Feature Archive

Ultrasound: A Womb With a View

Ultrasound Testing: A Womb with a View

WebMD Feature

Carla Laszlo and her husband Robert recently went for a 20th-week ultrasound, and seeing the baby come to life on the computer screen before them was an experience like no other. The Southwick, Mass., couple even brought home photographs and a video, just in case they need another fix before meeting the genuine article in December.

"To see your baby for the first time and count fingers and toes is spiritual," says Laszlo. "I was absolutely mesmerized. Aside from desperately wanting to see this little creature inside of me was the anxiety that everything would be forming perfectly and that the baby would be healthy. The news couldn't have been better. To celebrate, we bought a crib!"

More than half of pregnant women have at least one ultrasound, also known as a sonogram, sometime during their pregnancy. The test, which works by bouncing harmless sound waves off the fetus to create an image onto a computer screen, can help doctors and midwives monitor the development of your fetus and help assess various conditions, including some birth defects.

Ultrasounds are also typically a welcomed rite of passage for expectant parents. Not only can they give peace of mind (or, on the flip side, advance warning of a condition that might require other decisions and planning), but the pictures are often parents' first tangible peek at the miracle growing inside. "It was a real bonding experience," says Janet Kalbhen, a Chicago free-lance Web consultant.

"Even though you know intellectually that there's a child growing inside you, when you see it on the screen and you can see a heartbeat and see it moving, you just feel more connected. It felt like a baby, instead of a fetus, to me at that point," says Kalbhen, who had several ultrasounds before her baby was born two years ago.

The Powers of a Jelly Belly

If you're offered a sonogram, chances are that your doctor or midwife is trying to assess something in particular. The American College of Obstetricians and Gynecologists (ACOG) and the National Institutes of Health (NIH) discourage routine ultrasounds, but instead suggest that ultrasound screening be done for specific indications.

The most common reasons for an ultrasound include verifying a due date and number of fetuses; measuring the baby's growth, movement, position, heart rate and breathing; locating the placenta; diagnosing most structural defects, such as congenital heart diseases or cleft lip; assessing the root of complications, such as bleeding; or guiding doctors through diagnostic tests, such as amniocentesis or chorionic villi sampling (CVS).

The procedure can be done two ways. In the first trimester, a transvaginal ultrasound is usually most informative and takes only a few minutes. A flexible probe called a transducer is inserted into the vagina, which allows a close-range view of the gestational sac, fallopian tubes and fetus. The standard second-trimester scan takes about 20 minutes and is done by moving the transducer gently over the abdomen, which is covered with a special jelly that conducts sound waves.

Doctors used to tell patients not to ask the ultrasound technician questions about what's projected onto the screen and to wait instead for the radiologist's report and an explanation from their health-care provider. But Dr. John Larsen, a professor of obstetrics, gynecology and genetics at The George Washington University, says such etiquette is unrealistic.

"The current milieu, for better or worse, is to talk about what's going on while it's happening," says Dr. Larsen. "The technician can say 'There's the head; there's the heart; there's the limbs; these are the testicles,' and on you go."

If there's something wrong, waiting is often impractical because everyone's attention is on the screen. "It's right in your face," Dr. Larsen says. "Patients feel a tremendous sense of discomfort if suddenly the technician isn't talking to them."

Despite the ACOG and NIH recommendation that sonograms be done only for specific purposes, many doctors routinely order an ultrasound between 18 and 20 weeks to head off problems that otherwise might not be apparent.

"When a pregnant woman goes to the doctor, why should that doctor only look at the mother?" asks Dr. Ilan Timor, director of New York University Medical Center's obstetrical and gynecological ultrasound unit. "We have the tools to look at the fetus to anticipate things, so why shouldn't we?" Pregnant women in other countries, such as Germany, Sweden and Denmark, are typically offered at least two.