Posted on July 5th, 2017 by wombwithaviewblog.com

Determining fetal sex by ultrasound is not as easy a task as most think. Actually, gender misconceptions pertaining to ultrasound are so common that I thought it worthy of yet another post.

Making a boy vs girl determination requires far more expertise than just sticking probe to belly. And babies do not just automatically cooperate! Baby’s legs need to be wide open and other parts cannot be covering over external genitalia. If so, the chances of holding that “reveal” party are slim to none.

Another common misconception is that we can force Baby to move. I promise you that if there was one magical button to push, there’s not one sonographer on earth who would hesitate for a second. Why struggle to give you the information you want if we could simply and magically flip Baby? Ugh, a girl a dream, but I think this technology lies in our distant future. Unfortunately, babies get comfy and only move into another position if they get the urge…and not a moment sooner.

Determining sex accurately is all about angles. Being far enough along with Baby in the right position is only part of the task..when I’m the one scanning, that is! Most of my emails come from people who want a second opinion. However, most of the time, it’s one I cannot give! Either Baby is too early or the image is just plain, well..terrible. In these scenarios, the truth is I just can’t comment on what I can’t see.

Most sonographers don’t mind telling you your baby’s sex, by the way! The problem for us comes when we can’t see what our patients want to know.  Even if we explain all the reasons, patients sometimes become upset or angry. I have scanned tens of thousands of babies. Anyone who has scanned as much can recognize when this information is obtainable and when it isn’t.

Tips For Your Next Ultrasound

So, here are a few recommendations for you to follow before your next ultrasound. No guarantees! But if you are busting at the seams to find out what you’re having, these tips just might work!

•Try eating or drinking something about 30 minutes prior to the exam. Baby typically becomes more active after eating. Now, I’m not condoning a double espresso and Snickers combo (yummy, yes; smart, no). We don’t want your fetus launching into orbit. Instead, try enjoying a hearty and healthy lunch or breakfast prior to your scan.

•Keep an open mind! Understand that not seeing the sex is definitely a real possibility!

•Don’t shoot the messenger! In other words, your sonographer would never intentionally withhold this info! …Unless, of course, it’s a policy of the facility to not guess sex.

Believe me! We would love to help you plan your party, shop for baby clothes, or decorate a nursery. It’s the most fun when we can! And when we cannot, it’s a real bummer..for you, because you leave disappointed and for us, because we’re (sometimes) blamed as the party poopers.

Great Pics of Fetal Sex

I’ve posted these before, but below are a couple of really great images of external genitalia, first boy then girl.

male fetal sex, around 27 Weeks

Male Gender

female fetal sex, mid-second trimester

Female Gender

Also, if you send an email asking for a second opinion earlier than 18 Weeks, you may receive the links below to other posts containing very easy, no-mistake pics of boys and girls!

http://wombwithaviewblog.com/female-gender-on-ultrasound-2/

http://wombwithaviewblog.com/boy-girl/

http://wombwithaviewblog.com/boy-vs-girl/

http://wombwithaviewblog.com/twin-gender-update/

http://wombwithaviewblog.com/third-trimester-male-gender/

Good luck on your next scan!

As always, thanks for reading and email me with your comments at wombviewerblog@gmail.com!

You can also subscribe for automatic posts in the right margin! >> You’ll receive a little something special (and free!) when my book on first-trimester ultrasound is published!

Here’s to happy and healthy!

wwavblogger, RDMS
wwavblogger, RDMS

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Posted on June 23rd, 2017 by wombwithaviewblog.com

Ultrasound gender determination can be tricky!

female fetus, 16 Weeks pregnant

Female Gender

male fetus, 16 Weeks pregnant

Male Gender

 

How many times have all you moms out there, young and old, heard the story that goes, “They told her it was a ‘this,’ and they decorated an entire nursery, and it came out a ‘that’! Those ultrasounds are wrong sometimes, ya know!”

A dollar for every one of THOSE comments would buy me my dream cottage on the Amalfi coast! However, I understand why this happens, and sonographers everywhere need to apply more discretion. First of all, you may already know that it’s not the machine that’s wrong. The sonographer or observer scanning you evaluates what she sees and determines Baby’s sex. And inexperience and/or caving to the pressure from persistent parents will often cause a sonographer to guess…and, unfortunately, sometimes guess incorrectly.

Advice Regarding Gender Determination for the New Sonographer

First rule of thumb for any newbie sonographer out there…IDON’T GUESS! I don’t put a percentage on my guess, and I don’t say “I think.” I also don’t say “It kinda looks like ‘this,’ but let’s wait until next time.” Parents may want you to guess, but they also want you to be RIGHT! And this last statement is what I typically will share with parents when they become red-faced by my unwillingness to toss out a quasi-guess based on a quasi-image. And, believe me, I’ve had more than my fair share of patients angry with me for something I have no control to change. We can’t just flip Baby in there at will.

The problem with saying “I think..” is that psychologically and emotionally most parents start to really become attached to this guess. They have already envisioned the first dance recital or baseball game by the time the next ultrasound exam rolls around. It’s so true. Mostly, someone else guessed incorrectly (usually, too early!), and I had to be the bearer of bad news. I decided to adopt a personal policy to ONLY offer a guess when I didn’t have to guess! In other words, Baby had to be in a perfect position with an easily seen penis and scrotum or labia/clitoris.

True Story!

One grandmother, so excited by the doctor’s early guess, flew right out and bought thirty-two dresses! Yep, 32. She did so despite the doc’s warning about his level of confidence and told her to wait for the sonogram with me. Fortunately, he got lucky with his baby girl guess, and grandma was a very happy woman (and a little less rich)! However, you can imagine the disappointment in returning all those frilly frocks if doc was wrong. I always hated giving such news!

Please, patients! Please remember your sonographer doesn’t withhold information about fetal sex just because. We’d actually really rather all our babies cooperate after five seconds of examination and that our patients didn’t leave the room cursing our existence. A button to make Baby flip on command? Now that’s a magic trick I’d like to patent:)

Thanks for reading, guys! You can email me at wombviewerblog@gmail.com and/or subscribe for automatic posts! >>>

wwavblogger, RDMS
wwavblogger, RDMS

Comments: 2 Comments »

Posted on April 27th, 2017 by wombwithaviewblog.com
3D, 9 Weeks, ultrasound facts

3D 9 Week Embryo

Ultrasound Facts About General Stuff

  • Technically speaking, ultrasound is the study of the subject (the field of ultrasound) and a sonogram refers to the examination itself.
  • Current biohazard testing reveals no ill effects of ultrasound on the fetus, mother, or sonographer. However, ongoing tests show increasing levels of heat after scanning for several hours in one area. Over-scanning for long periods can cause cavitation or the creation of bubbles. This is much longer than the time required for performing a diagnostic test. Additionally, for this reason, only the prudent and diagnostic use of the technology is recommended by ACOG, ARDMS, and any other professional medical organization. The benefits of the information from diagnostic exams for patient and physician currently outweigh any known risk.
  • Ultrasound is just that…sound waves that operate at a frequency far beyond human hearing. Nope, Baby cannot hear the sound waves! Human hearing ranges from 20Hz to 20,000Hz. Diagnostic ultrasound operates in the millions of Hertz. Ultrasound probes range from about 2 – 13MHz.
  • Ultrasound is sound waves, NOT radio waves. No radiation is emitted by ultrasound equipment or Dopplers utilized by your physician to detect Baby’s heartbeat.
  • 4D is 3D in motion or a live 3D image.
  • Most people are familiar with 3D imaging as a fun way to see the outside of their baby. Additionally, the best and cutest 3D images are obtained later in the 2nd trimester or very early in the 3rd. Baby’s skin has developed more fat at this point which makes for chubbier cheeks!

 

Ultrasound Credentials for Sonographers

  • Someone newly trained in the field earns the credentials of DMS or Diagnostic Medical Sonographer. He or she has completed some sort of formal or on-the-job ultrasound training. This person is usually relatively inexperienced and has not yet passed the registry examination. This person should have direct supervision in performing your examination.
  • RDMS stands for Registered Diagnostic Medical Sonographer. A sonographer earns these credentials when he or she has passed a registry examination in his/her ultrasound specialty. Moreover, a certified sonographer will typically have at least two years of experience.
  • Not everyone who scans an expectant mom in a 3D non-medical business is a certified OB sonographer. Some have no formal ultrasound training whatsoever! These businesses are not regulated like medical practices. They may not be knowledgeable of or follow guidelines for equipment maintenance. Ultrasound equipment that is not properly maintained can be an electrical hazard for mother and/or fetus!!!

 

Ultrasound Facts About Performing Your Exam

  • Every practice is different. Most physician’s order a first-trimester ultrasound examination to date the pregnancy. This is usually performed with a vaginal probe. If no other problems necessitate another scan, the next is performed around 18-20 Weeks. Most women know this scan as the anatomy screen where we evaluate fetal and maternal parts for abnormalities. This study is not ordered to determine sex! Also, important to note here is that determining sex is never a guarantee, nor should it be an expectation. However, most sonographers will happily provide the info if at all possible!
  • The health of your pregnancy determines whether you will receive more ultrasound scans later in your pregnancy.
  • 2D ultrasounds are the grey-scale images you might recognize during your diagnostic examinations. Occasionally, a high-risk practice (MFM or Maternal Fetal Medicine) will usually also use 3D to assist in visualizing a fetal abnormality. We also frequently use the technology for GYN scans to attempt a better look at uterine shape and/or IUD placement.
  • Ultrasound cannot predict how much your baby will weigh at birth. While we can measure your baby’s head, belly, and femur for an educated guess for weight at the time of your scan, a large discrepancy for weight determination exists due to fetal position and sonographer inexperience or skill. We can typically track a trend for large or small babies. We know the average gained weight in the last few weeks is about 1/2 lb per week. However, every baby is different!

 

Ultrasound Facts About Fetal Sex

Most expectant moms today already know this little fact. The ultrasound machine is never “wrong” in determining fetal sex. Actually, it is the observer who is incorrect!

Guessing the wrong sex can be due to one or a combination of many factors. It is possible your baby was in a difficult position to see well. Maybe you were too early in your pregnancy for an accurate guess or your sonographer is inexperienced. In addition, an overall poor view can also limit fetal sex determination!

Ultrasound Facts About Your Ultrasound Results

Yes, the sonographer can read your examination. However, your OB/GYN physician or radiologist must ultimately interpret the images and report we create. Consequently, only your physician can legally give you results!!!

***

Patients ask me these questions on a very regular basis. I hope it was helpful! Feel free to email me at wombviewerblog@gmail.com with your comments or questions!

Thanks for reading!

wwavblogger, RDMS
wwavblogger, RDMS

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Posted on April 11th, 2017 by wombwithaviewblog.com

Yep, it happens..the mistaken fetal sex guess. It can happen to anyone and sometimes does! We all have heard the story somewhere. A friend. Family member. Someone’s friend’s cousin’s sister-in-law.. The truth is that the right conditions can make anyone susceptible to an incorrect guess.  Consequently, discovery of the opposite sex inevitably leads to a roller coaster of emotions!

I have certainly been on the giving end of that conversation. Most of the time, it’s not pretty. The result usually accompanies shock and wonder at how this could have happened, especially with today’s technology. This is the typical feeling. However, still get the feeling that the general public thinks it’s the machine doing the guessing and not the observer. It always has been and always will be the observer who guesses, very experienced sonographers versus new to the field. Other healthcare professionals are more experienced and better than others at scanning. And some observers, unfortunately and unbeknownst to you, are not formally trained in ultrasound at all! Some (in the 3D business) are taking a crack at your baby’s sex don’t even come from the medical field. Scary, right?

That said, a whole world of other issues can interfere with the guess of someone more than qualified to make it. Factors like fetal position and patient size can both make visualization limited. This last statement is not an opinion..it’s a long-known fact within the field and has everything to do with the laws of ultrasound Physics. The more tissue the sound waves have to penetrate, the more limited the image will be once traveled back to the monitor. That said, I could see very well in a few of my heavier patients over the years and definitely struggled in some thinner ones. This is also because air and gas are not our friends in ultrasound. If your intestines are full, it can get in the way of what we need to see..even in the thinnest of people!

Readers from all over the world email me with their images for a second opinion on fetal sex. This can be very difficult when the image isn’t great to begin with. I always like to play it cautious..with my patients and readers. You’ll find one reader’s story below who wanted my opinion, but I was clueless. This baby didn’t look like a boy or girl to me, either!

She wrote initially expressing her confusion. She was 20 Weeks but couldn’t make out typical girl or boy parts. This was the image below.

Honestly, it looked a lot a like a girl to me but not a 20 Week fetus..maybe 25 Weeks or so. And it certainly didn’t look like a boy.

I wrote her back saying this:

Hi, this is not a very clear image but does seem to be a good angle. I don’t see anything sticking out so I would have to guess girl based on that alone. Maybe a future ultrasound may be more clear? I’m sorry I couldn’t help more!

Best,
wwavblogger 

She wrote me back a couple of weeks later:

Everyone said it’s a girl again. I was a little disappointed, but now he is here. Blessed with a baby boy. The family is complete now. Wanted to share this happiness with you. Thank you.

She was obviously much farther along than the image she sent, but I was a bit shocked that she had a boy (I have to admit)! However, I was so happy for her that she got what she wanted. My reply to her:

Oh, congratulations!! This is precisely why I don’t like to try to confirm sex with other sonographer’s images! Sometimes they just aren’t very good and depend on angle and experience. A lack of something in one shot is not a definite girl! Many blessings to you!

Now, obviously, we all look differently from one another and abnormally developing parts can cause confusion on sonography. I surely can’t say her baby didn’t have normal genitalia, but I’m still perplexed to this day. I feel very sure I could show that image to any of my former co-workers in ultrasound or docs, and I would bet my left arm they’d all guess girl!

I’d rather play it safe any day!

 

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Posted on March 13th, 2017 by wombwithaviewblog.com

Deciphering fetal sex can be a very difficult job, especially when trying to read an image taken by someone else! Sometimes, it’s a piece of cake.

So often, when readers send me their images for a second opinion on fetal sex, I just cannot provide a confirmatory guess. This is either due to too early gestational age, too poor an angle, or too poor an image. Sometimes, it is a combo of all three!

Ultrasound is such a different animal because it is nothing like just looking at a photo of someone and recognizing that person. In a photo, you can see what’s in the distance or up close to the camera. With ultrasound, we cannot. We can only see exactly what is directly under the probe. It is a 2D (two-dimensional) image only, and we have to move the probe around to obtain different angles to create that “photograph” in our minds. And there are so many variables that go into creating a good ultrasound image.

Since ultrasound is completely subjective and observer-dependent, some sonographers take great images and some..well..don’t. It’s much like comparing a professional photograph to an out-of-focus, too dark, cell phone group portrait where everyone has red or white eyes. You know, the ones you always see posted on social media?

I am too much of a perfectionist. This wasn’t always a good thing when trying to take keepsake photos for patients because it caused me to run late on more than one occasion. And everyone knows people don’t like to wait in a medical office! Factors to take into consideration are maternal and fetal position, angle, magnification, depth, as well as brightness and contrast of the image. It’s a learned skill and some are simply better at it than others. Some just don’t tweak all the knobs as much as they should. Maybe they were never really taught how to do so very well.

And some things that cause a poor image are just beyond a sonographer’s control..like an uncooperative fetus, extra weight around a patient’s abdomen, or a gassy patient. This has everything to do with the laws of ultrasound physics which dictate the further sound waves have to travel, the poorer the image; also, sound does not travel well through air or gas. I’ve scanned heavier patients where I could see pretty well and thinner, gassy patients where I struggled to see at all! That said, I can tell when an image is not great or when she didn’t work with all the knobs. This can make reading an image snapped by someone else extraordinarily difficult. One image represents only one angle. Scanning real-time allows me to look from all angles possible, where I can subjectively determine my confidence in fetal sex..or whether a guess is too risky at all.

ALL that said, sometimes taking a second guess is easy-peasy. Check out the email I received from a reader about whether her baby is a boy. Her images didn’t leave much of a question in my mind:) She was just over 20 Weeks along. Can you tell what she’s having?

mama: Hello, I’ve been following your blog, and I was wondering if you could take a look at my baby’s scans and give me your opinion on gender. We were told it’s a boy, but I’ve read that girls can have parts that look similar to boys? I agree that it looks like a boy, but wanted a second opinion. Thanks!

male fetal sex

male fetal sex

wwavblogger: LOL No ma’am! Little girls don’t normally look like that at 20wks! I will wager my bet on a baby boy:) Congrats!

mama: Lol! I wasn’t quite sure but I’ve had a feeling it’s a boy from the beginning of the pregnancy!

Reader mom! I forgot to mention in my reply to you that, yes, girls and boys can indeed look similar, but that is more true between the 12-16 Week range when parts are small, just developing, and when combined with other factors that come into play which result in limited visualization!

Did you guess boy? If so, I agree! Compare the images I’ve edited below.

boy parts1-jpeg

boy parts2-jpeg

Even though it would be quite unusual for this to be a baby girl, I’m still always a bit cautious about guessing fetal sex based on someone else’s image. When I’m casting a vote for Team Blue, I like to ensure I see a scrotal sac which requires a slightly lower angle. Sometimes, you can obtain both scrotal sac and penis in the same image, sometimes not. I get a slight impression of a scrotal sac here where I placed the circle. The sac at this age can appear quite small, and testicles are not expected to descend until about 26-28 Weeks. This is why scanning real-time helps; it allows me to see Baby at all angles possible, while moving and stretching and opening his legs more.

Stay tuned! My next post will be one where a questionable and poorly technical image comes into play. Mom wrote back saying she delivered the opposite sex. Oops!

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Posted on May 12th, 2016 by wombwithaviewblog.com

What’s the worst position a fetus can be in if you want to determine fetal sex? You guessed it! Look no further than the image below to answer this question. The breech fetus compromises most of what both you and I want to see.

What You Don’t Want to See

breech fetus

This image is really an example of just how much position plays a part in how well we see. This baby (above) is not only lying in a breech position, or butt-down, but baby is also facing Mom’s back (prone).

The wait for your 20 Week sonogram and whether you’ll be shopping for pink or blue may have you losing sleep! The LAST thing you’ll want to see is your baby looking like the image above. It spells one word…disappointment. If baby stays in this position throughout the examination, the possibility of seeing anything cute is essentially nada.

20wk facial profile

 

Above is an example of baby flipped over and looking up. How much better do you see baby’s face?

Here’s hoping you have more luck than this patient did for her anatomy screen ultrasound exam!

Email me with your questions and comments at wombviewerblog@gmail.com

wwavblogger, RDMS

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Posted on February 8th, 2016 by wombwithaviewblog.com

Not all ultrasound images are created equal! I know I’ve said this before but it is difficult for many people to understand that not all images between a baby’s legs produce an image of fetal sex. It is a tricky business!

An image may include part of a rear, part of a leg or foot or part of a cord without ever including external genitalia. Sometimes part of the genitalia might be in the image but if not entirely or at the proper angle, determining boy or girl just can’t be done. This is why you may have gotten an email from me saying that I just cannot confirm your baby’s sex even if you had a sonographer who contrarily appeared very sure with her guess. In my professional and very discriminating opinion, if her angle isn’t great and the image is questionable then her guess carries just as much weight in my mind.

A good analogy is if you look at a closed fist as certain angles, can you tell if all someone’s fingers are there? If you look at someone’s foot from the back, can you see whether they have toes? The same can be said for any number of body parts, not to mention any other thing in the world. Looking at a person standing directly in front of you doesn’t mean you know what they look like from the back. Oh, you might assume but you truly do not know whether you would find a curly pig’s tail or a third arm projecting from his back!

This is why not all images people send me of fetal sex are good, nor are they obviously boy or girl. So many factors go into what makes a good image, angle being the most important of all these. But that, my friends, is a post for another day!

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Posted on January 10th, 2016 by wombwithaviewblog.com

Hi, all! Tonight’s post serves as just a reminder when you go in for your 18-20wk diagnostic scan.

Remember that, at the end of the day, we all get what we need. Boy or girl, sometimes it’s your child-to-be that needs you or you that needs this child for whatever reason which you may not understand entirely right now. Maybe you’ll never really know while living this life; maybe you have instinctively always known. Regardless, I do believe that most people at the time of delivery do not ultimately care about fetal sex, no matter the preference previously. We take one look at that face and stare into those eyes and most women fall in love instantly. This is the child whom you nurtured all along. You’ve finally met!

So, as I’ve said a million times, it’s OKAY to have a preference of one sex over the other so long as one remembers that healthy is more important than anything else. Just ask someone who lost a baby or who experienced a difficult pregnancy. Moreover, ask a couple who could never become pregnant or suffered infertility many years. Oh, they may choose to still find out with subsequent pregnancies but it’s not top priority on their list. Typically, when asked if they want a boy or girl, they are usually pretty quick to respond “Healthy!” It’s all about perspective.

As with anything in life, keeping an open mind about such things allows us to keep our priorities in line and provides us freedom from sweating the small stuff! (And most of it, like fetal sex, is small stuff..)

Best wishes for a happy and HEALTHY pregnancy!

Comments: 3 Comments »

Posted on November 19th, 2015 by wombwithaviewblog.com

“How sure are you?” I’ve heard this question probably more than any other in my career.

Every sonographer is different. One person’s sure is another’s iffy. I’ve seen images where a person was told one sex and the sonographer had “no doubts” only for me to scan later to confirm how very wrong she was. The fact here is that as long as people keep wanting to see fetal sex by ultrasound, there will always be challenges surrounding the guessing fetal sex.

As long as ultrasound-for-entertainment businesses are allowed to remain open, they will continue to take money from any person who wants to pay them. They will guess at sex because you are a paying customer. You paid for a guess; they’ll give you just that. But is it right? Who knows?

From my end, as long as new graduates and people with little experience are guessing sex, there will be incorrect guesses. Since we all practice differently, there will always be some sonographers, even experienced ones, who jump the gun and guess too early or despite suboptimal visualization. Others are more cautious, examining from every angle but still hesitant to commit.

I’m more of the latter persuasion. I want to be VERY sure, superduper sure, sure-as-white-is-on-rice sure. I need perfect views in more than one angle and textbook imaging. In other words, baby parts have to be ultra obvious for me to feel comfortable making a guess. There will be none of this 70% stuff on my watch. What does a percentage mean anyway except that someone is just really not sure! Does anyone really feel comfortable with buying pink or blue based on that? ..Or painting a nursery based on that supremely expert opinion?

What needs to happen is bipartisan cooperation (is that really a thing in the U.S.?????). People who cannot scan well should just put down the probe and walk away. Those who are new to ultrasound should not attempt to guess sex without first consulting someone else more experienced. Patients should not push to find out sex at the first positive sign on a pee stick nor should they pressure sonographers to guess NOR should they throw a fit when we refuse. And, last but most certainly not least, non-medical, non-necessary, thorn-in-my-side, bane-of-my-existence, menace-to-society-and-medical-communities-alike 3D cash cow businesses need a cease and desist from scamming the general public into believing they can actually provide a 100% guarantee on sex at 14wks. SO! If all the above happened, we would never have another incorrect fetal sex determination by ultrasound again. Unfortunately, there’s about as much chance as my waking up to a million bucks in my driveway. I think I’ll be going in to work tomorrow after all:/

And for those of you who have not yet seen them, check out the links below for my images of fetal sex which are textbook, classic, no-guesswork-needed images of both male and female sex:

http://wombwithaviewblog.com/female-gender-on-ultrasound-2/
http://wombwithaviewblog.com/boy-girl/
http://wombwithaviewblog.com/boy-vs-girl/
http://wombwithaviewblog.com/twin-gender-update/
http://wombwithaviewblog.com/third-trimester-male-gender/

Best wishes for a happy healthy baby!

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Posted on September 30th, 2015 by wombwithaviewblog.com

One of the highlights of parenthood for everyone is the day they hear the words “It’s a Girl!” or “It’s a Boy!”, no matter whether they are heard in the delivery room or the ultrasound room.  While no one ever invites news that something is not quite normal, it’s rarely expected that the problem will be with regard to fetal sex determination. I recently received just such an email about the subject of ambiguous fetal genitalia. Some of the technical information of the case has been omitted.

concerned mom:  I was just told by a doctor at the perinatal center that my baby’s genitals appear abnormal on my late 3rd trimester ultrasound. My only other scan was at 20 weeks and I was told “probably boy” but it took the tech a while to make that guess. I’m aware that there are a range of genital abnormalities that can occur so I asked my physician if she saw both male and female parts. She told me she thought it was a boy but admitted that it can be hard to distinguish labia from scrotum (because of the appearance of the presumed sac and questionable small penis). I was referred to get some genetic testing done but I sense the chromosomal info will still leave me with questions about the probable condition if there is a mismatch between genotype and phenotype.

I’ve gathered info on some of the more common genital abnormalities to try to come to overcome disappointment and find peace. I find myself wondering about this one doctor’s opinion and likelihood of accuracy. In your years of practice, do you find labia and scrotum difficult to distinguish towards the end of pregnancy? I realize you can not confirm or clarify the details of my particular situation but I’m still interested in your general thoughts.

Thank you for sharing your expertise.

wwavb:  Firstly, I will say that a perinatologist should be the most qualified physician to answer these questions for you. Her specialty being high-risk pregnancies qualifies her as the go-to for your general OB for all things presenting as unusual. Though it is one doctor’s opinion, it is a highly specialized one and she would be able to provide answers for you to a likely far greater degree than your general OB.

I can only speculate here, of course, but it sounds as though the perinatologist has questions, too, and ordered genetic testing to help clarify whether baby is genetically male vs female and to possibly rule out whether a chromosomal abnormality could explain the physical appearance of the genitalia. I imagine any information it yields could only help aid your physician in a diagnosis which can, in turn, aid you in the educational and emotional preparation of baby’s condition. I have to advise here to not consult “Dr. Google”, as we refer to the Internet in our office, because it only adds to your confusion and provides a whole spectrum of variables of potential diagnoses that do not apply to your case. I know it’s hard to wait but, truly, until you get genetic results, all of your time spent looking for answers can compound the problem in your mind and peace is the last thing you’ll find there…it typically only leads to more questions. The only time I find it’s good advice is if your doc has referred you to a specific site.

In my experience, gender typically becomes easier to distinguish as pregnancy progresses, fetal position providing. Your case, though not frequent, is the prime example for why we prudent sonographers do not throw out a random sex guess with a quasi peek. It’s why, also, I never guess prior to 18wks or any time if I cannot see well with respect to all the variables that can hinder that determination. Later on, the labia become more full and, sometimes, the clitoris remains visible. Testicles usually descend about 28wks which are typically easy to visualize, and though penis size does vary, it still is fairly easy to see in most babies.

Below are links for some of my normal-appearing male and female genitalia images at different times in pregnancy:

http://wombwithaviewblog.com/female-gender-on-ultrasound-2/
http://wombwithaviewblog.com/boy-vs-girl/
http://wombwithaviewblog.com/twin-gender-update/
http://wombwithaviewblog.com/third-trimester-male-gender/

I hope my information hasn’t been entirely redundant and that I’ve helped in some small way. I wish you all the very best and, please, if you don’t mind, I would love a follow-up email once you have more answers.

Take care and please do not hesitate to contact me if I can assist you in the future!

Regards,
wwavblogger

***

Ultrasound and other antenatal testing was created, first and foremost, as a vehicle to education, understanding and preparedness when our pregnancies become challenging with information and events we don’t understand.  There has been no better time than the present for medical advances and those with the ability to use and understand them to hold our hands and help us navigate through the roller coaster of emotions.  The goal in the end is the most healthy baby and educated parent(s) to care for him.  And although what results for medical professionals is education through experience, it’s ONLY the experience of treating such patients that creates the empathy to care for them.

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Posted on December 18th, 2014 by wombwithaviewblog.com

Well, folks..I have been in full swing as most of you have also during this spiritual, joyous and crazy as a nutcracker of a holiday this really is.  The only place more chaotic  than your local malls and Targets this time of year is..you guessed it..your OB/Gyne office.  Yep, we got kids swinging from the lamp shades all hyped up on gingerbread and moms of all ages trying to get seen before the dreaded deductibles start all over again like the new year.  It’s crazytown in my neck o’ the woods.

Working late on top of trying to get my own shopping tackled (no kidding, I just decorated my tree last weekend) has made for one tired sonographer but I digress..the show must go on.  I promise to deliver some seriously super-cute 3D images over the next few days so please stay tuned!

Most every year I typically have several couples who request that we write down gender and seal it instead of telling them during their scan. They wait for Christmas morning and open the envelope together to find out boy or girl.  Sweet idea!  However, in this day and age of never-ending technological advances in the field of medicine, your modern day parent-to-be doesn’t need the sonographer to determine gender any longer. New antenatal blood tests for genetic abnormalities can include gender and are offered somewhere around 11-12wks. Don’t get too excited just yet!  Your doc will not perform them for gender only and the tests are not made for that purpose..it just happens to be a by-product of the true nature of the test.

That being said, I now have patients all the time who say they already “know” what they are having but still want to confirm it with ultrasound. I do laugh a bit here at that request. I tell them we can have a disagreeable baby but we can’t argue with genetics!

 

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