Facts About Ultrasounds

Eils Hewitt: Ultrasounds are an absolutely routine procedure during any pregnancy. But with technology moving on so quickly, the ultrasound is now capable of spotting a whole host of different potential problems with the pregnancy Gill Scott is a Midwife and Sonographer and has joined the Baby Channel to guide you through the ultrasound process. Lovely to see you. Thanks for coming in. Gill Scott: My pleasure! Eils Hewitt: Now, one of the first things that pregnant mums have, what are their first concerned, is whether the ultrasound process will harm the baby. Has that been only evidence to show that it's harmful? Gill Scott: No, ultrasounds in particular diagnostic ultrasounds has been around in the medical field for about 40 years and there hasn't been any evidence decide that there are any problems or any side effects cause to harm babies. There have been 1000s of studies and they are all ongoing, to say that there has been no side effects. Eils Hewitt: So how does it actually work? Gill Scott: How does ultrasound work? Eils Hewitt: Actually perhaps if you explain what ultrasound is, for people who haven't kind of gone through it, that will be helpful. Gill Scott: Okay. Ultrasound is one of the tools that we use in antenatal pregnancy, to find any problems with the baby. So we can go right from the start of pregnancy, looking at viability, making sure that the pregnancy is in the right place, and that there is an indeed one or more babies inside. We can go on through to looking at any anomalies that are detected and also to make sure that the baby is growing well and everything is progressing as it should be. Eils Hewitt: So it's not a scan, isn't it? I remember when I had seven-months-old little baby boy, I remember when I went along, I think it was about 12 weeks. Would that be right about 12 weeks? Gill Scott: Yeah. Different NHS hospitals will call people at different times. The majority of people will look, will receive a code around about 12 weeks to come in for dating scan. Eils Hewitt: Basically you have that kind of cold jelly, isn't it? They put it on your tummy and they rub this kind of cold gel around. Gill Scott: That's right. Eils Hewitt: Then you have got that, what is that -- Gill Scott: Probe. Eils Hewitt: The probe, well said, and they just kind of move this instrument around, across your tummy, don't they? Then the picture comes up on the TV screen. So there is just really mums watching, it doesn't hurt, because you don't feel anything, and it's kind of funny. But it's fascinating, when I went -- me and my husband went to have had our first scan, we looked at the monitor and we could just see, it was a very kind of grainy black and white shot. Gill Scott: That's right. Eils Hewitt: But our little baby boy was moving about and so a bit movement, then suddenly everything became real. We were got -- both quite tearful. Gill Scott: And people do get very emotional, and they don't realize how well formed babies are at 12 weeks. I think a lot of people just say that they think it's just like a little bean-shape, but in fact they are complete, they just need to grow 12 weeks, so yeah, they are very excited. Eils Hewitt: And now there is 2D scans and there is 4D ones, isn't it? So I have the basic, the 2D that you only get in NHS, tell us more about the four dimensional pictures you can get? Gill Scott: Okay, now basically just to say, there are -- we do 2D. We have to saw also 4D scanning in 2D, just to make sure that where the baby is lying and so there would be the 2D scan as well. But what happens is the 2D is like, looking at slice of breads in black and white, and then when we're going to the 4D, it's like looking at the whole loaf of breads. So it's slightly different and people are quite shock to have detailed. We can see these little people on the screen. Eils Hewitt: So the documentaries or babies in the room, they often use kind of four days, as you can see, babies from all different angles basically. Gill Scott: That's right. They do, and people are quite shocked how much the baby is moving and what facial expressions they do, they are just not aware that these babies do everything the same inside as they do outside but you are not just aware of it. Eils Hewitt: And the four dimensional ones, are they in color? They are always in color? Gill Scott: They are in sepia color. They are in sepia color. We do them -- the machines do them -- can do them in all different colors but sepia is a little bit contour to the eye. Eils Hewitt: And I know with the two-dimensional ones you get a little prints off, you get a little photo, don't you? You are going to slice your child, it's like profile. Do you do that with the 4D ones, how does that work? Gill Scott: We can do that with the 4D as well. Really, there is no such thing as 4D, it is 3D, but the fourth dimension is the movement of the baby on the screen. Eils Hewitt: That's right. Gill Scott: That's the difference. So yes we can print off 3D black and white images which are really, really nice. We can also print off colored images of the baby which of the same as you see on the screen. Eils Hewitt: Now, what kind of problems as we were just talking earlier, what kind of problems can be picked up by your scan? Gill Scott: The 4D Ultrasound when it first came out, which was about 4 years or so ago, was really initially to detect things like cleft lips. Any defects like spina bifida, that type of thing and we can see that. So that was very, very clear on the screen and it's literally like me and you looking at each other and you can see all the soft tissue around the face. So it's very -- we can detect those little firm problems in 2D, which is detectable on via, normally scan which women will have, probably their second scan ranges back 22 weeks to 24 weeks. But in the 4D, it's very, very clear and we can see just a more extend these problems are. Eils Hewitt: So if there is any need for intervention I suppose you can find out what -- the soon you find out, the quicker you can respond. Gill Scott: That's right. And a lot of these are really, when we are talking about harelip and etcetera, it's really to prepare woman and so that helps show woman what is babies look like because when you say to someone, your child have got harelip, and they are like, oh, it's the worst thing in the world and that's an issue -- reaction and that's very common. But often when you show woman these pictures they realize that this is a beautiful baby and it has just got a small defect in the lip which can be rectified after birth and they are very, very good nowadays to do that. Eils Hewitt: So you find that it puts mums and dads kind of more at ease, once they have seen their baby, they feel like, it's a special bonding experiencing as well. Gill Scott: Yeah. You can get these 4D scans not on the NHS but you can go to the private clinics and yeah, they are all called bonding scans, they are non medical but obviously if we see anything that is not right, then we would counsel women there and then and talk to them and refer them to obstetricians. So they are very, they are really good. Eils Hewitt: What's involved in a nuchal scan? Gill Scott: A nuchal scan is we do that between 11 weeks to full 13 and plus 6 days and it's very specific, because the baby has to measure between certain amount of millimeters. Now, we know from research that babies that have a larger nuchal translucency area which is some fluid at the back of the neck which all babies have, the more increased that is, the high incidence in relation to down syndrome, we know that. So what we can do is we can actually take the mother's age because all women are at risk of having a baby with down syndrome that's from 15-years-old to 50. So we take the age, we take how many millimeters the baby's length is from head to bump, the crown-rump length and we take this measurement, a fluid at the back of the neck, and what we can do, we can put it to our computer package and that gives us an incidence of down syndrome. So it's not diagnostic - Eils Hewitt: Right, okay, so it's not definite yes or no, but it's a likelihood. Gill Scott: Yeah, that's right. But it tells us that you can have a one in so many chances. Now, whether the worst scenario that's one in two, or one in 7,000. Along with that what we can do, that actually I just -- that nuchal test has a 90% sensitivity. So it's quite a good indication. But along with that what we can do is we can take some bloods from the mum, because we know that these little babies have down syndrome, admits high incidence of hormones into the mother system, blood system. So what we can do, we can take some blood, we can spin it onto a special machine and we can get the information from that and put that with the package as well, and that makes it even more sensitive. So that would change the outcome and give us a more sensitive reading. With that, depending on whether that goes up or down or then we would counsel the women and along with them decide what they want to do with that information. Eils Hewitt: What if you find something seriously wrong with the baby, say for example, I know when -- I remember from my scan they checked and they were oh yes, the brain is inside the skull and we were like of course the brain is inside the skull, why wouldn't it? What if there is something major, replace or missing, an organ is missing for example? Gill Scott: Well, it does depends obviously how severe this is and what it is. So what we would do -- now different hospitals have different backup systems where I came from, we were very closely link to King's college. So if any problems at all occurred, we would contact them by phone while the lady was in the room and we would discuss what the problem was with the midwife there and then we would get them to go out to an appointment at the Kings and then they would see one of the research fellows or one of the specialist ultrasound doctors there and then they take over that sort of care from there. So if anybody comes and I am sure that's nation wide, if anybody was to come in and they had a problem then they would even be referred to a pass doctor or to a specialist. Eils Hewitt: That's something a little long. Now I know it's possible on the scan to know the sex of their baby at certain weeks and I know not all NHS hospitals apply the service, but what, I mean how many weeks we would be able to really determine the sex of the baby? Gill Scott: Well, there is a little controversy about this. Personally, it's anytime after 20 weeks, that is generally in the guidelines of most hospitals. Some hospitals will say that they can see the sex of the baby at 15 weeks. It does depend on lots of factors. It depends on if the baby's legs are splayed, because if they are like these then you have got no hope at any age. But yeah, I would say 20 weeks is a good time to sex their baby Eils Hewitt: Well, thank you very much for answering all those questions for us and giving us all those advice. It's lovely to meet you. Thank you! Gill Scott: Me too. Thank you!