Screening 12 weeks that shows. Ultrasound during pregnancy: transcript. When is a planned ultrasound performed?

At the twelfth week of pregnancy, the baby is now more like a little man. Its dimensions are large enough to examine the anatomy of its structure using an ultrasound examination. Let's figure out what ultrasound can tell about 12 weeks of pregnancy and why its implementation is so important. We will decipher the results of the examination, what the abbreviations of their norm and pathology mean, and also tell you about determining the sex of the baby at this stage of pregnancy.

The purpose of the first ultrasound and the importance of the 12th week

At the end of the third month of pregnancy, ultrasound diagnostics along with is part of the first screening, which is carried out in the period of 11-14 weeks. Often it is also called a genetic ultrasound, as they look to see if the child has genetic abnormalities.

Ultrasound screening at this time examines the features of the skull, spine, brain, anterior abdominal wall, stomach, Bladder, upper and lower extremities fetus and other important parameters.

The examination is mandatory for all pregnant women. A woman may refuse to perform the study, but must be warned of all the consequences of her decision.

For a number of reasons, the 12th week of pregnancy is considered the ideal time for the first ultrasound screening. If there is an opportunity to be examined at this particular time, it should not be missed. With ultrasound at week 11 and earlier, some features of the development of the fetus can be misinterpreted, and often the doctor prescribes a follow-up examination.

By doing ultrasound at a period of 13 or more weeks, if the obstetric gestational age does not coincide with the actual one, you may not be screened. Starting from 14 weeks, some indicators lose their information content. This applies, for example, to the thickness of the collar space.

What will ultrasound show at 12 weeks

The examination allows you to safely assess the condition and development of the fetus. With a successful course of the period of gestation, it is the first study of a pregnant woman. With the help of ultrasound at this time, you can:

clarify the gestational age and determine the expected date of birth;
set the number of fetuses in the uterus;
determine the viability of the fetus;
look at the development of the child, assess his life;
search for markers of fetal chromosomal pathology indicating the possible presence of Edwards, Down, Patau, Turner syndrome, Cornelia de Lange disease;
detect pathology of the reproductive organs of the mother;
to diagnose the threat of termination of pregnancy, detachment gestational sac and other possible pathologies
measure the size of the organs and compare with the norms for the due date - fetometry of the fetus.

Fetometry of the fetus

At this time, the fetus already looks like a person, it has already formed arms and legs, even fingers are visible. The baby is very active, moving his arms and legs, may play with the umbilical cord or suck his thumb.

The internal organs have formed and many are already functioning. The weight of the fetus is 14-15 grams, height 45-80 mm.

Important! Not all of the above features can be seen on ultrasound at 12 weeks, not all antenatal clinics and clinics have a modern ultrasound machine with high resolution and detail. But any scanner will show the movement of the fetus and the mother can hear her baby's heartbeat.

How to prepare for an ultrasound

The first screening by expectant mothers is perceived as a very serious examination, and this is partly correct. But don't worry too much, but don't neglect proper preparation to the survey.

For better diagnosis, so that nothing interferes with visualization, it is necessary to exclude the formation of intestinal gases. To do this, do not use gas-producing foods such as cabbage, legumes, sparkling water, etc. for 2-3 days. For safety, you can drink anti-flatulence drugs in the evening and in the morning (for example: Espumizan, Simethicone, Smecta).

If you are going to have an ultrasound scan in a public health facility, bring slippers, a diaper to lay on the couch, a towel to wipe the gel applied to the stomach.
A transvaginal exam will require a pair of condoms.
In private clinics, as a rule, all these accessories are already included in the cost.
On the day of the procedure, do hygiene of the external genital organs.
When performing a transabdominal routine ultrasound (through the anterior wall of the abdomen), you must come with a full bladder. To do this, drink 1-1.5 liters of ordinary non-carbonated water an hour before the procedure. If the ultrasound is transvaginal, then on the contrary, before the examination, you need to empty the bladder.

In the event that you have already undergone an ultrasound before this examination, take the results with you. They may be needed by an ultrasound doctor to assess the dynamics of growth and development of the fetus.

How is an ultrasound done at 12 weeks pregnant?

From the twelfth obstetric week volume amniotic fluid enough for a good ultrasound, and the baby is large enough to have a good look at it. Ultrasound is performed in 2 ways. The choice of one method or another is up to the doctor. The choice of method can be influenced by many reasons, one of them is the physique of the mother.

Transabdominal and transvaginal ultrasound methods.

transabdominal

It is carried out through the front wall of the woman's abdomen, the people also call it external. With this method, the pregnant woman lies on her back, and the doctor moves the ultrasound sensor of the machine along the surface of the abdomen. This is done using a special water-soluble gel to improve the transmission of ultrasonic waves.

Sometimes the doctor may tap the transducer against the anterior abdominal wall. Don't be scared, it's effective method make the baby roll over. The need for this maneuver is due to the fact that often the fetus can be in a position in which it is impossible to measure the necessary indicators and evaluate the features of development.

transvaginal

It is carried out vaginally with a special ultrasound sensor, popularly also called internal. You should not worry about this diagnostic method, since the sensor is 3 cm in diameter, and a disposable condom is put on it with lubricant applied.

Norms and interpretation of ultrasound screening of the fetus

It is impossible to draw conclusions only on the conclusion of an ultrasound scan of 12 weeks. Doctors decipher the first screening based on the conclusion of the ultrasound and the results of a biochemical blood test. In some cases, additional diagnostic methods may be prescribed.

After ultrasound diagnostics, a woman receives an examination protocol, on which the development of pregnancy, the parameters of the child’s condition and fetometry indicators are “encrypted” with numbers and letter abbreviations.

We warn you that even people with a medical education cannot understand the indicators; in order to understand the full picture, you need to be a specialist in this field. Do not wind yourself up and do not be nervous if you see any inconsistencies with these standards. Each case is individual and you need to listen and ask your doctor if something is bothering you.

KTR

Fetal KTR on ultrasound

KTR stands for - coccygeal-parietal size, the distance from the crown of the head to the coccyx, the length of the legs is not taken into account. Significance for determining the duration of pregnancy and the rate of development of the child. KTR norms by terms in the table.

Table of average norms of fetal KTR for a period of 11-12 weeks and 12-13 weeks

If the CTE is higher than normal, this may mean that the child is developing rapidly and there is a risk of a large fetus.

KTR is less than normal - one of the reasons is that the fetus is younger than the doctor and the pregnant woman think. An additional ultrasound is prescribed in 1-1.5 weeks. If the indicators are significantly less than the accepted norms, this may indicate problems in the development of the fetus. Possible reasons include bad habits, poor nutrition, or lack of the hormone progesterone in the mother's body. With a low CTE, genetic abnormalities are not excluded. An additional examination is needed.

heart rate

Fetal heart rate on ultrasound monitor

The abbreviation HR stands for - heart rate, a description of the fetal heartbeat. An important indicator for assessing general vital activity. The movement of the child is difficult to discern, and heart rate readings are taken for evaluation, motor activity in this period is simply determined.

With a low or high heart rate, slow, uneven, non-rhythmic heartbeat, an additional examination is indicated. Abnormal results may indicate that the child is not feeling well.

TVP

The main part of the 1st screening is the TBP and the nasal ossicle. Important indicators that are markers of chromosomal diseases.

Fetal TVP on ultrasound

The size of the "neck fold" or TVP stands for - the thickness of the collar space. TVP is informative only in this particular period, more than 14 weeks it is not determined.

This is one of the most important parameters of the first ultrasound screening. According to it, doctors judge the risk of a child having chromosomal diseases (Edwards syndrome, Down syndrome, etc.). The indicator is quite accurate, but not one hundred percent method for the early diagnosis of chromosomal abnormalities. Thickening of the collar space is not a final diagnosis, but the identification of a risk group among pregnant women for additional examination.

A slight excess does not cause alarm among doctors; an excess of 6-8 mm of the upper limit from the norm is considered critical. In such cases, the pregnant woman is referred for a consultation with geneticists. According to indications, geneticists conduct their additional research methods.

Amniocentesis or chorionic biopsy with 99.9% accuracy can confirm or refute the assumptions.

In addition to the high excess of the collar space, the assumption of an anomaly should be supported by indicators of a biochemical blood test, changes in hCG and plasma protein-A (PAPP-A).

Table of average norms of fetal TVP for a period of 10 to 14 weeks and 6 days

nasal bone

Nasal bone on ultrasound

Nasal bone (nasal bone) - the norm of the length of the nose also refers to markers of probable problems.

The absence of a nasal bone (aplasia) or a small nasal bone (hypoplasia) increases the risk of a child having a chromosomal abnormality. If the child has chromosomal diseases, then ossification will occur later than the due date. During 1 screening, it may be absent or be less than normal. However, the accuracy of ultrasound diagnostics does not allow us to judge the pathology.

With other normal indicators, it is more often a feature of the child (small nose, snub nose).

To understand what is the cause of the phenomenon will help the results of a biochemical blood test, as well as a control ultrasound additionally, at the appointed time in a few weeks.

BDP

Biparietal head size on ultrasound

The abbreviation BPR stands for bipareital head size, the index indicates the width of the skull. The distance between the temples is measured, the development of the brain is being assessed.

If the indicator is below the norm, insufficient development is possible, or the absence of any components (right or left hemisphere, cerebellum, etc.).

With indicators above the norm, it may indicate a large fetus, rapid development, intrauterine diseases (hydrocephalus, tumor, cerebral hernia).

Table of fetal BDP norms from 10 to 14 weeks

Is it possible to determine the sex of the child

The first ultrasound screening does not include the determination of the sex of the child, but can be included for an additional fee. In commercial clinics, this procedure is usually included in the cost of the examination.

It is impossible to establish with an accuracy of 100% within a period of 12 weeks, errors are possible. However, an experienced doctor, based on indirect signs, can assume who will be born a boy or a girl. Nevertheless, there is a high probability of confusing the genitals with limbs or the umbilical cord. The determination accuracy varies within 75–80%.

On two ultrasound images, the fetus is a boy and a girl for a period of 12-13 weeks. As you can see, it is difficult to understand the gender of the child.

If, for any reason, you were assigned an additional genetic study, then they can tell with 100% accuracy on the chromosomes who will be born.

Other Options

The ultrasound doctor, in addition to assessing the state of the anatomy and physiology of the child, evaluates the embryonic structures, the condition of the uterus, chorion, appendages, neck length and other indicators. And indicates whether there is a risk of abortion.

For this, first of all, the features of the chorion (the future placenta) are described. Its location is determined.
The presence of signs of detachment of the chorion indicates the threat of termination of pregnancy.
Subchorial hematoma is often found in pregnant women even in the absence of complaints.
The amount and uniformity of amniotic fluid is assessed.
With the help of ultrasound, the tone of the uterus can be recorded.
In one of the ovaries, a corpus luteum is determined. Its function is to produce progesterone to maintain pregnancy.
The reproductive organs of the mother are examined for the presence of pathology and developmental features.
The saddle and bicornuate uterus, uterine fibroids, cysts and ovarian neoplasms are diagnosed.

Yolk sac

Table for assessing the indicators of the yolk sac of the fetus

They look at the shape, measure the inner diameter and echogenicity. The indicator may indicate the normal course of pregnancy or a deviation.

The position of the chorion

The position of the chorion is determined - this is the future placenta. Normally, it is fixed on the back or front wall of the uterus.

If presentation is determined, then it will be necessary to develop a separate tactic for managing pregnancy. Low placentation at this stage is often a physiological phenomenon. As the uterus grows with increasing gestational age, the placenta in most cases rises.

In addition, the structure of the chorion is assessed, it is normally homogeneous.

Condition of the uterus

At twelve weeks of pregnancy, the length of the cervix must be measured, normally it is 30 mm. An indicator of 20 mm is considered critical. In such cases, bed rest is prescribed, more in difficult cases, they are hospitalized. The muscle tone of the uterus is also evaluated, with hypertonicity there is a risk of miscarriage. Outpatient treatment or hospitalization for preservation is prescribed.

amniotic fluid

The condition and amount of amniotic fluid is examined. An increase or decrease in amniotic fluid is a sign of pathology. It may indicate the addition of an infection, impaired renal function, a disease of the central nervous system. Turbidity of the amniotic fluid can also indicate pathology, so an additional examination is prescribed.

FAQ

Conclusion

After all examinations of the first screening, the results are analyzed in conjunction with the determination of the value of the total risk. Ultrasound data, biochemical blood tests, as well as the pregnant woman's personal information about previous pregnancies, age, the presence of hereditary genetic pathology and other factors are taken into account.

An overall risk of 1:350 or more is high. Prenatal screening calculates the probability of having a baby with chromosomal developmental anomalies such as Down syndrome, Edwards syndrome, Patau syndrome, neural tube defects and others.

The presence of an increased risk on the first screening does not diagnose the presence of a chromosomal pathology. It only indicates a greater likelihood of having a baby with this anomaly in this woman than the average risk in the population. In such a situation, a completely healthy child can be born. However, a pregnant woman will be offered to undergo an additional examination in the form of an amniocentesis or a chorionic villus biopsy to determine the chromosome set in the fetus.

Good screening results do not guarantee the birth of a completely healthy baby. Therefore, a woman is recommended to additionally undergo a second screening, where all organs and systems will be studied in more detail.

The cost of ultrasound in the first trimester up to 10 weeks is 450 hryvnia. The price includes biometrics according to protocols, 3D/4D visualization.

The cost of ultrasound in the first trimester for a period of 10 weeks 6 days is 550 hryvnia. The price includes prenatal screening, biometric protocols, 3D/4D visualization.

The cost of complex prenatal screening according to PRISCA (ultrasound + beta hCG + PAPP with the calculation of the individual risk of chromosomal pathologies (for example, Down syndrome or Edwards syndrome) is 1005 hryvnias.

On fetal ultrasound at 12 weeks of gestation, a number of very important measurements are taken to identify the risk group for fetal chromosomal abnormalities. It has been found that the most optimal time for screening of the first trimester of pregnancy - 12 weeks of pregnancy (from 11 to 13 weeks and 6 days). At Fetal ultrasound at 12 weeks pregnant in addition to the length of the embryo (coccyx-parietal size - KTR), the size of the fetal head (head circumference, biparietal size, frontal-occipital size) is measured. Mandatory ultrasound of the fetus at 12 weeks of gestation is an assessment of the structures of the fetal brain, the symmetry of the hemispheres. Normally, the fetal brain on ultrasound looks like a butterfly. The long bones of the fetus are measured (shoulder, ulna, radius, femur, tibia, fibula), an assessment is made of the symmetry of the limbs, their motor activity. With ultrasound of the fetus at 12 weeks of gestation, the transverse size of the abdomen of the fetus, the circumference of the abdomen are measured, the presence of the stomach, heart in typical places is noted. When conducting an ultrasound of the fetus at 12 weeks of gestation, the presence of heart defects can be suspected with sufficient resolution of the ultrasound scanner and the proper experience and education of the ultrasound operator. There are published data on the diagnosis of transposition of the great vessels, the common atrioventricular canal, cardiac ectopia, etc., registered during fetal ultrasound at 12 weeks of gestation.

Prenatal screening in the first trimester

In addition to the measurements listed above, during fetal ultrasound at 12 weeks of gestation, screening for fetal chromosomal pathologies is performed. It has been established that most chromosomal pathologies are accompanied by an increase in the collar space located in the neck of the fetus. This feature is due to the fact that with chromosomal abnormalities of the fetus, in particular with Down syndrome, the skin has increased folding, i.e., roughly speaking, there is more skin. Fluid accumulates under such skin, which contributes to the visualization of a thickening of the collar zone during ultrasound of the fetus at 12 weeks of gestation. In fetuses with a karyotype disorder (with chromosomal diseases), the thickness of the collar zone is 2.5 mm (or more) greater than the average value for a given gestational age in fetuses with a normal karyotype.

Ultrasound of the fetus at 12 weeks of gestation with Down syndrome

In addition to the enlargement of the nuchal area in trisomy 21 (Down's syndrome), 60–70% of fetuses do not show nasal bones. It is noticed that people with Down syndrome have a short nose. In the process of embryogenesis, the nose with Down syndrome (nasal bones) is formed later than in fetuses with a normal karyotype. Also, from 15 to 21 weeks of gestation, there is an increased frequency of shortening of the nasal bones compared with the average values for this gestational age in fetuses with Down syndrome.

In fetuses with Down syndrome, there is a shortening of the upper jaw, which manifests itself as a smoothing of the contours of the face.

In fetuses with Down's syndrome, dopplerometry determines the pathological nature of the curves of blood flow velocities in the venous duct. Assessment of the nature of blood flow in the venous duct is one of the mandatory screening parameters when performing ultrasound of the fetus at 12 weeks as part of the prenatal screening of the first trimester. Reverse blood flow in the venous duct is considered pathological.

Ultrasound of the fetus at 12 weeks of gestation with Edwards syndrome

Trisomy 18 (Edwards syndrome) is characterized by early manifestations of fetal growth retardation and a tendency to bradycardia (decrease in the fetal heart rate). Moreover, until a certain period of pregnancy, the fetus develops normally (more often up to 8 weeks of pregnancy)

In fetuses with Edwards syndrome, an omphalocele (hernia abdominal cavity with displacement into the hernial sac of the abdominal organs).

Fetuses with Edwards syndrome show a lack of visualization of the nasal bones.

In fetuses with Edwards syndrome, a single umbilical cord artery is a common finding. Normally, the umbilical cord has two arteries and one vein.

Ultrasound of the fetus at 12 weeks of gestation with Patau syndrome

With trisomy 13, 70% of fetuses have tachycardia (increased heart rate).

Also, in fetuses with Patau syndrome, early detection slowing down the development of the fetus.

In fetuses with Patau syndrome, megacystis (bladder enlargement) is noted.

Holoprosencephaly in fetuses with Patau syndrome (impaired brain formation) and omphalocele are more often associated signs detected by fetal ultrasound at 12 weeks of gestation.

Ultrasound of the fetus at 12 weeks of gestation with Turner syndrome

With Turner syndrome, 50% of fetuses have tachycardia (rapid heart rate over 160 beats per minute) and early manifestations of fetal growth retardation (the size of the fetus ceases to correspond to the gestational age, usually from the 8th week of pregnancy.

Ultrasound of the fetus at 12 weeks of gestation with Triploid syndrome

Triploidy is characterized by early signs of slowing down the development of an asymmetric type.

Bradycardia (heart rate below 120 beats per minute), holoprosencephaly (violation of the division of the brain into sections, and, accordingly, the impossibility of normal mental development of the child), omphalocele (eversion of the abdominal organs into the hernial sac in the umbilical cord) are also characteristic of triploidy.

Cysts of the posterior cranial fossa, vascular plexus cysts. Cysts are represented by the accumulation of fluid in the brain. An unfavorable sign is the presence of bilateral cysts, while the isolated presence of one cyst in the brain small size(in particular, choroid plexus cysts), the absence of other markers of chromosomal diseases are not regarded as a pathology and require dynamic monitoring.

Early pyelectasis (dilation of the renal pelvis) is also a marker of fetal chromosomal abnormalities.

All these data can be recorded with ultrasound of the fetus at 12 weeks of gestation. It is important to note that the presence of these markers is not a diagnosis that reliably confirms the presence of a chromosomal pathology in the fetus. If several markers of fetal chromosomal pathologies listed above are detected during ultrasound, invasive prenatal diagnosis is recommended to obtain material of fetal origin. These procedures include amniocentesis and chorionbiopsy. After receiving a section of the chorion (placenta) or amniotic fluid, the chromosome set of the child is determined (karyotyping). Only karyotyping is the reason for the diagnosis of a chromosomal abnormality in the fetus.

Biochemical prenatal screening

Screening carried out at an early stage of pregnancy is the most informative method for assessing both the condition of the fetus and the characteristics of its intrauterine development. This diagnosis includes not only an instrumental method - ultrasound, but also a laboratory study, - biochemical analysis blood. So in the course of the latter, the level of the free subunit of chorionic gonadotropin and plasma protein A is fixed. That is why the second name of this study is “double test”.

When is the screening done?

For the entire period of gestation, ultrasound screening is carried out three times, while at 12 weeks of pregnancy it is done for the first time. This time is the most optimal. However, this study is also acceptable at 11, 13 weeks.

What is screening and how is it done?

Many pregnant women who are to be screened at week 12 are interested in the question of how it is done and whether it hurts. As mentioned above, this procedure is a conventional ultrasound, which is absolutely painless. Therefore, special psychological preparation for this procedure is not required.

Special attention when carrying out such a diagnosis is removed from the state. Normally, fluid accumulates there, which then, as the baby grows, decreases in volume. By the thickness of this fold, one can judge the defects and developmental disorders of the baby.

A blood test of a pregnant woman, which is also part of the screening at week 12, shows the risk of developing pathology, as indicated by a deviation from the norm. So, for example, an increase in the level of beta-hCG in the blood may indicate the development of such a chromosomal pathology, as better known as Down syndrome. However, when making a diagnosis, the doctor never relies only on the results of the screening. As a rule, this is only a signal for further diagnosis.

Evaluation of results

Many pregnant women, even before they are screened at 12 weeks and ordered to donate blood, try to find information about the norm indicators of this study. It is pointless to do this, because. analysis of the results can be carried out only by a doctor. This takes into account not only the data obtained during the screening, but also the features of the development of the fetus at a certain period, and the condition of the pregnant woman herself. Only a comprehensive assessment and analysis of the results of the study can detect a violation in time.

Because this is the period in which you can see the main anatomical structures of the fetus and determine a significant one. The procedure is included.

information Postponing the passage of the first ultrasound to a later period should not be, as time may be lost to eliminate the detected violations.

Researched indicators

When undergoing an ultrasound scan at week 12, the doctor evaluates the following indicators of fetal development and the course of pregnancy:

: body length, fetal head size, length of some bones.
Symmetry of the cerebral hemispheres. This indicator allows you to objectively assess the correctness of the formation of the central nervous system to exclude the occurrence of pathologies. Normally, during an ultrasound scan at week 12, the image of the brain should look like a “butterfly”. The asymmetry of the cerebral hemispheres is one of the signs of such a chromosomal disorder as triploidy(complete extra set of chromosomes).
Location of the stomach, heart and other organs.
Definition possible vices hearts.
Assessment of brain structure. Violation of the formation of brain structures can be diagnosed in the presence of some other diseases. For example, with triploidy, the process of dividing the brain into sections is disrupted.
Identification of signs of possible genetic diseases( , and etc.).
Place of attachment of the fetus to the placenta. Normally, it should be attached or on the site of its bottom. (it covers the internal uterine os) can be recommended when the baby's due date is approaching, if the situation does not normalize in the future.
. The norm is the presence of two arteries and one vein in it. The detection of only one artery indicates a possible development in the fetus.
Determination of the state of the walls and. The length of the neck should not be less than 30 mm, otherwise the expectant mother may be prescribed bed rest and hospital treatment.
Clarification of the gestational age.

important It can also be determined, but by no means in all cases, since external differences by gender during this period are still barely distinguishable.

At 12 weeks, an ultrasound can be performed as transvaginal method(using a probe inserted into the vagina) and abdominal method(using a transabdominal probe) through the skin of the abdomen. As a preparation for an abdominal examination during this period, a woman needs to drink 0.5 liters of still water half an hour before the examination.

Interpretation of results and norms

In the process of conducting an ultrasound examination, the doctor records all the results in writing and forms a protocol on the condition and development of the fetus, making records of possible identified violations or suspicion of them. In this case, the data obtained must be compared with the normative parameters corresponding to the specified gestational age.

When undergoing ultrasound at week 12, the average indicators of fetal development are:

fetal body weight- from 9 to 13 g;
body length- 6-9 cm;
– from 51 to 83 mm;
- allows you to estimate the size of the fetal head. The norm of this indicator is 21 mm at the 12th week of pregnancy;
volume chest(OG)- 24 mm;
thigh length- 9 mm;
- from 1.6 to 2.5 mm. With a significant deviation of this indicator from the norm, there is a high probability that the fetus has;
assessment of the size and shape of the nasal bone- not less than 3 mm. This indicator also allows you to diagnose the presence of Down syndrome;
- from 150 to 174 beats / min. Deviation of the actual result from the norm may indicate violations in the formation of cardio-vascular system fetus.

Deviations

If a slight deviation of the obtained actual indicators from the normative values is detected, one should not panic, because each pregnancy proceeds individually, and the fetus can develop spasmodically, with periods of acceleration or deceleration in adding body size.

It is better to entrust the interpretation of the results of an ultrasound examination to a doctor, because only a specialist can reliably assess the degree of risk of developing a particular disease.

If there are suspicions of the presence of some chromosomal disorders in the fetus, an additional examination should be carried out, since based on the results of only one procedure, it is impossible to draw a final conclusion about the existence of a serious abnormality.

additionally Even if individual alarm signals are identified, the situation can be normalized by the observance of the daily routine by a pregnant woman, and an optimistic attitude towards the birth of a healthy baby.

Twelve weeks of pregnancy is a very important period. It is expected that a woman will visit a gynecologist by this time, register and sign up for an ultrasound scan. Many expectant mothers look forward to the first examination, which will help make sure that everything is in order with the baby.

At a period of 12 weeks, the first screening of pregnant women is carried out, which includes a set of tests and ultrasound.

Why is this needed? What is the screening that doctors refer? What can be learned from the indicators of a woman’s blood tests and ultrasound at 12 weeks of gestation? How to decipher the results? What are the rules for this period?

Purpose of the survey

The first trimester of pregnancy is coming to an end, when the embryo is most vulnerable to various adverse factors. By this time, the mother's body should already be in time instead of the corpus luteum, which was needed for early dates to form the placenta. If at the moment everything goes right, you can exclude the presence of serious pathologies. At the same time, the fetus is already large enough that it is possible to notice some problems during examination.

In order to be fully prepared by the time of delivery and avoid complications of pregnancy in the second and third trimester, it is necessary to identify weaknesses, if any, already now. Therefore, the first screening is carried out. The next one will be carried out at a period of 16-20 weeks, depending on what the results of the first examination will be.

ultrasound

There are two options for conducting ultrasound diagnostics: transabdominally (usually this method is used) and transvaginally (for special indications). Depending on which view is shown in your case, you will be told what to bring with you.

Usually the first ultrasound is very much awaited. Parents want to know what gender their baby is and whether he is doing well. Doctors will receive accurate information about the period and how to conduct a pregnancy, what you need to prepare for.

Fetal development

The baby is already large enough to make it possible to see and measure the most important parameters on ultrasound, which characterize how well it develops, whether there are any pathologies. Also, after the examination, it will be possible to more accurately determine the gestational age and date of birth. It is important for future parents to know what they look at ultrasound and how they draw conclusions based on it.

Here is the transcript and the norm of the main indicators that the doctor of functional diagnostics will write down in the results of the ultrasound:

Height - up to 10 cm, most often about 8 cm.
CRL - body length in a sitting position (from the coccyx to the crown), from 4.3 to 7.3 cm.
Weight - up to 20 grams.
Pulse - about 160 heartbeats per minute.
Gender - usually the genitals are already well formed enough to be able to understand whether it is a boy or a girl. But sometimes the child is in such a position that it is difficult to consider something. Then you have to wait for the next examination.
The number of embryos - sometimes parents find out that they are expecting not one baby, but two or three. If so, it is already possible to determine who they are - twins or twins.
Position or presentation - this indicator in the early stages can be anything. It only matters after 32 weeks.
Umbilical cord entanglement - normally this should not be. If entanglement is observed, this must be reported to the doctor who is leading your pregnancy. This will help reduce the risk of intrauterine death and choose the right tactics for managing childbirth.
The collar zone is one of the most important indicators that are measured only on ultrasound at 12 weeks. Normally, it does not exceed 3 mm. Large sizes can indicate such a serious genetic pathology as Down syndrome.
BPD, BDP, BRGP - biparietal size, the distance between the parietal bones is measured. At 12 weeks, it is 21 mm.
FML, DlB - thigh length, from 7 to 9 mm.
To assess the uniformity of development, they can also measure the diameters of the chest, abdomen, heart size, head circumference, abdomen, shoulder length.

By combining the results of all measurements, it is judged whether the development corresponds to the deadline, how harmonious it is, whether there are any delays and pathologies.

In this case, the conclusion must be made by the doctor. Parents can sometimes be frightened if the results of the ultrasound show that all the parameters of the child are at the lower limit of the norm. But this is not necessarily a sign of problems, just the actual gestation period may be slightly less than expected. The same happens if everyone in the family is small in stature.

The course of pregnancy

In addition to assessing the growth of the embryo, according to the results of ultrasound, conclusions can be drawn about how correctly and timely the body future mother coping with pregnancy. By week 12, the corpus luteum of pregnancy is practically no longer functioning, but a placenta should form instead. The size of the uterus is changing, but much larger growth should be observed in the future.

Thanks to the fact that there is a screening ultrasound, in our time it is possible to trace everything that previously remained a mystery. This makes it possible to correct the motor regimen, prescribe drugs if there are suspicions of some problems that can cause miscarriage or premature birth before they begin to manifest themselves.

Here are some criteria that are important to pay attention to when doing ultrasound screening for a period of about 12 weeks:

The amount of amniotic fluid is normally 50 ml. To determine this indicator, they can also measure the distance between the fetus and the wall of the uterus, it should be within 2–8 cm. With a lack of amniotic fluid, “oligohydramnios” will be written on the card, with an excess of “polyhydramnios”. Both situations are undesirable and may indicate the presence of an infection. Therefore, they are the basis for the appointment of additional studies.
The size and position of the uterus. It should expand by about 10 cm. Usually, with such dimensions, it no longer fits in the hip region, therefore it is partially located in the abdominal cavity.
Myometrial tone. At 12 weeks of pregnancy, the muscular layer of the uterus should not be in hypertonicity. If the tone is increased, then there is an increased risk of miscarriage. In this case, the doctor may recommend to lie down and undergo treatment.
condition of the placenta. It should be of zero degree of maturity, without calcifications. It is very dangerous if there are areas of placental infarction, because this can lead to its death and oxygen starvation fetus.

In most cases, it turns out that everything goes well, and expectant mothers leave the ultrasound room very joyful. But if problems were found, it is worth remembering that modern medicine can help solve most of them. The main thing is to start on time and not worry too much.

Analyzes

Screening during pregnancy includes not only ultrasound, it will also be necessary to pass more than one blood test. If a woman registers earlier, then by week 12 she already has the results of general urine and blood tests, tests for HIV, sexually transmitted diseases, blood type and Rh factor. The deadline for their appointment is exactly 12 weeks. Of course, in cases where a woman first comes to the gynecologist for more later dates, she will be prescribed the same tests, but it is better to do them on time and be screened at 12 weeks.

In the presence of chronic diseases or complications of pregnancy, additional studies may be carried out.

For example, with an increased risk of chromosomal abnormalities, the doctor may advise checking the level of PAPP-A and b-hCG. Be sure to listen to all the recommendations, because additional tests help clarify the situation and do everything possible so that you soon become happy parents.