Hi there , I hope you all have an amazing Christmas, as you can see on the title I will be explaining all about one of the most important ultrasounds on your baby, the 11 week one, in which we will be talking about the Nuchal Translucency as well, if you want to learn how your baby is developing at 11 weeks stay with me, as usual, all ultrasound images regarding this topic will be on the middle of the post…
At 11 weeks your baby is as big as a Lime, measuring about 4.1 to 5.2 cm long and weighing about 0.25 ounces.
Some of the most common 11 Weeks Pregnant Symptoms are:
Fatigue: Even though you are still under the effects of many hormones you are feeling some of your energy coming back slowly. Until then, give yourself permission to kick back and get some extra rest.
Skin darkening.: Well is about time for you to start noticing a dark line down the center your belly, this is a totally normal pregnancy symptom called the linea nigra. This dark line is caused by hormonal changes and is not permanent, even though you might notice that it stays for a while after you give birth, especially if you breastfeed.
Mood swings: Girl try anything and everything that keeps you calm and happy you really need it right now and remember if is possible, avoid stressful situations.
Leg cramps: The cause of leg cramps are not fully known, however, they can be caused by reduced levels of calcium or increased levels of phosphorus in the blood, leg cramps are painful involuntary muscle contractions that typically affects the calf, foot or both and are more common at night in the second and third trimester. Drinking plenty of water can prevent leg cramps, and so can stretching your legs during the day. You also want to take a look at your diet to be sure you’re getting enough potassium and magnesium.
Nausea. Should be getting better by now but you still feeling some here and there, be patient, some moms to find relieve taking natural remedies like ginger tea.
Vaginal discharge: Remember this substance is simply nature’s way of getting rid of bacteria. If it’s colored, tinged with blood, has a foul odor, or causes discomfort to call your doctor for a check-up.
Links for my previous posts are down below in case you want to check them out to see more about other weeks ultrasounds or symptoms.
What you need to know about the normal 10 week ultrasound.
What you need to know about the normal 9 week ultrasound.
What to expect on your 11 week ultrasound scan:
As usual, we start with the maternal organs first then the baby…
Remember the 11 weeks scan is still done transvaginally.
At 11 weeks your baby should look more like a human being, legs are clearly seen, the amnion is clearly seen, and the placenta is almost developed completely.
Another view of how your baby should look like, the ultrasound image shows the fetal head, arms, abdomen, and legs.
Can we take a moment to appreciate the most cutest thing you are going to see today, this is how your baby’s legs should look like.
Ultrasound image of the Doppler of the fetal heart.
Normal Nuchal Translucency.
And now let’s talk about nuchal translucency ultrasound shall we?
Nuchal translucency (NT) is the sonographic appearance of a collection of fluid under the skin behind the fetal neck in the first trimester of pregnancy. In fetuses with chromosomal abnormalities, cardiac defects, and many genetic syndromes the NT thickness is increased.
How is the nuchal translucency measurement done:
*The gestational period must be 11 weeks to 13 weeks and 6 days.
*The fetal crown-rump length should be between 45 mm to 84 mm.
*The magnification of the image should be as follow, the fetal head and thorax occupy the whole screen.
*The presence of the nasal bone, the rectangular shape of the palate anteriorly, the translucent diencephalon in the Centre and the nuchal membrane posteriorly are crucial to take an accurate measurement of the NT.
*Fetal head should not be extended or flexed.
*The fetus should be in a neutral position, with the head in line with the spine. A deviation of this position can lead to false positive or negative of the test.
*Is important to distinguish between fetal skin and amnion to avoid errors.
*The widest part of translucency must always be measured.
*During the scan more than one measurement must be taken and the maximum one that meets all the above criteria should be recorded in the database.
*A value of less than 2.2-2.8 mm is considered normal which means not associated with high risk.
The blood tests that are combined with the NT on the first trimester screening to rule out genetic and chromosomal diseases are:
*Free BhCG (beta human chorionic gonadotrophin)
*PAPP-A (pregnancy-associated plasma protein A).
The level of these proteins is known to change with certain conditions including chromosome abnormalities.
How the abnormal NT looks on Ultrasound??
Ultrasound image of an Abnormal NT measurement, as you can see on this image the NT was measuring 5.9 mm.
What’s next if you have an abnormal NT??
If your risk is increased then further testing (such as CVS or amniocentesis) should be considered.
Chorionic villus sampling (CVS) is a prenatal test that is used to detect birth defects, genetic diseases, and other problems during pregnancy. During the test, a small sample of cells (called chorionic villi) is taken from the placenta where it attaches to the wall of the uterus.
Amniocentesis is a prenatal test in which a small amount of amniotic fluid is removed from the sac surrounding the fetus for testing. The sample of amniotic fluid (less than one ounce) is removed through a fine needle inserted into the uterus through the abdomen, under ultrasound guidance. The fluid is then sent to a laboratory for analysis. Different tests can be performed on a sample of amniotic fluid, depending on the genetic risk and indication for the test.
Both of these tests have risks you should talk to your doctor if you have any concerns.
OK, guys so this is the shortest way to get you the most important things happening at 11 weeks, with all of this testing you probably need a Baby Moon right now lol, you deserve it…
On my next post, we will continue with the weekly Pregnancy Ultrasounds, I see you there, as usual, thanks for staying till the end.
Hi guys, welcome back to another post, this time about Normal 10 week ultrasound, as usual, I will talk about the important things you need to know at this time and finally we will go to the Ultrasound part, so let’s get started…
At 10 weeks your baby is as big as a strawberry, measuring about 3.1 to 4.1 cm long and weighing about 0.14 ounces.
10 weeks pregnant symptoms.
Wondering what to expect at 10 weeks pregnant? As your baby grows, your ligaments and muscles are starting to stretch on your pregnant belly, your breasts are getting bigger, they are probably sore too and some other changes are also happening. Here are some of the most common 10 weeks pregnant symptoms:
Morning sickness: Still strong at 10 weeks, morning sickness is caused by high levels of hormones in your body, this symptom gets better after you pass the first trimester.
Fatigue: Remember that you are under the effects of many hormones, especially increased levels of progesterone that is responsible for making you sleepy and also your body is producing more blood to carry nutrients to your growing baby, therefore, your blood pressure and blood sugar levels are lower, the best remedy for this symptom is more REST.
Mood swings: Because of the hormones and also because other symptoms, you may find your emotions more difficult to control. Remember is okay to slow down and take breaks throughout your day ( to do whatever makes you feel good and relax), also try to avoid stressful situations.
Round ligament pain: At this time you start feeling some aches and pains in your abdomen as it stretches to accommodate your growing baby. While some moms-to-be don’t really feel this pain for other mothers is very uncomfortable. If you’re 10 weeks pregnant with twins, round ligament pain could be even more noticeable. Let your OB doctor know if your discomfort is intense.
Growing breasts. Your breasts have probably gotten bigger by this time since they’ve been prepping for breastfeeding for weeks already!
Increased vaginal discharge. An increased blood flow to your vagina coupled with an increase in estrogen production could cause more of clear, odorless discharge. Might seem a little gross, but this substance is simply nature’s way of getting rid of bacteria. If it’s colored, tinged with blood, has a foul odor, or causes discomfort call your doctor. Those could be something else.
Visible veins: Another thing you may start noticing at this time is all those blue lines that suddenly has appeared on your skin, these veins are doing a very important job which is carrying the increased blood supply needed to nourish your growing fetus.
Other symptoms discussed on my previous post like Frequent urination and Headaches, combined with other symptoms like indigestion, bloating and gases are also happening right now, be patient, I promised it will be better soon, links for my previous posts are down below in case you want to check them out.
What to expect on your 10 week ultrasound scan:
As usual, we start with the maternal organs first then is baby time…
Remember the 10 weeks scan is still done transvaginally.
Ultrasound image of a fetus at 10 weeks, the round area surrounding the baby is called the Amnion, this structure is more visible at this time, placenta is still developing, yolk sac is visible at this time as well, your fetus is starting to look more like a baby, arms and legs are clearly seen, and movements are more noticeable too.
Ultrasound image of a 10 week fetus, the measurement that is done at this time is still the Crump Rump Length(CRL)
And remember we always need to get a signal on the doppler, that’s the heart of your baby beating!!!!!
Image of a 3D ultrasound on a 10 week fetus.
Ultrasound image of Fraternal twins at 10 weeks, you can see the thick membrane separating the babies.
Ultrasound image of Identical twins at 10 weeks, these babies share the same sac.
Remember the possibility of a Miscarriage is still high, Ultrasound will always check for Subchorionic bleedings or any other abnormalities, after ultrasounds you should be seeing your doctor for the results.
Facts about your baby!!!
At 10 weeks your baby has working arm joints, and cartilage and bones are forming. Your baby’s vital organs are fully developed and they’re starting to function as well. Fingernails and hair are starting to appear too! And your baby is already swallowing and kicking inside your belly!!!
At 10 weeks you will start having genetic testing to rule out diseases, the first test will be the Harmony, this test analyzes cell-free DNA in maternal blood and gives a strong indication of whether the fetus is at high or low risk of having trisomy 21 (Down syndrome), trisomy 18 (Edwards syndrome) or trisomy 13 (Patau syndrome). If the Harmony test shows that there is a high risk that the fetus has trisomy 21 or 18 or 13 it does not mean that the fetus definitely has one of these defects. If you want to be certain if the fetus has one of these defects you should have CVS or amnio.
I will explain more in deep CVS , AMNIO and Nuchal Translucency on my next post which will be published next Thursday because Tuesday will be Christmas day, I wish all my readers and followers a very Merry Christmas, thanks for being with me in this new adventure, I hope to have you around next year and the following years to come, Next post will be Normal 11 week Ultrasound, I see you there….
A picture of me and my family on Christmas last year!!!!
Hey there, welcome back to another post. Today I will be talking about Twin pregnancy ultrasound, I love doing this post because to me personally I love scanning twin pregnancies, so let’s go…
As in any pregnancy, single or multiple the ultrasound protocol is the same, the first ultrasound is performed to get measurements for dating purposes , also the heartbeat should be obtained, checking the yolk sacs, amnion and Chorionicity on twins is essential to know how to proceed with the pregnancy , in case you haven’t seen I will link down below the previous post where I explained the normal protocol for the first scan.
Well as you probably know by now being pregnant with one baby is difficult, imagine with 2 or more babies, the risks of complications on multiple pregnancies is a lot higher than single pregnancies.
If you are pregnant with twins you need to know that:
Morning sickness is worse due to high levels of hormones in your body.
Vaginal spotting and/or cramping is more common during twin pregnancies which means you will be having Ultrasounds more often.
Higher chances of having medical conditions like Gestational diabetes, preeclampsia etc.
Labor and delivery will be sooner and most likely be by C-section.
Now there are different types of twins
So below I explain the most important types of twin pregnancies seen on ultrasound, I will start with the rarest and most dangerous one which is the MONOAMNIOTIC-MONOCHORIONIC, follow by DIAMNIOTIC-DICHORIONIC, and finally, I will briefly talk about the DIAMNIOTIC-MONOCHORIONIC.
picture # 1
Ultrasound image of an Early gestation, about 7 weeks, you see the 2 fetuses inside the sac with NO membrane separation which means this is a Monoamniotic-Monochorionic twin pregnancy or Identical twins, this type of twins form after a SPLIT occurs on a fertilized egg, this type of twin shares ONE amniotic sac and ONE placenta.
Picture # 2Picture # 3
Ultrasound images on picture #2 and picture #3 are also Monoamniotic-Monochorionic but at a different gestational age, 10 weeks and 11 weeks respectively.
So because Monoamniotic-Monochorionic twin pregnancy shares ONE amniotic sac and ONE placenta, the risks associated with this pregnancy is higher than other twins, some of the risks are listed below:
Cord Entanglement: since there is no membrane separation between the babies their umbilical cord could get entangled, cutting off the blood supply to one of the babies.
Cord compression: As they share the same sac they might press against the others umbilical cord while making internal movements. Prolonged pressure may cut off blood supply and nutrients to one of the babies resulting in fetal death or weight discrepancies.
Twin to Twin Transfusion Syndrome: This syndrome happens when one of the twins receives the majority of the nourishment in the womb, causing the other twin to be undernourished. That is detected on regular scanning based on the physical development of both babies.
Preterm labor: always occurs on mono-mono twins due to the high risks on cord entanglement and compression, is usually done by C-section between 34 to 36 weeks, however, some mono-mono can be delivered at 26 weeks if there are other complications.
Other facts about Mono-Mono twin pregnancies:
Mono-Mono babies are always the same gender since they originate from the same fertilized egg.
Mono-Mono twins are rare, ONLY 1% of twins are mono-mono.
Now let’s talk about DIAMNIOTIC-DICHORIONIC.
Diamniotic-Dichorionic at 7 weeks.
Diamniotic-Dichorionic at 9 weeks.
Diamniotic-Dichorionic at 11 weeks.
The last 3 ultrasound images are Diamniotic-Dichorionic twin pregnancies, This type of twins can be Monozygotic or Dizygotic which means that can occurs after 2 different eggs are fertilized by 2 different sperms or ONE fertilized egg DIVIDES into 2 blastocysts and Reaches the uterus and is implanted, this type is the most common type of twins about 72 to 80% of all cases.
Complications of Diamniotic-Dichorionic twins:
While the complication rate is still much higher with twins than with a singleton pregnancy, a Diamniotic-Dichorionic pregnancy carries the lowest rate of complications amongst twin pregnancies however some of the complications can include:
*Increased risk of intrauterine growth restriction (IUGR): Means that one baby is not growing appropriately compared to the other twin.
*Placental related problems such as increased risk of velamentous cord insertion, marginal cord insertion or placenta previa.
Now let’s talk about DIAMNIOTIC-MONOCHORIONIC.
This type of twins is about 20% of all twins, forms after ONE single fertilized egg SPLITS, this type of twin shares ONE placenta but have 2 different Amniotic sacs.
Ultrasound image that shows SINGLE SHARED placenta seen on the bottom of the picture, clear membrane separation between the babies is seen in the middle.
Ultrasound image of a mono-di twin pregnancy again showing a SINGLE SHARED placenta that is located on the left side of the picture, you can see also the membrane in the middle of the babies.
So remember that this type of twin shares ONE placenta, so there are complications associated with it:
Potential complications that can occur with this type of pregnancy include:
problems related to abnormal placental vascular anastomoses
*twin to twin transfusion syndrome.
*twin embolization syndrome
*twin reversed arterial perfusion sequence.
*demise of one twin: often associated with some adverse outcome to the other twin.
*Other placental insertion related problems such as increased incidence of velamentous cord insertion and/or increased incidence of marginal cord insertion.
Other types of multiple pregnancies can also occur (Triplets, quadruplets etc.) the most important purpose of the Ultrasound is identify Chorionicity, one placenta vs two placentas can make the world of the difference.
The ultrasound protocols are always the same for any type of pregnancy.
And remember that being able to grow inside your body one life is precious but being able to grow more than one life at a time is even more precious, as I called it ” the miracle of life”, you are blessed and every baby is a blessing.
OK so this is the most relevant info about TWINS, I will start the weekly scanning on my next post, from week 7 to week 40 of pregnancy with ultrasounds, as usual, see you on my next post.
Hey guys, welcome to another post, today I want to briefly talk about the Abnormal first trimester ultrasound before I continue to weekly ultrasounds, as usual, I will be including ultrasound pictures on my post, in case you haven’t seen my previous article about Normal first trimester ultrasound I will link it down below:
Pregnancy failure is a common problem in the first trimester with failure rates approaching 25%. A threatened abortion is defined as bleeding and cramping in the first 20 weeks of pregnancy. Ultrasound plays a key role in evaluating women with threatened abortion since HCG levels do not always correlate with a specific diagnosis.
Subchorionic hematoma or Subchorionic bleedings.
Is the most common sonographic abnormality in the presence of a live embryo. Vaginal bleeding affects 25% of all women during the first trimester. In women whose sonogram shows a Subchorionic hematoma, the outcome of the fetus depends on the size of the hematoma, the mother’s age and the fetus gestational age.
If the Subchorionic hematoma appears in the late first or second trimester the risks for miscarriage, stillbirth, placental abruption or preterm labor are increased.
However small asymptomatic Subchorionic hematoma vs Subchorionic bleeding associated with No other complications can resolve by itself.
Anembryonic pregnancy ( Blighted ovum).
Is a form of failed pregnancy defined as a gestational sac in which the embryo failed to develop. A large gestational sac without the visualized embryo is unequivocal evidence of a failed anembryonic pregnancy.
Embryonic demise and Bradycardia.
The most convincing evidence that pregnancy has failed is the documentation of embryonic demise. As stated previously, all embryos greater than 5 mm in size should demonstrate cardiac activity. Embryonic bradycardia is a poor prognosticator of pregnancy viability and needs follow up. An embryonic heart rate less than 90 beats per minute, in embryos less than 8 weeks is associated with 80% rate of eventual embryonic demise.
Tubal ectopic pregnancy located at the LT adnexa.
The most reassuring sign that an ectopic pregnancy is not present is the sonographic demonstration of a normal intrauterine pregnancy.
Which means that when the HCG levels are 1500 IU or more an intrauterine pregnancy has to be seen, if not the possibility of an Ectopic pregnancy is really high, Follow up with HCG in blood and Ultrasound are highly recommended.
Patients that are in high risk for ectopic pregnancy have:
*History of pelvic inflammatory disease ( PID )
*Previous ectopic pregnancy.
Transvaginal ultrasound has an accuracy of 90% and should be routinely be used in the evaluation for ectopic pregnancy.
A variety of uterine findings can be seen with ectopic pregnancies. The may be empty or contain endometrial fluid collection, this should not be confused with an intrauterine gestational sac.
The most common adnexal finding is a complex mass which represents hemorrhage. Other adnexal findings included a normal adnexa or a well formed adnexal ring with or without a yolk sac or embryo. The posterior uterine pouch or pouch of Douglas should be carefully investigated since complex peritoneal fluid may be the only finding in 15% of ectopic pregnancies.
OK so I am ending my post here, on the next one I will be talking probably about Twin pregnancies, and the following week I will be going week by week on scanning, if you stay until the end, thanks and I hope you come back…
feel free to comment if you have any questions.
HI guys is Zadi, welcome to another post, today I will be talking about Normal first-trimester ultrasound and all you need to know, so stay with me !!!!
OK, so assuming that you have a positive pregnancy test, HCG ( pregnancy hormone ) blood work that confirms pregnancy, next thing is an ultrasound to rule out gestational age, estimated due date, how many babies and also maternal organs are check to rule out Fibroids, ovarian cysts etc..
If you haven’t seen my previous posts about fibroids and ovarian cysts I will link down below for you:
All you need to know about Fibroids.
All you need to know about Ovaries, normal hormonal cycles, and common cysts.
So now back to the post, what are you going to see on the first ULTRASOUND scan ( 6 weeks of gestation )??
Gestational sac: The first structure seen on ultrasound, the gestational sac can be visualized as early as 5 weeks by Transvaginal technique. A normal gestational sac can be round or oval and is located within the fundus or mid portion of the cavity in the uterus.
Gestational sac within the cavity.
Ultrasound image of the gestational sac and yolk sac.
Yolk sac: The yolk sac is the first structure visible within the gestational sac. The yolk sac should always be seen when the gestational sac measures greater than 1.0 cm or 10 mm.
A normal yolk sac is round and should measure less than 6 mm. If the yolk sac measures more than 6 mm, is bizarre in shape or is calcified follow up scan is required since most pregnancies with Abnormal yolk sacs will fail.
Normal looking yolk sac.
Enlarged yolk sac.
Calcified yolk sac.
Yolk sac with a bizarre shape.
Embryo: The second structure that becomes visible within the gestational sac is the embryo. Embryonic cardiac activity should always be seen when an embryo measures greater than 5 mm.
A normal fetal heart rate usually ranges from 115 to 160 beats per minute during the first weeks of gestation, It is measurable with ultrasound from around 6 weeks, the normal range varies during gestation, increasing to around 150 to 175 beats per minute at 10 weeks and decreasing to around 130 beats per minute at term.
A heartbeat of 100 BPM or less In the first ultrasound may indicate a pregnancy that is going to fail however a follow up is always recommended.
Ultrasound image of an Embryo at about 6 weeks of gestation.
Membranes: The amnion grows against the chorion and the membranes eventually fuse, usually by 17 weeks.
Most COMMON and usually harmless cause of vaginal bleeding on the first trimester is Subchorionic bleedings, it resolves by itself however precautions have to be follow.
Ultrasound image of subchorionic bleeding.
And remember if you see an image like this one:
you guess it !!!! YOU ARE HAVING TWINS…
Ultrasound image of Fraternal twins. ( I will explain this in another post )
Ultrasound image of Identical twins.
If is more than 2 babies GOOD LUCK!!!! LOL
All ready so this was Normal ultrasound at 6 weeks, next post I will be talking about Normal pregnancy Dating, protocol, and guidelines, how we measure the baby to have an accurate due date, this and more so I will see you next time, next post on Thursday, see you there…
Hello my friends , its zadi here with another post, this time we starting already with Pregnancy , let me guess ?? you did a pregnancy test and shows a positive pregnancy, eyyy that’s awesome now pay attention because I will walk you through all the important things that you need to know before going to your first appointment with your Gynecologist.
First of all I want you to know that there are several periods before we even see a viable pregnancy on Ultrasound, Those periods are:
Ovarian period: its 1 to 2 weeks after the first day of your last period , this is the period when ovarian follicles mature.
Conception period: its 3 to 5 weeks after the first day of your last period , this is the period where fertilization occurs .
Embryonic period: its 6 to 10 weeks after the first day of your last period , is in this periods where a viable pregnancy is seen on ultrasound at about week 6 , this is the period where Embryo forms and the major organs develops.
Fetal period : its 11 to 12 weeks after the first day of your last period , all major fetal development is already done and this period is all about fetal growth.
Fist trimester of pregnancy is defined as the 13 weeks following the first day of the last menstrual period (LMP).
Hormone measurements ( HCG ) : Urine pregnancy test can detect the presence of HCG at the level above 25 IU/L which corresponds to day 24 of a regular 28 day cycle.
In normal pregnancy serum HCG levels double approximately every 2 days and it is done with a blood test.
Once the HCG levels are above 1000-1500 IU a vaginal ultrasound usually identifies the presence of an intrauterine pregnancy.
An Ectopic pregnancy is suspected if the HCG does NOT DOUBLE in 2-3 days. If NO pregnancy is seen in the uterus by week 5 with an HCG levels of 1500 UI or more.
Now Let me talk a little about Miscarriages.
Miscarriages occurs approximately on 20% of early pregnancies.
Typical miscarriages symptoms are: Vaginal bleeding, abdominal / pelvic pain.
However some miscarriages are asymptomatic.
Risk factors for early pregnancy miscarriages are:
Previous pregnancy losses.
Miscarriages are classified in 3 different major categories:
Missed Abortion or Miss AB: Retention of gestational sac within the uterus following embryonic or fetal death, Absence of cardiac activity is detected on Ultrasound.
Ultrasound image of a gestational sac and fetal pole still seen within the cavity , The measurements of the fetal pole are usually smaller than the gestational age and NO heart beat is identified on Ultrasound.
Incomplete Abortion: Gestational sac is not seen on the uterus however the cavity still appears to be thick and blood clots and/or retained products of conception are still visualized inside the cavity.
Ultrasound image of the cavity of the uterus showing No gestational sac and/or fetal pole but still some fluid , blood clots and debri are seen inside.
Complete Abortion: its diagnosed when the endometrial cavity appears thin and clean of products of conception after the bleeding.
Ultrasound image of the cavity that appears to be clean and thin.
Ectopic pregnancy is defined as implantation of the fertilized ovum outside the uterine cavity.
Ultrasound image on an Ectopic pregnancy, the uterus was seen to the Left and the Left ovary to the right of the image and in the middle the ectopic pregnancy was clearly seen, now in some cases ectopic pregnancies can appears as a rounded mass instead of a sac with a fetus inside.
Ok so this covers important aspects of the first visit , on early gestation Ultrasound can not see a viable pregnancy inside the uterus unless you are 6 weeks or more, the patients usually don’t know and get nervous when the pregnancy is not seeing on the first scan, on the next post I will start covering Normal first trimester ultrasound , I hope to see you there, as usual thank you so much.