The use of ultrasound in pregnancy has become indispensable in our hospital and all over the world. The safety of ultrasound and the routine utility obtained is so marked that ultrasound becomes invaluable in antenatal check up.
As soon as the patient misses her periods, urine test is done for pregnancy. Along with this, ultrasound is also done which reveals changes due to pregnancy in the uterus and ovaries. At the end of the 5th week (35 days) the gestational ring becomes evident and during the 38-40th day the yolk sac is seen and 41-45th day, the fetal heart pulsations can be seen.
Gestational age where the history is insufficient, can be clarified by ultrasound by certain parameters like crown rump length in early pregnancy and Biparietal diameter, abdominal circumference and femur length in later dates.
In maternal diseases complicating pregnancies, like hypertension and diabetes mellitus where there is definite utero-placental insufficiency leading to intra uterine growth retardation, ultrasound proves to be invaluable in assessing periodic growth and helps in timely termination of the pregnancy before intra uterine death occurs.
Other important features identified with the help of ultrasound are:-
- Vaginal bleeding of unidentified etiology during pregnancy.
- Severe fetal malformations not compatible with life. When identified well in time, the pregnancy can be terminated before the period of viability.
- Multiple pregnancies like twins, triplets quadruplets etc and abnormal presentation of the foetus.
- Size, site and calcification of the placenta and its aging.
In early pregnancy ultrasound helps to identify unruptured ectopic pregnancy which is life saving for the mother by helping the obstetrician to terminate the pregnancy well in time. Any invasive procedures like amniocentesis and chorion villi biopsy can be done more safely with ultrasound guidance.
Fetal blood transfusion in Rh iso immunisation, fetal cord blood sampling and minor intra uterine surgery of the foetus can be performed by ultrasound guidance.
Selective foetal reduction is now possible by ultrasound guidance in the 8-10 weeks of foetal life. This is done in triplets, quadruplets and quintuplets pregnancy by injection of 15% potassium chloride into the foetal heart causing death of that foetus only.
Routine screening after the 20th week of the pregnancy ensures the well being of the baby.
Contrary to the common belief that ultrasound may be harmful to the foetus, in my practice, ultrasound has proved to be invaluable in every step towards a successful pregnancy
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