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Ultrasound

First ultrasound scan
The first ultrasound usually takes place between 7-9 weeks of pregnancy, during the first check-up. With this ultrasound we can see whether the heart is beating, how far along in your pregnancy you are, and whether it is a single or multiple pregnancy. At this term, the baby is still very small and it is preferable to make the ultrasound vaginally for the best image (this is of course negotiable).

Medical ultrasounds

Term ultrasound
This ultrasound preferably takes place between 10 and 12 weeks. At this ultrasound we determine the due date, and we look at the development of the baby. Usually it is possible to make the ultrasound through the abdomen.


Ultrasound blood loss
Sometimes it happens that there is vaginal bleeding. This is of course worrying for the expectant mother. Bleeding in early pregnancy is common and can be the first sign of a miscarriage. Depending on the duration of the pregnancy, we can make an ultrasound to see if we can detect a cause. At around 6-7 weeks of pregnancy, we can see your baby's heart beating with the ultrasound. In case of concern, we will bring the first ultrasound forward to 6-7 weeks.


Growth ultrasound
We can follow the growth of your baby at every check-up by feeling the abdomen. We call this the external pregnancy examination. However, sometimes, there is a reason to keep an eye on the baby's growth using an ultrasound. We do this if there is a greater chance of a smaller or larger child, or if there are concerns about the baby's growth.

If there is no requirement to make a growth ultrasound, there is always the possibility to look at your baby via an ultrasound, if it is your wish.


Ultrasound baby position
Between 35 and 37 weeks of the pregnancy, we will look at the position of the baby using an ultrasound.
During pregnancy, your baby rotates in the womb and assumes different positions. Towards the end of the pregnancy, from 32 weeks, most babies lie head down to prepare for birth. From 28 weeks, we check the baby's position using the external pregnancy examination method. A few weeks before the expected delivery date, we make an ultrasound to confirm that your baby is positioned head down. After this period, your baby will rarely turn around. We will continue to monitor the baby's position at every check-up by feeling the abdomen.

13 and 20 weeks ultrasound

At around 13 and 20 weeks of pregnancy, you can have your baby checked for a physical abnormality with an ultrasound exam. A physical abnormality means that part of the child's body looks different from normal. Examples of physical abnormalities are an open back, open skull, hydrocephalus, heart defects, hole in the diaphragm, hole in the abdominal wall, abnormality of the kidneys or abnormality of the bones.

You choose whether you want information about these studies. During the first check, we will explain this in detail if desired.


The result is not a certainty
The results of the 13- and 20- week ultrasounds are normal in about 95 out of 100 pregnant women. The sonographer will not see any physical abnormalities in your baby. The results of the ultrasound can be reassuring. However, the result can also worry you, or scare you if there is a suspicion of a physical abnormality. In addition, the sonographer cannot see all abnormalities during the ultrasound.

Does the sonographer see something that could be an abnormality? Then it is not always clear whether it really is a deviation. And if it is a deviation, how serious it is and what that means in quality of life for your child. That is why you are always offered follow-up research.

Therefore, it is important that you think carefully about whether you want research into physical abnormalities. The results of the ultrasound can mean that you have to make difficult choices, in the event that your child has a physical abnormality that cannot be treated. Sometimes it can be treated by surgery or different treatment methods, for instance, in the case of some heart defects. This is not always clear in advance.

The 13-week ultrasound and the 20-week ultrasound are types of prenatal screening. Would you like more information about this?: Examinations during pregnancy and after birth | Prenatal and neonatal screenings (pns.nl)..

The 13- and 20- week ultrasounds take place at our regional Centre for Midwifery Research North Limburg (CVONL) located at the birth centre. Our colleague Ingrid, and a number of colleagues from the region, have specialized in these extensive ultrasounds and provide them for the region.

What are the differences between the 13 and 20 week ultrasound?

13 weeks ultrasound

20 weeks ultrasound

Ultrasound between 12+3 and 14+3 weeks of pregnancy. The child is smaller and less developed.

Ultrasound between 18-21 weeks of pregnancy. Preferably in the 19th week. The child is bigger.

Some (serious) deviations can be seen. If follow-up testing is needed, you have more time to decide what to do with the results.

There are more details to see. If follow-up testing is needed, you have less time to decide what to do with the results

The sonographer does not check whether the child is a boy or a girl.

The sonographer can usually tell whether the child is a boy or a girl. You will only be told this if you wish.

In the Netherlands you can only opt for the 13-week ultrasound if you take part in the scientific IMITAS study. You must be at least 16 years old for this.

This study investigates the advantages and disadvantages of the 13-week ultrasound.

On the one hand, it seems good to know early in the pregnancy whether your child has a serious physical abnormality. You then have more time for additional research and to decide what to do with the results. On the other hand, an early ultrasound may also cause extra anxiety and uncertainty.

Everyone can opt for a 20-week ultrasound.

The sonographer looked at your baby but couldn't see everything clearly.

This does not necessarily mean that something is wrong. For example, it may be that your baby is not clearly visible in the belly. And in women who are somewhat heavier, the ultrasound is sometimes more difficult to make.

No further investigation is necessary. Do you opt for a 20-week ultrasound? Then the sonographer can look at that ultrasound again.

The sonographer looked at your baby but couldn't see everything clearly.

This does not necessarily mean that something is wrong with your child. For example, it may be that your baby is not clearly visible in your belly.

You will be offered a repeat examination.

 

Fun ultrasound

While a medical ultrasound aims to measure a child or to assess whether abnormalities are visible, a fun ultrasound allows you to enjoy and reflect on the fun side of an ultrasound: finding out the gender, take a detailed look at the face, observe the movements of your child's hands and feet etc..

Making a fun ultrasound is possible within our regional Pretecho Centrum Noord- Limburg at the birth centre. Our colleagues Judith and Nanda together with co-workers provide these fun ultrasounds.

A fun ultrasound can be made in both 2D and 3D/4D. 2D is possible during the entire pregnancy, 3D and 4D are the most beautiful between 26-32 weeks of pregnancy.


2D ultrasound
With a 2D ultrasound you see your baby in cross-section in black and white images. With a 2D ultrasound you can see the contours of your baby and you can watch 'live' when the baby moves.

If you would like to know the gender of your baby, you can do this with the early NUB theory, or at 16 weeks. From week 13, the sex of your child has developed to such an extent that you can have a sex determined on the basis of the NUB theory. This theory looks at the angle that the genital bone (tubercle) makes with the spine. This angle is greater in boys than in girls. Based on this theory, one can make a gender prediction that is 75% certain.
If no sex determination can be made based on the NUB theory (for example, if the position of the baby is not optimal), it is possible to come back at 16 weeks for a normal sex determination.


3D ultrasound
A 3D ultrasound is made up of several 2D images. The image stands still and shows your child clearly in perspective. What's nice about 3D ultrasounds is that you see depth on these images and they are in colour.


4D ultrasound
With 4D ultrasounds you see 3D moving images. The 3-dimensional image is continuously updated so that you see a “live” moving view of your baby.
These ultrasounds are intended to visualize your child in the clearest and most fun way possible, so that a recognisable image can be made. The clarity of these images depends on the position of the baby, the amount of amniotic fluid and the thickness of your abdominal wall.