Posted on April 29th, 2017 by wombwithaviewblog.com
9 Weeks Pregnant, 9 Weeks

9 Week Embryo

What Does Diagnostic Mean?

Anything “diagnostic” describes a test performed to try to find a problem. So, diagnostic utrasound is ordered to rule out problems in pregnancy for mom and baby. Most people are very familiar with ultrasound but most consider it a fun and exciting event allowing you to see your baby and determine gender. However, first and foremost, it is a very important diagnostic tool used by your doctor to find structural abnormalities, follow fetal growth, and determine multiples. And this only scratches the surface!

What Do I Really Do When I Scan?

In a nutshell, my job requires me to see what’s in there and to make a report about it. More intricately speaking, I have to document with images and measurements everything I can see relative to fetal and maternal anatomy. Of course, what I can see and need to document all depends on how far along you are, in other words, your gestational age. Once I write a detailed report, I can present a complete ultrasound picture of your case to your physician.

What Things Can I See on Mom?

A few organs and measurements we try to see on mom are as follows:

  • The uterus and any pathology (like fibroids which are muscular tumors and very common)
  • The ovaries (those become obscured later as the uterus gets larger)
  • The cervix, which holds in the pregnancy and is sometimes observed in the 2nd trimester

 

What Things Can I See on Baby?

What parts we can see on Baby varies greatly depending on your gestational age. But a few things we look for are:

  • Baby’s size, to determine age or follow growth
  • Internal organs, depending on age, include the brain, heart, stomach, bladder and kidneys
  • Upper and lower extremities (arms and legs), again, depending on age. We try to see fingers and toes on your anatomy screen, but they can be a challenge! ..especially if the fists are closed in a ball.
  • Baby’s spine
  • Baby’s umbilical cord
  • The placenta and where it’s located
  • And last but not least! Maybe, possibly, if all the stars align and Baby cooperates, you just might be able to find out fetal sex.

 

How Does It Work?

Ultrasound is just that..sound that is beyond human hearing.  Sound waves, much like a fish finder, are sent from crystals in the transducer (the probe placed in the vagina or rubbed on your belly) and transmitted with the help of the ultrasound gel.  The waves penetrate the tissues directly below the probe until they reach Baby. They bounce back and create the image you see on the monitor.  Things like the size of the patient and fetal position can limit what parts we see and how well we can see them on the examination.

Many other diagnostic ultrasound examinations are performed on many other parts of the body, as well. Ultrasound is THE most technologist-dependent modality there is.  This means the machine does nothing without someone operating it. This is precisely why fetal sex is still incorrectly guessed! If the observer, or person holding the probe, is not very experienced at looking at fetal sex..oops!..wrong sex. And we’ve ALL heard those stories, haven’t we?!

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Thanks for reading! Feel free to email at wombviewerblog@gmail.com.

wwavblogger, RDMS
wwavblogger, RDMS

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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 May 24th, 2014 by wombwithaviewblog.com

Who doesn’t love ribs on Memorial Day weekend??!  Today’s post is all about ribs but not the kind we love to bathe in barbecue sauce.

Bone on ultrasound shows up white because it is very dense.  Water, on the other hand, is the opposite and shows up black.  Ultrasound cannot travel through bone so as your baby’s bones become more dense, they become more of an obstacle to see certain things like the heart.

Next time you have a scan, notice the appearance of  baby’s bones.  Because sound cannot penetrate through bone, what you’ll see instead is a perfect shadow behind the bone.  We cannot see anything in that shadow.  Therefore, anything that lies behind bone cannot be well-visualized.

Take a look at the image of this baby’s ribcage below.  Notice the arrows pointing to the white dots (ribs) and the black shadow that follows each one!

SONY DSC

 

Thank you to all the moms and dads who serve our country in the armed forces!  It’s a hard job and we appreciate you!  Have a great Memorial weekend!!

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Posted on May 2nd, 2014 by wombwithaviewblog.com

What’s the purpose of the gel?

Ah..that amazing blue stuff..sometimes shockingly cold, oftentimes warm like a comfy blanket but always messy and usually hated by Mom.  Ultrasound gel gets everywhere, it takes a few drapes to get off, it feels tacky until it dries but no one will have an ultrasound without it!

The role of gel is two-fold:  one, obvious to most, is that it allows the probe to move smoothly over Mom’s belly; second, it actually, and most importantly, helps to conduct the sound waves.  No gel, no see!  Ultrasound cannot travel through air or gas.  Without the gel, there lies a bit of air between the probe and skin which produces no image on the monitor!

I did this little experiment one time for a patient who asked and she was pretty amazed.  It’s really cool, actually..touch the probe to the skin with no gel and all you see is black.  Add a little gel and voila’!  Baby.

So, there you go.  Another lesson in Ultrasound 101.

Have a great day and a healthy pregnancy 🙂

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Posted on February 16th, 2014 by wombwithaviewblog.com

Why do some people have great ultrasound images and some look like fuzz?

Most people know that ultrasound uses sound waves, basically sonar (like a fish finder!) to obtain images.  The sound waves leave the probe, travel through the gel, through skin, fat, muscle, through the uterus and fluid, through Baby and then back up again.  Voila’.  An image is seen on the monitor made up of all the things the waves hit along the way.

The sound waves travel great through water, in this case, amniotic fluid but they slow down as they travel through tissue and don’t travel at all through bone, air and gas.  This is why ultrasound has some limitations and can’t see everything. This is also why we use gel. It acts as water to help conduct the sound waves. Without it, a thin layer of air exists between the probe and skin producing no image…or very little.

Sound attenuates as it goes further into the body..that is, it loses power.  So the deeper the sound waves have to go to get to Baby, the less power they have by the time they get back and the poorer the quality of the image on the monitor.  When a thin person is scanned, the sound waves don’t have to travel very far which usually produces a phenomenal image.  When a heavy person is scanned, the sound has farther to travel and it loses much of it’s power on the way down so it then has very little to send back up to the monitor.  It is simply Ultrasound Physics 101, though we can absolutely not undermine the VAST complexity of this subject to call it simple.

Other things interfere, as well.  If Baby is facing your back, we see very little, especially in the way of cute images.  Maternal intestines or bowel loops contain air and gas and we can’t see past that, either.  For some patients, it is an unexplained body type issue.  I have scanned thin people that ended up a terrible scan and heavy people where I thought I’d see nothing but ended up getting great images.  It all just depends on how much and what kind of tissue lies between the probe and Baby.

It hasn’t happened very often in my career, but every once in a while I’ll get a patient who is not thin and snaps at me because I’m not getting great images for her.  She’ll say something like “My friend had an ultrasound done and HER pictures were great. These aren’t very good at all.  Can’t you get better ones?”  …Like it’s my fault and I am intentionally slacking off or just don’t know how to get these great images like her friend got to take home.  I can’t say what I’d like to here.  Some patients will ask “if their fat is getting in the way” and I’ll just explain the above and that it can interfere…I’d never want to hurt a patient’s feelings.

So, there ya go.  A little ultrasound education on a Sunday never hurt anyone 🙂

 

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