2 trimester of pregnancy, ultrasound: transcript

Many people are interested in what trimester of pregnancy is biochemical analysis and ultrasound performed? The 2nd trimester of pregnancy make a comprehensive examination without exception for all women. It is needed to determine the positive or negative response to the data obtained earlier, as well as when symptoms appear, in which ultrasound is shown.

To make US (2 trimester of pregnancy) it is possible only under certain rules of preparation for the procedure. The interpretation of the received data is carried out in accordance with the same principles as in the first survey.

The second screening for carrying a baby involves two stages:

1. Carrying out in the 2nd trimester of pregnancy ultrasound.
2. Screening test - a blood test in the veins on a series of hormones.

The main indications for the survey

Studies are carried out exactly according to the same indications as in the first trimester:

1. The presence of a bacterial or viral infection.
2. Diseases betrayed by inheritance.
3. Diabetes.
4. Diseases of the joints.
5. Oncological diseases of one of their parents.
6. Pathologies of chromosomal nature
7. The presence in the anamnesis of miscarriages or spontaneous childbirth.
8. Birth of a child with certain abnormalities.
9. The previous death of the fetus in the womb;
10. The poor results of the first screening, made at a period of 14 weeks and later, showed the pathological development of the embryo.

Norms of ultrasound in the 2nd trimester of pregnancy make it possible to ascertain the proportionality of the development of the skeleton of the child, to reveal the condition of the ventricles of the brain, cerebellum, spine and facial structures. In particular, attention is paid to the nose, lips, orbit, atrium of the heart, large vessels, kidneys, bladder and gastrointestinal tract.

Fetometry

The ultrasound protocol of the 2nd trimester of pregnancy assumes the designation:

• Location of the placenta and its thickness;
• Structures of maturity of the placenta;
• Number of vessels in the umbilical cord;
• The amount of amniotic fluid;
• Condition of the cervix and uterine walls and its appendages;
• Indicators of fetometry.

Fetometry is the measurement of the size of the fetus. It includes:

• Size of the head of the fetus, forehead and occiput;
• Diameter of the circumference of the head and abdominal circumference;
• Cephalic index for assessing the structure of the head;
• Length of tubular bones (thighs, tibia, large and small, humerus, ulna and ray) on both sides.

Deciphering of ultrasound of the 2nd trimester of pregnancy makes it possible to establish the correspondence of its development to the gestation period, to estimate the level of fetal growth, to confirm the duration of pregnancy, to reveal the development lag and the presence of pathologies.

Developmental delays

The delay of intrauterine development can be symmetrical and asymmetrical. In the first case, development occurs in proportion and all the indicators of ultrasound indicate a lag from the norm of this period of pregnancy.

Asymmetric features look like this:

• The index of the abdominal circumference is below the norm;
• Head size and DBK are normal for a long time;
• Increased ratio of exhaust gas / coolant and coolant / coolant.

Depending on the results obtained, we can distinguish three degrees of lag:

1. Lagging for 2-3 weeks.
2. Lagging for 3-4 weeks.
3. For 5 weeks or more.

Assessment of the internal organs of the fetus: 2 trimester of pregnancy, ultrasound

Cross sections of the head:

• Abnormal structures are eliminated in the form of lemon, banana and strawberry, or pronounced brachycephaly, the presence of a double contour of the head, which signals a dropsy of the brain;
• The integrity of the structure of the bones of the skull is studied.

Evaluation of the brain:

• Ventriculomegaly shows enlarged ventricles of the brain;
• The presence of cysts is noted in the vascular system;
• In the cerebellum pathologies are noted;
• Neoplasm in the skull, which are located on its surface.

Detection of indirect signs of Down syndrome:

• The distance between the eye sockets is increased;
• The mouth is in the open state;
• The tongue is stuck out;
• Heart defects are detected;
• The bones of the lower leg are shortened.

Facial structures:

• Studying the profile of the upper and lower jaw;
• Presence of cyclopia and anophthalmia (examination of the orbit region);
• Presence of cleft in the lip and sky (wolf mouth and hare lip);
• Presence of protrusion of the upper jaw.

With an anomaly of the spine, there is a splitting in this area. It is combined with the pathological development of the spinal cord. This is a very dangerous pathology.

The chest is scanned. This excludes the pleural and pericardial effusion - normally in the pericardial cavity, the fluid band is not more than 2 mm. The level of maturity of the lungs is indicated - each correctly developing lung occupies one third of the cross section. There are three degrees:

• 0 - the echogenicity index of the lungs is less than the echogenicity of the liver.
• 1 - the index of echogenicity of the lungs and the liver is equivalent;
• 2 - the echogenicity index of the lungs is higher than the echogenicity of the liver.

The condition of the heart (presence of a four-chamber structure without pathologies) and main vessels is determined. Also evaluated are the stomach, liver, intestines, kidneys, bladder and diaphragm.

Assessment of the placenta

The organs of a temporary nature are also subject to study. These include the placenta, the umbilical cord and the amount of amniotic fluid. Carrying out in the 2nd trimester of pregnancy ultrasound makes it possible to determine the position of the placenta in relation to the internal throat of the uterine neck.

If it is attached at a distance of 5.5 cm below the inner pharynx, it is said that the placenta is low, if it covers the entire internal jaw completely or partially, this is evidence of placenta previa.

However, during the third trimester, it can move and rise higher, so mandatory ultrasound is shown at 27-28 weeks.

The thickness of the placenta increases depending on the gestation period and is evaluated at the site of attachment of the umbilical cord. If the index of thickness is more than 4.5 cm, this indicates the presence of dropsy in the embryo, rhesus conflict, an infectious process or the presence of diabetes.

Maturity of the placenta:

• O - up to 30 weeks;
• 1 - up to 27-36 weeks;
• 2 - 34-39 weeks;
• 3 - after 36 weeks.

Condition of amniotic fluid and umbilical cord

Evaluation of amniotic fluid allows us to determine their number. Increased or decreased levels cause infection of the fetus in the womb, contributes to the emergence of various pathologies.

To determine the volume of amniotic fluid, the index of the amniotic fluid is taken. If it is less than 2 cm, then talk about a lower content, and more than 8 cm - about increased.

When evaluating the umbilical cord, the number of vessels is counted. Normally, it contains one vein and a pair of arteries. Also, the presence of the umbilical cord loops and the hanging around the neck of the embryo is indicated.

Uterine status

The ultrasound of the 2nd trimester of pregnancy contains information about the condition of the uterus. The level of its voltage is indicated. With hypertension of the walls, the presence of pain and blood secretions, a diagnosis of presentation is made.

Uterine walls are considered from the position of the presence of oncological tumors (myomas). Also, the tendency of their growth and location relative to the embryo and placenta is indicated. In the case of surgical intervention on the uterus, the condition of the scar is assessed:

1. Consistent type of scar. Its structure does not contain an inclusion, differs homogeneity and evenness of the contours of the lower segment. The index of the thickness of the scar is not more than 3 mm.
2. Insufficient type of rumen. There is a defect in it. For example, in the rumen a deep niche, a thin tissue, a high number of hyperechoic inclusions of connective tissue.

Cervical Conditions

To determine the ischemic-cervical insufficiency of the uterine cervix condition, the index of its length and the channelability of the neck canal is estimated. Normally, the neck size should be at least 35 mm. With a shortening of up to 30 mm in a woman bearing the first child, and up to 20 mm in the second pregnancy, it is possible to judge ishmic-cervical insufficiency.

Preparation

Ultrasound (2nd trimester of pregnancy) does not require special training. The intestine, despite the presence of gases, moves backwards with an enlarged uterus. The full bladder is replaced by amniotic fluid.

But before giving blood for analysis, some training is required. The day before the procedure, a pregnant woman should not consume chocolate, cocoa and fried foods. In addition, before donating blood should not eat for 4-6 hours. You can only drink water for 4 hours, but not carbonated and not more than 150 ml.

It should be noted that screening for the third trimester does not require any preparation at all.

When a survey is conducted

Diagnostic terms for the second trimester are 16-20 weeks. This condition is very important for the correct determination of the level of hormones in the blood. The terms of the second trimester ultrasound coincide with the biochemical analysis of the blood. Ultrasound is done in the first place, and with the results the woman is sent for a blood test.

The second screening should be done at week 17 of pregnancy or a week before that date.

Many are interested in where to make ultrasound 2 trimester of pregnancy? Such a procedure is carried out in district clinics, gynecological and perinatal centers. Deciphering the testimony is done by the doctors-uzisty.

Research Rules

The study of pregnant women includes a number of specific manipulations.

Ultrasound examination is performed only transabdominally, that is, on the skin of the abdomen. To this end, the woman is laid on the couch, open the stomach. The surface of the abdomen is smeared with gel. The doctor drives the sensor along its front wall. Painful sensations or any discomfort this manipulation does not cause.

And how is biochemical analysis carried out? A pregnant woman comes to the laboratory on an empty stomach. Blood is taken from the vein in the amount of several milliliters. In the laboratory, a woman provides ultrasound results and completes the questionnaire. The received data is processed by the program. The results will be ready in only 14 days.

Explanation

Decoding involves a number of indicators, each of which has its own norm. The result of biochemical screening involves determining the level of such hormones:

• Chorionic gonadotropin;
• Estriol;
• Fetoprotein;
• Inhibin, if carried out a triple and quarter test.

The results of the second survey depend on the period of pregnancy. They are evaluated in accordance with the MoM value. This is the average figure that is calculated based on the age, body weight of the pregnant woman and the area in which she lives. Dignity indicators are divided by the value obtained in a large sample of women of the same age who live in the same region.

If the hormone is in the range of 0.5-2.5 MoM, this is considered normal. If the figure is less than this indicator or vice versa, then in this case the consultation of a specialist is shown.

Deciphering the diagnosis of the second trimester is to identify the level of risk in the field of a particular pathology. It is designated as a fraction. A high degree of risk is the indicator 1: 250 or 1: 360 for any type of pathology. Thus, Down syndrome, neural tube defect, Edwards, Patau are revealed. This requires a consultation of a geneticist. At a score of 1: 100, an invasive examination can be offered that involves the detection of a suspected pathology through a set of chromosomes of the embryo itself.

Some vices may appear much later and will be indicated only at the second screening for a period of 16-20 weeks (2nd trimester of pregnancy). Ultrasound in this period is carried out taking into account this feature. If negative results of the second screening are advised to seek advice from a geneticist.