VIABILITY SCAN

This is an ultrasound examination that is usually carried out between 6-10 weeks of pregnancy. The purpose of this scan is to see where the location of pregnancy is. It is reassuring to see the pregnancy sac inside the womb; occasionally pregnancy may be seen outside the womb; which requires further investigation and management plan. When pregnancy is inside the womb it is very helpful to determine the number of embryos present and whether the pregnancy is progressing normally inside the uterus. This scan is especially useful for women who are experiencing pain or bleeding in the pregnancy and those who have had previous miscarriages or ectopic pregnancies. It may require to have transvaginal scan to complete the assessment.

NUCHAL TRANSLUCENCY(NT)SCAN

This scan is carried out from 11 weeks to 13 weeks and six days. The scan is usually performed transabdominally but in a few cases it may be necessary to do the examination transvaginally.

Purpose of the nuchal scan :

• To accurately date the pregnancy. This is particularly relevant for women who cannot recall the date of their last period, have an irregular menstrual cycle, or who have conceived whilst breastfeeding or soon after stopping the pill. We measure the size of the fetus and from this we calculate the expected date of delivery.
• To diagnose multiple pregnancy. Approximately 2% of natural conceptions and 10% of assisted conceptions result in multiple pregnancy. Ultrasound scanning can determine if both babies are developing normally and if the babies share the same placenta which can lead to problems in the pregnancy. In such cases it would be advisable to monitor the pregnancy more closely.
• To diagnose major fetal abnormalities. Some major abnormalities may be visible at this gestation. However, it will still be necessary to have a 20-week anomaly scan.
• To diagnose early miscarriage. Unfortunately, in 2% of women who attend for a nuchal scan it is found that the fetus has died, often several weeks before and without any warning. Couples will receive full counselling as to the possible causes of this problem and the options for subsequent measures that may be necessary.
• To assess the risks of Down’s syndrome and other chromosomal abnormalities. Each woman will be given an estimate of her individual risk for this pregnancy. This is calculated by taking into account the age of the mother, measurement of two hormones in the mother’s blood and the scan findings of nuchal translucency thickness, nasal bone, blood flow through the fetal heart and ductus venosus and fetal abnormalities. Parents will receive full counselling concerning the significance of these risks and the various options for further investigations including invasive testing or non-invasive prenatal testing (NIPT)

ANOMALY SCAN

This ultrasound is a detailed scan performed usually between 18 to 20 weeks pregnancy. During the scan we examine each part of the fetal body, determine the position of the placenta, assess the amount of amniotic fluid, and measure fetal growth. Special attention is paid to the brain, face, spine, heart, stomach, bowel, kidneys and limbs.

Approximately 2.5 to 4% of all pregnant women found to have some abnormalities in their developing babies. If any abnormalities are detected the significance of the findings will be discussed in detail and further management plan would be discussed by Dr. Adinarayana Makam.

LEVEL 3 (TARGETED) ULTRASOUND SCAN

This scan is performed usually for second opinion. When a fetal abnormality is detected or suspected, it is very essential that this is confirmed by a Fetal Medicine Specialist. Our internationally qualified expert not only would explain the specific condition, he would provide you with a up to date comprehensive information and help couple to make appropriate decision and management plan.

FETAL ECHO

During the nuchal scan (11-13 weeks), the anomaly scan (20-24 weeks) and wellbeing scan (30-34 weeks) we routinely examine the fetal heart and connecting blood vessels.

A specialist and detailed examination of the fetal heart is recommended for:

• Women with family history of congenital heart abnormalities, those with diabetes mellitus and those taking antiepileptic drugs.
• Fetuses with suspected heart defect and those with increased nuchal translucency or certain non-cardiac abnormalities detected during the routine scans.

FETAL NEUROSONOGRAM

When an abnormality is suspected in the central nervous system (Brain and spinal cord), a detailed targeted ultrasound study is carried out to identify specific problems. This often requires 3D and 4D scans and also transvaginal ultrasound examination.

FETAL WELLBEING SCAN

This ultrasound scan is usually performed after 26 weeks of pregnancy. Some obstetricians advise that this scan is offered to all women. Others reserve such scans for those women who have had previous complications of pregnancy such as pre-eclampsia, growth restriction, diabetes, stillbirth, and for those women who develop a problem during the course of their current pregnancy.

Growth scan, Fetal Doppler study, BPP scan

This scan aims to determine the growth and health of the fetus by:

• Measurement of the size of the fetal head, abdomen and thigh bone and calculation of an estimate of fetal weight.
• Examination of the movements of the fetus
• Evaluation of the placental position and appearance
• Measurement of the amount of amniotic fluid
• Assessment of blood flow to the placenta and fetus by colour Doppler ultrasound

3D AND 4D SCANS

It is fascinating to watch your baby throughout pregnancy by 3D / 4D state-of-the-art technology. Many fetal conditions may require 3D/4D for better assessment.