Prenatal examination of the first trimester
Prenatal examination is the basic diagnostic tool in the course of pregnancy.
According to the Standards of the Polish Gynecological Society for the management of normal pregnancies, this examination should be offered to all pregnant women at least 3 times during pregnancy. Depending on the week of pregnancy in which the test is performed, its purpose is also different.
At the FLOSMED clinic, prenatal examinations are performed by our gynecologists using the equipment recommended by the Polish Gynecological Society: the GE VOLUSON E8 apparatus. In our Clinic, we only perform the first trimester examination.
The primary goal of ultrasound examinations in pregnancy is to minimize the occurrence of adverse obstetric outcomes that may occur as a result of unrecognized fetal anomaly, fetal immaturity or other intrauterine abnormalities. The task of the doctor performing the screening test is to refer the pregnant woman to the referral center in each case of diagnostic doubts or suspicion of abnormal fetal development.
At each stage of pregnancy, ultrasound examination has a different specificity. The purpose of the examination in the first trimester of pregnancy is different than in the second and third trimesters. Irrespective of the period of pregnancy in which the examination is performed, the pregnant woman undergoing the examination should receive accessible information about the obtained result from the doctor.
Screening ultrasound should be offered to all pregnant women.
At present, there are no studies suggesting that ultrasound examination adversely affects fetal development. When performing this examination, the principle of minimal exposure and examination time should be followed to complete the procedure - the ALARA principle (As Low As Reasonably Achievable. In particular, the values of the thermal (TI) and mechanical (MI) indexes should be below 1, throughout the entire examination ( TI<1, MI<1) The safety principles of ultrasound examinations have been described in detail in separate publications [1].
An ultrasound device in obstetrics and gynecology diagnostics should have: 2D presentation in real time, at least 128-degree gray scale, it should be able to measure distance (at least two measurements), circumference and surface area, and an obstetric program. In addition, it should be equipped with transabdominal and transvaginal transducers with the possibility of photographic and electronic documentation. The color Doppler option is a valuable supplement to the functions of the ultrasound machine.
The result of the ultrasound examination should contain the following data:
- patient's name, surname, date of birth and PESEL number,
- place and date of the examination, name and surname of the person performing the examination,
- information on the name of the ultrasound machine and the type and frequency of transducers used to perform the examination,
- preliminary diagnosis of the referring physician,
- date of last menstruation (OM) and week of pregnancy according to OM,
- advancement of pregnancy according to possible previous ultrasound examinations,
- It should be clearly emphasized that all deviations from the normal structure of the fetus, genitals of the pregnant woman and any other disturbing symptoms diagnosed during the examination should be included in the description of the examination. It is unacceptable to provide this type of information verbally, without placing an appropriate note in the result.
- If it is impossible to perform a complete examination (e.g. due to pregnant obesity, unfavorable fetal position or other technical difficulties) - this fact should be noted as a result of the examination, provide instructions for further procedure, subsequent examination.
- When informing the pregnant woman/parents about the results of the ultrasound examination, attention should be paid to the limitations of this method, which do not allow 100% determination of normal fetal development.
* the above information comes from the recommendation of the Polish Gynecological Society - the full text of the recommendation can be read at https://usgptg.pl/media/dopobrania/rekomendacje2015/Rekomendacje_poloznictwo_2015_GP.pd
In our Clinic, she performs prenatal examinations of the first trimester Magdalena Barlik, MD, PhD.
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