The vital role of pregnancy scans: Ensuring baby's health and well-being

Pregnancy necessitates regular scans that play a pivotal role in comprehending the baby's growth. These scans are instrumental in enabling doctors to identify potential issues and closely monitor the baby's developmental journey.

In the first trimester, two important scans are performed. The first one, usually done around the 7th or 8th week, helps determine the location of the pregnancy, whether it's in the uterus or outside (ectopic pregnancy). It also checks for the baby's heartbeat and overall health. It can even reveal if it’s a multiple pregnancy.

If the initial scan shows that everything is normal, the next scan called the NT (Nuchal Translucency) scan, takes place between the 11th and 13th weeks. During the NT scan, doctors check for Down syndrome and other chromosomal abnormalities, as well as issues with the baby's brain and spine. This scan is often combined with a blood test from the mother, known as the double marker test, which can be done up to the 14th week. Alternatively, a more accurate test called the NIPT test can be performed later on.

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What are the Double Marker, Quadruple, and NIPT Tests?

The double marker test, quadruple test, and NIPT test are all blood tests that provide information about the baby's risk of Down syndrome, Edward syndrome, or certain chromosomal disorders. The double marker test is usually done shortly after the third-month scan or NT scan, within a specific time frame.

Checking the baby's health in fifth month: The Anomaly Scan

During the 5th month of pregnancy, a crucial scan called the Anomaly Scan is performed between the 18th and 21st week. This scan examines all major organs to ensure they are developing normally. The Anomaly Scan may take longer than usual, especially if the baby isn't in the right position for clear images. It's essential to get the right pictures to accurately measure the baby's growth and development.

What do doctors check during the anomaly scan?

During the anomaly scan, doctors look at several parameters to ensure the baby's health is normal from a physical and chromosomal point of view. They examine all the organs of the baby in detail to check for any abnormalities.The kidneys are also examined to ensure they are normal and the right size. Doctors also inspect the bones for any skeletal problems and do a basic check on the heart, although the heart is best seen between the 22nd and 24th weeks. They also recheck markers like T21, T18, and T13 for Down syndrome, Edward syndrome, and Patau syndrome.

Different scans for monitoring growth

In various situations, additional scans are done to monitor the baby's growth. These are known as growth scans. They are performed at varying intervals and in the following cases

● Multiple pregnancies (twins, triplets): Varying intervals based on the specific situation, with some special twin cases requiring scans every 2 weeks. For monochorionic diamniotic twins, growth scanning starts at 16 weeks in the second trimester.

● For mothers with conditions like high blood pressure and gestational diabetes, a growth scan is done every 4 weeks.

● Cases where doctors identify that the baby is not growing properly, a scan is done every 2-4 weeks, depending on the baby's growth. These scans typically occur in the third trimester.

During scans, doctors look at specific measurements to understand how the baby is developing. These include:

● Abdominal or Tummy Circumference: Evaluating the baby's tummy size.
● Head Circumference: Measuring the baby's head size.
● Thigh Bone Length (Femur Length): Checking the length of the upper leg bone.

Advancements in pregnancy scans over the last decade

Over the past 15 to 20 years, there have been significant improvements in pregnancy scans. These include

● Enhanced Technology: Modern machines used for scans are more advanced and provide clearer images. This improvement allows sonographers and radiologists to see details more effectively.

● Better Operator experience: Over time, medical and technological advancements have led to greater expertise in conducting and interpreting scans. The inputs from these scans have enhanced the skills of the radiologists and sonographers, in turn resulting in better results.

● Specialisation: Some doctors specialise in or have extra expertise in Pregnancy scans. This leads to more precise care for expectant mothers.

The significance of pregnancy scans

Getting proper pregnancy scans is crucial because they help detect any issues with the baby at specific stages of development. In some cases, certain problems like Down syndrome or chromosomal issues cannot be changed. However, if the baby has issues like a heart problem or talipes (clubfoot), these can often be treated after birth. It's important to note that some problems may have a poor prognosis for the baby, whether inside or outside the womb, meaning the baby might not survive for long after birth. In such cases, addressing these concerns will only be possible after birth.

Most parents are happy to get the scans and blood tests done as per schedule. However, a small number may choose not to have scans or blood tests and continue with the pregnancy regardless - this is a personal choice depending on the couple’s beliefs.

It is important to follow the recommended schedule for scanning and blood tests because certain issues can only be detected during specific time periods, such as the third and fifth-month scans. Doing the scans too early or too late might result in missing abnormalities. Therefore, it's essential to have scans during these specific times to ensure they are as effective.

(Authored byDr Prathima Reddy, Director and Lead Consultant, Department of Obstetrics and Gynaecology, SPARSH Hospital for Women and Children)

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