about sex in the 16th week.
How to read the results?
Papers with the results of the study you will receive on hand after the screening is done (12 weeks). Decryption of the analysis will be given below.
Starting from the third month it is already clearly visible whether one child or not. Therefore, if two or more are written in the column “number of fruits”, this indicates that you will have twins (triplets, etc.). You can also already find out if the fruits are identical (twins) or if they are twins (heterozygous).
Presentation
This is the part of the fetus that is closest to the birth canal. At 12 weeks, it can be anything: legs, head, or the child is completely diagonal. Finally, presentation is evaluated at 32nd week of pregnancy. If the head is not located at the exit from the uterus, then every possible measure is taken to correct this situation.
Measurement of fetal size (or fetometry)
The transcript of ultrasound is also needed to evaluate the parameters, however, this should be done by a doctor who focuses not only on the numbers, but also on the general situation of the pregnant woman. All norms are identified by specific letters and numbers. Here are the main ones:
- BDP (BPD, BRGP) - this abbreviation refers to the so-called biparietal size, i.e. the distance of the head from one parietal bone. On a period of 12 weeks, an ultrasound scan should show 21 mm BDP.
- The height of the baby is about 8.2 cm, weight should not be less than 17-19 g.
- FML, DLB is the length of the thigh. The norm is from 7 to 9 mm.
- Collar space should not exceed 2.7 mm. By its size, it is determined whether there are any serious illnesses. On average, it is approximately 1.6 mm.
- The term KTR (CRL) denotes the coccyx-parietal size, i.e., the maximum length from the head to the coccyx, the norm is 43-73 mm.
There are also other abbreviations:
- HUM (DP) - shoulder length.
- AC (coolant) - abdominal circumference.
- ABD (J) - diameter of the abdomen.
- MS is the size of the heart.
- OG - head circumference.
For all these parameters, 1 screening during pregnancy allows the sonologist to determine how the baby's structures grow and develop. If the measurements taken are less than the norm, then the total totality assesses how they decreased: proportionally and simultaneously or not. If only a little does not coincide, then there is no reason for panic. Perhaps the deadline was incorrectly determined, and in fact, now is only the 11th week. And perhaps the baby has such growth due to short parents.
They also find out if there are any defects in the development of internal organs, whether there is an entanglement of the umbilical cord, what is the frequency of the heartbeat (the norm is from 150 to 174 beats per minute), whether there are deviations in the characteristics of amniotic fluid.
Reading the conclusion of an ultrasound, a pregnant woman may encounter concepts such as “polyhydramnion” and “oligohydramnion”. What is it and is it worth it to be afraid of something? There is nothing wrong with these words. This is just a determination of the amount of those waters in which the fetus floats: if there are more of them than necessary, a polyhydramnion is fixed, if less, an oligohydramnion. Often this indicates some kind of violation: intrauterine infection (IUI), impaired renal function, central nervous system. They also see if the waters are cloudy. If so, then this is a clear sign of infection.
The main rule when detecting deviations from the norm is not to panic, but to go to a specialist.
Can there be deviations from the placenta?
Ultrasound shows where the "child's place" is attached, how mature it is, whether there are pathologies and more. The best option is to attach to the back of the uterus. But the placenta can "cling" to the front, and even to the bottom. However, it should not overlap the internal pharynx of the uterus. This condition is called the chorion, or central placenta previa. In this case, they monitor whether the situation will change, and if not, then they perform a cesarean section for delivery. If the pharynx is not completely blocked, this is called incomplete presentation; childbirth is carried out in the usual manner.
If the placenta "settled" near the exit (less than 70 mm), then this is a low previa. Since it can become a threat of bleeding, a less active regimen is recommended for pregnant women. Then observe whether the placenta rises. If this happens by 32-36 weeks, then there will be no threat, and the woman will give birth in the usual way.
The maturity of the placenta at this period is 0. The “lobed” placenta is the second degree of maturity, and in such a situation it is necessary to consult a doctor. Deposits of calcium salts are called calcinates. The norm is considered if they are present in the placenta of the first degree of maturity.
If a section of the "child's place" dies, this is called a placental infarction. In this case, you urgently need to consult a doctor to find out the cause and prescribe treatment, because if this continues to happen, then the child will lack oxygen and the substances necessary for its development.
Cervix: condition, structure
At the 12th week, the size of the cervix is ​​measured, which should not be shorter than 30 mm. The longer it is, the better. If it is already very short, less than 20 mm, then the pregnant woman will be hospitalized, and possibly, surgery will be used to treat it. The uterus must be closed, both external and internal.
Myometrium (or muscle condition) indicates whether there is a risk of miscarriage. If the diagnosis indicates that at this time there is uterine hypertonicity, then a woman is treated. Especially alarming are facts such as “petrification” of the abdomen, “pull-push” in the lumbar region.
How ultrasound determines the term
Using special tables, KTR calculates the gestational age. It may be that a similar function is built into the ultrasound machine program. Terms are compared - calculated from the last menstrual period and issued by ultrasound. If the difference is small (one or two weeks), then consider the exact period determined by the obstetrician. In the event of a larger mismatch (more than 2 weeks), the period determined by the ultrasound is taken for granted.
Prenatal screening: what it is and how it is done
You should be especially careful when the pregnancy is 12 weeks. Ultrasound, screening - all these studies are designed to evaluate the development of the fetus. In this case, an ultrasound scan is done first, and then screening is also prescribed (depending on the indicators). Spend it if:
- Pregnant 35 years and older.
- Before that, dead children were born.
- When examining previous fetuses, an intrauterine infection was detected.
- A child was born with a chromosomal abnormality.
- It was established that relatives of both parents have such anomalies.
Only in special centers screening (12 weeks). How do they do it? All tests are collected: ultrasound, blood, external data. The geneticist makes an assessment of the study, and attention is mainly paid to the collar and these indicators: free β-hCG and PAPP-A. Basically, these markers are examined in a clearly defined combination. If at least one of them has changed, this does not mean that the fetus has any pathologies.
So, when screening is performed at 12 weeks gestation, the characteristics of these markers are used. These are whey proteins. If they have abnormalities, then the child will have genetic disorders. Free β-hCG is a subunit of human chorionic (chorion is an embryo) human gonadotropin, and PAPP-A is protein A associated with pregnancy. ELISA (enzyme-linked immunosorbent assay) is used to study these parameters .
HCG stimulates the synthesis of steroid hormones (in the placenta and corpus luteum). Doctors have already found out that it is hCG that protects the fetus from rejection. By examining its level, you can make predictions for the further course of pregnancy. According to medical statistics, hCG gradually increases until the 10th week, and then remains approximately at the same level (from 5,000 to 50,000 IU / L) to 33 weeks, after which it can rise slightly.
1 screening during pregnancy is done from the 10th to the 13th week of the term. To calculate all the risks, they take a lot of data: the date of the ultrasound, KTR and TPV (thickness of the collar space).
These analyzes are very important for determining the existing pathologies in the chromosomes. However, if the testimony is slightly increased, do not worry and draw hasty conclusions. You just need to turn to a geneticist who will tell you what to do next. It is also likely that an ultrasound scan is not read correctly. Screening for a 12-week pregnancy can be repeated - to clarify, or the doctor will prescribe an invasive diagnosis that will more accurately determine the genetic set of the child. Depending on what the period is, either a chorionic villus biopsy or amniocentesis is done.
If even 1 screening showed a very low risk of fetal chromosome pathologies, then one should not refuse an examination conducted at 4-5 months of pregnancy. In addition to hCG and AFP, the level of free estriol is determined (triple test).
In order to determine the performance of β-hCG and PAPP-A, they donate blood for screening. 12 weeks is already a sufficient period for biochemical analysis to reveal the presence (or absence) of abnormalities in the chromosomes.
Analysis Conclusion
Depending on the results of a blood test, they reveal why the indicators differ from the norm. So, screening for a 12-week pregnancy may reveal the following:
- Down syndrome.
- Not one fruit, but 2 (3, etc.). More fruits - more hormone levels.
- Toxicosis.
- Incorrect pregnancy. For each week of development of the child corresponds to some indicator that determines the exact age of the fetus.
- The presence of diabetes in the mother.
- Ectopic pregnancy.
- Great risk of miscarriage.
Are there any norms for indicators?
Of course there is! You can recognize them by doing such tests as ultrasound, screening (12 weeks). Norm will become known after studying the data by the doctor. However, there are average medical indicators clearly established for each week of pregnancy. For example, β-hCG at 11-12 weeks should be from 200,000 to 90,000 mU / ml.
However, it should be borne in mind that the screening of a 12-week pregnancy gives, of course, very high, but still not one hundred percent results, because each woman has her own characteristics of the body, which the doctor must take into account. If the fetus is not alone, then it is more difficult to diagnose it. Look at the indicators. If they are one and a half or two times more, then we can conclude that there are 2 or more embryos. Each of the fruits has its own chorion and different hormone production. Therefore, the rates are so high, and the expectant mother is sent for an ultrasound scan to confirm a multiple pregnancy.
As soon as the screening is performed (12 weeks), the normative values ​​are immediately checked with the data obtained in order to calculate whether there are any pathologies. For these purposes, doctors use a special coefficient called MoM. It is calculated according to a specific formula: the amount of the hormone that was determined by the screening results is divided by hCG (corresponds to the norm during this period of pregnancy). It should be a unit (this is ideal). Well, already according to the results of all studies, it is judged whether to include the expectant mother in a risk group with chromosomal abnormalities or not. It is worth noting that even if this suddenly happened, this is not a final sentence, but only one of the probabilities. Therefore, the remaining indicators are compared and only after that they make any conclusions. Review the entire screening of a 12-week pregnancy: ultrasound, hormones, TBP, may prescribe a second study in the second trimester.
The PAPP-A protein is responsible for the immunity of the pregnant woman, and it also helps the placenta to work. Since the boundaries of the thresholds are clearly established, its deviations are extremely undesirable. The thing is that such “jumps” of indicators not only indicate a possible miscarriage, but also such terrible anomalies as Down syndrome, de Lange syndrome, etc. The following numbers are considered normal: from 11th to 12th week - 0.7 - 4.76; from the 12th to the 13th week - 1.03-6.01.
Research Reviews
Women who did the screening (12 weeks) respond differently about it. Someone has incorrectly determined the gender of the child. There is an explanation for this - the period is too short, it will finally be possible to say who will be born: a girl or a boy, only at the 16th week. They also talk about different prices. Some take tests for free, others pay from 1000 to 3000 rubles.
However, most mothers note that ultrasound and screening help to understand how the baby is developing. Since now these procedures are mandatory, it is possible to diagnose and start treating existing diseases in time so that the baby is born healthy.