What To Look For In An Ultrasound And What They Mean: 20 Points

Sound waves can work magic for moms-to-be. The technology used in an ultrasound allows moms and doctors to get a glimpse of the baby growing in the womb, even when the baby is the size of a cherry. Even though the machine has only been a staple in prenatal care for a couple of decades, it's made all the difference in terms of saving lives. While professionals can get answers to health questions, the black and white images are hard for parents to understand.

Moms-to-be typically have at least two ultrasounds during their nine months of pregnancy. The first usually comes in the first trimester, usually around the nine-week mark, when the image won't show a lot. But what the scan captures, while limited, is critical. A second-trimester ultrasound at around 20 weeks is very in depth and can give the doctor a good idea about the baby's development and health — and allow the mom to have a peek at the baby's personality.

Some women get other opportunities to see their baby through ultrasounds at specialist appointments or fun 3-D scans. Those images can show a lot more than moms can imagine if only they can figure out what is going on in the picture.

Here is what to look for in an ultrasound and what it means.

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20 Due Date Defining

As soon as that pink line shows up on a pregnancy test, some women rush to an online due date calculator to find out what their due date might be. But even after factoring the first day of the last menstrual cycle, doctors prefer to set the due date after doing a first-trimester ultrasound.

During those first 12 weeks, an embryo follows a very predictable growth pattern, so the measurement can determine when the baby is expected, even if mom doesn't remember her last cycle. The date is defined in that initial ultrasound, although moms need to remember that only about 2 percent of newborns actually arrive on that date.

19 How Many Babies On Board?

One of the first things that doctors do during an ultrasound is count. While the baby's features can't be seen in an early pregnancy ultrasound, it can be a lot more evident if there is more than one baby developing or more than one gestational sac forming.

Some parents have been surprised later on because a first-trimester ultrasound wasn't clear. But most of the time, the news of twins, triplets or more comes very early with an ultrasound in the first 12 weeks. That gives moms and dads lots of time to plan and prepare to bring home more than one baby, and the doctor even more opportunities to check the babies' health along the way.

18 Seeing Baby's Heartbeat

The most magical moment comes during the first trimester. It happens when the mom realizes that the little butterfly flutter that she is seeing on the ultrasound screen is actually the baby's tiny heart in motion. It's hard to see much more than a movement but knowing what it means can make a mom's heart soar.

Seeing the baby's heartbeat — and the technician usually flips a switch to allow mom to hear it too — is a major milestone for parents. The rate of miscarriage goes down dramatically after the heartbeat is detected. That's an amazing feeling, and it's definitely a reason to go out for ice cream to celebrate the first-trimester scan.

17 Little Baby Bean

It's normal for a mom to get confused when looking at an ultrasound, especially in the first trimester. At around nine weeks, the baby is so tiny that it's hard to see. And in truth, it doesn't look much like a baby.

Moms shouldn't be looking for a regular baby shape. The baby's head is big and the arms and legs are short. The baby even has a tail for a while. For a little longer, the embryo will look more like a bean on an ultrasound that a baby. But just about three months later, by the second-trimester scan, things will have changed a lot.

16 Counting Fingers And Toes

At the second trimester ultrasound, usually scheduled around the 20-week mark, most of the baby's major body parts are in place. While some moms don't think about counting the baby's fingers and toes until after the birth, it can happen with a good ultrasound image.

In fact, doctors and technicians will be on the lookout for any deformities in the formation of the fingers and toes. Some babies might have issues that doctors can note at the time that might help in planning for the future. It's amazing to see those little fingers and toes waving on the screen, and it can be a relief for mom and dad as well.

15 Checking Out The Cord

The baby's body isn't the only part that is under consideration when the mom goes through an in-depth ultrasound. The umbilical cord provides the baby nutrition and oxygen, but sometimes an ultrasound could reveal that it isn't structured like normal.

A typical umbilical cord has one vein that carries the nutrients to the baby and two arteries that bring the waste away. But sometimes the baby's cord might have two or even four vessels, and that might require some extra monitoring. An ultrasound might also detect if the cord is too long or too short, although it can be hard to detect knots. Doctors will check out the cord to see if the cord seems to function properly, as that is so important for the baby's health.

14 Amniotic Fluid Levels Matter

Amniotic fluid might be an afterthought to some pregnant women — they only worry about it when they are concerned about their water breaking. But the fluid can be an indication of the baby's health, so it's an important part of the 20-week ultrasound scan.

The technician will get a look at the fluid by taking measurements of the pockets around the baby and adding them together. Too little fluid can be a concern for the kidneys, while too much might show an issue such as gestational diabetes. In fact, the amniotic fluid could provide clues for a lot of issues. The levels are important, so don't be afraid to ask about them.

13 A Look At The Organs

The second-trimester ultrasound can take time because of there are so many parts to the exam. The scan is the first opportunity to get a good look at the baby's health, and every single organ will be measured as part of the ultrasound.

The doctor might be able to diagnose a problem before the birth based on the size of the organs, and it's possible that they could even be able to fix an issue before it impacts the baby's health. Each organ will be considered individually, so the overall appointment could take a while. But it's important to make sure the baby is healthy as a whole, so it is worth the wait.

12 Specialist Considerations

The 20-week ultrasound is a thorough exam, but it doesn't always provide all the answers. Sometimes that appointment can lead to a referral to a specialist, who might need more in-depth imaging to fully diagnose and investigate any problems that might be happening with the mom or the baby.

The specialist ultrasound will differ depending on the issue. Moms who have gestational diabetes might need more common checks of the amniotic fluid, for example. And a kidney problem might require further testing. Specialist appointments can be stressful, but moms should try to relax and enjoy each opportunity to get a glimpse of the baby.

11 The Big Gender Reveal

Most women look forward to the second-trimester ultrasound for one reason — because they can learn the gender of the baby. But it isn't always so easy to figure out. While the external organs are usually developed at this point, the baby might not be in a great position to get a look.

Moms should be aware that sometimes the technician gets it wrong. Sometimes an arm blocks another appendage or the baby's legs don't allow for the right view. Even then, the test is just not 100 percent accurate, and that could mean that you could end up announcing a gender, picking a name and then figuring out that it was a girl instead of a boy the entire time (or vice versa). The gender reveal is exciting, but it isn't always accurate.

10 Baby's Movements Say A Lot

At the second-trimester ultrasound, moms might be able to get a look at their little one's personality. That's because the baby might be stubborn about moving or really excited and giving lots of kicks. The point is that the baby is probably going to be moving around, and that is a sign of good health.

In the womb, babies practice breathing. They might suck their thumb or play with their cord or maybe even seem to wave hello. The movements are a sign that his reflexes are kicking in, and it's as much an indicator of how well the baby is developing as it is cute.

9 Baby's Beautiful Heart

While the doctor was able to see the baby's heart beating in the first-trimester ultrasound, it was too small to see in full at that point. In the second trimester, though, he wants to take a closer look. Heart issues are the most common birth defect in babies, so it's an important part of the exam.

Most defects are minor and that doctor may not even pick up on an anomaly until years after the birth, if ever. But some major issues might be detected early, and that might allow for the doctors to figure out a plan of action to help the baby be delivered safely and get treatment as soon as possible after the birth.

8 Baby's Growth Can Determine Health

At each prenatal appointment, the doctor tracks the growth of the uterus through fundal height measurements. But the only way to get a closer look is through an ultrasound. If the baby is small for gestational age or even large, it could be a sign that something is wrong, so it's an important part of an ultrasound exam.

If the baby stops growing, doctors might think that it's safer for the baby to be delivered to get treatment than being left for labour to begin. Babies can stop growing for a number of reasons, but most of the time it's a serious situation. So the growth measurements are really important.

7 Is That Hair?

Moms spend a lot of time imagining what their baby will look like, and if they have had indigestion, a lot of people tell them that the baby must have a lot of hair. So they might start looking for signs on the ultrasound image. It's not likely true at the 20-week point, but women who might get a later image might get a glimpse.

The hair can look like tiny fibres waving in the amniotic fluid. Some women might think that they look like grass. Not many parents get to see that in an ultrasound, but it's really interesting if they do get the opportunity. Otherwise, they might have to wait until the birth.

6 A 3-D Look At Features

Technology has come a long way in just a generation. While our parents might not have had the benefit of an ultrasound exam at all, millennial moms and dads have the option of having elective scans that can show 3-D images of the little one.

While some doctors offices allow the occasional 3-D look, many offer an extra image for a surcharge. But the technology is still based on waves passing through the womb. That means that the image might show a sweet nose, but it could also have distortions that make moms worry about their baby's appearance. A 3-D image is fun, but it's not always helpful.

5 Placement And Placenta

While the baby's organs are getting examined, the technician will also take a look at another important organ — the placenta. It's hard to get a lot of information about the placenta during pregnancy, but if it isn't healthy, that can mean that the baby isn't getting the nutrients he needs.

The ultrasound might not reveal a lot, but it can show where the placenta is located, and if it covers part of the cervix or becomes partially detached, it's a problem. It's definitely worth a few minutes in the examination to make sure that things are OK with this vital organ.

4 Taking A Peek At The Exit

Finally, the doctor could also get a look at the cervix during the 20-week ultrasound. The passage between the uterus and the downstairs area isn't something that moms think about before they have to worry about it dilating, but the doctor pays attention because it could tell him a lot about how the birth might go.

The length of the cervix could have something to do with when the baby arrives. A shortened cervix could mean a possibility of early labor. The doctor might be able to delay that by recommending bed rest, so it's worth paying attention to the cervix during the ultrasound exam.

3 Size Matters

In the third trimester, doctors keep a close eye on how big the baby is getting. They might even order an ultrasound to try to get a measurement of the baby's size. That's because size can matter a lot when it comes to the delivery.

The average size of a newborn has been going up in recent years, which is likely related to the increasing average for adults. But there are dangers associated with giving birth to a big baby, including the possibility the baby could get stuck, be deprived of oxygen or have an injury to their shoulder that could cause permanent damage. Doctors might recommend being induced a little earlier than expected or even a C-section, both are which are debatable. But size does matter, and the ultrasound could help reveal it.

2 A Note About False Positives

The ultrasound is an amazing tool. The technology has allowed doctors to diagnose issues and save lives, but it isn't a totally reliable piece of machinery. Images can get distorted or misinterpreted, and there are times when the ultrasound produces a false reading.

Ultrasounds have resulted in parents worrying about illnesses for months before learning that the baby is healthy. Moms can be surprised to learn that the ultrasound tech was wrong about the baby's gender, and size readings are often off by a decent amount. Sometimes it's impossible to get a true indication of the baby's health and appearance until after the birth.

1 Last Look Before Birth

For many women, the last look at the baby via ultrasound might come at the 20-week exam. But some might have several more scans before the baby arrives, including a last-minute look in the days before the delivery.

There can be a number of reasons why an ultrasound before birth is a good idea, including a possible complication, like a placental abruption or finding out how the baby is tolerating high blood pressure. Sometimes, n ultrasound can help doctors prepare for a planned C-section, especially if there are things like fibroids that could complicate the surgery. The exam might be stressful, but moms should look at it as a precaution that allows them to get one last beautiful look at the baby before she finally sees him in person.

References: Very Well Family 

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