Midterm ultrasound-how does it look like?

When to perform a midline ultrasound?

A midterm ultrasound is otherwise known as an ultrasound II. trimester. According to PTGiP recommendations, this test should be performed between 18. a 22. week of pregnancy. This is the second mandatory ultrasound at  during pregnancy. The first of these-an ultrasound of the first trimester, so called. genetic, is performed between 11. a 14. week. Other examinations include a third trimester ultrasound (between 28 and 32 weeks) and an ultrasound at the time of delivery.

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Mandatory ultrasound in pregnancy

Midterm ultrasound-how to prepare?

A pregnant woman does not need to prepare in any special way for a midterm ultrasound. The most important thing is to sign up for the test between 18. a 22. week of pregnancy. The child is then at such a stage of growth and development that all the necessary measurements can be taken. Unlike the early pregnancy examination performed with a transvaginal transducer, the midterm ultrasound is performed through the abdominal shell. There is also no need for the urinary bladder to be empty. Just in case the baby is placed in a position that makes it difficult for the doctor to assess the various anatomical elements, it is a good idea to stock up on something sweet.

Midline ultrasound – parameters studied

The main purpose of the midterm ultrasound is to accurately assess the baby’s organs. The gynecologist evaluates the skull, its size, shape, continuity and echogenicity. In addition, it should visualize elements of the child’s central nervous system such as, among others. lateral ventricles or cerebellum. During the midline ultrasound, the gynecologist also looks closely at the baby’s face, inspecting the upper lip, eyeballs or nasal bone. Next, the doctor must visualize the organs of the chest and abdominal cavity, such as the stomach, intestines, kidneys and urinary bladder. The gynecologist also carefully evaluates all the structures of the heart to look for possible defects. In addition, it is extremely important to check the attachment of the umbilical cord and determine the number of its vessels.  The midline ultrasound also evaluates the baby’s spine and limbs.

In addition, the estimated weight of the baby is also determined in the postpartum ultrasound, and the placenta and its position are assessed. In virtually all cases during ultrasound II. trimester it is also possible to identify the sex of the baby.

Midline ultrasound-detected defects

The abnormal image, referred to as the “banana and lemon image,” may be associated with spina bifida. Any deviation from the norm should be properly described by the doctor. For example, the strawberry-shaped skull suggests Edwards Syndrome. During a midline ultrasound, the gynecologist is able to diagnose a cleft lip or palate. Some of the most commonly detected defects in II. trimester of pregnancy are heart defects. The doctor can also detect hernias, esophageal overgrowth, and kidney defects during a midline ultrasound. The image of the so-called. “Double bubble,” or duodenal atresia, can occur in children with Down Syndrome. It is important to realize that ultrasound is a subjective assessment by the examining physician and the presence of anatomical defects cannot be confirmed or excluded with 100% certainty. It is advisable to choose a specialist for a midline ultrasound, whose ultrasound skills are confirmed by relevant certifications and courses taken.   

Midterm ultrasound- length of the cervix

During the ultrasound examination in II. trimester, it is also possible to assess the risk of preterm labor by measuring the length of the cervical canal. If it is less than 25 mm at the midterm ultrasound, there is an increased risk of preterm labor. The gynecologist in such a situation may suggest to the pregnant woman appropriate prophylaxis, for example, in the form of a pessary or taking progesterone preparations.

Price of a midline ultrasound

Most often, the price of a midline ultrasound performed in a private practice, depending on the city and the title held by the specialist, ranges between PLN 200 and PLN 400. In the case of twin pregnancies, the cost of a midline ultrasound can be higher, reaching up to PLN 600.           

3D midline ultrasound

II. The trimester of pregnancy is the best time for 3D imaging of the baby. With three-dimensional ultrasound imaging, parents can see what their offspring looks like inside the uterine cavity. This is much closer to reality than the classic grayscale ultrasound. Doctors also use 3D imaging to identify defects such as cleft lip, palate or polydactyly (the presence of extra fingers). Besides, the technique is used when analyzing kidney or bladder defects. In most cases, however, the 3D technique serves as an adjunct to the mid-term ultrasound and is usually performed at the request of Parents who want a souvenir in the form of realistic photos or video.