Importance of ultrasound during the first months of pregnancy

Doctors regularly need to investigate what happens inside the patient when he or she experiences some discomfort that is not necessarily due to a pathology, such as pregnancy.

And all radiological equipment such as ultrasounds (US) and other laboratory studies are used in these situations.

What is ultrasound?

Ultrasound, also known as ultrasound, is a support tool widely used in medicine to investigate and diagnose what is affecting the patient inside.

It is the first choice study to detect and study pregnancies up to the day of birth.

Unlike conventional radiology equipment such as X-rays, CT or MRI.

Ultrasound does not use ionizing radiation to work, so in addition to being effective it is considered safe.

The reason for this is that ultrasound implements high-frequency sound waves capable of offering visual structures belonging to the human organism. These waves are represented in the ultrasound as dotted images in movement, whether they are two-dimensional, three-dimensional and even in 4D.

Ultrasound as the study of choice during pregnancy

Obstetric ultrasound is a totally safe, painless and non-invasive procedure, so it will not affect the health of the mother or the baby.

Complementing the above, its simplicity, functionality and cost make it accessible for the medical service. 

Control and monitoring of pregnancy mediated by ultrasound

The most common routine finding during the first trimester is confirmation of pregnancy.

And as a result of this, the other necessary studies arise throughout intrauterine life and are discovered via ultrasound .

• First trimester: confirmed pregnancy, multiple pregnancy traits, determine gestational age and estimated date of delivery, nuchal translucency test, normal study of the anatomical development of the fetus, examine the woman’s uterus, ovaries and cervix.
• Second trimester: careful study of the anatomical development of the fetus, monitor the position of the fetus inside the uterus, determine the sex of the baby, examine the position of the placenta .
• Third trimester: determine that the fetus has had correct development, diagnose any problem of the woman during pregnancy.

During each trimester it is essential to reaffirm that the fetus is alive and also to diagnose any genetic malformation that puts its life at risk.

Types of ultrasound used in pregnant women

Being trained to use and interpret the ultrasound is essential when performing the different techniques.

In order to find and analyze what we are investigating at that time.

Each of these techniques allows the doctor to observe different angles of the fetus and in different resolutions, thus benefiting timely care in the event of presenting any complication , abnormality or inconclusive diagnosis.

Fetal ultrasound exams, Ultrasound scans:

• Transabdominal ultrasound: it is the most used technique due to its simplicity and efficiency , it is only placed on the abdomen to begin to reflect the ultrasound.
• Transvaginal ultrasound: used during early stages of pregnancy, a transducer is inserted through the vagina capable of transmitting the waves reflected in the ultrasound, it is usually backup when the transabdominal US does not transmit enough information.
• 3D application: unlike traditional methods, 3D ultrasound provides volumetric data of both the fetus and its organs, it also helps detecting neural tube defects or any other suspicion.
• Doppler ultrasound method: when you need to check the blood flow of the fetus, the US Doppler is able to calculate the circulating blood through its sound waves, which is useful during pregnancy.
• Fetal echocardiography: this study provides a detailed image of the fetal heart, it routinely helps to verify correct operation or, where appropriate, rule out any heart defect.

Necessary care for the fetus and mother during pregnancy

When the ultrasounds show the perfect condition and growth of the baby, it is due in large part to the care that the mother maintained during the months of gestation.

Although there are more factors that harm fetal development, undoubtedly the maternal one is transcendental for the fetus.

Drugs and food

The essential thing before and during pregnancy is to consume folic acid in amounts around 400 mg daily.

Since it is proven that ingesting it potentially reduces any risk of genetic mutations in the fetus.

In the same way, it is suggested to suspend certain medications, this because some drugs are highly lethal for the fetus and it is necessary to avoid any complications. 

Currently, the FDA has a classification of drugs in 5 different categories in order to ensure if your drug is acceptable or should be restricted during pregnancy.

Also restricting alcohol, cigarettes and any other addictive product is necessary for pregnancy care.

Complementary laboratory studies

Although ultrasound serves its purpose in pregnancy, it is not a 100% true study.

Therefore, additional tests may be required to confirm or rule out genetic alterations.

Some of them are chorionic villus sampling, amniocentesis or conventional blood and serum tests to determine the health status of the fetus .

Chorionic villus sampling is obtained after removing a tiny part of the placental tissue.

And it serves to analyze the presence of chromosomal failures, it is recommended to perform between weeks 10 to 12 of gestation.

For amniocentesis, this test is performed weeks after villus sampling and consists of extracting amniotic fluid from the woman’s uterus.

If the fluid contains two of the most important proteins produced in the fetus, alpha-fetoprotein (AFP) and acetylcholinesterase (ACE), it indicates a developmental defect.

In the case of blood and serum tests, they are performed on the mother to verify the levels of human chorionic gonadotropin (hCG) and plasma protein A associated with pregnancy.

If they are altered in the mother, they give indications of a possible chromosomal alteration.

Complications during pregnancy found by ultrasound

Congenital anomalies are rarely seen very often and are usually associated with:

• poor cell division
• mother’s age and health
• environment of the fetus as well as the pregnant woman

Many genetic diseases can be discovered by ultrasound , and the most common are those related to neural tube defects (NTDs) that involve the brain, spine, and spinal cord. 

Among the most viewed DTNs are:

• spina bifida
• anencephaly
• encephalocele

Although there is also a risk of hydrocephalus, microcephaly, myelomeningocele or Dany Walker syndrome.

On the other hand, they are also caused by cardiovascular defects.

Such as the development of a single ventricle or atrium, left or right chamber hypoplasia syndrome, and cardiac tumors.

The digestive system defects found by US are duodenal atresia, gastroschisis and omphalocele.

While in the kidney, unilateral or bilateral renal hydronephrosis and polycystic kidneys predominate.

What else can ultrasound be used for?

Unlike pregnancies, ultrasound is very useful to find cancerous processes, for example:

When studying a possible case of breast cancer, both mammography and US Doppler are the most widely used tests .

Both make it easy to find abnormal masses in the breast areas.

Differentiating the large amount of tissue from the tumor and discovering new blood vessels that supply it, which favors a timely diagnosis.

In addition to this, it also has many other uses in medicine , as a guide during aspiration biopsies, so that in the ultrasound you can see the needle in the extraction area.

As mentioned above, it provides support to perform a not necessarily fetal echocardiogram.

And it is that pathologies such as coronary disease and heart failure are found through ultrasound.

Other tasks of the ultrasound are to discover causes of infections, visceral pain, kidney organs and conditions in the thyroid and parathyroid glands.