Session 3: Week 18 - Hey Baby, There You Are

What is ultrasound? Ultrasound is using high-frequency sound waves to create a picture. A little bit of history on that: back in the late 1700s, scientists decided to study bats and how they could see at night without being able to use their eyes. That was echolocation, which they followed up on, trying to figure out how it could be used in the everyday world. During World War II, it finally came to fruition when sonar was used in submarines to detect anything underwater. It's kind of crazy that we're using the same technology today that they used in World War II, albeit with more advancements.

Ultrasound is pretty amazing. I can sit here and put this little plastic probe on your belly after I squirt some gel on, and I can see into your skin. When we put the ultrasound probe down, it sends out pulse waves of sound that bounce off different structures in your body. Depending on how dense those structures are, the signal returns to the probe at different speeds, creating a picture on the ultrasound machine. Despite its amazing capabilities, ultrasound has limitations. We can't see through air or bones. During pregnancy, it takes a while for the baby's bones to ossify and create shadows where we can't see through. Ultrasound is an amazing tool, but it's just one piece of the big picture of your baby's well-being.

There is a statistic that 50% of pregnancies where the baby is born with Down syndrome had a normal ultrasound. If your physician recommends other testing or blood work, we encourage you to do those things because they give us more pieces to our big puzzle.

How many ultrasounds will I get during my pregnancy and how will they be performed? Typically, in a normal pregnancy, you'll get two ultrasounds. One is during or as close to the first trimester as possible to give a dating for the pregnancy. The second is around 20 weeks, which is the full anatomy scan where we look at all the baby's structures. There are two types of ultrasounds: transabdominal, which is on top of your belly, and transvaginal, where the ultrasound probe goes into the vagina. The transvaginal ultrasound does not affect the baby as it does not go into the uterus.

There are a couple of reasons for doing a transvaginal ultrasound. In the first trimester, it depends on the position of your uterus and how far along you are in the pregnancy. This relates to not being able to see through certain things. Our pelvic organs are in the middle of our bowel, which contains air. We ask you to come for ultrasounds with a full bladder. This isn't to torture you, but to push some of the bowel out of the way so we can see what we need to see. If you come without a full bladder, what I might have been able to see with a full bladder, I won't be able to see because of the air. We may have to do a vaginal ultrasound to get better pictures. There are other reasons for a vaginal ultrasound later in pregnancy, like checking cervical length if there's a history of preterm labor or a leap procedure, or ensuring the placenta isn't over the cervix.

Will I be able to hear my baby’s heartbeat on ultrasound? No. Especially in the first trimester when all of the baby's systems are developing and growing, listening to the heartbeat puts all the energy from the machine into the baby's tiny heart, which we avoid. Once you get far enough along, typically around 12 weeks, providers will start listening to the baby's heartbeat with a Doppler, which is safe. Later in pregnancy, if the baby is in a bad position, we may use the Doppler to listen to the heartbeat, but only briefly. At every ultrasound, we watch the heartbeat, measure it, and tell you the beats per minute.

When will I get the results from my ultrasound? If you have an appointment with your provider the same day after your ultrasound exam, you'll get the results then. Otherwise, the doctor will read the ultrasound report and send it to MyChart, usually with a message, and they'll also go through it with you at your next appointment.

Can I take pictures or videos of my ultrasound? No. Lee Health has a policy against photos, audio, or video recordings in the ultrasound room because it's a diagnostic exam. Not every pregnancy has a normal outcome, so physicians need to review all images before providing a diagnosis. While we can't allow pictures or video, we, as Ultrasound Techs, will do our best to give you pictures to take home. Babies aren't always in the best position, so we might jiggle your belly, have you use the bathroom, or roll you from side to side to get better pictures. Drinking cold water can sometimes get the baby to move. We do everything we can to get you good pictures because we understand this is an exciting time in your lives.