The decision of the Ministry of Health of the Russian Federation determined that every pregnant woman must undergo an examination of the condition of the fetus using ultrasound diagnostics, that is, undergo an ultrasound. The purpose of this order is to prevent the birth of children with severe hereditary diseases. In this case, a woman up to 12 weeks must register for pregnancy at the antenatal clinic at her place of residence.
The ultrasound examination is carried out as part of triple screening. To get an informative conclusion, a woman should not only get a diagnosis from a doctor, but also take a blood test on the same day. Thus, doctors receive more reliable results, supported by the results of biochemical tests.
At what time to do an ultrasound is established by order No. 457 of December 20, 2000. The study periods correspond to the trimesters of pregnancy, one for each. Each diagnosis has strictly defined goals.
Pay attention to the fact that the so-called obstetric period appears in determining the timing of pregnancy and the conclusions of diagnosticians!
What does this mean? Doctors do not keep track of the actual gestational age; they count from the 1st day of the last menstruation, if only because the woman herself sometimes cannot say as a result of what sexual intercourse she became pregnant. The calculations include a standard menstrual cycle of 28 calendar days. At your first visit to the antenatal clinic, you need to know exactly the date of your last period. With this information, the doctor will calculate the number of weeks of pregnancy.
The actual period is clarified at all ultrasound sessions, especially in the first trimesters. During the diagnostic process, individual parts of the fetal body are measured, their length, circumference and correlated with development tables. The ultrasound method, especially in the early stages, is the most reliable indicator.
It is generally accepted that the difference between the obstetric and actual gestational age is 14 calendar days. But this is true in about 25% of cases, sometimes the difference can be 3 or 1-1.5 weeks. This is due to the peculiarities of the process of fertilization of the egg.
Each ultrasound is done for a specific purpose; it is important that the timing of the examinations is strictly observed. In this case, the information content will be maximum.
The first is done as part of a comprehensive examination, which should identify gross chromosomal, genetic pathologies and defects in the anatomical structure of the fetus. It is performed between 11 and 14 weeks.
What is done as part of the first diagnosis of the condition of the ovum using ultrasound?
To detect chromosomal abnormalities, measure:
The first ultrasound examination is a source of valuable information about how the fertilized egg and the “baby place” were formed, one of the most important examinations of the early period. Information obtained up to 14 weeks based on the first ultrasound, coupled with blood tests, allows you to make decisions about continuing the pregnancy or terminating it.
Ultrasound of the first trimester allows you to avoid the birth of children with organ pathologies, such as Edwards syndrome, Down syndrome, Cornelia de Lange syndrome, as well as malformations of the cardiovascular system, neural tube and other abnormalities.
If any abnormalities in the development of the fetus are suspected based on the results of an ultrasound and blood test, the woman is referred for additional examinations.
The second planned ultrasound of the fetus, performed in the period from 22 to 24 weeks, is aimed at obtaining information about the development of the fetus, the condition of the placenta and umbilical cord. What actions does the doctor perform during the second planned ultrasound examination?
Not all malformations can be examined in the early period, therefore, the second ultrasound is no less important than the first. On it, doctors can see signs of diseases that are incompatible with life. In this case, you can have time to make an interruption for medical reasons.
An ultrasound examination is prescribed in the third trimester from 30 to 34 weeks. During the 3rd ultrasound procedure, they look at the same indicators as in the second trimester, only they are guided by other age norms. Considering that the due date is approaching, pay attention to the position of the baby in the uterus. The degree of aging of the placenta and the condition of the cervix are assessed.
At this time, Doppler diagnostics of the condition of the vessels of the umbilical cord, uterus and middle cerebral artery is also mandatory.
It is important to adhere to the specified time frames in weeks and not to delay the ultrasound examination. The periods are determined according to the trimesters of pregnancy, one for each. Each diagnosis has strictly defined goals.
Ultrasound examinations during pregnancy are carried out in two ways: abdominal and transvaginal. Both methods are absolutely painless and do not require special preparation. During the procedure, a superficial transducer examines the abdominal cavity, then the doctor uses another, narrower transducer, which is placed into the vagina. In this way, it is possible to examine even the smallest features of fetal development.
Just 40-50 years ago, our grandmothers never dreamed of seeing a baby before he was born. Now, periodic dates with a belly-dweller are commonplace. Although the benefits of ultrasound examination are obvious, there is still debate about its danger or non-danger in relation to the baby in the womb.
Ultrasound is a method and tissue. It is carried out using an ultrasound machine equipped with a special sensor and monitor. The sensor is called a transducer. When it comes into contact with the skin of a pregnant woman’s abdomen, it produces vibrations (sound waves), which it directs deep into the body. There they collide with the woman’s internal organs (as well as with body parts and internal organs of the baby) and are reflected from them, subsequently displayed on the monitor.
Ultrasound can be two-dimensional, three-dimensional and four-dimensional. What's the difference between them? With a two-dimensional ultrasound, only vague outlines of the fetus are visible on the monitor in black and white. Thanks to a three-dimensional ultrasound, the doctor will be able to see a three-dimensional color image and examine the baby’s organs and systems in detail. Four-dimensional ultrasound allows you to see fetal movements.
This procedure is absolutely painless and does not create any discomfort.
Carrying out research using ultrasound is not determined by the whims of future parents, but by the urgent need for problems in the course of the pregnancy itself.
Actually, the first ultrasound will be able to confirm pregnancy in the early stages, establish the presence of a fertilized egg (sometimes as many as two, or even three), and determine the exact duration of pregnancy. This method is very valuable if available. After all, if you diagnose it early, you can avoid surgery.
Moreover, at a later date, ultrasound allows you to see whether pathologies exist. These include placental abruption, the threat of spontaneous abortion,. Timely diagnosed pathologies and, accordingly, taken measures will allow you to maintain the pregnancy and give birth to a healthy baby. Ultrasound can also detect fetal malformations. Sometimes they can be cured, and sometimes, unfortunately, the woman will be asked to terminate the pregnancy.
On the eve of childbirth, an ultrasound will allow you to find out some nuances that will determine both the course of the process itself and the behavior of doctors. Remember, only this method can tell with 100% accuracy whether there is an umbilical cord entanglement. And this is very important, since it threatens complications of the birth process, and sometimes creates a danger to the health, or even life, of the baby.
Do not forget that some women are required to undergo an ultrasound. And much more often than the majority of pregnant women. Such indications include chronic diseases. The most common among them are various blood diseases.
You should not neglect the procedure if you have already had pregnancies that ended unsuccessfully (miscarriages, frozen pregnancies) or if there are seriously ill people in the family (for example, with Down syndrome).
A woman usually receives a referral for her first ultrasound during pregnancy at 12-13 weeks of pregnancy. This early research method is extremely important: with its help, the doctor will be able to assess the primary formation of the fetus and assess the process of the formation of organs and systems.
In some cases, the first ultrasound during pregnancy may be performed earlier. Firstly, to confirm the presence of pregnancy, and also to exclude the fact of an ectopic pregnancy. Suspicion of an ectopic pregnancy requires mandatory examination using ultrasound - only in this way will it be possible to reliably establish whether this pathological condition actually occurs. And only in this way will it be possible to intervene in time in the situation and carry out the necessary cleaning, otherwise serious consequences cannot be avoided.
The reason for an earlier ultrasound may also be alarming symptoms in the form of vaginal bleeding (or spotting) and nagging pain in the lower abdomen. Such symptoms most likely signal a threat of termination of pregnancy. And, although it is very difficult to determine solely by ultrasound alone whether there is a threat of miscarriage, however, through such a study it is possible to find out the cause of the bleeding. According to the ultrasound results, the doctor will be able to comprehensively assess the situation and give the woman appropriate recommendations.
Very often, a woman goes for an ultrasound, only suspecting pregnancy, without a referral from a gynecologist and of her own free will. Such actions are usually dictated by the desire to find out whether it is worth talking about pregnancy when characteristic symptoms are present, but the test does not show a result.
The question arises: at what stage will an ultrasound show pregnancy and is there any point in going for an examination at 1-2 weeks of delay in order to finally decide? The answer is yes: an ultrasound can show pregnancy already at 3-4 weeks, and this is precisely those 1-2 weeks of missed periods.
But it’s not always the case that if an ultrasound shows a fertilized sac in the very early stages, you can be guaranteed to be pregnant. Unfortunately, the fertilized egg may turn out to be empty and not contain an embryo, and this will only be possible to establish from the 5th week of pregnancy.
If the pregnancy proceeds favorably and without any abnormalities, the woman will be scheduled for three scheduled ultrasound sessions during the entire period of bearing the baby. The first ultrasound is performed in the first trimester, the second in the second, and the third, respectively, in the third trimester. A planned ultrasound during pregnancy allows you to assess whether everything is going “according to plan”, and, if there is suspicion, it is repeated.
First scheduled ultrasound serves as a method for diagnosing pregnancy as such, allows you to determine whether there are risks of miscarriage, and diagnose “failures” in the development of the fetus at the earliest stages - when all vital organs and systems are formed and any deviation is fraught with the development of pathologies.
Second scheduled ultrasound during pregnancy, it is prescribed in the second trimester in order to assess the development of the baby, and at the same time the condition of the placenta. In addition, during the second ultrasound session, it is usually possible to determine the sex of the unborn baby.
Third planned ultrasound falls, as you might guess, during the third trimester. At this stage, the degree of development of the baby, the state of the uteroplacental blood flow and even the presentation of the baby are traditionally examined.
The specialist who is managing the pregnancy will clearly answer the question of when to do an ultrasound during pregnancy. As a rule, the timing of ultrasound is determined as follows:
Most representatives of modern medicine unanimously assure that ultrasound is safe for the fetus and does not cause embryotoxic effects. Their opponents, representatives of different spheres of life, unanimously declare the allegedly monstrous consequences of using an ultrasound machine. In fact, there is information that almost all “horror stories” are very exaggerated and do not have any serious evidence. Yes, ultrasound actually causes a slight heating of body cells, but this does not affect the condition and health of the fetus. The connection between the use of ultrasound and various pathologies and anomalies of newborns has not been proven.
However, many question such arguments, saying that just because it has not been proven, this does not mean that it has no effect. Based on this, the following judgment will be reasonable: while scientists and doctors are researching this issue, we will be careful and once again we will not expose ourselves and the baby to ultrasound. But if it is vitally necessary, that’s another question, because sometimes 10 minutes of examination save the baby’s life. Are any more arguments really needed? For those who are not convinced by this, we inform you: it has been proven that ultrasound for half an hour is safe for both the baby and the mother. And the radiation, which opponents of ultrasound are so afraid of, actually lasts less than a minute. The rest of the time the device works for reception.
Especially for- Olga Pavlova
From Guest
My pregnancy was late and very long-awaited. A lot of ultrasound has been done since the very first days. I still remember the first ultrasound, when there was a delay and they told me that I was either pregnant or had a polyp in the uterus. It turned out to be pregnancy. I don’t remember exactly how many ultrasounds I had later, but I completely trusted my doctor, so I followed all her recommendations and didn’t even think about anything bad. And the baby was born healthy. I think it’s better to find a good doctor than to read various horror stories on the Internet. I found my doctor at the Nearmedic Clinic, and I am grateful for everything they did for me.
From Guest
I also think that it is better to do ultrasound according to indications. My husband and I really decided to do one unscheduled 3D ultrasound and were very pleased! We visited Art-Med on Presnya. I liked the doctor, the equipment is the most modern. We were first diagnosed as 2D, then the sensor was switched to 3D/4D. And they saw the baby in real time.
From Guest
I sometimes get the impression that many expectant mothers just don’t know anything about ultrasound. Don't watch TV series, but read the latest achievements of world-famous scientists. About the harm ultrasound can cause and what it entails. To this I can add that doctors are reluctant to talk about possible consequences. Moreover, ultrasound can detect defects only in 50% of cases. Therefore, ask your doctor about all the positive and negative aspects of ultrasound, and then make a decision: to do it or not.
According to indications, there are three dates when the first ultrasound is performed during pregnancy. This is a planned one and two additional sonographies. They are performed earlier in case of painful sensations in the abdomen or scanned later to clarify the results of the first ultrasound diagnosis. If a woman becomes pregnant using IVF, or she undergoes therapy, the frequency of ultrasound examinations becomes more frequent.
Routine fetal examinations are mandatory. They are done in the middle or end of each trimester. The timing of the first ultrasound screening depends on the well-being of the expectant mother at the beginning of gestation.
At the first ultrasound, the anatomy of the embryo is assessed, the attachment site and the condition of the amniotic membranes are examined. During the first screening, the true duration of pregnancy and the number of children are also clarified.
In the 1st trimester, according to the schedule, ultrasound screening is prescribed at the end of the third obstetric month (1 month is equal to 28 days). That is, the planned first ultrasound during pregnancy is performed at 12 or 13 gestational weeks. The gynecologist calculates the date based on menstruation from the beginning of the last menstruation. In fact, fertilization occurs 14–16 days later (from the day of ovulation). Therefore, the difference between the gestational age and the true duration of pregnancy is two weeks.
At up to 2.5 months, an unscheduled first ultrasound scan is performed during pregnancy. This is the period from the 25th day from the start of menstruation to the 12th week of gestation.
An unscheduled ultrasound is performed in the following cases:
Can be done 1.5–2 weeks after ovulation. A fertilized egg grows quickly. If it remains inside the fallopian tube, after a few days of pain, the oviduct ruptures. If medical care is untimely, the woman will die from blood loss.
Watch the master class on the first screening:
For the procedure at the state antenatal clinic, it is recommended to take napkins, a large diaper, shoe covers, and for TVUS - a condom. From the documents they take a pregnancy management card, a passport, and a medical insurance policy.
You need to go for the first planned fetal examination to the antenatal clinic of the clinic where the pregnant woman is registered. An emergency ultrasound is performed in the hospital where the ambulance took you.
In the first trimester, a transabdominal and/or transvaginal ultrasound is performed. These methods have different preparation rules.
Preparatory stage for the first screening:
| What to do before an ultrasound | Access method and differences | |
| Abdominal | Vaginal | |
| Diet | Observe 3 days before the examination. Stop drinking all drinks or foods that increase gas formation. |
No need to change your diet |
| Carminatives | If you have bloating, your doctor will prescribe simethicone for 1-3 days. | No need to take anti-flatulence medicine |
| Drinking regime on the day of examination | Fetal scanning is done when the pregnant woman has a full bladder. 40–60 minutes before the ultrasound, they begin to drink still water (3–4 glasses), and do not go to the toilet “small times”. |
You must empty your bladder before the procedure. |
On the morning of the first study, take a shower without soap. There is no need to apply body cream, powder, or ointment to the skin of the abdomen. They may impair ultrasound penetration. It is advisable to go to the 1st ultrasound in clothes that will allow easy access to the vagina or abdomen.
During pregnancy, the first ultrasound is done in the same way as an ultrasound examination of the pelvic organs. There should be no discomfort during the procedure. Pain indicates the likelihood of inflammatory diseases and complications. The diagnostician is immediately told about such sensations and the cause is found out.
During the first ultrasound, each fetus and its membranes are examined separately. During pregnancy screening, photographs of the baby are taken using an ultrasound machine, and the uterus and ovaries are photographed for pathologies.
How to do the first transvaginal ultrasound:
Transabdominal ultrasound is done the same way in all trimesters. For a singleton pregnancy, the procedure takes less than 15 minutes. The first step is to cover the couch with a diaper. The woman lies on her back, puts her legs straight, exposes her stomach from the suprapubic area to the ribs. The diagnostician lubricates the skin in the projection of the uterus and ovaries with gel. Applies the sensor and moves along longitudinal and transverse lines. After scanning, wipe off the gel and print out the protocol.
The protocol is deciphered by the gynecologist-obstetrician leading the pregnancy. The doctor checks the actual indicators of the first ultrasound with the norm for each week of gestation. While interpreting the results, the doctor calculates the expected due date. The birth is planned at 40 obstetric weeks.
What the first ultrasound shows from the 12th week of pregnancy:
It is not advisable to determine the sex of the child at the first ultrasound. The genitals are poorly distinguished by ultrasound. It will be reliably visible after the 16th week of pregnancy, but it is better to do sonography to find out the sex of the baby in the 3rd trimester.
Possible fetal pathologies in the results of the first ultrasound:
The presence of pathology should be confirmed by tests and repeated ultrasounds after the 13th week of pregnancy.
At the beginning of pregnancy, at the same time as the ultrasound, the first biochemical blood screening is done. Analysis indicators confirm/exclude fetal development abnormalities. In case of complications, a biopsy and other types of diagnostics may be prescribed.
To view on an ultrasound monitor 12 weeks pregnancy:
There are no contraindications to ultrasound examination during pregnancy. The only limitation is damage to the skin in the lower abdomen (burn, wound). Screening using the abdominal method is carried out after tissue healing.
During early pregnancy, transvaginal ultrasound is performed in women with obesity or other medical conditions. The first TVUS is not recommended before if gestation is proceeding normally: there is a risk of rupture of the fertilized egg. From the 2nd trimester this method is not practical.
The first ultrasound never caused gestational complications or embryo development abnormalities.
There is not a single evidence in evidence-based medicine that ultrasound waves can harm a child. During the gestation period, minimal ultrasound power is used. The first scan with a transvaginal probe lasts less than 5 minutes. Transabdominal examination during a singleton pregnancy lasts a maximum of a quarter of an hour.
In the early stages, the price of an ultrasound examination in non-state clinics is 700–4000 rubles. For multiple pregnancies, the procedure will cost 600–8000 rubles. The cost of the planned first screening starts from 300 rubles. In budget antenatal clinics, ultrasounds are performed for pregnant women at the place of registration free of charge.
The first ultrasound in the early stages evaluates the condition of the uterus, the presence and location of the embryo. From the twelfth week, the structure of the embryo is studied.
The reason for the identified deviations is the low technical ability of the device or improper preparation for ultrasound, inexperience of the diagnostician, or another human factor. To exclude pathologies, it is better for a woman to do this and consult with doctors at an independent medical institution.
During the appointment, the obstetrician-gynecologist will tell the patient at what time an ultrasound should be done when pregnancy occurs. Typically, three studies are carried out during the entire period of gestation: 10-12 weeks, then 20-22 weeks, and the last one at 30-32 weeks.
Ultrasound 
snapshot photograph
apparatus consultation inside
planned in rest position
development snapshot view
Each of these diagnostics has its own goals. Three is the number of studies that need to be done. Sometimes the doctor prescribes more procedures. It all depends on the condition of the mother and baby.
A qualified doctor will always tell you in detail how many weeks you need to do the first and subsequent ultrasound scans during pregnancy. Which .
So, the first study is done at 3-5 weeks. This is necessary to confirm pregnancy and understand the location of the fetus. However, the baby is still very tiny, so you need to do a diagnosis at 10-12 weeks to understand how he is developing.
The first procedure should be carried out between the 3rd and 5th week
At this time the doctor:
The second diagnosis is done at 20-22 weeks. The fetus is already quite large, so details that cannot be seen at the age of 10-12 weeks become visible on the screen. You can already understand whether it is a girl or a boy, how he is developing.
At this age, the doctor, through research, obtains information about:
A possible threat of miscarriage is determined. In this case, the woman can undergo hospital treatment and avoid serious consequences.
In general, the main purpose of diagnostics at this time is to identify genetic pathologies, for example, Down syndrome and other developmental defects. If the situation is unfavorable for the fetus and mother, the doctor suggests an abortion.
Second diagnosis at 20-22 weeks
The last ultrasound is done at 30-32 weeks. Diagnostics are carried out for:
It is important to determine the baby's presentation. The baby should already turn head down. This position is called cephalic presentation. If the fetus is in a breech state, there can be serious complications during childbirth. Doppler ultrasound is also performed, which allows you to determine congenital heart defects and see the blood flow in the vessels.
If you suspect twins, you need to know at what time an ultrasound is performed during a multiple pregnancy. It is installed during the first study in the second month. Multiple pregnancy can be diagnosed with a routine gynecological examination. The main symptom is the growth rate of the uterus is too fast.
After the IVF procedure, you must definitely clarify at what time it is best to do an ultrasound during pregnancy. Diagnosis is necessary after approximately 20 days to:
The doctor also monitors the condition and development of the fertilized egg and the condition of the woman’s ovaries.
At the first appointment, the specialist will tell you what kind of ultrasound is done to determine the presence of pregnancy, as well as to collect information about the condition of the fetus.
There are several types of baby studies.
The doctor determines the required number of screenings. Sometimes the number of procedures increases. It depends on the condition of the woman and her fetus.
Chromosomal abnormalities are found using biochemistry
The procedure for a planned study is similar to how an ultrasound is done at earlier stages. There is a transabdominal and transvaginal method. A specialist will advise which one is right for you.
In the early stages, research will help:
The term can be determined by the size of the embryo. However, sometimes there is an error of 1-2 weeks. Let's find out when is the best time to do an ultrasound in the early stages of pregnancy.
The location of the fertilized egg makes it possible to identify an ectopic pregnancy, which can be detected within 7 days after a missed period. As already mentioned, multiple pregnancies can be detected during the first study.
Also, early diagnosis is designed to confirm the viability of the fetus. Heart function can be detected at 3-4 weeks. At this stage, the expectant mother can feel the baby’s heartbeat. This also confirms that he is alive.
But it is very difficult to determine the sex of a child in early diagnosis. This requires a minimum of 12-13 weeks.
Only a doctor should advise whether to do ultrasound examination in the early stages. After the expectant mother registers at the antenatal clinic, the obstetrician-gynecologist creates a card, which includes the following information.
You should know in what cases ultrasound during pregnancy is performed in the early stages. First of all, the indicator is chronic and internal diseases that can provoke the development of fetal abnormalities. Particular attention is paid to:
Also, the doctor’s close attention is drawn to cases where the first child was born with abnormalities or pathologies, if the woman experienced a miscarriage or fetal death.
Fetal examination
The danger comes from pathologies of the pelvic organs, cancer, severe and prolonged toxicosis. It is worth knowing that the doctor can print out a photo of the fetus regardless of the timing of the ultrasound examination during pregnancy. Many mothers want to get photos as quickly as possible. Modern equipment allows this to be done.
It doesn’t matter when an ultrasound is done at any stage of pregnancy, it is important to prepare emotionally for the diagnosis. Many women worry that the procedure is harmful and the ultrasound waves harm the tiny embryo. As a result, the body begins to produce stress hormones, and they are immediately transmitted to the child. This is why the baby begins to actively move during diagnosis, and this can interfere with the procedure.
The schedule of days when you need to do an ultrasound examination is made only by the doctor. Usually three procedures are enough. Sometimes more diagnostics are required, but this is the exception to the rule.
You should drink plenty of water before the first test, but you do not need to do this before subsequent tests. The drunk liquid will be replaced by amniotic fluid.
Please note that it is best to drink water immediately before your appointment, because if some time passes, the urge to urinate will interfere with the procedure. You should make sure that the doctor is qualified and that there is high-quality equipment in the clinic where the diagnostics are carried out. This will avoid errors and inaccurate results.
Private healthcare facilities usually provide the necessary supplies. A diaper, condom and shoe covers are already included in the price of admission. However, in most city clinics you need to bring them with you. It’s worth calling the reception desk and checking this out. Also learn and accept.
: Borovikova Olga
gynecologist, ultrasound doctor, geneticist
Routine ultrasounds during pregnancy are used to determine indicators of intrauterine development. Such studies help to timely diagnose various anomalies in the baby or excessive stress on the mother’s internal organs.
The timing of planned ultrasounds during pregnancy corresponds to each stage of fetal formation:
In addition, the 2nd and 3rd planned ultrasounds during pregnancy are additionally performed with Doppler ultrasound, which makes it possible to assess the blood circulation in the mother-placenta-fetus system. Because deviations in the blood flow contribute to the formation of hypoxia, the baby does not receive sufficient nutrients.
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