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Decoding Of The Second Screening Of Ultrasound

In the second trimester, a pregnant woman is assigned a repeated screening, confirming or refuting the data obtained in the first comprehensive study. This period is most suitable for the diagnosis of hormonal levels of the fetus. The data obtained make it possible to assess its development.

If the expectant mother has to wait for a consultation of the attending physician for several days, she will certainly be interested in whether the results of the perinatal screening are normal in advance. It should be remembered that the doctor always judges the pathology only by the totality of the indicators of fetometry, and almost never takes anyone value into account.

Each child is individual even before birth. And if the future mother has really serious reasons for concern, then the ultrasound clinic will inform her about this immediately. Nevertheless, we will talk about the main indicators of the second screening and their normal values.

Body length and fetal weight

At the beginning of the second trimester, the embryo is growing very actively, and it is difficult to judge the standards. On average, the length of the fetus grows from 10 to 16 cm between the sixteenth and twentieth weeks of pregnancy. It is important to consider not an absolute indicator in centimeters, but an increase in growth by weeks. If the specialist is alert, the pregnant woman will be offered a second study after a week or two.

The fetal weight by ultrasound can only be determined using special formulas so that this value can be very inaccurate depending on the device, the doctor, and the posture of the baby in the womb. Weighing about 300 grams by the 20th week, all the organs of the baby are fully formed, and from 22 weeks or about 450 grams, a prematurely born baby can survive. It seems unbelievable!

The circumference of the abdomen and head

As well as the growth of the child, these important values ​​vary over a wide range and must strictly correspond to the gestational age. There are frequent cases when the “developmental delay” in practice turned out to be an incorrectly diagnosed gestational age. However, the widespread introduction of ultrasound diagnostics in the early stages has reduced the number of such errors.

Biparietal (BPR) and Frontooccipital Foetal head size

It is not surprising that the level 2 ultrasound of pathologies during pregnancy is based on head measurements in 3 projections. It is unlikely that at least one human organ is comparable in complexity and importance to the brain. Deviations from reference values ​​may indicate the formation of severe fetal malformations, such as anencephaly or dropsy of the brain. But as a rule, such diseases are judged by several repeated ultrasounds.

Bone length: lower leg, femur, humerus, and forearm

Some deviation from the norms indicated in the table for the weeks of pregnancy is permissible and can be determined by individual characteristics. The doctor will be warned by a sharp shortening of the entire limb or a different length of arms or legs in one child.

Ultrasound For Children – Reasons Can Be Many

Ultrasound in children is a popular technique for diagnosing congenital abnormalities. Ultrasound helps to diagnose painlessly, quickly and accurately. Such an examination is used in all areas of medicine. Ultrasound helps to visualize the size, shape, and structure of the internal organs of the child and to identify pathological disorders in the early stages.

Types of ultrasound examination of the child

Depending on the symptoms, the children are examined such organs:

  • Examination of the abdominal cavity;
  • Kidney and bladder;
  • Brain (neuro sonography);
  • Thyroid gland;
  • Heart (echocardiography);
  • Hip joints;
  • Pelvic organs;
  • Mammary glands;
  • Doppler scanning of blood vessels.

Indication for an ultrasound of the child

A pediatrician, neurologist, orthopedist, cardiologist, pediatric gynecologist, or urologist will refer you for an ultrasound examination of the child. An indication for an ultrasound of a girl or boy is a suspicion of a deviation from the normal development or pathology of the internal organs.

There are also many congenital diseases that are asymptomatic from birth, and only after a year can somehow manifest themselves. Therefore, prophylactic ultrasound examinations of the brain, hip joints, and kidneys are recommended at an early age.

Mandatory ultrasound is performed on premature babies, babies with hereditary tendencies to pathologies, and children after difficult births. Also, an ultrasound examination of the baby will not hurt if the mother had infections during pregnancy.

Preparation for the procedure

Some special preparation for an ultrasound scan of a boy or girl is not needed, but there are several recommendations that must be adhered to: before examining the pelvic organs, give the child to drink up to 100 ml of water, since the examination is performed with a full bladder. For 1 - 2 days before ultrasound of the abdominal cavity, bakery products, fresh vegetables, fruits, and beans should be excluded from the diet.

Other types of children's ultrasound do not need special training.

Also, before the ultrasound testthink about how to dress the baby. For example, if you need to examine your hip joints, then your legs and hips are exposed, an abdominal ultrasound scan reveals your stomach. Therefore, especially in winter, choose clothes so that they can be easily removed and put on.

How is the ultrasound procedure in children?

Children's ultrasound lasts about 15 minutes. Depending on the studied area, the desired part of the body is exposed, the doctor applies a special gel and examines the image on the monitor. Parents are given a conclusion according to which a pediatrician or a specialist doctor will prescribe an individual treatment regimen.

If necessary, such an examination can be carried out daily for monitoring during treatment therapy.

Is it possible to do an ultrasound examination for children up to a year?

This is an absolutely harmless examination method. It can be carried out even for a baby a couple of hours after birth. Ultrasonic waves do not affect the health and development of the baby.

There are many advantages to such a study:

  • Allows you to identify congenital abnormalities;
  • High information content;
  • Painlessly;
  • Safely;
  • Quickly.

The child grows very quickly, and in order to control the development of internal organs, ultrasound clinics recommend systematic ultrasound diagnostics. Thanks to modern devices, the information content of ultrasound is very high and give a complete picture when making a diagnosis.

Ultrasound Of The Kidneys In Health And Disease

How the kidneys look on ultrasound is normal and how pathology is determined can be found in this article. Here you will find the basic principles that experienced doctors’ use in their work.

A normal view of the kidneys on ultrasound

A complete ultrasound examination having high ultrasound scan cost of the kidneys includes an assessment of the location, orientation, axis, size, and echogenicity of the parenchyma, the contour, the nature of the centrally located echogenic disk and the lack of visualization of the proximal ureter. Normally, the kidneys are located in the retroperitoneal space along with the lumbar muscles and are oriented parallel to their course. They occupy an oblique position, and the upper pole is located dorsal to the lower pole.

The size of the kidney depends on the age; it is measured between the two poles and compared with known nomograms. From the point of view of ultrasound of the kidneys, the most important adjacent organ on the right is the liver, and on the left is the spleen. During the first few months of life, the kidney parenchyma may be iso- or hyperechoic compared with the liver or spleen, and then it becomes hypoechoic.

The cortex can be differentiated from the cerebral bylines, reflecting slight differences in echogenicity. The presence of cortico-medullary differentiation is an indicator of the normal structure of the kidney and the integrity of the parenchyma.

The contour of the kidney in children on ultrasound can be smooth, but often it has a lobed structure. Parenchymal lobules consist of a central pyramid covered with parenchyma of cortical substance and pillars located between the pyramids. With age, the lobed structure disappears, and the contour becomes smooth.

Abnormal development of the kidney on ultrasound

Anomalies or pathology of the kidneys in children can be divided into congenital and acquired, and anatomically- anomalies in the number, localization, vascular, parenchymal and abdominal systems.

One-sided kidney agenesis on ultrasound is often detected. Unilateral agenesis of the kidney is most often determined in children during an ultrasound scan conducted:

  • With urination problems;
  • When screening for related anomalies and
  • About unrelated pathology.

On ultrasound in the renal fossa is not defined as a bean-shaped structure, and it may be located intestines. The surrounding organs are usually not changed. In such cases, it is important to conduct an ultrasound examination of the pelvis to prevent kidney dystopia. In infants, the adrenal glands are visualized in a normal anatomical position.

Kidney dystopia on ultrasonography

The kidneys begin their embryonic development in the large pelvis with the pelvis oriented anteriorly, and then they migrate to the renal fossa and complete the medial rotation by the 6th week of gestation. This process can be interrupted at any stage.

Renal vein thrombosis with an ultrasound scan

Ultrasound done by professional Ultrasound Clinics has a high diagnostic value for suspected renal vein thrombosis. Risk factors include dehydration, birth injury, and sepsis. During the acute phase, marked edema develops, and an ultrasound examines an increase in the kidney with a loss of corticomedullary differentiation. Due to edema at an early stage, the parenchyma looks hypoechoic, but with the progression of fibrosis, it becomes hyperechoic. Thrombi of small vessels look like radiant linear echogenic bands in the parenchyma. Atrophy and calcifications are visualized at a late stage in the thrombus localization zone. When color Doppler on ultrasound, there is a lack of venous blood flow.

Major Liver Disease During Ultrasound

Steatosis of the liver (different names may be: fatty hepatosis, fatty infiltration, fatty liver), which occurs on liver ultrasound, is an etiologically and pathogenetically heterogeneous syndrome, which is characterized by a prolonged and significant accumulation of triglycerides in hepatocytes. The main factor of steatosis is alcohol abuse, diabetes, obesity, unbalanced nutrition (protein deficiency), chronic diseases of the gastrointestinal tract, accompanied by impaired absorption (enteritis, pancreatitis, ulcerative colitis, etc.), chronic debilitating diseases (cancer, anemia, cardiac and pulmonary insufficiency, etc.), toxic (hepatotropic, medicinal) and bacterial factors.

Ultrasound test with a diffuse form of fatty hepatosis, as a rule, reveals an increase in the size of the liver, an unclear contour. The edges of the liver are rounded. Characteristic features include increased echogenicity of the parenchyma. Its structure is in most cases homogeneous, however, sometimes on the background of hyperechoic tissue, it is possible to detect areas of reduced reflection with uneven, fuzzy contours that do not deform the vascular pattern.

These are areas of unchanged parenchyma, which, as a rule, are detected in the portal fissure of the liver, in the projection of I, IV, V segments. The sound conduction of the liver is often reduced; the vascular pattern is depleted. In addition to diffuse, ultrasound of the liver also produces local and focal forms, when fatty infiltration extends only to limited segments and sectors of the liver, and sometimes manifests itself in the form of individual small zones, resembling focal education.

Ultrasound picture of fatty hepatosis does not always allow to clearly differentiate it from other diffuse organ lesions (chronic hepatitis, the initial stage of cirrhosis). Crucial importance in the diagnosis of steatosis and its delimitation from chronic hepatitis belongs to the puncture biopsy of the liver.

How does hepatitis show on ultrasound?

Acute hepatitis is an acute degenerative and inflammatory lesion of the liver. Hepatitis can be alcoholic or viral etiology, develop as a result of exposure to toxic or metabolic factors. The main ultrasound sign of this disease is hepatomegaly. In a significant number of observations, moreover, an increase in the size of the spleen is found. The contour of the liver usually remains clear and smooth.

Edges can be both sharp and rounded. In the severe course, accompanied by the presence of foci of necrosis, the parenchyma has a heterogeneous structure due to the appearance of multiple areas of reduced echogenicity alternating with fragments of unchanged parenchyma. With significant swelling of the liver tissue, its echogenicity is reduced to a greater extent.

Organ conduction is often increased; as a result, the vascular pattern becomes clearer, and the walls of the portal vein more contrasting. Detection of enlarged lymph nodes in the area of the hepatoduodenal ligament may be of some help in making a diagnosis.

As a rule, on ultrasound in chronic hepatitis, an increase in the size of the liver due to the right and left lobes is observed, a rounding of the edges and an increase in the angles formed by them can be observed. The contour of the liver often remains clear and smooth. The structure of the parenchyma is usually diffusely heterogeneous, the echo is increased, and the sound conductivity is reduced in most cases. There is also a progressive impoverishment of the vascular pattern. In chronic hepatitis, diffuse liver damage was found only in 2/3 cases, which, according to the ultrasound labs, is due to the absence in most cases of fairly pronounced fibrosis and/or steatosis.

What Ensures a Good Sonogram Image?

For a pregnant woman, the images of sonogram matters the most and why not? After all they give a sneak peek of what the baby may look like. In this age of social media many Ultrasound Clinic have also created online groups for sharing the ultrasound images which make the ladies drool over them. In the last 4-5 years elective ultrasound has become increasingly popular as more mothers want to see their baby’s face before he/she is born. And thanks to recent advances in technology, ultrasound machines can render 3D and 4D imaging that is more lifelike than ever before. But, there is something to be very specific about; that the two expecting mothers do not have the same wombs and the 3D images of sonogram does get influenced by the same. There are quite a lot of factors that influence the clarity of ultrasound photos. I am going to list the top 5 in order of importance below:

1.     The Location of the Placenta- Your placenta is the organ that develops inside your uterus during pregnancy that provides oxygen and nutrients to your growing baby. The placenta is attached to the uterine wall either in the front (called an anterior placenta), or in the back (a posterior placenta). If you have an anterior placenta, it will be over the top of baby’s face, making it harder to get clear photos. Therefore, the recommended timeframe to get 3D/4D imaging is at 28-34 weeks, before baby gets too big and squished into the placenta. If your placenta is posterior, it will be under the baby, and you can wait until 34-38 weeks to have your ultrasound. If you don’t know where your placenta is located, you can email us an ultrasound picture from your anatomy scan, and we can tell you.

2.     The amount of amniotic fluid- A higher amount of fluid present in the amniotic sac would ensure that the 3D/4D imaging is clear. Higher fluid levels are especially important if you have an anterior placenta because we need to have fluid between baby’s face and the placenta to be able to get images. To make sure you have fluid in the amniotic sac, it is recommended that you drink 65 to 80 ounces of water a day, every day, the week leading up to your ultrasound appointment.

3.     The position of the baby- It is ideal that your baby is head down (meaning the head is down low near your cervix). This is the position baby should be in before you go into labor. This position also yields the best 3D/4D imaging in the Ultrasound Test. The baby’s face should also be pointing upwards towards your stomach. If baby is looking towards your spine it would be impossible to get images. Babies in the breach position i.e. the gaping position are also harder to get images of, especially with an anterior placenta.

4.     The make and model of the Ultrasound Machine- Just like any other technology, the newer more modern devices and equipment produce better quality imaging. There are several major manufacturers of ultrasound machines. The leading brands offer the latest cutting-edge 3D/4D and high definition ultrasound technology. Ultrasound facilities that use newer, updated machines in the Ultrasound labs Delhi can provide you with better imaging of your baby.

5.     The experience of the sonographer- Learning to do ultrasounds is not an easy endeavor. Extensive professional training and several years of hands on practice is required to gain the experience necessary to acquire clear 3D/4D imaging. Additionally, the ultrasound tech should be knowledgeable about the tricks to get baby in the right position for photos. You’ll want to choose a facility that has an experienced tech who has performed, not just hundreds, but thousands of ultrasounds.

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