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Second Level Ultrasounds in Pregnancy

27/01/2023 Gynecology

During pregnancy, in addition to the basic ultrasounds, there are those known as second-level ultrasounds, structural or genetic, which consist of a detailed evaluation of the baby, analyzing internal and external structures to detect possible anomalies promptly. Additionally, the growth and evaluation of the placenta and the amniotic fluid are checked.

 A total of 3 ultrasounds are performed throughout the 9 months of gestation:

 

Genetic / Structural Ultrasound 

First Trimester

Time to do it: 11 to 13.6 Weeks of Gestation

Focused on risk assessment in early pregnancy. It allows us to identify:

In the Fetus: 

  • - Exact age of the baby
  • - Babies at risk for Down syndrome
  • - Major birth defects
  • - Risk of heart defects
  • - Risk of intrauterine growth restriction before 34 weeks

 

In the mother:

  • - If there is implantation of placenta previa or low insertion placenta.
  • - Risk of preeclampsia
  • - Risk of premature delivery

If any risk to the mother or fetus is identified, interventions can be performed to prevent complications.

Diagnostic detection rate for Down syndrome of 80%. 

False positive rate of 5%.

 

Structural Ultrasound

Second Trimester

Time to do it: 18 to 22 weeks Weeks of Gestation

It continues with the objective of early detection of developmental risks to the baby during pregnancy, with other markers specific to the second trimester.

Detects:

  • - Structural, non-chromosomal or genetic abnormalities*, such as:
    • o Cleft lip and palate
    • o HydrocephalusSíndrome de Down
    • o Spina Bifida
    • o Cardiopathies
    • o Bone deformities
  • .- Risk of preterm delivery
  • - Risk of preeclampsia
  • - Evaluation of fetal growth, amniotic fluid, and placenta

*For this purpose, a first trimester Genetic Ultrasound is contemplated.

73% test sensitivity 

False positive rate of 5%.

 

Doppler flowmetry

Third Trimester

When to do it: 30 to 34 Weeks of Gestation

Focused on detecting/ruling out alterations in the baby's growth and evaluating its correct oxygenation through various blood vessels.

 

Basic fetometry.

Flow analysis of:         

  • o Middle cerebral artery
  • o Umbilical artery
  • o Cerebro-placental index
  • o Uterine artery pulsatility index.

It also evaluates the position of the placenta, cord and amniotic fluid. 

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What happens if something is wrong with my baby?

Depending on the case, other studies can be done to determine which treatment options are available alongside your doctor.

 

Second Level Ultrasound Benefits

  • - Generate more focused follow-up consultations according to what is detected, specific to mom and baby.
  • - Peace of mind for the family in ensuring the proper development of the baby during pregnancy.
  • - Timely detection of potential problems to correct them or prepare for the conditions that may arise.
  • - Accurate birth planning, under the conditions encountered.

 

Who should have these studies performed?

They are recommended for any expectant mother, but especially those who:

  • - Have a history of heart disease or down syndrome in their family or their partner's family.
  • - Have had preeclampsia in previous pregnancies.
  • - Have diabetes
  • - Are older than 35 years old

 

Additional

  • - In every case, you will receive a medical report from our Gynecologist specializing in Maternal-Fetal Medicine with the interpretation required for your follow-up.
  • - The ultrasound time may vary, but it ranges from 45 minutes to 1 hour and a half.
  • - You must come to your ultrasound:
    • o You do not have to fast, but you should eat only a light meal.
    • o No creams or products applied on your tummy.
    • o Empty your bladder before the ultrasound.

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