What should be the frequency of ultrasound examination during pregnancy?

Dr. Birgül Karakoç / Gynecologist

Why is ultrasound examination performed more frequently in our country compared to developed countries? Are the ultrasound examinations inconvenient? Can they offer doctors a desire to reduce the frequency of ultrasound examination during pregnancy in which everything goes well? Here are the answers to these questions and more…

Ultrasound examination during pregnancy is very valuable in terms of providing some data regarding the health of babies and the course of pregnancy. However, the frequency of ultrasound examination is just as important. In a developed pregnancy in developed countries, this examination is performed 3-4 times during pregnancy, while in our country, unfortunately, it is done approximately 11-12 times. However, ultrasound examinations, which are frequently entered when there is no health problem, can cause both unnecessary expenses and false predictions about the course of pregnancy.

• Why is ultrasound examination done during pregnancy?

In the first 3 months

* It is checked whether there is an ectopic pregnancy.

* Significant structural and chromosomal disorders can be detected in the baby.

* It is determined whether there is a plural pregnancy.

* It is determined whether twin babies are in one pouch or in two separate pouches.

* If there is a threat of miscarriage, it is determined whether the baby is alive and whether it continues its movements.

* If pregnancy development is normal or an abnormal condition is checked.

In the second 3 months

* It is checked whether the placenta is healthy in the uterus.

* The anatomy of the baby's womb is evaluated and, if any, disorders are detected.

* The state of blood flow to both the baby and the uterus is measured.

* Whether the amount of amniotic fluid is ideal is measured.

* The length of the cervix is ​​examined and the risk of preterm delivery in the baby is investigated.

In the last 3 months

* Disorders not identified in the first months of pregnancy are detected.

* In the development of the baby, it is checked whether everything is in order, whether the amniotic fluid is too much or not, and the blood flow levels.

* The position and posture the baby takes in the womb is determined.

* The location and age of the placenta are checked.

• How often should ultrasound be done during pregnancy?

Ultrasound during pregnancy is done routinely in countries in Europe and in the United States where necessary. For example; The average frequency of ultrasound performed during pregnancy in Switzerland is 4.6. 36 percent of these examinations are routine screening, 48 percent were performed due to a medical problem. The Academy of Obstetricians and Gynecologists (ACOG) in the U.S. suggests that performing routine ultrasound in pregnancy does not reduce disability, mortality and unnecessary interventions in the baby. For this reason, he opposed this practice and advocated its use only in very necessary situations. In our country, an expectant mother is examined about 11-12 times during her pregnancy. Doing so often will put the family at unnecessary costs and cause false predictions. So the most ideal; It is the conscious and effective ultrasound examinations in certain periods of pregnancy.

Periods that every expectant mother must have an ultrasound examination:

11-14. Nuchal thickness measurement and early anomaly screening in weeks,

18-23. genetic ultrasound during pregnancy weeks,

28-32. evaluation of baby development in weeks,

37-40. Baby position and amniotic fluid assessment in weeks

• Can ultrasound be harmful to the baby?

In recent years, the number of studies performed for the safety of ultrasound devices has been quite a lot. In ultrasound examination, it is necessary to consider tissue warming caused by sound waves. It is not yet clear what kind of problems will increase the temperature during the ultrasound examination. However, if doppler examinations are performed for a short period in the first weeks of pregnancy, the risk of heat is reduced. As a result of a research, it has been stated that performing ultrasound application for more than 2 minutes has negative effects. It is stated that ultrasound may have mechanical effects besides the heat effect during pregnancy. Namely, this heat creates a current in the fluid that the baby is in. It can also distinguish cells from each other. We can state that these effects are very small and unlikely to cause harm. In epidemiological studies performed with diagnostic ultrasound, no negative situation was shown regarding the increased risk of anomaly in infants as a result of increasing frequency of ultrasound examination. Despite this result, there is unfortunately not very strong evidence for the effects of ultrasound in pregnancy. However, unnecessarily large numbers of ultrasound examinations should not be performed during normal progressing pregnancy. In summary; Frequent ultrasound in a pregnancy with healthy development and no risk factors has no positive effect on the baby in the womb.

• Attention to 3D and 3D ultrasounds!

It is stated that energy output is more in 3 and 4 dimensional ultrasound. Especially in the first 3 months of organ development; cell division rate is higher, blood flow is limited and fetal is small. More care should be taken as ultrasound is also an energy modality. It is therefore important that experts adhere to the lowest dose principle appropriate for ultrasound during pregnancy. Unless especially necessary, 10-12 of pregnancy. Doppler examination should not be done between weeks.

• Ultrasound applications in Turkey and the world

In all developed countries, ultrasound examination is usually carried out 3 times, if the course of pregnancy is normal. For example; In the United States, medical institutions cover a total of 3 ultrasound fees during pregnancy. Candidates who want to have an extra ultrasound examination pay the fee themselves. In pregnancy follow-up, all risks should be known and precautions should be taken accordingly. Unfortunately, there is no common decision on this issue in our country. This is related to the health systems of the countries. Prospective mothers who are on the path of pregnancy development may ask their doctor not to undergo ultrasound at the very beginning of pregnancy, unless necessary, once a month.

I think that if such a request comes from the family, the doctors will not object. However, ultrasound is seen as an entertainment tool in our country. In other words, it was asked by expectant mothers, “Why is it short? But I could not see. Where's the hand? Let's wave her brother. ” unfortunately, there are requests like.

• Do not enter the ultrasound much!

Ultrasound examination has been used in pregnancy for many years and is pointed out to be safe for both mother and child, but despite this; There are studies revealing the conditions associated with ultrasound in neurodevelopmental problems such as dyslexia, epilepsy, mental retardation and schizophrenia in children. Therefore, unless there are any health problems, care should be taken not to undergo ultrasound more than the recommended ones.

Editor's note: Be sure to read other articles of our specialist.