Posts Tagged ‘ultrasound’

Is it a boy or a girl?

Friday, August 26th, 2016

its-a-girl-storkFinding out the sex of your baby is such an exciting part of pregnancy. While some people choose to be surprised at the time of delivery, many couples want to know the sex of the baby before they give birth. its-a-boy-stork

XX or XY

Your baby’s sex is determined at the moment of conception.  Of the 46 chromosomes that make up your baby’s genetic material, two chromosomes–one from the egg and one from the sperm–determine your baby’s gender.  A woman’s egg contains only X sex chromosomes.  A man’s sperm, however, may contain either an X or Y sex chromosome.  If, at the instant of fertilization, a sperm with an X sex chromosome meets the egg (another X chromosome), your baby will be a girl (XX).  If a sperm containing a Y sex chromosome meets the egg, your baby will be a boy (XY).  It is always the father’s genetic contribution that determines the sex of the baby.

How can I find out the sex of my baby?

Most women find out their baby’s sex during a routine ultrasound in the second trimester—usually between 18-20 weeks.  Traditional ultrasound is approximately 93% to 100% accurate at detecting the baby’s sex. But, just remember that sometimes the sex is not clearly identifiable from an ultrasound. This is usually due to the position of the baby.

While ultrasound is accurate, if you want to be absolutely certain of your baby’s sex, you would need a diagnostic test, such as a CVS (done between 10-12 weeks of pregnancy) or amniocentesis (done between 15-20 weeks of pregnancy). It is important to keep in mind that these prenatal tests are invasive and are done primarily to diagnose certain genetic conditions, such as Down syndrome.

Another way you may find out if you are having a boy or a girl is through cell-free fetal DNA testing (also called noninvasive prenatal testing or NIPT). NIPT tests your blood for your baby’s DNA to see if he may have certain genetic conditions, like Down syndrome. While this test is not used specifically to determine the baby’s sex, it can provide that information. It can be done after 10 weeks of pregnancy.

Did you find out if you were having a boy or a girl? Did you reveal it in a special way? Let us know—we’d love to hear your stories!

Have questions? Email us at AskUs@marchofdimes.org.

Screening vs. diagnostic testing—what’s the difference?

Friday, June 26th, 2015

DoctorPregnant_zps3ac96800If you are pregnant, you know that every visit to your prenatal care provider involves a number of tests. At each prenatal checkup, your provider checks your weight, blood and urine. But in addition to these routine tests, you will also be offered prenatal tests that can assess your risk to have a baby with certain birth defects.

The American College of Obstetricians and Gynecologists (ACOG) recommends that all pregnant women, regardless of age, be offered prenatal testing for Down syndrome and some other birth defects. There are two different types of tests that you can have: a screening test or a diagnostic test. It’s important to understand the difference between a screening test and a diagnostic test. Screening tests help evaluate the risk for certain birth defects, but they cannot diagnose a birth defect. Screening tests pose no risk to mother or baby. Diagnostic tests are highly accurate at diagnosing or ruling out specific birth defects. However, these tests may pose a very small risk of miscarriage.

Screening tests offered during pregnancy include:

  • Cell-free fetal DNA testing (also called noninvasive prenatal screening or testing): Some of your baby’s cells can be found in your blood. This test uses a sample of your blood to look at your baby’s DNA to check for certain genetic conditions. You can have this test after 10 weeks of pregnancy. This test is not recommended for women who aren’t likely to have a baby with a birth defect or who are pregnant with multiples.
  • First-trimester screening: Using a blood sample and ultrasound measurements, first-trimester screening can tell you if your baby is at risk for some birth defects, like Down syndrome. It is usually done between 11 to 13 weeks of pregnancy.
  • Maternal blood screening: This test measures four substances in your blood to determine the chance that a woman has a baby with certain birth defects like Down syndrome and neural tube defects. The test is done between 15 to 20 weeks of pregnancy.

Diagnostic tests are done by obtaining samples of your baby’s actual cells and therefore are more invasive. Diagnostic testing can detect most birth defects caused by a change in the number or shape of chromosomes. And testing for many inherited disorders can be done as well. However, not all birth defects can be detected.

Some women may choose to have diagnostic testing done instead of screening tests based on their age or family history. Other women may choose to start with a screening test and then, depending on the results, decide whether to have a diagnostic test. Prenatal diagnostic tests do carry a small risk of miscarriage (about 1 in 300-500).

  • Chorionic villus sampling (also called CVS): During this procedure, the doctor removes a small sample of tissue from the placenta. This can either be done transvaginally or transabdominally. You can get CVS at 10 to 12 weeks of pregnancy.
  • Amniocentesis (also called amnio): Your health care provider will use a needle to remove a small amount of amniotic fluid. Amnio is done between 15 to20 weeks of pregnancy.

Remember, all of these tests are optional. Make sure that you discuss your questions and concerns with your health care provider.

Questions? Send them to AskUs@marchofdimes.org.

 

Concerns surrounding “keepsake” ultrasounds

Friday, February 20th, 2015

pr_mr_lg_ultrasound1The first ultrasound is one of the most exciting times in pregnancy. Most parents can’t wait for the opportunity to share their baby’s first pictures with family and friends. However, it is important to remember that an ultrasound is a medical imaging technique and should only be done under the supervision of medical professionals, such as your doctor and/or a trained ultrasound technician. “Keepsake” ultrasounds offered by commercial businesses are not recommended.

Ultrasound is the most commonly used tool for viewing a developing baby. Sound waves bounce off curves and shapes within your body and these patterns are then translated into images. Standard ultrasound creates a 2-D image of a developing baby. Some women have an ultrasound during the first trimester to confirm and date the pregnancy—this is called an early ultrasound.  But not all providers offer this. Most doctors perform an ultrasound between 18 and 20 weeks. At this time your provider will check your baby’s heartbeat, muscle tone, movement and overall development.

Although it is always fun and exciting to see your unborn baby on the ultrasound monitor, it is very important to remember that this is a medical procedure. You may have seen places in a mall that offer “keepsake” 3-D or 4-D ultrasound pictures or videos for parents. While ultrasounds have been used for over 30 years and are considered safe for you and your baby, the American College of Obstetricians and Gynecologists, the Food and Drug Administration and the American Institute of Ultrasound in Medicine do not recommend these non-medical ultrasounds. The people doing them may not have medical training and may give you wrong or even harmful information.

In a recent consumer update regarding fetal keepsake images, the FDA warns that “In creating fetal keepsake videos, there is no control on how long a single imaging session will last, how many sessions will take place, or whether the ultrasound systems will be operated properly.” And although there is no evidence that ultrasound may cause harm to an unborn baby, there is also no medical benefit to exposing the baby to unnecessary ultrasound waves only for the purposes of keepsake images.

If you are pregnant, talk to your doctor about when to schedule your ultrasound. He or she will be more than happy to give you pictures to take home with you. You can read more about the different types of ultrasound that your provider may recommend, when they are offered, and what information they may be able to provide here.

When your baby is overdue

Monday, September 30th, 2013

bellyThe average healthy pregnancy is around 40 weeks. Some babies come earlier and others run later. A pregnancy that lasts longer than 42 weeks is called a post-term pregnancy.

Dr. Siobhan Dolan discusses overdue pregnancies in the book Healthy Mom Healthy Baby. Here is an excerpt from the book.

“Although many post-term babies are healthy, some risks do start to increase after 41 to 42 weeks. An overdue pregnancy takes a toll on the placenta, amniotic fluid, and umbilical cord. As the baby grows larger, the chances of stillbirth and delivery injuries go up, and there is a greater likelihood that the baby will experience meconium aspiration (inhaling stool from the amniotic fluid into the lungs) or a condition called dysmaturity syndrome (in which the baby is no longer getting enough nourishment because the placenta is aging and becoming calcified).

“When a baby is overdue, the provider may do some tests to check on the baby’s health. They include:
– Ultrasound exam
– Kick count, which is a count of how many times your baby moves or kicks you during a certain period of time
– Nonstress test, in which a fetal monitor measures your baby’s heart rate for a certain amount of time
– Biophysical profile, which uses a fetal monitor and an ultrasound to score a baby on each of five factors (nonstress test, body movements, breathing movements, muscle tone, and the amount of amniotic fluid)
– Contraction stress test, which compares your baby’s heart rate at rest with the heart rate during contractions induced by a shot of oxytocin or nipple stimulation

“If these tests suggest that your baby is in good condition, you can continue to wait for labor to begin naturally. If they raise concerns, your provider may wish to induce labor or perform a c-section. Providers rarely allow a pregnancy to go beyond 42 weeks.”

Chat on genetic counseling

Monday, March 4th, 2013

Susan Klugman, MDEver wonder if genetic counseling is for you? Join us for a #pregnancychat on genetic counseling and why it’s important. Dr. Susan Klugman, Director of Reproductive Genetics at Montefiore Medical Center, will be our guest to answer your questions, such as: What ethnic groups are more at risk for a genetic disorder? What does a family health history entail? Which prenatal tests are right for you? and more.

Dr. Klugman is a “medical detective” who works to identify the possible genetic risk factors for many inherited diseases. She encourages couples to consider genetic testing even before they get married so they can be as informed as possible when planning their families. She serves on the Board of Directors of the New York State Genetics Task Force. 

Dr. Klugman has appeared on many broadcast media outlets including ABC World News Tonight with Diane Sawyer. Take this unique opportunity to learn from her and ask questions. Join us on Twitter Wednesday, March 6th at 1 PM. Don’t forget to use #pregnancychat to make sure we see your questions.

New prenatal blood test

Thursday, December 13th, 2012

New prenatal tests can give some parents piece of mind that the baby they’re expecting doesn’t have a disorder.  The tests are given sooner and with greater accuracy and less risk of miscarriage than current tests.

The new tests, which use fetal DNA suspended in the mother’s blood, can test for chromosomal disorders such as Down syndrome (trisomy 21) and trisomy 18, and Rh blood incompatibility. They also can determine the baby’s gender, which allows health care providers to screen for disorders such as hemophilia.

During pregnancy, fetal cells and cell-free fetal genetic material circulate in the mother’s bloodstream.  This DNA can be used to screen for certain genetic disorders without having to perform invasive procedures such as amniocentesis or CVS (chorionic villus sampling).

At present four widely used procedures assist health care providers in prenatal diagnosis. They are:
Amniocentesis: a procedure that collects some of the amniotic fluid that surrounds the fetus for analysis. This is a diagnostic test.
Chorionic villus sampling (CVS): a procedure that obtains tissue from around the placenta. This is a diagnostic test.
• Maternal blood tests: screening tests that use mother’s blood to help identify problems with the fetal brain, spinal cord, intestines or chromosomes. These tests include alpha-fetoprotein (AFP), hCG and other hormones. As with all forms of screening, abnormal results require follow-up testing to make a diagnosis.
Ultrasound: a scan using sound waves to visualize the fetus.

Cell-free DNA methods of screening are a new option. “Prenatal diagnosis gives parents important information about the health of their baby and the status of their pregnancy. More often than not, prenatal screening reassures parents that their baby is healthy and that these disorders are not present,” says Joe Leigh Simpson, MD, March of Dimes senior vice president for Research and Global Programs.  “For a high-risk infant, prenatal diagnosis gives parents and health care providers options that may include planning for a health problem or arranging for delivery in a medically appropriate setting. The first step toward treating these problems is diagnosing them, and cell-free DNA methods, without the need for invasive measures, are welcomed.”

Dr. Lee P. Shulman of Northwestern University says, “while this represents a profound improvement in our ability to identify women at increased risk for carrying fetuses with the most common chromosome abnormalities, still, this technology represents a limited screening protocol and should not serve as a substitute for diagnostic tests such as chorionic villus sampling and amniocentesis, which provide the most accurate and comprehensive assessment by the direct analysis of fetal tissue.”

The American College of Obstetricians and Gynecologists and the American College of Medical Genetics recommend that information on prenatal genetic screening and diagnosis should be made available to all pregnant women and those considering pregnancy.

With all the above options for testing available, it’s important to discuss what is best for you and your pregnancy with your health care provider.

What is Doppler ultrasound?

Tuesday, October 16th, 2012

Doppler ultrasound is a noninvasive prenatal test that can be used to check a baby’s health in high-risk pregnancies. Providers usually use Doppler ultrasound during the last trimester, but it may be done earlier.

During Doppler ultrasound, your provider or ultrasound technician holds a plastic tool, called a transducer, against your skin to measure the blood flow in the umbilical cord and some of your baby’s blood vessels. (Regular ultrasound will show you a still image, but it cannot show the actual blood flow.) High-frequency sound waves are bounced off circulating red blood cells to project the image of the flow. This test shows if your baby is getting enough oxygen. Your provider also can listen to your baby’s heartbeat using Doppler ultrasound.

Some providers use Doppler ultrasound to check mothers with Rh disease.  This is a condition where a difference between the mother’s blood and baby’s blood can cause a dangerous kind of anemia in the baby. Anemia is when the body doesn’t have enough red blood cells or the red blood cells are too small. When the condition is found early and treated, most affected babies survive. Doppler ultrasound has reduced the need for amniocentesis to monitor fetuses at risk of Rh disease.

What is placenta previa?

Thursday, October 11th, 2012

During pregnancy, the placenta attaches to the wall of the uterus and supplies the baby with food and oxygen through the umbilical cord. Placenta previa is a condition in which the placenta lies very low in the uterus and covers all or part of the cervix. (The cervix is the opening to the uterus that sits at the top of the vagina.)

Placenta previa happens in about 1 in 200 pregnancies. If you have placenta previa early in pregnancy, it usually isn’t a problem. It will be monitored, however, because it can cause serious bleeding and other complications later in pregnancy.

Normally, the placenta grows into the upper part of the uterus wall, away from the cervix. It stays there until your baby is born. During the last stage of labor, the placenta separates from the wall, and your contractions help push it into the vagina (birth canal). This is also called the afterbirth.

During labor, your baby passes through the cervix into the birth canal. If you have placenta previa, when the cervix begins to efface (thin out) and dilate (open up) for labor, blood vessels connecting the placenta to the uterus may tear. This can cause severe bleeding during labor and birth, putting you and your baby in danger.

The most common symptom of placenta previa is painless bleeding from the vagina during the second half of pregnancy. Call your health care provider right away if you have vaginal bleeding anytime during your pregnancy. If the bleeding is severe, go to the hospital.

An ultrasound usually can find placenta previa and pinpoint the placenta’s location. In some cases, your provider may use a transvaginal ultrasound instead.

Even if you don’t have vaginal bleeding, a routine, second trimester ultrasound may show that you have placenta previa. Don’t be too worried if this happens. Placenta previa found in the second trimester fixes itself in most cases.

Treatment depends on how far along you are in your pregnancy, the seriousness of your bleeding and the health of you and your baby. To learn more, read our article on placenta previa.

Single umbilical artery

Friday, August 3rd, 2012

insideAbout 1 percent of singleton and about 5 percent of multiple pregnancies (twins, triplets or more) have an umbilical cord that contains only two blood vessels, instead of the normal three. The cause of this abnormality, called single umbilical artery, is unknown.

The umbilical cord is the life-line that attaches the mother and developing baby. Connecting through the placenta, a normal umbilical cord is made up of three blood vessels. One large vein carries oxygen and nutrient-rich blood to the baby and the two smaller arteries carry blood and waste products back to the placenta. The umbilical cord normally grows to about two feet in length, allowing the baby enough cord to safely move around without causing damage to the cord or the placenta.

In a single umbilical artery, one artery is missing. Studies suggest that babies with single umbilical artery have an increased risk for birth defects, including heart, central nervous system and urinary-tract defects and chromosomal abnormalities. A woman whose baby is diagnosed with single umbilical artery during a routine ultrasound may be offered certain prenatal tests to diagnose or rule out birth defects. These tests may include a detailed ultrasoundamniocentesis (to check for chromosomal abnormalities) and in some cases, echocardiography (a special type of ultrasound to evaluate the fetal heart). The provider also may recommend that the baby have an ultrasound after birth.

The diagnosis of a single umbilical artery does not necessarily mean that the baby will have a birth defect. It does mean, however, that some tests are warranted and that closer attention needs to be paid for the remainder of the pregnancy.

Concerns about fifth disease

Tuesday, March 27th, 2012

We get questions about fifth disease from time to time. It’s a common childhood illness that’s usually pretty mild, but if you get infected during pregnancy, it may hurt your baby. The good news is that about 6 in 10 adults (60 percent) had the infection as children and if you’ve already had fifth disease, you can’t get it again.  Nonetheless, about 1 in 400 women in the United States gets infected with fifth disease during pregnancy.

Fifth disease is caused by a virus called parvovirus B19. (It’s called fifth disease because many years ago, it appeared fifth in a list of common causes of childhood rash and fever.) It usually spreads through the air from an infected person’s cough or sneeze. People with young children and who work with children (such as child care providers and teachers) are most likely to come in contact with fifth disease and get infected. You can read about symptoms in children and adults at this link.

Most unborn babies are not harmed if their mother gets fifth disease. But some babies do become infected. The virus can make it hard for babies to make red blood cells, which can lead to a dangerous form of anemia, heart failure, miscarriage, or stillbirth.

You can protect yourself from getting infected by washing your hands well after being around children. Be sure to carefully throw away tissues used by children, and don’t share drinking glasses, cups, forks or other utensils with anyone who has fifth disease or who is in contact with someone who has fifth disease.

If you’re pregnant and become infected, your health care provider monitors your pregnancy carefully for problems with your baby. He may recommend that you have an ultrasound once a week or every other week for 8 to 12 weeks. If ultrasound doesn’t show any problems, you don’t need any more testing.  If an ultrasound shows that your baby is having problems, your provider may recommend amniocentesis to confirm the infection. If your baby has fifth disease, chances are the infection will go away on its own. Your provider may monitor your baby’s health during routine prenatal care visits.

While there is no treatment for fifth disease, there may be treatment options for problems caused in a developing baby. In rare cases of severe anemia, sometimes a provider can treat it by giving the baby a blood transfusion through the umbilical cord. If hydrops, a build up of fluid in the baby’s body, forms in the third trimester, the baby is sometimes induced and born early to receive treatment.

Again, the majority of pregnant women do not get fifth disease and, if they do, their babies are not harmed. But if you work in a day care center or are around school aged children a lot, it’s good to know about fifth disease and how to protect yourself.