For optimal pregnancy outcomes, detailed monitoring of fetal development in the womb is crucial.
One of the most advanced methods for this is a detailed ultrasound, also known as a level II or anomaly scan.
This procedure allows the doctor to examine the baby's organs, ensuring they are developing properly, and detect any abnormalities early on.
For those considering pregnancy follow-ups in Istanbul, working with an experienced doctor is crucial to ensure the best care throughout the process.
Ultrasound imaging plays a crucial role in pregnancy follow-ups, helping to determine key aspects such as the presence of pregnancy, fetal viability, the possibility of multiple pregnancies, and the risk of ectopic pregnancy. It also estimates the gestational age, assesses fetal growth, monitors amniotic fluid levels, and provides a close estimate of the potential delivery dates. Essential parameters like fetal position, placenta placement, cervical length, umbilical cord vessels, and measurements for growth tracking (including head diameter, head circumference, abdominal circumference, and long bone lengths) are evaluated during the ultrasound.
Most ultrasound examinations are performed using a black-and-white (2D) probe. The quality of the ultrasound machine plays a significant role in ensuring clear, high-resolution images, which greatly aids the examination. Color Doppler ultrasound is used for measuring blood flow, while 3D and 4D ultrasounds are particularly useful in specific cases, such as examining surface anatomy (face, lips, hands, feet) and diagnosing certain heart anomalies. When the baby's position and image quality are favorable, detailed images of the baby’s face can be captured. After the ultrasound, 4D images, CDs, videos, and colored images may be provided to the patient.
A detailed ultrasound is different from standard 3D or color ultrasounds, often providing a four-dimensional image of the baby. However, the purpose of this scan is not to show the baby's face or limbs to the parents but to detect any developmental issues. This ultrasound allows for a thorough examination of the baby’s anatomy, including the brain, spine, heart, kidneys, and more.
Many mothers worry about whether a detailed ultrasound might harm the baby or affect the pregnancy. However, ultrasounds do not emit radiation, like X-rays, and studies show no harmful effects on the mother or the baby, making them a safe choice for regular pregnancy monitoring.
During a detailed ultrasound, the baby’s internal structures, facial profile, nasal bone, upper lip, nuchal translucency (measured at 11-14 weeks),and skin thickness (measured later in pregnancy) are examined. Organs like the lungs, diaphragm, heart chambers, major arteries, stomach, kidneys, bladder, spine, limbs, and long bones are also thoroughly assessed. Using this detailed examination, pregnancy complications can be detected early, ensuring better outcomes.
A detailed ultrasound is typically performed between the 19th and 23rd weeks of pregnancy. It is usually requested by the doctor overseeing the pregnancy, and it can last between 30 to 40 minutes. If there is suspicion of an abnormality, the doctor may recommend a follow-up scan or further diagnostic procedures. Some conditions may not be visible during the early stages of pregnancy, so follow-up ultrasounds might be necessary.
A second-level detailed ultrasound, sometimes referred to as a repeat scan, may be recommended if any potential issues are identified during the initial screening. This allows the doctor to monitor the baby’s growth and development more closely and assess any potential risks to the pregnancy.
While detailed ultrasounds offer in-depth views of the baby's development, they do not guarantee the detection of all anomalies. Even in the most advanced centers, ultrasounds can identify about 70-80% of potential abnormalities. Some issues might not be visible at the time of the scan or may develop later in pregnancy.
During the ultrasound, certain issues may not be detected at the time or may develop later in pregnancy. For example, brain function disorders, vision and hearing impairments, small heart defects, valve issues, gland, skin, and nerve diseases, and blockages in the throat, intestines, kidneys, or anus may not be visible, especially due to the fetus's small size. Conditions such as gender abnormalities, hip dislocation, subtle bone shortening, finger and toe abnormalities, certain chromosomal disorders, and rare genetic diseases may also remain undetected and go undiagnosed early on.
In about 5-10% of these scans, a non-existent issue may appear, causing unnecessary concern. To alleviate these worries, additional tests, including laboratory analyses or procedures such as amniocentesis, might be recommended. While these procedures help confirm a diagnosis, they can lead to extra costs and, though rare (around 1%),may increase the risk of pregnancy loss.
This detailed insight emphasizes the importance of experienced doctors for pregnancy follow-ups and monitoring in Istanbul, ensuring a smooth pregnancy journey.
Doppler ultrasound examines the blood flow from the uterus to the placenta and through the umbilical cord. This analysis helps predict complications like pregnancy-induced hypertension, infections passed from the mother to the baby (such as CMV, rubella, parvovirus),chromosomal abnormalities (like trisomy 18, trisomy 13, trisomy 21),congenital malformations, or growth restrictions, especially in cases of twin or multiple pregnancies.
While ultrasound is a valuable tool, it has limitations in detecting chromosomal abnormalities. Screening tests for chromosomal disorders, such as the nuchal translucency test, combined with first and second trimester screening (double and quadruple tests),are typically performed from the 11th week of pregnancy. The detection rate for these tests ranges between 80-95%. Recent advancements include non-invasive prenatal testing (NIPT),which analyzes fetal DNA from the mother’s blood, offering over 99% sensitivity for detecting chromosomal abnormalities.
However, when results indicate high risk, diagnostic procedures such as chorionic villus sampling (CVS) or amniocentesis are required to confirm the diagnosis. These tests provide definitive results for chromosomal anomalies and can be performed between 11-14 weeks (CVS) or 15-22 weeks (amniocentesis). It’s essential to understand that screening tests, including NIPT, ultrasound, and others, are not diagnostic; only invasive tests like CVS or amniocentesis can provide a definitive diagnosis.
About 2% of pregnancies may involve congenital anomalies. A detailed ultrasound performed between 11-13 weeks can detect approximately 30-50% of these anomalies. Further detailed ultrasound evaluations, conducted between 18-23 weeks, can increase the detection rate to about 50-70%, making this period crucial for identifying potential issues.
For those seeking pregnancy follow-ups or even pregnancy termination in İstanbul, having a detailed ultrasound performed by an experienced doctor is crucial for making informed decisions regarding the pregnancy.
By choosing an experienced doctor in Istanbul, with over 40 years of expertise in pregnancy follow-ups and detailed ultrasounds, couples can ensure the health and safety of their pregnancy, allowing for early intervention if necessary. Early diagnosis and careful monitoring are key to managing any complications effectively.
With proper monitoring and expert guidance, parents can take proactive steps to ensure their baby’s healthy development throughout the pregnancy.
This content provides valuable information for those seeking expert care and accurate diagnostics during pregnancy, helping to optimize pregnancy health and outcomes.
Prof. Dr. Nilgün TurhanGynecology, Obstetrics and IVF Treatment Specialist
PROF. DR. NILGÜN TURHAN
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