The first ultrasound examination is carried out for all pregnant women. When is it better to do the first ultrasound during pregnancy and what does it show?

For any expectant mother, the first ultrasound during pregnancy is an unusually touching, exciting moment that leaves indelible impression for life. You will never forget this moment - when you see your baby on the monitor screen for the first time.

But no matter how touching it is, for doctors the value of this examination is purely practical. If your pregnancy is going well and there are no indications for emergency examination, you will have to wait quite a long time for the first meeting with your baby.

The timing of the first examinations is strictly regulated; this is 11-12 weeks of pregnancy. This is the first screening examination, which is also called genetic.

What does the first ultrasound show?

There is a period of time during pregnancy when the baby is very vulnerable to external influences. This is the entire first trimester of pregnancy. If the mother becomes ill during this period and uses herbs and medications prohibited during pregnancy, this may adversely affect the development of the embryo. The formation of fetal malformations and severe anomalies, sometimes incompatible with the continuation of pregnancy, is possible.

The first planned ultrasound scan during pregnancy is aimed at identifying such gross developmental abnormalities so that, if necessary, the pregnancy can be terminated in a timely manner if it develops pathologically. It is important to determine how correctly the fetus is formed: the spine, arms and legs of the child are clearly visible, you can see how its heart, brain and other organs have formed. By 11-12 weeks of pregnancy, the baby is already large enough that you can even examine his face to see if he has a cleft lip or cleft palate (facial clefts). The size of the collar zone and the length of the fetal nasal bones - markers of Down syndrome - are determined.

And of course, ultrasound in the first weeks of pregnancy makes it possible to clarify its duration down to the day. All babies at this age develop in exactly the same way; there are no differences caused by the gender of the baby, the mother’s physique or her diet.

IN in rare cases The date of the first ultrasound during pregnancy is shifted back several weeks. As a rule, there are indications for this, for example, the threat of miscarriage or pregnancy after IVF. In any case, there is no point in doing an ultrasound before 5 weeks, you won’t see anything, the embryo is too small.

How is the first ultrasound done?

Currently, the initial examination, up to 12 weeks, is carried out with a transvaginal probe.

How it goes:

The doctor will ask you to remove underwear, lie down on the couch and spread your knees. A special disposable ultrasound condom is placed over the vaginal probe (you may be asked to bring one with you). The sensor is thin, about 2 cm in diameter, no more than 20 cm long, and is inserted into the vagina. It is not painful and does not cause discomfort.

There is no need to be afraid of how the examination is carried out; this method of conducting it is much more informative than the outdated transabdominal ultrasound.

The results of the examination depend on the period. At 5-6 weeks you can estimate the size ovum, the embryo looks like a dot on the monitor, but already from 6 weeks its heartbeat is visible. After 7 weeks, arms and legs become visible, and by 12 weeks the baby will have grown so much that all of its organs and systems can be seen. Decoding the ultrasound allows you to clarify what stage you are currently in, by the size of the fertilized egg in the early stages, and by the length of the body and the size of the baby’s head at 11-12 weeks of pregnancy.

Remember that during the first procedure, ultrasound will not show the sex of the child; this is possible no earlier than 15 weeks, even with the most modern equipment.

First ultrasound during pregnancy, how to prepare

For the reasons described above, it matters to the doctor how many weeks you do the ultrasound. If you go for it too early, then you will have to go again, but whether ultrasound is harmful to the fetus or not has not yet been proven.

Dates when the first checks are scheduled in antenatal clinic- from 10 to 13-14 weeks, depending on your luck, it depends on the capabilities of your medical institution.

How to prepare for the examination?

We described how it is done, and with this approach no preparation is needed at all. You can safely eat before the ultrasound and do not need to drink water. Make sure that you have an empty bladder before the test so as not to experience any discomfort.

If you are scared, you can take your husband with you, but most likely this study will not make much of an impression on him; too little can be seen on the doctor’s monitor screen.

Is it worth doing the first ultrasound during pregnancy at 5 weeks if everything is fine? It is believed that the less a woman is disturbed in the early stages, the better. The uterus reacts to ultrasound by becoming toned, so it is better to refrain from examination when the baby is most vulnerable.

At 5 weeks you may experience additional stress due to the fetal heartbeat if too early examination it may not be detected, they may suspect a frozen pregnancy, and in a week you will have to go to the doctor again. And all this time you will worry in vain. If nothing worries you, it is better to wait 12 weeks.

During pregnancy, by repeated ultrasounds in different terms the physiological development of the fetus can be monitored.

When is an ultrasound done during pregnancy?

Intrauterine development of the fetus is a dynamic process, so ultrasound must be performed at a time that provides maximum information about the anatomy of the fetus.

By Order of the Ministry of Health of Russia dated November 1, 2012 No. 572n “ On approval of the Procedure for providing medical care in the field of obstetrics and gynecology» During a normal pregnancy, ultrasound is performed 3 times. There is no need to conduct an ultrasound every month or every time a pregnant woman visits a doctor at the antenatal clinic, except in cases where there are reasons to suspect the presence of a pathology that requires dynamic monitoring. For example, in case of miscarriage, the number of ultrasound scans increases to monitor the dynamics of fetal development.

Ultrasound during pregnancy is performed in each trimester:

in the first trimester - at 11-14 weeks;
in the second trimester - at 18-21 weeks;
in the third trimester - at 30-34 weeks.

The optimal periods for triple screening are 12, 22 and 32 weeks. If a pregnancy complication is suspected (bleeding, pain, etc.), an ultrasound may be scheduled unscheduled.

Ultrasound in early pregnancy (in the first trimester of pregnancy)

With the transvaginal ultrasound method using a vaginal sensor, pregnancy can be established at 4-5 weeks. With transabdominal ultrasound (through the abdominal wall), the presence of pregnancy can be established 2-2.5 weeks later.

In the early stages, the diagnosis of pregnancy is established based on the detection of the fertilized egg, yolk sac, embryo and its heartbeat in the uterine cavity, in more advanced cases late dates– thanks to visualization of the fetus (or fetuses with multiple pregnancy).

to confirm pregnancy. An increased level of hCG in the blood or urine is an indicator possible pregnancy, which can be confirmed by ultrasound. Detection of hCG in a woman’s blood without taking into account ultrasound and clinical signs is not an absolute confirmation of pregnancy. Transvaginal ultrasound can detect pregnancy in the early stages (already in the fifth week of pregnancy), when the size of the fetal sac is only 2-3 mm, that is, when menstruation is delayed by 1-3 days.
to clarify the location of the ovum (to confirm normal or outside intrauterine pregnancy) . If at hCG level over 750-1000 units it is not possible to detect the fetal sac in the uterine cavity or if the fetal sac is detected outside the uterine cavity, this means the presence of an ectopic (ectopic) pregnancy. Detection of a yolk sac by ultrasound in the uterine cavity confirms a normal intrauterine pregnancy.
to exclude hydatidiform mole – dangerous complication in which there is an enlarged uterus with or without the presence of a fertilized egg, but normal development no embryo develops, and the chorionic villi grow in the form of blisters filled with fluid.
to confirm the viability of the embryo. The embryo's heart begins to contract on the 23rd day of development (that is, starting from the sixth week of pregnancy), which is recorded on the monitor screen. At this time, the fetal heart rate is normally 90-100 per minute. After the 8th week of pregnancy, the fetal heartbeat should always be detected.
to determine the duration of pregnancy. Before the embryo is visible, the gestational age is determined by the average internal diameter of the gestational sac. With the appearance of the embryo from 7 to 14 weeks, the gestational age (gestational age) is determined by coccyx-parietal size(CTP) of an embryo or fetus. If before pregnancy menstrual cycle was irregular or the date of the last menstruation is not precisely known, the most reliable indication of the gestational age is an ultrasound performed in the first trimester when measuring CTE.
to detect multiple births. In a multiple pregnancy, in the very early stages you can see two or more fertilized eggs located separately.
in case of threat of miscarriage. In the presence of bloody discharge it is very important to assess fetal viability (heartbeat, motor activity). Ultrasound in case of threatened miscarriage is one of the main and important diagnostic methods. When performing an ultrasound, the main sign of a threat of interruption is local thickening of the muscles of the uterus (hypertonicity of the myometrium), as well as an increase in the diameter of the internal pharynx. In most cases, myometrial hypertonicity is accompanied by pain in the lower abdomen.

At 11-14 weeks of pregnancy, 1st trimester screening is performed. Screening for the first trimester is a complex of the following studies:

measuring the thickness of the nuchal translucency (NT) of the embryo using ultrasound.
“double test” (blood test for hCG and PAPP-A (PAPP-A)).

Ultrasound in the second trimester of pregnancy

The second ultrasound is performed at 20-24 weeks. The main purpose of the second ultrasound performed in the second trimester of pregnancy is to carefully evaluate the fetal anatomy for diagnosis the largest number congenital malformations of the fetus (CDF), subject to prenatal detection.

During the third ultrasound, diagnostic doctors determine:

Fetal presentation. An ultrasound shows which part is located at the exit of the uterus - the baby’s head or the baby lying bottom down. The best option for natural birth – cephalic presentation. Pelvic or transverse presentation may be an indication for caesarean section.
Fetal fetometry. Just as in the second trimester, ultrasound determines the indicators of fetal development: fetal development, TG, OB, limb length. Based on the data obtained, the gestational age is calculated. The norms of the third ultrasound during pregnancy may be 1-2 weeks ahead or behind the normative indicators for a given gestational age. This is due to the fact that the child grows and develops in leaps and bounds. Based on the results of the ultrasound, the weight of the fetus is calculated.
Internal organs of the fetus. At the third ultrasound, they look at the correct structure of the internal organs: abdominal organs (stomach, liver, spleen), kidneys, heart, lungs, brain, facial structure. At the third ultrasound, the sex of the child is usually clearly visible, provided that the baby does not cross his legs.
Fetal motor activity. Normally, at the 3rd ultrasound during pregnancy, it should be visible that the fetus is actively moving its arms and legs, its limbs are bent, and its fingers are clenched into fists. Relaxed muscles indicate hypoxia (oxygen starvation). There should be at least two or three movements per half hour of inspection.
Placenta. The third planned ultrasound during pregnancy examines the placenta very carefully. Right now it may become difficult for this organ to cope with the ever-increasing needs of the fetus, as a result of which the baby may experience oxygen starvation. Ultrasound evaluates parameters such as location, thickness, structure, and degree of maturity of the placenta.
Dopplerography, when blood flow in the vessels of the fetus, uterus and umbilical cord is assessed. The study of uteroplacental blood flow allows us to assess and prevent the state of hypoxia (lack of oxygen) in the fetus and identify the pathology of the placenta (for example, its abruption). Examination of the umbilical cord vessels makes it possible to find out whether there is enough nutrition for the baby and to identify the entanglement of the umbilical cord before birth. Doppler is not prescribed to all women, but according to indications.

Is ultrasound dangerous during pregnancy?

Ultrasound examination is the basis for prenatal diagnosis of various fetal diseases, the most informative and accessible method.

Foreign studies have proven that ultrasound in the standard, so-called B-mode is safe for the fetus. Ultrasound can be performed during pregnancy as many times as necessary to obtain important information. The only question is which terms are the most informative. The endless number of ultrasounds that are performed on most expectant mothers are, in principle, harmless, but often do not provide additional information about the fetus, and are therefore pointless.

Leading foreign and domestic ultrasound diagnostic specialists, when performing ultrasound during pregnancy, are guided by the principle “as little as necessary.”

3D and 4D ultrasound

IN last years New ultrasound technologies have been developed based on three-dimensional (3D) and real-time (4D) echography. Now ultrasound can be two-dimensional, three-dimensional and four-dimensional. With a two-dimensional ultrasound, the outline of the fetus is visible on the monitor in black and white. Three-dimensional – 3D ultrasound – is already a three-dimensional color image. 4D ultrasound shows the fetus in motion in real time.

Three-dimensional ultrasound as a diagnostic method is preferably used only for special indications as prescribed by a doctor and is not recommended for a standard examination in every case of pregnancy, and even more so for obtaining images of the fetus without medical indications. After all, scientists have still not been able to prove whether ultrasound is harmful to the fetus (be it two-dimensional, 3D or 4D) or not, especially in the early stages, when the baby’s organs and tissues are just developing.

An ultrasound examination is a mandatory procedure for a pregnant woman. The main task is to determine the condition of the fetus and its environment, the correct development of the baby, to identify early stage various diseases. A timely diagnosis helps surgical treatment and avoiding the birth of children with various defects and diseases. A procedure in the early stages or the very first ultrasound during pregnancy can identify the threat of miscarriage, which is very important for the preservation and normal course of pregnancy.

The first is prescribed by a gynecologist within 12 weeks. The following procedures are carried out at around 24 and 32 weeks. This applies to pregnancy normal course and without special problems. But if carrying a child is accompanied by a constant threat of miscarriage, uterine tone and other diagnoses, then ultrasound is prescribed as needed.

Quite often, this procedure is also used as a way to determine or exclude pregnancy. Many women do not completely trust tests, but ultrasound does not guarantee accurate diagnosis. Modern equipment can discern the embryo as early as three weeks. The most important advantage of early diagnosis is the exclusion or confirmation of an ectopic pregnancy, which threatens the woman’s life. The embryo outside the uterus is visible from about five weeks.

So, the observing gynecologist prescribed a procedure at 12 weeks. Why is it necessary to do the first ultrasound during pregnancy? This period can be called a certain milestone, a transition from the embryonic stage to the fetal stage. Almost all of the baby’s organs are developed and have begun to function. Children's place, the placenta, all the necessary attributes for favorable development work perfectly, the fetus receives nutrients and oxygen through the umbilical cord. Although the baby is no more than a decimeter in size, it has the outline little man with an enlarged head for now.

This is the ideal course of pregnancy, when the fetus corresponds to the term, everything is fine with it, it is provided with everything necessary. But, unfortunately, things are not always so rosy. It is to identify the slightest developmental deviations that the first ultrasound is performed at twelve weeks.

A specialist will take measurements of the fetus to determine the correctness anatomical structure. It is very important to measure the collar area to exclude chromosomal abnormalities All internal organs of the baby will be examined for correct structure and functioning, and the heart rate will be measured. Be sure to examine the placenta, its development, place of attachment, whether the fetus is supplied required quantities oxygen. The threat of interruption and developmental anomalies are diagnosed. An exact due date will be set and an estimated date of birth will be assigned. There are a lot of studies and they are all important for a favorable pregnancy.

The 12 week period was not chosen by chance. If the first ultrasound scan during pregnancy reveals developmental anomalies or other dire diagnoses, parents still have time to decide whether to continue this pregnancy.

Among many mothers, there is talk about the harmfulness of the procedure. In fact, there is no harm and the frequency of ultrasound examinations does not affect the baby’s development in any way. The only important thing is the time of the procedure, but all specialists conducting the study are well aware of the time frame and do not exceed it.

If the equipment is good and the specialist is sufficiently experienced, then already on this short term you can see the gender of the baby.

During pregnancy, the expectant mother’s body needs regular examinations and monitoring of the process of bearing a child, so you need to know at what week to do the first ultrasound during pregnancy.

Ultrasound photo photograph
apparatus consultation inside
planned in rest position
development snapshot view

This examination allows you to always keep the situation under control and obtain data that can guide the gynecologist on further actions, if required. In addition to many indicators that only a doctor can understand, the expectant mother will be able to receive visual information about your baby.

The research principle is based on echolocation: ultrasonic waves are reflected from the tissues they penetrate. At the same time, images of these tissues appear on the screen. The reflected rays are received by a sensor, which perceives the received signals depending on the density of the tissue. This allows a clear image of the fetus to be displayed on the screen.

Today, such research is the safest and most effective. It has been used for 40 years, but has not yet been noticed negative influence for the future baby. Let's figure out when is the best time to do the first ultrasound during pregnancy.

Time of first examination

Each to the expectant mother you need to know when you can do the first ultrasound to confirm pregnancy. It is carried out 3-5 weeks after the start of the last menstruation. Today in obstetrics two diagnostic methods are used:

through the abdominal wall;
transvaginal using a vaginal sensor onto which a special condom is placed.

It is worth knowing that no matter at what stage you perform your first ultrasound during pregnancy, it is the vaginal examination that increases the reliability and accuracy of the information obtained, since the sensor comes into contact with internal organs. In this case, there is no need to fill the bladder before diagnosis. Already on the 4-5th day of delay, the fact of classes can be confirmed. It turns out that embryological pregnancy is determined at a period of 2 weeks.

Vaginal examination

At the time when you can do your first ultrasound if you are pregnant, the diameter of the ovum is only about 5 mm. For determining exact date It is necessary to measure the size of the embryo from the head to the coccyx. The probability of error in this case is no more than three days. If there is no need to confirm the fact of conception, and the absence or presence of uterine pathology has been established in another way, the first planned ultrasound visit is carried out during pregnancy for up to 12 weeks.

We figured out when you can go for the first ultrasound during intrauterine pregnancy, and now let's understand what it shows:

7 weeks – embryonic head;
8 weeks – fetal limbs;
9-11 weeks – limb bones and ossification points;
11-14 weeks – presence or absence of stomach, kidneys, Bladder, all fingers of the fetus.

When the first ultrasound examination is performed during pregnancy, the “nuchal collar space” needs to be measured. Normal size– maximum 3 mm. At 3 mm or more, the fetal neck begins to swell, which indicates a chromosomal disorder and the risk of Down's symptom.

It is important to measure the “nuchal space” when carrying twins. The sooner you detect it, the more accurate the result of the examination for the presence of Down syndrome will be, since it is during pregnancy with many children that errors in detecting this symptom are possible.

Collar space

Conducted ahead of schedule

Sometimes the doctor decides to prescribe ultrasound diagnostics earlier than usual. This happens when there is a risk of developing any pathology.

There are several cases when the first ultrasound examination when pregnancy appears is done ahead of schedule.

Risk of abnormal development of the genital organs.
Differential diagnosis of a woman with a uterine tumor or fibroma.
Suspicion of hydatidiform mole, unfinished pregnancy.
Suspicion of the development of tubal and other ectopic pregnancy.
Possible miscarriage.

In these cases, the woman experiences certain symptoms, which is why the doctor changes the date at which he performs the first ultrasound of the pregnant woman. Most serious symptom- bleeding after a missed period and positive test. About.

Bleeding may indicate any of the conditions mentioned above. During ectopic pregnancy and miscarriage, women experience severe pain in the lower abdomen.

If a hydatidiform mole is observed, the fetus does not develop, but membranes begin to grow in the form of blisters that grow into the uterus and can enter the brain and lungs. This condition can be determined by the size of the uterus, which begins to grow faster than expected. The woman’s health deteriorates and, if measures are not taken, death is possible.

Examination in the first trimester

The first screening ultrasound is done at 10 to 14 weeks of pregnancy. It is prescribed to detect fetal development abnormalities, genetic abnormalities and also helps to diagnose possible problems placental blood flow and fetal position. Screening can be performed vaginally and through the abdomen.

First planned trip

In the first case, you will have to undress from the waist down and lie down with your legs bent, after which the doctor inserts a thin sensor into the vagina. The procedure does not bring any unpleasant sensations, but the next day you may experience some bleeding. When examining through the abdomen, you need to undress to the waist or lift your clothes. Specialist applies special liquid on the stomach and moves the sensor along it.

After screening, the doctor draws up a protocol where he writes down the main parameters determined during the study. These include:

heart rate;
coccyx-parietal size;
embryo imaging;
collar space size;
chorion structure;
location of the chorion;
structural features of the uterine walls;
features of the uterine appendages.

After the ultrasound, the patient is sent to biochemical research, which is also included in the first screening procedure. The specialist takes blood from a vein to obtain the necessary information. The last meal should be four hours before the test.

Once you have figured out when to do the first screening ultrasound examination during pregnancy, you should not hesitate. With the help of diagnostics, it is possible to determine the term with an accuracy of one day, find out how the fetus is developing, whether there are defects or features of the genital organs that can complicate the process of bearing a child or even interrupt it.

Ultrasound helps determine the due date

Preparing for the study

Once you have decided when it is better to go to the doctor and do the first ultrasound during pregnancy, you should prepare for the study. If the diagnosis is performed through the abdomen, you will need to drink approximately two liters of still water two hours before the procedure. You should not urinate before the procedure.

If you are deciding how to prepare for your first ultrasound during early pregnancy, you need to know what you need to take with you to the doctor:

condom;
towel;
shoe covers;
diaper.

A condom is required to fit over the transvaginal sensor. Some paid clinics provide their Consumables, which are included in the cost of admission. So you don't have to carry them with you. Check with your administrator for this information. Use .

Also, before the examination, you need to wash the external genitalia and put on clean underwear. The day before the planned study, it is necessary to completely eliminate fried and fatty foods, limit the consumption of seafood, chocolate, and citrus fruits.

As soon as you understand what time doctors do the first ultrasound in early pregnancy, make an appointment. You are now future mommy, so take care of your baby and do everything to protect him from various diseases.

Thank you 0