Obstetric ultrasound: timing, types and objectives for a peaceful pregnancy.

2024-05-10 10:30:00

Painless and safe for the fetus as well as for the mother-to-be, ultrasound is a technique of choice to ensure the smooth progress of the pregnancy.

When to do an obstetric ultrasound?

The term obstetric ultrasound refers to ultrasound examinations of pregnancy. In France, the High Authority for Health (HAS) recommends carrying out an ultrasound every trimester.

What are the 3 obligatory ultrasounds?

During pregnancy, three screening ultrasounds are strongly recommended:

in the first trimester: between 11 and 14 weeks of amenorrhea; in the second trimester: between 20 and 25 weeks of amenorrhea; in the third trimester: between 30 and 35 weeks of amenorrhea.

Additional ultrasound scans may be performed depending on the patient’s history, in the event of a multiple pregnancy or clinical signs suggestive of a pathology: for example an excess or a low quantity of amniotic fluid, gestational diabetes, an infection such as rubella. or toxoplasmosis…

What are the different types of ultrasound for pregnancy?

The different types of obstetric ultrasound are:

screening ultrasound; so-called diagnostic ultrasound; and focused ultrasound.

Screening ultrasound

There are three antenatal screening ultrasounds: they are carried out in the first, second and third trimester of pregnancy.

“The objective is to do a sort of check-up of the fetus and the mother to ensure that everything is fine,” explains Pierre-Antoine Migeon.

1st trimester ultrasound: ensuring that the pregnancy is progressing normally

The first trimester ultrasound makes it possible to visualize the future baby in its entirety, to identify possible malformations, to count the number of fetuses, to measure the craniocaudal length (CCL) in order to precisely date the pregnancy and above all to evaluate the risk of genetic anomaly (screening for trisomy 21) thanks, in particular, to measuring nuchal translucency.

The so-called morphological ultrasound of the 2nd trimester: baby under the microscope!

In the second trimester, the so-called morphological ultrasound methodically studies the anatomy of the future baby. The examination lasts a little longer than the first, it allows you to observe the limbs as well as the different organs of the fetus (brain, heart, kidneys, stomach, etc.), to ensure their good development and to detect possible possible malformations. This is also the time for parents who wish to find out the sex of their child!

3rd trimester ultrasound: checking the growth of the fetus

The third trimester ultrasound also includes a morphological study of the future baby and offers the practitioner the possibility of estimating its weight. If it is too large, additional investigations will be carried out to ensure that the mother does not suffer from gestational diabetes. Finally, the practitioner will examine the structures surrounding the fetus – quantity of amniotic fluid, position of the placenta, umbilical cord – and will check its presentation (breech, transverse).

Focused ultrasound

As its name suggests, focused ultrasound responds to a very specific indication. “ We will focus on a very specific pointconfirms Pierre-Antoine Migeon. For example: monitor the baby’s growth, check the amniotic fluid, check the presentation of the fetus (breech) or even analyze the patient’s cervix. »

Dating ultrasound

The dating ultrasound is one of the focused ultrasounds. “ It is carried out before the first trimester examination, only on indicationspecifies the midwife. For example: in case of doubt regarding the start of pregnancy, irregular cycles, history of ectopic pregnancy, twinning or unexplained bleeding. »

So-called diagnostic ultrasound

Diagnostic ultrasound is performed as a second intention if the midwife sonographer or gynecologist discovers an unusual image or suspects an anomaly. “ As soon as there is any doubt regarding the screening, to confirm or refute a possible pathology or to discuss the course of action to take, the patient is referred to a referring doctor to have a diagnostic ultrasound done.explains Pierre-Antoine Migeon. These highly experienced referring doctors are designated by a multidisciplinary prenatal diagnosis center (CPDPN). They are the ones who ultimately make the diagnosis. »

How is an obstetric ultrasound performed?

Obstetric ultrasound can be performed abdominally or endovaginally. “ The two paths complement each otherindicates Pierre-Antoine Migeon. By the endovaginal route we can observe certain structures that might not be visualized abdominally and vice versa. We always start with the abdominal route and continue, if necessary, with the endovaginal route. » During the examination, the patient lies on her back and the sonographer moves the probe to her stomach in order to visualize the fetus. “ No preparation is necessary, however, it is strongly recommended that expectant mothers do not apply moisturizer or oil on the stomach before the ultrasound in order not to harm the quality of the imageinsists Pierre-Antoine Migeon. No need to come with a full bladder either. However, it is advisable to drink enough water. Ultrasounds pass much better when the tissues are well hydrated. “. If the practitioner needs to use the endovaginal route in order to examine certain structures that are more difficult to visualize abdominally, he will ask for your consent and then insert an ultrasound probe into your vagina. Don’t worry, the exam is not painful…

Obstetric ultrasound versus gynecological or pelvic ultrasound

The term gynecological ultrasound refers to an ultrasound examination of the pelvic area. It can be carried out by a gynecologist-obstetrician or a midwife in a specific context. For example: abnormal bleeding, pelvic pain or palpation of a mass on clinical examination. The exam involves inserting a small probe into the vagina to view the uterus, cervix and ovaries. “ We always start with the abdominal ultrasound and very often complete it with the endovaginal route following the patient’s agreement. »

Gynecologist or midwife: what training is needed to perform a fetal screening ultrasound?

Only doctors and midwives holding a gynecological and obstetrical ultrasound IUD are authorized to perform the three pregnancy screening ultrasound examinations. “ The National Obstetric-Fetal Ultrasound Conference recommends that practitioners perform a minimum of 300 screening exams per year to be relevant », concludes Pierre-Antoine Migeon.

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