Ability to hear ultrasound

The upper frequency limit in humans (approximately 20 kHz) is due to limitations

of the middle ear, which acts as a low-pass filter. Ultrasonic hearing can occu
r if ultrasound is fed directly into the skull bone and reaches the cochlea thro
ugh bone conduction without passing through the middle ear.
It is a fact in psychoacoustics that children can hear some high-pitched sounds
that older adults cannot hear, because in humans the upper limit pitch of hearin
g tends to become lower with age.[2] A cell phone company has used this to creat
e ring signals supposedly only able to be heard by younger humans;[3] but many o
lder people are able to hear it, which may be due to the considerable variation
of age-related deterioration in the upper hearing threshold.
Some animals — such as dogs, cats, dolphins, bats, and mice — have an upper frequenc
y limit that is greater than that of the human ear and thus can hear ultrasound,
which is how a dog whistle works.
[edit] Diagnostic sonography

Sonogram of a fetus at 14 weeks (profile)

Head of a fetus, aged 29 weeks, in a "3D ultrasound"

Medical sonography (ultrasonography) is an ultrasound-based diagnostic medical i
maging technique used to visualize muscles, tendons, and many internal organs, t
o capture their size, structure and any pathological lesions with real time tomo
graphic images. Ultrasound has been used by radiologists and sonographers to ima
ge the human body for at least 50 years and has become one of the most widely us
ed diagnostic tools in modern medicine. The technology is relatively inexpensive
and portable, especially when compared with other techniques, such as magnetic
resonance imaging (MRI) and computed tomography (CT). Ultrasound is also used to
visualize fetuses during routine and emergency prenatal care. Such diagnostic a
pplications used during pregnancy are referred to as obstetric sonography.
As currently applied in the medical field, properly performed ultrasound poses n
o known risks to the patient.[4] Sonography is generally described as a "safe te
st" because it does not use mutagenic ionizing radiation, which can pose hazards
such as chromosome breakage and cancer development. However, ultrasonic energy
has two potential physiological effects: it enhances inflammatory response; and
it can heat soft tissue. Ultrasound energy produces a mechanical pressure wave t
hrough soft tissue. This pressure wave may cause microscopic bubbles in living t
issues and distortion of the cell membrane, influencing ion fluxes and intracell
ular activity. When ultrasound enters the body, it causes molecular friction and
heats the tissues slightly. This effect is typically very minor as normal tissu
e perfusion dissipates most of the heat, but with high intensity, it can also ca
use small pockets of gas in body fluids or tissues to expand and contract/collap
se in a phenomenon called cavitation; however this is not known to occur at diag
nostic power levels used by modern diagnostic ultrasound units.[citation needed]
In 2008, the AIUM published a 130-page report titled "American Institute of Ultr
asound in Medicine Consensus Report on Potential Bioeffects of Diagnostic Ultras
ound"[5] stating that there are indeed some potential risks to administering ult
rasound tests, which include "postnatal thermal effects, fetal thermal effects,
postnatal mechanical effects, fetal mechanical effects, and bioeffects considera
tions for ultrasound contrast agents."[6] The long-term effects of tissue heatin
g and cavitation have shown decreases in the size of red blood cells in cattle w
hen exposed to intensities higher than diagnostic levels.[7] However, long term
effects due to ultrasound exposure at diagnostic intensity is still unknown.[8]
There are several studies that indicate the harmful side effects on animal fetus
es associated with the use of sonography on pregnant mammals. A Yale study in 20
06 suggested exposure to ultrasound affects fetal brain development in mice. A t
ypical fetal scan, including evaluation for fetal malformations, typically takes
10–30 minutes.[9] The study showed that rodent brain cells failed to migrate to t
heir proper positions and remained scattered in incorrect parts of the brain. Th
is misplacement of brain cells during their development is linked to disorders r
anging from "mental retardation and childhood epilepsy to developmental dyslexia
, autism spectrum disorders and schizophrenia." However, this effect was only de
tectable after 30 minutes of continuous scanning. No link has yet been made betw
een the test results on animals such as mice and the possible effects on humans.
Although the possibility exists that biological effects on humans may be identi
fied in the future, currently most doctors feel that based on available informat
ion the benefits to patients outweigh the risks.[10] Also the ALARA (As Low As R
easonably Achievable) principle has been advocated for an ultrasound examination
; that is keeping the scanning time and power settings as low as possible but co
nsistent with diagnostic imaging; and that is the principle by which non-medical
uses which by definition are not necessary are actively discouraged.
Obstetric ultrasound can be used to identify many conditions that would be harmf
ul to the mother and the baby. Many health care professionals consider the risk
of leaving these conditions undiagnosed to be much greater than the very small r
isk, if any, associated with undergoing an ultrasound scan. According to Cochran
e Review, routine ultrasound in early pregnancy (less than 24 weeks) appears to
enable better gestational age assessment, earlier detection of multiple pregnanc
ies and earlier detection of clinically unsuspected fetal malformation at a time
when termination of pregnancy is possible.[11]
Sonography is used routinely in obstetric appointments during pregnancy, but the
FDA discourages its use for non-medical purposes such as fetal keepsake videos
and photos, even though it is the same technology used in hospitals.[12]
Obstetric ultrasound is primarily used to:
• Date the pregnancy (gestational age)
• Confirm fetal viability
• Determine location of fetus, intrauterine vs ectopic
• Check the location of the placenta in relation to the cervix
• Check for the number of fetuses (multiple pregnancy)
• Check for major physical abnormalities.
• Assess fetal growth (for evidence of intrauterine growth restriction (IUGR))
• Check for fetal movement and heartbeat.
• Determine the sex of the baby
Unfortunately, results are occasionally wrong,[citation needed] producing a fals
e positive (the Cochrane Collaboration is a relevant effort to improve the relia
bility of health care trials). False detection may result in patients being warn
ed of birth defects when no such defect exists. Sex determination is only accura
te after 12 weeks gestation. When balancing risk and reward, there are recommend
ations to avoid the use of routine ultrasound for low risk pregnancies. In many
countries ultrasound is used routinely in the management of all pregnancies.
According to the European Committee of Medical Ultrasound Safety (ECMUS) "Ultras
onic examinations should only be performed by competent personnel who are traine
d and updated in safety matters. Ultrasound produces heating, pressure changes a
nd mechanical disturbances in tissue. Diagnostic levels of ultrasound can produc
e temperature rises that are hazardous to sensitive organs and the embryo/fetus.
Biological effects of non-thermal origin have been reported in animals but, to
date, no such effects have been demonstrated in humans, except when a microbubbl
e contrast agent is present."[13] Nonetheless, care should be taken to use low p
ower settings and avoid pulsed wave scanning of the fetal brain unless specifica
lly indicated in high risk pregnancies.
It should be noted that obstetrics is not the only use of ultrasound. Soft tissu
e imaging of many other parts of the body is conducted with ultrasound. Other sc
ans routinely conducted are cardiac, renal, liver and gallbladder (hepatic). Oth
er common applications include musculo-skeletal imaging of muscles, ligaments an
d tendons, ophthalmic ultrasound (eye) scans and superficial structures such as
testicle, thyroid, salivary glands and lymph nodes. Because of the real time nat
ure of ultrasound, it is often used to guide interventional procedures such as f
ine needle aspiration FNA or biopsy of masses for cytology or histology testing
in the breast, thyroid, liver, kidney, lymph nodes, muscles and joints.
Ultrasound scanners have different Doppler-techniques to visualize arteries and
veins. The most common is colour doppler or power doppler, but also other techni
ques like b-flow are used to show bloodflow in an organ. By using pulsed wave do
ppler or continuous wave doppler bloodflow velocities can be calculated.
Figures released for the period 2005-2006 by UK Government (Department of Health
) show that non-obstetric ultrasound examinations constituted more than 65% of t
he total number of ultrasound scans conducted.
Ultrasound is also increasingly being used in trauma and first aid cases, with e
mergency ultrasound becoming a staple of most EMT response teams.
Procedures: Ultrasound
General Introduction
Ultrasonography or ultrasound scanning involves the application of an ultrasound
transducer on the area to be examined. The transducter is used to transmit high
-frequency sound waves, which bounce off internal structures to produce an image
that can be displayed and recorded.
There are different versions of ultrasound scanning that are used in pregnancy a
nd to help diagnose certain gynaecological problems. These include a pregnancy u
ltrasound (pelvic ultrasound scanning or sonography), Doppler ultrasound and a t
ransvaginal ultrasound (endovaginal ultrasound or ultrasonography).
Pregnancy Ultrasound
Description and Purpose
A pregnancy ultrasound, also known as pelvic ultrasound scanning or sonography,
consists of high-frequency sound waves, which provide an image, a sonogram, simi
lar to an X-ray. The sonogram shows the baby's entire body, organs, and the surr
ounding tissues. A pregnancy ultrasound is used for the following reasons:
• To establish the age and number of foetus(es) , evaluate their size and well-bei
ng, determine the location of the placenta , establish the amount of amniotic fl
uid , and detect abnormalities in the foetus and mother's pelvis (e.g. incompete
nt cervix ).
• If the baby is at risk of inheriting a sex-linked disease , to determine the sex
of the baby (usually possible from 16th to 18th week).
• To reveal foetal malformations and severe disorders such as spina bifida.
• May be performed to monitor foetal growth in late pregnancy.
• To assist in other procedures, such as amniocentesis , CVS , and foetal blood te
sting , that require placement of a needle in the uterus.
Preparation and Procedure
If the test is performed early into the pregnancy (i.e. during the first trimest
er), the woman will be asked to drink a lot of fluids beforehand in order to hav
e a full bladder. This is because the full bladder descends, thus allowing a bet
ter view of the uterus , as well as the fact that the fluid is a good medium for
the transmission of sound waves.
Later in pregnancy, a full bladder is not necessary, since the amniotic fluid pr
ovides the medium, and the enlarged uterus not only pushes the bladder down but
extends so that it lies directly against the abdomen.
During the procedure, gel is applied to the abdomen, and an ultrasound transduce
r (used to transmit high-frequency sound waves, which bounce back to produce an
image that can be recorded on X-ray film) is moved across the abdomen. The image
is relayed in real time to a screen, which the doctor observes (for the reasons
stated above). The sonogram, can be printed on film or paper or recorded on vid
eotape, to be examined more carefully later, although the doctor may analyse the
scan immediately during the procedure. The whole procedure takes between 15 min
utes and 1 hour, in general.
Advantages Disadvantages
• It entails no exposure to X-ray radiation.
• It's non-invasive.
• It produces quick results.
• It creates a moving image. • Less reliable than amniocentesis or CVs in
osing certain disorders, such as Down syndrome.
• False-positive and false-negative results are possible.
Obstetrical Ultrasound
Play Video Clip (00:02:52)
Your Radiologist Explains
Pelvic and Obstetric Ultrasound
• What is Obstetrical Ultrasound Imaging?
• What are some common uses of the procedure?
• How should I prepare?
• What does the equipment look like?
• How does the procedure work?
• How is the procedure performed?
• What will I experience during and after the procedure?
• Who interprets the results and how do I get them?
• What are the benefits vs. risks?
• What are the limitations of Obstetrical Ultrasound Imaging?
What is Obstetrical Ultrasound Imaging?
Click to view larger
Ultrasound imaging, also called ultrasound scanning or sonography, involves expo
sing part of the body to high-frequency sound waves to produce pictures of the i
nside of the body. Ultrasound exams do not use ionizing radiation (as used in x-
rays). Because ultrasound images are captured in real-time, they can show the st
ructure and movement of the body's internal organs, as well as blood flowing thr
ough blood vessels.
Ultrasound imaging is a noninvasive medical test that helps physicians diagnose
and treat medical conditions.
Obstetrical ultrasound provides pictures of an embryo or fetus within a woman's
uterus, as well as the mother's uterus and ovaries.
A Doppler ultrasound study may be part of an obstetrical ultrasound examination.
Doppler ultrasound is a special ultrasound technique that evaluates blood flow t
hrough a blood vessel, including the body's major arteries and veins in the abdo
men, arms, legs and neck.
During an obstetrical ultrasound the examiner may evaluate blood flow in the umb
ilical cord or may in some cases assess blood flow in the fetus or placenta.
top of page
What are some common uses of the procedure?
Click to view larger
Obstetrical ultrasound is a useful clinical test to:
• establish the presence of a living embryo/fetus.
• estimate the age of the pregnancy.
• diagnose congenital abnormalities of the fetus.
• evaluate the position of the fetus.
• evaluate the position of the placenta.
• determine if there are multiple pregnancies.
• determine the amount of amniotic fluid around the baby.
• check for opening or shortening of the cervix or mouth of the womb.
• assess fetal growth.
• assess fetal well-being.
top of page
How should I prepare?
You should wear a loose-fitting, two-piece outfit for the examination. Only the
lower abdominal area needs to be exposed during this procedure.
If an ultrasound is ordered by your clinician early in your pregnancy, you may b
e instructed to have a full bladder for the procedure. Air interferes with sound
waves, so if your bladder is distended, the air-filled bowel is pushed out of t
he way by the bladder and an image of the uterus and embryo or fetus is obtained
.
The radiologist or sonographer may elect to examine an early pregnancy by means
of transvaginal ultrasound. This requires an empty urinary bladder. You should a
sk for specific instructions for this imaging study when you make your appointme
nt. For more information on transvaginal ultrasound, see the Pelvic Ultrasound p
age (www.RadiologyInfo.org/en/info.cfm?pg=pelvus).
top of page
What does the equipment look like?
Click to view larger
Ultrasound scanners consist of a console containing a computer and electronics,
a video display screen and a transducer that is used to scan the body and blood
vessels. The transducer is a small hand-held device that resembles a microphone,
attached to the scanner by a cord. The transducer sends out high frequency soun
d waves into the body and then listens for the returning echoes from the tissues
in the body. The principles are similar to sonar used by boats and submarines.
The ultrasound image is immediately visible on a nearby video display screen tha
t looks much like a computer or television monitor. The image is created based o
n the amplitude (strength), frequency and time it takes for the sound signal to
return from the patient to the transducer and the type of body structure the sou
nd travels through.
top of page
How does the procedure work?
Transabdominal transducer
Ultrasound imaging is based on the same principles involved in the sonar used by
bats, ships and fishermen. When a sound wave strikes an object, it bounces back
, or echoes. By measuring these echo waves it is possible to determine how far a
way the object is and its size, shape, and consistency (whether the object is so
lid, filled with fluid, or both).
In medicine, ultrasound is used to detect changes in appearance of organs, tissu
es, and vessels or detect abnormal masses, such as tumors.
In an ultrasound examination, a transducer both sends the sound waves and record
s the echoing waves. When the transducer is pressed against the skin, it directs
small pulses of inaudible, high-frequency sound waves into the body. As the sou
nd waves bounce off of internal organs, fluids and tissues, the sensitive microp
hone in the transducer records tiny changes in the sound's pitch and direction.
These signature waves are instantly measured and displayed by a computer, which
in turn creates a real-time picture on the monitor. One or more frames of the mo
ving pictures are typically captured as still images.
Click to view larger
The movement of the embryo or fetus and his or her heartbeat can be seen as an o
ngoing ultrasound movie. Most ultrasound devices also have an audio component th
at processes the echoes produced by blood flowing through the fetal heart, blood
vessels and umbilical cord. This sound can be made audible to human ears and ha
s been described by patients as a whooshing noise.
Doppler ultrasound, a special application of ultrasound, measures the direction
and speed of blood cells as they move through vessels. The movement of blood cel
ls causes a change in pitch of the reflected sound waves (called the Doppler eff
ect). A computer collects and processes the sounds and creates graphs or color p
ictures that represent the flow of blood through the blood vessels.
top of page
How is the procedure performed?
For most ultrasound exams, the patient is positioned lying face-up on an examina
tion table that can be tilted or moved.
A clear water-based gel is applied to the area of the body being studied to help
the transducer make secure contact with the body and eliminate air pockets betw
een the transducer and the skin. The sonographer (ultrasound technologist) or ra
diologist then presses the transducer firmly against the skin in various locatio
ns, sweeping over the area of interest or angling the sound beam from a farther
location to better see an area of concern.
Sometimes the radiologist determines that a transvaginal scan needs to be perfor
med. This technique often provides improved, more detailed images of the uterus
and ovaries. This method of scanning is especially useful in early pregnancy.
Transvaginal transducer
Transvaginal ultrasound is performed very much like a gynecologic exam and invol
ves the insertion of the transducer into the vagina after the patient empties he
r bladder. The tip of the transducer is smaller than the standard speculum used
when performing a Pap test. A protective cover is placed over the transducer, lu
bricated with a small amount of gel, and then inserted into the vagina. Only two
to three inches of the transducer end are inserted into the vagina. The images
are obtained from different orientations to get the best views of the uterus and
ovaries. Transvaginal ultrasound is usually performed with the patient lying on
her back, possibly with her feet in stirrups similar to a gynecologic exam.
Doppler sonography is performed using the same transducer.
When the examination is complete, the patient may be asked to dress and wait whi
le the ultrasound images are reviewed. However, the sonographer or radiologist i
s often able to review the ultrasound images in real-time as they are acquired a
nd the patient can be released immediately.
This ultrasound examination is usually completed within 30 minutes.
top of page
What will I experience during and after the procedure?
Click to view larger

Most ultrasound examinations are painless, fast and easy.

After you are positioned on the examination table, the radiologist or sonographe
r will apply some warm water-based gel on your skin and then place the transduce
r firmly against your body, moving it back and forth over the area of interest u
ntil the desired images are captured. There is usually no discomfort from pressu
re as the transducer is pressed against the area being examined.
If scanning is performed over an area of tenderness, you may feel pressure or mi
nor pain from the transducer.
At times the sonographer may have to press more firmly to get closer to the embr
yo or fetus to visualize the structure better. Any discomfort is usually minimal
and temporary.
If a Doppler ultrasound study is performed, you may actually hear pulse-like sou
nds that change in pitch as the blood flow is monitored and measured.
With transvaginal scanning, there may be minimal discomfort as the transducer is
moved in the vagina.
Once the imaging is complete, the gel will be wiped off your skin.
After an ultrasound exam, you should be able to resume your normal activities im
mediately.
top of page
Who interprets the results and how do I get them?
A radiologist, a physician specifically trained to supervise and interpret radio
logy examinations, will analyze the images and send a signed report to your prim
ary care physician or the physician who referred you for the exam, who will shar
e the results with you. In some cases the radiologist may discuss results with y
ou at the conclusion of your examination.
top of page
What are the benefits vs. risks?
Benefits
• Most ultrasound scanning is noninvasive (no needles or injections) and is usuall
y painless.
• Ultrasound is widely available, easy-to-use and less expensive than other imagin
g methods.
• Ultrasound imaging does not use any ionizing radiation.
• Ultrasound scanning gives a clear picture of soft tissues that do not show up we
ll on x-ray images.
• Ultrasound is the preferred imaging modality for the diagnosis and monitoring of
pregnant women and their unborn babies.
• Ultrasound has been used to evaluate pregnancy for nearly four decades and there
 has been no evidence of harm to the patient, embryo or fetus. Nevertheless, ult
rasound should be performed only when medically indicated.
• Ultrasound allows the doctor to see inside the uterus and provides much informat
ion about the pregnancy.
Risks
• For standard diagnostic ultrasound there are no known harmful effects on humans.
top of page
What are the limitations of Obstetrical Ultrasound Imaging?
Obstetric ultrasound cannot identify all fetal abnormalities. Consequently, when
there are clinical or laboratory suspicions for a possible abnormality, a pregn
ant woman may have to undergo nonradiologic testing such as amniocentesis (the e
valuation of fluid taken from the sac surrounding the fetus) or chorionic villus
sampling (evaluation of placental tissue) to determine the health of the fetus,
or she may be referred by her primary care provider to a perinatologist (an obs
tetrician specializing in high-risk pregnancies).
Ultrasonography or ultrasound scanning involves the application of an ultrasound
transducer on the area to be examined. The transducter is used to transmit high
-frequency sound waves, which bounce off internal structures to produce an image
that can be displayed and recorded.
Doppler Ultrasound Scanning is used to measure the velocity of blood flow. Doppl
er ultrasound can be used to listen to the foetal heart beat , examine the foeta
l heart for defects , and estimate placental blood flow. This special type of ul
trasound shows different rates of blood flow in different colours on a monitor i
n real time.
A common procedure used in diagnosing and monitoring postterm pregnancy .
Other types of ultrasound scanning that are used in pregnancy and to help diagno
se certain gynaecological problems include pregnancy ultrasound (pelvic ultrasou
nd scanning or sonography), and a transvaginal ultrasound (endovaginal ultrasoun
d or ultrasonography).
The information in this page is presented in summarised form and has been taken
from the following source(s):
1. The Yale University School of Medicine Patient's Guide to Medical Tests, Barr
y L. Zaret M.D., Senior Editor, published by Houghton Mifflin. Online: common_pr
ocedures/doppler_ultrasound.html
Summary
Ultrasound is used during pregnancy to check the baby's development and to help
pick up any abnormalities. Ultrasounds do not give completely accurate informati
on. However they do provide good information and are non-invasive, painless and
safe. Ultrasounds may be transabdominal (on the stomach) or vaginal.
Share
this article
• Email this article
• Add link to social media Facebook, Myspace, Twitter
Download
this article
• PDF text & pictures for sharing & saving
• MP3 files listen and multitask
Ultrasound is a scan that uses high frequency sound waves to study internal body
structures. The sound waves are emitted from a vibrating crystal in a handheld
scanner. The reflected sound waves or ‘echoes’ are then translated into a grainy, tw
o-dimensional (or sometimes three-dimensional) image on a monitor.
Ultrasound is used during pregnancy to check the baby’s development and to help pi
ck up any abnormalities such as Down syndrome. Since the procedure can’t produce h
igh quality images, any suspected abnormalities need to be confirmed with other
tests. The ultrasound scan isn’t 100 per cent accurate, but the advantages of the
test are that it’s non-invasive, painless and safe for both mother and unborn baby
.
Uses of the ultrasound
Ultrasound may be used at various points during pregnancy, including:
• First trimester - ultrasound performed within the first three months of pregnanc
y is used to check that the embryo is developing inside the womb (rather than in
side a fallopian tube, for example), confirm the number of embryos, and calculat
e the gestational age and the baby’s due date.
• Second trimester - ultrasound performed between weeks 18 and 20 is used to check
the development of foetal structures such as the spine, limbs, brain and intern
al organs. The size and location of the placenta is also checked. The baby’s sex c
an be established, if the parents wish to know.
• Third trimester - ultrasound performed after 30 weeks is used to check that the
baby is continuing to grow at a normal rate. The location of the placenta is che
cked to make sure it isn’t blocking the cervix.
Medical issues to consider
Ultrasound is a safe, painless and non-invasive procedure. Many parents consider
the ultrasound as an opportunity to see their unborn child, and perhaps discove
r its sex. However, you should remember that the ultrasound is a diagnostic proc
edure and, in some cases, it may suggest that a foetus has an abnormality. Furth
er tests are usually needed to confirm the diagnosis.
Ultrasound procedure
The procedure depends on the type of ultrasound used, but may include:
• Transabdominal ultrasound - sound waves pass very well through water. The sonogr
apher uses your full bladder as a ‘porthole’ to your uterus, so you will have to dri
nk plenty of water before the test. You lie down on an examination table or bed.
Gel is applied to your abdomen (to provide better contact between your skin and
the scanner) and the sonographer moves the scanner in various positions. Pictur
es are sent instantly to a nearby monitor. The sonographer may have to push quit
e firmly at times in order to see the deeper structures. The scan usually takes
about 30 minutes.
• Vaginal ultrasound - in some cases, a transabdominal ultrasound can’t produce clea
r enough pictures. There may be too much air in your bowel, for instance, and ai
r is a poor conductor of sound waves. In these cases, a slender scanner is inser
ted into your vagina. The scan usually takes about 30 minutes.
Immediately after the ultrasound
Once the ultrasound is finished, you are given tissues to wipe away the gel, and
you can go to the toilet. The report is sent to your doctor, so you will have t
o make an appointment to get the result.
Possible complications
There are no known risks, complications or side effects for either the mother or
her unborn baby.
Taking care of yourself at home
An ultrasound scan is safe, painless and non-invasive, so there is no need to ta
ke any special precautions afterward. You are free to go about your normal busin
ess.
Long term outlook
What happens next depends on the results of your ultrasound. Note that a normal
result doesn’t guarantee that your baby is normal, because some abnormalities cann
ot be found using this test. If foetal abnormalities were detected, you may need
further tests to confirm the diagnosis. These tests, including amniocentesis an
d chorionic villus sampling, are optional. Discuss the benefits, risks and compl
ications of these tests with your doctor before deciding whether or not to go ah
ead.
Other types of pregnancy tests
Other types of pregnancy tests you may be offered could include:
• Amniocentesis - a small amount of amniotic fluid is taken using a slender needle
inserted through the abdomen. The needle is guided with the help of ultrasound.
 The fluid sample contains cells, which are then examined in a laboratory for ch
romosomal abnormalities. The risk of miscarriage following amniocentesis is arou
nd one in 250.
• Chorionic villus sampling - a slender needle is inserted through the abdomen or
cervix to take a small sample of placenta. The needle is guided with the help of
ultrasound. The chorionic villi are then tested in the laboratory for chromosom
al abnormalities. The risk of miscarriage following chorionic villus sampling is
one in 100.
Where to get help
• Your doctor
Things to remember
• Ultrasound is used during pregnancy to check the baby’s development, the presence
of a multiple pregnancy and to help pick up any abnormalities.
• The ultrasound scan isn’t 100 per cent accurate, but the advantages of the test ar
e that it’s non-invasive, painless and safe for both mother and unborn baby.
• If foetal abnormalities are detected, you may be offered further tests to confir
m the diagnosis, such as amniocentesis and chorionic villus sampling.
Ultrasound and Pregnancy
An ultrasound is a common diagnostic procedure that uses sound waves to create a
picture of the baby while you are pregnant. The following should help you unde
rstand more about ultrasound.
Ultrasound--A Safe and Painless Procedure
An ultrasound is a painless diagnostic procedure that bounces high-frequency sou
nd waves off the baby s body to create a picture. Ultrasounds are used as a stan
dard procedure in pregnancy and can be used to determine if any problems exist.
As part of the procedure a water-soluble gel is applied to your abdomen and a wa
nd-like instrument is positioned over it. Sound waves are then generated and ar
e bounced back to produce an image of the baby. While there is typically no pain
involved, there may be some discomfort from pressure as the sonographer guides
the wand on your abdomen.
Ultrasounds are safe and are not the same as an x-ray since an ultrasound uses s
ound waves and not radiation. Ultrasounds have been used for about 40 years and
there has been no evidence that it will be harmful to you or your baby. However
, the the long-term effects of repeated ultrasounds on a fetus are still unknown
. Accordingly, please make sure to talk with you health care provider about havi
ng an ultrasound and only have an ultrasound completed by a trained professional
.
http://www.youtube.com/watch?v=OFno5iOm84A
http://www.youtube.com/watch?v=2fORsymxX_0&feature=related
Ultrasound Exam
The ultrasound exam is a non-invasive procedure in which high-frequency sound wa
ves are directed into your uterus and are reflected back to the receiver. It is
commonly used to:
• confirm pregnancy
• detect ectopic pregnancy
• determine the number of babies you are carrying
• locate the placenta
• determine age of the baby (within a 10 day window)
• detect any gross deformities or structural malformations
• assess your baby’s growth and health
• evaluate risks such as placental implantation
• determine sex of baby (about 75% accurate)
• determine the presentation and position of baby
• assess fluid volume
What you need to know
Ultrasound benefits change based on when the procedure is done and why. For exam
ple, the most accurate dating of pregnancy is done during the first trimester of
pregnancy. This means you are less likely to be faced with an early due date th
at forces you to be induced to prevent a post-date pregnancy. Unfortunately, the
re is incomplete research on the safety of first trimester ultrasound. In contra
st, there appears to be a small increase in cesarean surgery rates for mothers w
ho receive a late (third trimester) ultrasound. This rise in cesarean rate comes
without any improvements in mother or baby outcomes.
There is some debate about routine ultrasound (routine means every woman has the
test during pregnancy regardless of medical need). Although many care givers fe
el the test is safe, there are a significant number who feel the technology is n
ot thoroughly tested and should not be used when there is no benefit. They site
research that shows no improvement in outcomes for mothers or babies from routin
e ultrasound. The concern is a technology that may pose risks should only be use
d when necessary, especially when there is no improvement of outcomes. The debat
e continues, and until research concludes one way or the other families would do
well to avoid any unnecessary (not medically indicated) use of ultrasound.
Not all ultrasounds are done for routine reasons. For example, when ultrasound i
s used in cases of maternal hypertension or impaired fetal growth there is a red
uction in fetal deaths and interestingly a reduction in induction of labor and h
ospital admissions without a rise in fetal distress or cesarean rates.
The decision to use ultrasound is complicated by the excitement families feel ab
out seeing their baby before birth. The key to making a good decision appears to
be in understanding why the test is being offered and what information is expec
ted to be gained. In this way families can avoid routine and unnecessary imaging
.
Procedure
The technician will place a gel (it may be warmed or cold) on your abdomen, and
then use a transducer to send the sound waves and collect information as they re
turn. As this happens, an image of your baby and uterine contents can be seen on
the ultrasound screen. Depending on the magnification, position of your baby an
d placement of the transducer the image may be recognizable as body parts or be
an unrecognizable blur. A standard ultrasound exam will last about 20 minutes. A
n advanced ultrasound will last around one hour. In many parts of the United Sta
tes, ultrasound has become a routine part of prenatal care.
Print
An ultrasound exam is a procedure that uses high-frequency sound waves to scan a
woman s abdomen and pelvic cavity, creating a picture (sonogram) of the baby an
d placenta. Although the terms ultrasound and sonogram are technically different
, they are used interchangeably and reference the same exam.
What types of ultrasound are there?
There are basically seven different ultrasound exams, but the principle process
is the same. The different types of procedures include:
Transvaginal Scans: Specially designed probe transducers are used inside the vag
ina to generate sonogram images. Most often used during the early stages of preg
nancy.
Standard Ultrasound: Traditional ultrasound exam which uses a transducer over th
e abdomen to generate 2-D images of the developing fetus .
Advanced Ultrasound: This exam is similar to the standard ultrasound, but the ex
am targets a suspected problem and uses more sophisticated equipment.
Doppler Ultrasound: This imaging procedure measures slight changes in the freque
ncy of the ultrasound waves as they bounce off moving objects, such as blood cel
ls.
3-D Ultrasound: Uses specially designed probes and software to generate 3-D imag
es of the developing fetus.
4-D or Dynamic 3-D Ultrasound: Uses specially designed scanners to look at the f
ace and movements of the baby prior to delivery.
Fetal Echocardiography: Uses ultrasound waves to assess the baby s heart anatomy
and function. This is used to help assess suspected congenital heart defects.
How is an ultrasound performed?
The traditional ultrasound procedure involves placing gel on your abdomen to wor
k as a conductor for the sound waves. Your healthcare provider uses a transducer
to produce sound waves into the uterus. The sound waves bounce off bones and ti
ssue returning back to the transducer to generate black and white images of the
fetus.
When are ultrasounds performed?
Ultrasounds may be performed at any point during pregnancy, and the results are
seen immediately on a monitor during the procedure. Transvaginal scans may be us
ed early in pregnancy to diagnose potential ectopic or molar pregnancies.
There is not a recommended number of ultrasounds that should be performed during
routine prenatal care. Because ultrasound should only be used when medically in
dicated, many healthy pregnancies will not require ultrasound. The average numbe
r of ultrasounds varies with each healthcare provider. Additional ultrasounds mi
ght be ordered separately if your healthcare provider suspects a complication or
problem related to your pregnancy.
What does the ultrasound look for?
Ultrasounds are diagnostic procedures that detect or aid in the detection of abn
ormalities and conditions related to pregnancy. Ultrasounds are usually combined
with other tests, such as triple tests, amniocentesis, or chorionic villus samp
ling, to validate a diagnosis. An ultrasound exam is medically indicated through
out pregnancy for the following reasons:
• First Trimester:
o Confirm viable pregnancy
o Confirm heartbeat
o Measure the crown-rump length or gestational age
o Confirm molar or ectopic pregnancies
o Assess abnormal gestation
• Second Trimester:
o Diagnose fetal malformation
Weeks 13-14 for characteristics of potential Down syndrome
Weeks 18-20 for congenital malformations
o Structural abnormalities
o Confirm multiples pregnancy
o Verify dates and growth
o Confirm intrauterine death
o Identify hydramnios or oligohydramnios – excessive or reduced levels of am
niotic fluid
o Evaluation of fetal well-being
• Third Trimester:
o Identify placental location
o Confirm intrauterine death
o Observe fetal presentation
o Observe fetal movements
o Identify uterine and pelvic abnormalities of the mother
What are the risks and side effects to the mother or baby?
The ultrasound is a noninvasive procedure that, when used properly, has not demo
nstrated fetal harm. The long term effects of repeated ultrasound exposures on t
he fetus are not fully known. It is recommended that ultrasound only be used if
medically indicated.
Answers to common questions related to an ultrasound exam:
If an ultrasound is done at 6 to 7 weeks and a heartbeat is not detected, does t
hat mean there is a problem? No it does not mean there is a problem. The heartbe
at may not be detected for reasons that include: tipped uterus, larger abdomen,
or inaccurate dating with last menstrual period. Heartbeats are best detected wi
th transvaginal ultrasounds early in pregnancy. Concern typically develops if th
ere is no fetal heart activity in an embryo with a crown-rump length greater tha
n 5mm. If you receive an ultrasound exam after week 6, your healthcare provider
will begin to be concerned if there is no gestational sac.
How accurate are ultrasounds in calculating gestational age? Your healthcare pro
vider will use hormone levels in your blood, the date of your last menstrual per
iod and, in some cases, results from an ultrasound to generate an estimated gest
ational age. However, variations in each woman s cycle and each pregnancy may hi
nder the accuracy of the gestational age calculation. If your healthcare provide
r uses an ultrasound to get an estimated delivery date to base the timing of you
r prenatal care, the original estimated gestational age will not be changed.
Why do some healthcare providers schedule ultrasounds differently? If there are
any questions regarding gestational age, placenta location, or possible complica
tions then more ultrasounds may be scheduled. Because ultrasound should only be
used when medically indicated, many healthy pregnancies will not require ultraso
und. The average number of ultrasounds varies with each healthcare provider.
How accurate are ultrasounds in determining the conception date to determine pat
ernity? Your healthcare provider will use hormone levels in your blood, the date
of your last menstrual period and, in some cases, results from an ultrasound to
generate an expected date of conception. However, many differences in each woma
n s cycle may hinder the accuracy of the conception date calculation. The viabil
ity of sperm varies as well, which means that intercourse three to five days pri
or to ovulation may result in conception. Ultrasound dating of conception is not
reliable for determining paternity because the ultrasound can be off by at leas
t 5-7 days in early pregnancy.
When can an ultrasound determine the sex of the baby? You may have an ultrasound
between 18 to 20 weeks to evaluate dates, a multiples pregnancy, placenta locat
ion or complications. It may also be possible to determine the gender of your ba
by during this ultrasound. Several factors, such as the stage of pregnancy and p
osition of fetus, will influence the accuracy of the gender prediction. To be 10
0% sure you will have an anxious wait until the birth!
Are ultrasounds a necessary part of prenatal care? Ultrasounds are only necessar
y if there is a medical concern. As noted above, ultrasounds enable your healthc
are provider to evaluate the baby’s well being as well as diagnose potential probl
ems. For women with an uncomplicated pregnancy, an ultrasound is not a necessary
part of prenatal care.