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Making the Grade
A Guide to Tests during Pregnancy
By Teri Brown
Ultrasound allows sound waves to create an image of a developing baby. There are various types of ultrasounds that can be done, depending on the purpose of the scan and the gestational age. Lori Farmer is an advanced practice nurse in genetics and the director of the Carolina Center for Perinatal and Genetic Counseling Services. She believes ultrasounds give a good overall picture of how the pregnancy is progressing.
"In the first trimester, centers that have special training can do a transvaginal ultrasound and measure the nuchal translucency (NT), the thickness in the back of the baby's neck, along with some special biochemical screening for beta hCG and PAPP-A, to determine if there is any increased risk of birth defects or a higher risk of miscarriage or pregnancy complications for the baby," says Farmer.
Farmer says general ultrasounds are done right in the doctors' offices on relatively simple ultrasound machines to determine if there is an intrauterine pregnancy, the number of fetuses present and the presence of heartbeat, and to do basic measurements that can estimate the gestational age.
"Other centers may have the ability to do a more sophisticated, Level II ultrasound, and both the machines and the technicians and those physicians that are reading the scans are trained to target specific organs of the developing baby, to determine if there is any evidence of birth defects r any developing problems with the uterus, cervix or placenta," says Farmer.
Although Farmer says that in general ultrasounds have been considered "safe" by most physicians, the newer, more heat intensive 3D and 4D ultrasounds have not been studied extensively to determine if there are any long-range effects on the baby.
"It is strongly recommended that patients not opt to go to a local mall or center offering these modalities to simply get 'good baby pictures,' since there should be a clear medical indication to have these studies performed," she says.
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