Screening, 12 weeks of pregnancy: normal, transcript
How to find out if the fetus is developing correctly, are there any abnormalities, how are the internal organs of the crumbs formed? The answers can be given (when the term to which your pregnancy approached - 12 weeks) ultrasound. Screening allows you to evaluate the development of the fetus, gives a clear picture of the genetic and chromosomal features of the future baby. This makes it possible to determine the presence or absence of anomalies.
Carrying out ultrasound on a 12-week period
Basically, the procedure is carried out in two ways: transvaginally (through the vagina using a special sensor) and transabdominal (through the skin of the abdomen). The latter is more common, and the first is prescribed not to all women in the position, but only to some of them, in the following cases:
- if the placenta (or chorion) is low attached;
- if cervical insufficiency is present and it is necessary to evaluate its degree;
- if there are signs of inflammation of cysts and appendages (to accurately establish the diagnosis), or uterine fibroid nodes are very specific, and Method 2 shows little information;
- when assessing the child's collar area or measurements of the desired size, which are difficult to make due to the fact that the fruit is not located as it should, or the subcutaneous tissue of the abdomen is very thick.
A study is being conducted in this way: a woman lies, bending her knees; The doctor inserts an ultrasonic transducer into the vagina, which a disposable condom puts on to protect it. Usually, everything is done with great care, so a pregnant woman does not feel pain.
Transabdominal research is done in the same position. All the air between the sensor and the skin is not forced out, therefore incorrect results are possible. In order to reduce the probability of an error as much as possible, a special gel is used, which is applied on the stomach. Gradually move the sensor along the abdomen so that you can see the crumbs of the organs, as well as the mother's uterus and placenta. Ultrasound is perfectly safe for the fetus and does not cause him any damage.
How to prepare for ultrasound
Preparation depends on the method. If transvaginal is used, then it is recommended not to eat the products that can cause fermentation 1 day before the study: white bread, legumes, cabbage, peas. The intestine must be emptied, otherwise the gases there will interfere with the examination of the uterus and fetus. If you feel that your stomach has pouting, you can drink the drug Espumizan, which is harmless to the fetus.
Before the transabdominal examination drink half a liter of water 30 minutes before the start. It is necessary to have a full bladder, which will allow to examine the fetus and assess its condition.
Child development at 12 weeks
Many of the main bodies of the crumbs have already developed, and some small structures continue to form. The average height of a child is 80 mm, and the weight is about 20 grams. Also, doctors note that the fetus eats such features:
- heartbeats are more frequent than in the third trimester, and can be about 170 beats per minute;
- the face of the child no longer looks like a tadpole, but acquires human traits;
- you can see the eyelids, lobes, a little fluffy hair (at the place of formation of eyebrows and eyelashes);
- the majority of muscles have practically already developed, therefore the fetus moves all the time, and the movements are mostly of an involuntary and rather chaotic character;
- Baby grimaces and squeezes his hands into cams, you can see marigolds on the fingers;
- the child has already developed kidneys and an intestine is almost formed, there are red and white blood cells in the blood;
- both hemispheres of the brain are fully formed, however, they “command” the spinal cord so far;
- you can see who it is: a boy or a girl, but since the fetus does not always lie the way your mother and doctors want, you can make a mistake, so they more accurately talk about sex on the 16th week.
How to read the results?
Papers with the results of the study you will get in your hands after screening is done (12 weeks). Decoding analysis will be given below.
Starting from the third month, it is already clearly visible, one child or not. Therefore, if two or more are written in the “number of fruits” column, this indicates that you will have twins (triplets, etc.). You can also find out if the fruits are identical (twins) or are twins (heterozygous).
This is the name of the part of the fetus closest to the birth canal. At 12 weeks, it could be anything: legs, head, or the child is located diagonally. Finally, previa is estimated at the 32nd week of gestation. If the head is not located to the exit of the uterus, then take all possible measures to correct this situation.
Measurement of fetal size (or fetometry)
Decoding ultrasound and need to assess the parameters, but this should be done by a doctor who is guided not only by the numbers, but also by the general situation of the pregnant woman. All norms are denoted by certain letters and numbers. Here are the main ones:
- BPD (BPD, BRGP) - this abbreviation denotes the so-called biparietal size, i.e. the distance of the head from one parietal bone. For a period of 12 weeks, the ultrasound scan should show 21 mm BPR.
- The growth of the baby is about 8.2 cm, the weight should not be less than 17-19 g.
- FML, DLB is the length of the hip. Norm - from 7 to 9 mm.
- Collar space should not exceed 2.7 mm. By its size it is determined whether there are any serious illnesses. On average, it is approximately 1.6 mm.
- The term CTE (CRL) refers to the coccyx-parietal size, that is, the maximum length from head to coccyx, the norm is 43-73 mm.
There are also other abbreviations:
- HUM (DP) - shoulder length.
- AC (coolant) - abdominal circumference.
- ABD (DJ) - the diameter of the abdomen.
- RS is the size of the heart.
- OG - head circumference.
For all these parameters, 1 screening during pregnancy allows the sonologist to determine how the baby’s structures grow and develop. If the measurements made are less than the norm, then the total population estimates how they have decreased: proportionally and simultaneously or not. If only slightly differ, then there is no reason for panic. It is possible that the deadline was incorrectly determined, and in fact it is now only the 11th week. And perhaps the baby has such growth due to short parents.
They also find out if there are any defects in the development of internal organs, is there a cord entanglement, what is the frequency of the heartbeat (the norm is from 150 to 174 beats per minute), whether there are any deviations in the amniotic fluid characteristics.
Reading the conclusion of an ultrasound, a pregnant woman may be confronted with such concepts as "polyhydramnion" and "oligohydramnion". What is it and is it worth being afraid of? There is nothing wrong with these words. This is just a determination of the number of those waters in which the fetus floats: if there are more of them than necessary, polyhydramnion is fixed, if less - oligohydramnion. Often this indicates some kind of disorders: intrauterine infection (IUI), disorders of the kidneys, the central nervous system. They also look if the waters are cloudy. If so, this is a clear sign of infection.
The basic rule in detecting deviations from the norm is not to panic, but to go to a specialist.
Can there be a deviation from the placenta?
An ultrasound scan shows where the “baby seat” is attached, how mature it is, whether there are pathologies and more. The best option is to attach to the back of the uterus. But the placenta can "cling" to the front, and even to the bottom. However, it should not overlap the internal orifice of the uterus. This condition is called chorionic, or central placenta previa. In this case, it is monitored whether the situation will change, and if not, then a cesarean section is performed for delivery. If the shed is not completely blocked, this is called incomplete presentation; childbirth at the same time held in the usual manner.
If the placenta "sat down" near the exit (less than 70 mm), then this is a low previa. Since it can become a threat of bleeding, a less active regimen is recommended for pregnant women. After which they observe whether the placenta rises. If this happens by 32-36 weeks, there will be no threat, and the woman will give birth in the usual way.
The maturity of the placenta at this time is equal to 0. The “lobed” placenta is the second degree of maturity, and in such a situation it is necessary to consult a doctor. The deposits of calcium salts are called calcinates. It is considered normal if they are present in the placenta of the first degree of maturity.
If some part of the "children's place" dies out, this is called a placental infarction. In this case, an urgent need to consult with your doctor to find out the reason and prescribe treatment, because if this happens further, then the child will not have enough oxygen and necessary for its development of substances.
Cervix: condition, structure
At week 12, the size of the cervix is measured, which should not be shorter than 30 mm. The longer it is, the better. If she is already very short, less than 20 mm, then the pregnant woman will be hospitalized, and may be used for the treatment of surgery. The uterine throat should be closed, both external and internal.
Myometrium (or muscle state) indicates whether there is a risk of miscarriage. If the diagnosis indicates that there is hypertonicity of the uterus at this time, then the woman is treated. Such facts as “petrification” of the abdomen, “push-pull” in the lumbar region are especially alarming.
How to determine the term by ultrasound
Using special tables for KTR calculate the duration of pregnancy. It may be that such a function is built into the ultrasound machine program. Compare terms - calculated from the last menstrual period and issued by ultrasound. If the difference is small (one or two weeks), then consider the exact time determined by the obstetrician. In the case of a greater discrepancy (more than 2 weeks), the period determined by ultrasound is taken for granted.
Prenatal screening: what it is and how it is done
It should be especially careful when pregnancy is 12 weeks. Ultrasound screening - all of these studies are designed to assess the development of the fetus. At the same time, ultrasound is done first, and then screening is prescribed (depending on the indicators). Hold it if:
- Pregnant 35 years and older.
- Before that, dead children were born.
- During the examination of the former fruits, an intrauterine infection was detected.
- A child was born who was diagnosed with a chromosomal abnormality.
- It is established that such anomalies are in the relatives of both parents.
Only in special centers produce screening (12 weeks). How do? Collect all the tests: ultrasound, blood, external data. The evaluation is done by a geneticist, and attention is mainly paid to the collar and these indicators: free β-hCG and PAPP-A. Basically, these markers are examined in a well-defined combination. If at least one of them has changed, this does not mean that the fetus has any pathology.
So, when screening is performed at the 12th week of pregnancy, the characteristics of these markers are used. These are serum proteins. If they have abnormalities, then the child will have genetic disorders. Free β-hCG is a subunit of human chorionic (chorion is an embryo) of human gonadotropin, and PAPP-A is a protein A associated with pregnancy. To study these indicators, an ELISA assay (ELISA) is used.
HCG stimulates the synthesis of steroid hormones (in the placenta and corpus luteum). Doctors have already figured out that it is hCG that protects the fetus from rejection. Exploring its level, you can make predictions for the future course of pregnancy. According to medical statistics, hCG gradually increases until the 10th week, and then remains approximately at the same level (from 5,000 to 50,000 IU / l) to 33 weeks, after which it may slightly increase.
1 screening during pregnancy is done from the 10th to the 13th week of the term. To calculate all the risks, take a lot of data: the date of ultrasound, CTE and TPV (collar thickness).
These analyzes are very important precisely for determining the existing pathologies in chromosomes. However, if the readings are slightly elevated, do not worry and make hasty conclusions. You just need to turn to genetics, which will tell you what to do next. There is also a chance that the ultrasound scan has been misread. Screening a 12-week pregnancy can be repeated - to clarify, or the doctor will prescribe an invasive diagnosis that will more accurately determine the genetic set of the child. Depending on the term, either a chorionic villus biopsy or amniocentesis is performed.
If even 1 screening showed a very low risk of the presence of chromosomal abnormalities in the fetus, then there is no need to abandon the examination carried out at 4-5 months of pregnancy. In addition to hCG and AFP, determine the level of free estriol (triple test).
In order to determine the indices of β-hCG and PAPP-A, blood is screened. 12 weeks is a sufficient time for biochemical analysis to reveal the presence (or absence) of deviations in the chromosomes.
Depending on the results of a blood test, they reveal why the indicators differ from the norm. So, screening a 12-week pregnancy can reveal the following:
- Not one fruit, but 2 (3, etc.). More fruits - more hormone levels.
- Incorrectly established period of pregnancy. For each week of development of the child corresponds to some indicator that determines the exact age of the fetus.
- The presence of diabetes in the mother.
- Great risk of miscarriage.
Are there any indicators of performance?
Of course, there is! You can get to know them by doing such research as ultrasound screening (12 weeks). The rate will be known after examining the data by a doctor. However, there are secondary medical indicators clearly established for each week of pregnancy. For example, β-hCG at week 11-12 should be between 200,000 and 90,000 mU / ml.
However, it should be borne in mind that the screening of a 12-week pregnancy gives, of course, very high, but still not 100% results, because each woman has her own body characteristics, which are necessarily taken into account by the doctor. If the fetus is not one, then it is more difficult to diagnose. Look at the indicators. If they are more than one and a half or two times, then we can conclude that there are 2 or more germs. Each fruit has its own chorion and different hormone production. Therefore, the indicators are so high, and the expectant mother is sent to an ultrasound to confirm a multiple pregnancy.
As soon as screening is done (12 weeks), the standard values are immediately checked against the data obtained in order to calculate if there are any pathologies. Doctors for these purposes use a special coefficient called MoM. It is calculated using a specific formula: the amount of the hormone that was determined from the results of the screening is divided into HCG (corresponds to the norm during this period of pregnancy). It should make one (ideally). Well, according to the results of all studies, it is judged whether to include the future mother at risk with chromosomal abnormalities or not. It is worth noting that even if this suddenly happened, this is not the final verdict, but only one of the probabilities. Therefore, other indicators are compared and only after that do they draw any conclusions. Review the entire screening of a 12-week pregnancy: ultrasound, hormones, TVP, may prescribe a second study in the second trimester.
Protein PAPP-A is responsible for the immunity of the pregnant woman, and also helps the placenta to work. Since the boundaries of the thresholds are clearly established, its deviations are highly undesirable. The fact is that such “jumps” of indicators indicate not only a possible miscarriage, but also such terrible anomalies as Down syndrome, de Lange syndrome, etc. The following figures are considered normal: from the 11th to the 12th week - 0.7- 4.76; From the 12th to the 13th week - 1.03-6.01.
The women who did the screening (12 weeks) speak differently about him. Someone incorrectly determined the sex of the child. There is an explanation for this - the term is too small, finally it will be possible to say who is born: a girl or a boy, only on the 16th week. Also talk about different prices. Some people take tests for free, others pay from 1,000 to 3,000 rubles.
However, most mothers say that ultrasound and screening help to understand how the development of the baby is going. Since now these procedures are mandatory, it is possible to diagnose and start treating existing diseases in time so that the baby is born healthy.