Ultrasound is is safe; it has been used for pregnancy checkups since almost forty years, and no direct harm to fetus or mother has ever been demonstrated. With the low ultrasonic energy level in contemporary devices, no negative effects are to be expected.
Ultrasound can give answers to important questions regarding the course and outcome of pregnancy:
In the first trimester (10-13 weeks), we can demonstrate the vitality of the pregnancy and calculate gestational age. This is of paramount importance, e.g. to ascertain slow fetal growth in a later stage. Multiple pregnancies can be diagnosed, as well as certain severe malformations. The measurement of nuchal translucency gives an important clue to detect genetic problems like Down's syndrome.
In the second trimester (20-23 weeks), we check fetal growth and quantity of amniotic fluid, both crucial indicators of normal development. Important malformations of head, brain, spine, heart, kidneys, stomach and extremities can be excluded. The location of the placenta is documented, as a low-lying or even overlying placenta can produce dangerous bleedings in later pregnancy.
In the third trimester (30-34 weeks), fetal growth is of highest interest. A baby of normal size with normal quantity of amniotic fluid proves good functioning of the placenta. The baby should now have turned in cephalic (head-down) presentation to allow a normal delivery. Some malformations with practical consequences for immediate postnatal care can only be detected at this late stage.
Significance of ultrasound
In case of normal ultrasound examination, your baby will most probably be fine. However, it is not possible to guarantee a completely healthy baby. Ultrasound has very good sensitivity (90%) to detect severe problems which could be incompatible with life; it has fairly good sensitivity (75%) to detect problems necessitating intensive postnatal care, but is only moderately sensitive (30%) in the detection of less important malformations like supernumerary fingers or minor heart defects.
A normal ultrasound scan influences the ensuing prenatal care and can be very comforting for the parents to-be. When a problem is detected, ultrasound is laying the foundation of informed decisions. Parents can prepare themselves for the birth of a sick child, the delivery can be planned in a center equipped for the expected problem, and even fetal treatment during pregnancy is occasionally available.
The routine scans at 10-13 and 20-23 weeks, as well as additional scans in case of risks or suspected problems, are being reimbursed by Swiss basic health insurance.
Ultrasound is a prenatal test under the Swiss law governing genetic testing in humans (GUMG). Depending on the result, additional tests like sampling of amniotic fluid can be necessary. An unexpected result, i.e. the detection of a major fetal problem, can place you in an ethical dilemma („should I continue my pregnancy or terminate it?”). As in all prenatal testing, there is a right not to know, so we kindly ask you to tell us if you do not wish ultrasound examinations for personal reasons. We will gladly give you more informations personally, and can organise independent counseling by experts.
Modern technology can visualise the baby in three dimensions (3D) or in serial 3D motion pictures (4D). Conventional ultrasound provides only a cross-section image (2D), e.g. of the fetal profile.
3D/4D ultrasound has normally no medical function and is meant to give pleasure to the parents to-be. Our group practice offers the following, non-reimbursable package for 250 Swiss francs:
- USB stick with Gyné logo (please bring it to every visit);
- 3D/4D images during the entire pregnancy, stored on the USB stick, provided the baby is lying in a favorable position and there is enough amniotic fluid to detect the body contours;
- Electronical copy of the medical file in PDF format, updated at every visit, which is practical for travelling.