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Diagnostic
Ultrasound Services at Park Surgery
Director:
Sally Hill MSc
Horsham
West Sussex RH12 1BG
For more
information please visit
www.diagnosticultrasound.org.uk
This centre offers a
choice of ultrasound scans during
your pregnancy, which are carried
out by a highly experienced
sonographer. We are committed to
providing the highest standard of
diagnostic ultrasound using a fully
equipped high-resolution scanner.
What are
ultrasound scans for?
Ultrasound scans are
a way of assessing the wellbeing of
the baby. Although most babies are
normal, all women - whatever their
age – have a small chance of
delivering a baby with a physical
and/or mental handicap. Ultrasound
scans can help pick up some of these
problems antenatally. Some physical
abnormalities (such as Spina Bifida)
may be picked up by scan at 22
weeks. In addition ultrasound may
sometimes show features in a baby,
which do not necessarily cause
problems themselves, but may be
linked to an underlying cause (such
as Down’s syndrome). In these cases
further tests may be offered to give
more accurate information.
Remember that diagnosis of a problem
is unusual and most often a scan can
be a reassuring experience – it is
also important to realise however
that a normal ultrasound scan cannot
give a 100% guarantee of a normal
baby.
Fetal viability
scan – 6-10 weeks
At this stage in
pregnancy, we can confirm the
presence and number of live fetuses
and the location within the uterus
using the trans-vaginal or abdominal
approach. This is an extremely
useful test for patients who have
had previous miscarriages or who are
experiencing pain and/or bleeding.
Nuchal
Translucency scan: 11 – 13 weeks
• Whether you are definitely
pregnant
• How many babies you are expecting
• How many weeks pregnant you are
• Whether there are any obvious
major abnormalities present at this
time
• The risk of chromosomal
abnormalities, especially Down’s
syndrome
At this gestation the fetus will be
2 – 3 inches (5 – 8cms) long and the
heartbeat can be demonstrated on the
screen. The “crown-rump” length will
be measured and your expected date
of delivery confirmed.
Unfortunately, in about 3% of women
who attend for this scan, it is
found that the fetus has died, often
several weeks before and without any
warning. If this has happened
appropriate arrangements will be
made.
Assessment of chromosomal
abnormality by measuring Nuchal
Translucency.
During the scan we
will measure the amount of fluid at
the back of your baby’s neck (Nuchal
Translucency). Using this
measurement along with your age and
the age of the fetus, a risk is
calculated to determine the
likelihood of your baby having a
chromosomal abnormality. 95% of
measurements will indicate a reduced
risk.
If the calculation gives you an
increased risk, you may be happy to
continue without further
investigation or you may feel you
want a more definite answer. In this
case we can offer an invasive test,
(usually chorionic villus sampling),
carried out at a specialist centre.
The advantage of an invasive test is
that you get a definite answer, the
disadvantage is that the test
carries a 1% risk of causing
miscarriage. This will be fully
discussed at the time of your scan.
We can also assess whether the baby
has a nasal bone. Current research
indicates that if the nasal bone is
present we can reduce the risk of
Down’s syndrome by three fold. This
is part of an ongoing research study
with Professor Nicolaides.
Fetal anomaly scan:
21 - 23 weeks
The fetus will now measure about 10
inches (25cms) in length and the
purpose of this scan is to examine
the anatomy, ensure normal growth
and check the placental position.
Uterine blood flow studies can be
performed when indicated. Cervical
length can be assessed to evaluate
the risk of pre-term delivery.
What do we look
for?
The structures
examined include the brain, spine,
heart, kidneys and limbs. Sometimes
the fetus is in a position which
makes scanning difficult and it is
quite normal to be asked to return
for a second appointment to complete
the examination. Generally the image
is not as clear in larger women and
again a second appointment may be
necessary.
What if a problem is detected?
Approximately 90% of
significant abnormalities will be
detected.
Not all abnormalities are life
threatening.
For example, sometimes there is an
excess of urine within the fetal
kidneys, which can be monitored by
further scans. Most kidneys return
to normal by the end of the
pregnancy, but early detection
reduces the incidence of childhood
kidney infections and obstructions.
If a more serious abnormality is
suspected, a second opinion at a
specialist centre may be arranged to
discuss the best management of the
pregnancy.
Remember that if there are any major
problems we should be able to pick
them up, but it is important to
realise that not all abnormalities
can be diagnosed on a 22 week scan.
Fetal well-being
scan 24-41 weeks
This scan aims to
assess how well the baby is growing.
We can also evaluate placental
location and amniotic fluid volume.
Aid to pre-test
counselling
1. Performed at 11-13
weeks’ gestation
2. Aimed at all pregnant women
3. Individual risk prior to the test
is determined by maternal age (see
chart opposite).
4. The test screens for those at
increased risk of chromosomal
abnormality-particularly Down’s
syndrome.
5. The test is performed by either
transabdominal or transvaginal
ultrasound scan.
6. 95% of women tested will have a
normal result.
7. Further testing is usually
offered if the recalculated risk
after nuchal translucency
measurement is greater than 1:300
8. The test will pick up 75- 80% of
pregnancies affected by Down’s
syndrome-this compares with 60%
picked up by serum screening (the
triple test) and 30% when selected
by age alone (35 years).
9. The test itself does not carry
any risk to the mother or baby.
10. If a test is positive (ie
recalculated risk is greater than
1:300) an invasive test is usually
recommended to determine the baby’s
chromosome pattern. This may be
chorion villus sampling
(CVS)-performed at 11-14 weeks-or
amniocentesis performed at 16 weeks’
gestation. Both of these tests carry
a risk of miscarriage of 1%.
Trisomy 21 (Down’s syndrome) risk by
maternal age and gestation:
estimated risk (1/number in this
table).
Age(years)
|
12 weeks |
Birth |
|
20 |
898 |
1527 |
|
22 |
872 |
1482 |
|
24 |
827 |
1406 |
|
26 |
756 |
1286 |
|
28 |
655 |
1113 |
|
30 |
526 |
895 |
|
31 |
457 |
776 |
|
32 |
388 |
659 |
|
33 |
322 |
547 |
|
34 |
262 |
446 |
|
35 |
210 |
356 |
|
36 |
165 |
280 |
|
37 |
128 |
218 |
|
38 |
98 |
167 |
|
39 |
75 |
128 |
|
40 |
57 |
97 |
|
41 |
43 |
73 |
|
42 |
32 |
55 |
|
43 |
24 |
41 |
|
44 |
18 |
30 |
Fees for Private Obstetric and
Gynaecological Scans
(Payment will be requested on the day
of your appointment.)
| Fetal
Viability |
£80 |
| Nuchal
& Nasal Bone Scan |
£110 |
|
Combined Test
(Nuchal, nasal bone & blood
test) |
£150 |
| Fetal
Anomaly Scan |
£160 |
|
Fetal Wellbeing
(including Dopplers) |
£150 |
|
4D Baby Scan &
DVD |
£200 |
|
Pelvic Scan |
£150 |
Gynaecological
Service
The female pelvis can
be examined using a trans-vaginal
approach. This gives the best
picture of the uterus, ovaries and
pelvis. The ultrasound transducer is
similar in size and shape to a
tampon: it is disinfected before
use, covered with a protective
sheath and lubricated. Approximately
2 inches is gently inserted into the
vagina in the same way as a tampon,
(if you prefer you can insert it
yourself).
Please arrive with an empty bladder.
There is no problem if you have a
period and are bleeding on the day
of the scan, it can still be
performed. Throughout the
examination you are covered up and
the door is locked.
If for a particular reason you are
unable to have a trans-vaginal scan,
an abdominal scan can be performed.
If this is the case you must drink
1½ pints of water by 1 hour before
your appointment time, because a
very full bladder is essential to
demonstrate the uterus and ovaries
clearly when the ultrasound
transducer is passed over the lower
abdomen.
Further
Information
For further information or
appointments please telephone:
Sally Hill: Mob: 07811 695651
Email:
ultrasound.scan@gmail.com
Helena Goldberg: Mob: 07961 323 766
Email :
helenagoldberg@nhs.net
This centre has been approved by
The Fetal Medicine Foundation,
London.
Director: Professor K. Nicolaides
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