Your Pregnancy After 35 : Tests for You and Your Baby (part 3) - Specialized Tests You May Have

3. Specialized Tests You May Have

Ultrasound

An ultrasound exam may be one of the most exciting tests you have during pregnancy! You and your partner can actually see your growing baby. The test is a valuable tool for your healthcare provider because it enables him or her to check for many details of fetal development. (Ultrasound, sonogram and sonography refer to the same test.)

Most healthcare providers routinely perform ultrasound exams on their pregnant patients. Some healthcare providers perform ultrasounds only when there is a problem.

Ultrasound exams pose no threat to you or your baby. The possibility of adverse effects has been studied many times without any evidence of problems.

Ultrasound gives a 2-dimensional picture of the developing embryo or fetus . It involves use of high-frequency sound waves made by applying an alternating current to a device called a transducer. The transducer sends and receives sound waves.

As you lie on your back, the transducer moves over gel that has been spread on your abdomen. The transducer picks up echoes of sound waves as they bounce off the baby, then a computer translates them into a picture, similar to radar used by airplanes or ships to create a picture of the terrain under a night sky or on the ocean floor.

Before the test, you may be asked to drink 32 ounces (1 quart; almost 1 liter) of water. The water makes it easier for the technician to see your uterus. The bladder lies in front of the uterus; when your bladder is full, the uterus is pushed up and out of the pelvic area and is more visible on the ultrasound. When your bladder is empty, your uterus lies farther down in the pelvis and is harder to see.

An ultrasound can help confirm or determine your due date, determine if there is one baby or multiples and determine if major physical characteristics of the fetus are normal. You can have an ultrasound any time during pregnancy.

Whether you have an ultrasound during your pregnancy depends on several factors, including problems such as bleeding, previous problem pregnancies and your insurance coverage. If your pregnancy is high risk, you may have several ultrasound exams.

A healthcare provider may order an ultrasound to learn vital information about a fetus’s brain, spine, face, major organs, limbs or sex. An ultrasound can show where the placenta is, so it is used with other tests, such as amniocentesis. The test can also provide information on fetal growth, the condition of the umbilical cord and the amount of amniotic fluid in the uterus.

Healthcare providers perform an ultrasound for many reasons. Some of the more common reasons include the following:

•to identify an early pregnancy

•to show the size and growth rate of the embryo or fetus

•to measure the fetal head, abdomen or femur to determine the duration of pregnancy

•to identify some fetuses with Down syndrome

•to identify fetal abnormalities, such as hydrocephalus

•to identify the location, size and maturity of the placenta

•to identify placental abnormalities

•to detect an IUD

•to differentiate between miscarriage, ectopic pregnancy and normal pregnancy

If you are at least 18 weeks pregnant when you have an ultrasound, you may be able to determine the sex of your baby, but don’t count on it. It isn’t always possible to tell the sex if the baby has its legs crossed or is in a breech presentation.

Ultrasound at around 20 weeks may be done to determine if the placenta has attached normally and is healthy. If you have an ultrasound exam in the third trimester, your healthcare provider is looking for particular information. Performed later in pregnancy, this test can accomplish many things:

•evaluate the baby’s size and growth

•determine the cause of vaginal bleeding

•determine the cause of vaginal or abdominal pain

Vaginal probe ultrasound.

•detect some fetal malformations

•monitor a high-risk pregnancy

•measure the amount of amniotic fluid

•determine which delivery method to use

•determine maturity of the placenta

Breathing movements, body movements and muscle tone can be checked. If the baby is too big, it may need to be delivered by Cesarean delivery. If the baby is very small, other decisions can be made.

The cost of an ultrasound varies. An average cost is about $150 but can range from $200 to $500. With many insurance plans, ultrasound is an extra—not part of the normal fee for prenatal care. Ask about cost and coverage before having an ultrasound. Some insurance plans require preapproval for the test.

You may be able to get a CD or DVD of your ultrasound; ask about it when your test is scheduled to find out what you need to bring. An ultrasound may also include black-and-white photos you can keep. You can usually take your partner with you to the exam, so arrange to have the ultrasound when he can join you. You may want others to come, such as your mother or older children. Ask if that is possible when you schedule your ultrasound.

Vaginal Ultrasound

A vaginal probe ultrasound or transvaginal sonography may be helpful in evaluating problems early in pregnancy, such as possible miscarriage or ectopic pregnancy. The instrument (probe transducer or other device) is placed just inside the opening of the vagina; it does not touch the cervix and will not cause bleeding or miscarriage. This type of ultrasound sometimes gives better information earlier in pregnancy than an abdominal ultrasound.

3-Dimensional Ultrasound

Pictures are so clear with a 3-dimensional ultrasound the image almost looks like a photograph. This ultrasound provides detailed, clear pictures of the fetus in the womb. For the pregnant woman, the test is almost the same as a regular ultrasound. The difference is that computer software translates the picture into a 3-D image. This advanced ultra-sound is used when the healthcare provider suspects abnormalities and wants to take a closer look.