Posted on December 11th, 2015 by wombwithaviewblog.com

The fetal facial profile on ultrasound is one of the shots expectant parents look forward to most. Unfortunately, they are not always possible to obtain! I totally get it. When we meet someone, we meet their face first — it’s entirely understandable the parents-to-be just want to see their Baby’s face.

Oftentimes patients express disappointment with a profile image because “baby wasn’t looking at the camera.” Some think they want the front view of the face, but it looks scary to most parents!

facial profile, fetal face

Just what I thought you’d say…a face only a mother could love! Truly, some moms don’t care and want positively anything we can get! I always tell them that seeing the face from the front mostly yields a skeletal appearance…eye sockets and triangular nasal bones – very “jack-o-lanternesque.”

Unless the shot is a 3D image, the profile or side view of Baby’s face is the one to shoot for in 2D. In this plane we can see the soft features of the face like the nose and lips that look more like a baby.

Since amniotic fluid is ultrasound’s best friend (and mine), we need a nice pocket of fluid in front of your baby’s face to see it well. If baby is facing your back or if it’s smushed into the placenta, unfortunately, face images may not be possible. It will be a “no paparazzi” day for Baby. This means you’ll likely get some precious images of hands and feet to take home. Let me just say I love some baby toes! But patients feel a bit let-down when the little diva doesn’t cooperate.

Great Images of a Fetal Facial Profile on Ultrasound

If you ever felt confused by a profile on ultrasound, the images below provide an explanation of two great ones! Both of these babies were just over 20 Weeks.

fetal profile, facial profile, 20 weeks pregnant

Fetal Facial Profile at 20 Weeks

In the image above, a little more fluid (the black stuff) in front of the face would have been helpful. As you can see, the tip of the nose and forehead just barely touch the uterine wall and placenta in front of it. However, it’s still a great shot!

 

fetal profile, facial profile, 20 Weeks pregnant

Fetal Facial Profile

How about this one?! PERFECT! This is an absolutely beautiful textbook image of a fetal profile. Can you appreciate how there is more fluid in front of this baby’s face?

Finally, if only ALL the babies I scanned looked like this…SIGH. Such is life. I suppose if every fetus cooperated like the one above, I’d never get any real work done! Mama would sure be happy, though, with a string of pics a mile long. 😉 Who doesn’t love a photogenic fetus?

***

Here’s hoping you’ll have great pics of your baby come anatomy screen time. And if you need more info on what visitors to take with you along with suggestions for that all-important test, just click here.

Email me with your comments and questions at wombviewerblog@gmail.com!

 

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Posted on November 19th, 2015 by wombwithaviewblog.com

Baby Gender Ultrasound – Guessing Fetal Sex

“How sure are you?” I’ve heard this question probably more than any other in my career during the baby gender ultrasound! Sometimes, guessing fetal sex is a big risk and a real guess. Patients want percentages; I just want to be right!

Every sonographer is different. One’s sure is another’s iffy. I’ve seen images where a person was told one sex and the sonographer had “no doubts” only for me to scan later, confirming the opposite gender. The fact is that as long as expectant parents remain interested in guessing fetal sex by ultrasound, there will always be challenges surrounding the task.

How Sure Are We When Guessing Fetal Sex?

Are we sure or is it a guess? Honestly, they are all guesses. No sonographer should tell you her guess is 100% accurate. Even genetic tests like 1st Trimester DNA and amniocentesis can brag of 99+% accuracy! We, as humans, sure can’t surpass those odds!

Who we have making all those guesses are new sonographers right out of training, observers with little training, and those who are not formally trained in ultrasound at all (some of the keepsake video places). And because reading the scan is so subjective, there will be always be incorrect guesses during the baby gender ultrasound. Even all us experienced sonographers practice a little differently. There will always be those who feel more confident to guess earlier than me. Others are more cautious, examining from every angle but still hesitant to commit if Baby’s legs are partially closed.

I’m more of the latter persuasion. I want to be VERY sure, super-duper sure before delivering a guess to my patients! I need great views in more than one angle and textbook imaging. After all, moms and grandmas want to shop! I would crawl under a rock to know I guessed incorrectly. Mostly, I would feel simply horrible for my patient, knowing it was because of me that she invested (both emotionally and financially!) in one sex vs the other! 😵😣

What’s the Answer?

Those who are new graduates or with limited experience could consult a more-experienced sonographer for a second opinion. And if a patient decides to visit an elective ultrasound business, make sure your sonographer has had formal training!

Patients should not pressure their sonographers for a percentage but also be understanding if she says she cannot determine their baby’s gender. I know! It sure stinks when this happens, but guessing fetal sex is something we can do if we have time and if Baby cooperates! Last but not least, Moms, don’t trust a fetal sex guess from anyone in a non-medical ultrasound facility that does not carry sonographer credentials! RDMS for those who are certified and DMS for those with formal training but who have not yet passed a registry examination. Experience in OB is preferable!

*And a final word of caution! Save your money during Weeks 14-16! Waiting until 17-18 Weeks is always better!*

Here’s hoping you get pics like this for your next scan!

For more stories about baby gender ultrasounds subscribe!

 

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Posted on October 5th, 2015 by wombwithaviewblog.com

Fetal Gender Determination – What Makes It Impossible!

Fetal gender determination is not always a walk in the park for us sonographers. Ultrasound, like many technologies, have their limitations. There exist many factors which can make fetal gender determination mission impossible! Your OB docs understand there are a number of variables that prevent good visualization in every ultrasound we perform. Unfortunately, many patients do not.

So, if you’ve been losing sleep in anticipation of this long-awaited news, read this first! My goal is to inform expectant moms so that you go into your ultrasound exams with realistic expectations. I sincerely hope that through understanding these limitations, you’re able to leave your experience feeling happy. If all you can see is Baby’s heartbeat, it’s an opportunity to bond with your new addition that doesn’t come everyday.

Is Fetal Gender Determination a Requirement?

Definitely not. Fetal gender determination is not a routine part of a diagnostic examination. It may be information you desire, but it’s not typically information your physician needs. The anatomy screen at about 18 – 20 Weeks or so is ordered to rule out structural fetal malformations. Most U.S. practices do not mind providing a fetal gender determination as a courtesy IF the sonographer feels she can see well. And we LOVE to give you this information, if we can!

What Factors Impair Fetal Gender Determination?

Some of these factors that can get in our way of how well we see are listed below. They are very common! Actually, some of them confront us on a daily basis.

  • A breech fetus
  • A fetus with the rear against the uterine wall
  • A foot or feet in the genital region or crossed feet
  • Closed legs
  • The umbilical cord between the legs or against the fetal body
  • Body habitus or too much weight around a patient’s middle
  • Uterine fibroids or contraction
  • A decrease in amniotic fluid
  • Genital malformations
  • Early gestational sac age

Even one of the above factors can prevent even the most experienced sonographer from determining fetal sex. A good sonographer knows when the views are good enough to provide you with a guess. A good sonographer also knows when not to guess! What you don’t want is someone who is inexperienced but willing to guess anyway. Many times, it’s not just one but several of the above variables that limit what we see. Unfortunately, we can’t change any of them.

Another little fact I’ll add here is that a non-arguable truth of the modality is Ultrasound’s laws of physics. The farther sound has to travel, the weaker the returned signal. The more tissue the sound waves have to penetrate, the worse the image. In other words, the more tissue there is around a patient’s middle, the more fuzzy the picture. The more fuzzy our picture is, the less we can see Baby’s parts. Any not just fetal gender, any parts. All it takes is one of the above factors to ruin the party. More often than not, a combo of factors will cause a little unwanted rain on your parade.

What Can We Do to Help?

We can try a couple of variables in an attempt to see better. Jiggling your belly or turning you to each side sometimes helps. We do this in the hopes that your change in position will also change Baby’s. Alas, it doesn’t always work.

What We Can’t Do

Unfortunately, we can’t scan you indefinitely! In an effort for fairness, we always try to get our next patients in as close to their appointment times as possible. Sticking to this schedule can be tough when patients arrive late or when we find abnormalities. Most patients are allotted a 30-minute appointment for their ultrasound exam. However, not all of this time is scanning time.

Before we scan you, we need to examine your chart for your history, an order from your doc, and an indication for the exam. After the exam, we need time to type up your report and send it to the physician. Most of us are nice enough to take more time with a patient if our schedule allows. I always did. Unfortunately, some of my patients (not understanding ultrasound) didn’t think I did!

What You Shouldn’t Do!

An unreasonable action disgruntled patients take these days includes airing their rants on social media. Consider, first, that venting your frustrations reflects poorly on your physician and practice. And you could be fired. Yes, a patient can be fired! In other words, I would advise against this method of revenge. If you are unhappy, you have the right to discuss it with Administration. But just know a practice does not have to tolerate any behavior deemed irrational or unreasonable. Just like one can fire an attorney, a plumber, or doctor, a patient can find herself in the same situation.

A Modern-Day Problem

Unfortunately, our society has become one of immediate gratification, even demanding it in the face unreasonable circumstances. I’m reminded of a few former patients and a like-minded character from one of my favorite childhood movies. Anyone remember Veruca Salt of Willy Wonka fame? These patients actually got angry, yelled, cried, and ranted in a place of medical business, much like the toddlers they would have themselves in another couple of years – all because I couldn’t tell them the sex of her baby. This. Is. Unreasonable.

I realize some sonographers don’t try very hard. In most circumstances, however, most of us make a sincere attempt to obtain this information for our patients who want it. We cannot, however, change the laws of physics.

Moreover, some patients mistakenly assume that because we couldn’t make a fetal gender determination, we must not be able to skillfully perform their diagnostic examination otherwise. Please keep in mind that medical professionals never judge such as gross incompetence. Rather, ranting such on social media is reflective of the patient’s ignorance, a lack of understanding of how the technology works. So, please! Don’t do this:)

We hate when our patients leave foaming at the mouth. Remember, this scan is about Baby’s health first! Just ask any mom who didn’t have a healthy baby.

Please feel free to leave comments below or email me at wombviewerblog@gmail.com with your questions and subscribe for more great ultrasound information!

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Posted on July 11th, 2014 by wombwithaviewblog.com

Is Unknown Gender Still a Secret…

If your mother-in-law thinks she can read your images?

We all know that our family and friends can be quite nosy, opinionated, and even rude when it comes to all things pregnancy-related. After all, they’ve been there and done that, and they know better than you. This is your first rodeo, and you know absolutely nothing. Sound familiar?

In the course of conversation during a scan, especially with my weekly patients, we glide from the political correctness and appropriate medical office pleasantries to cutting up about life happenings. My patients take this opportunity sometimes to vent about just such personal offenses. One of my readers recently did the same! Read on about her dilemma…

irritated mama:  Hello! Firstly, I would like to say what a great blog you have, and I’ve really enjoyed reading it. Secondly, I’m wondering if you can take a look at my scan pic from my 20 Week scan. I’m now 25 Weeks. We didn’t find out the gender as my husband didn’t want to, but his family is convinced it’s a boy from the scan pic. They are even calling it a “he” which is quite annoying. I’m just wondering if there is anything on this scan pic that confirms the gender? Obviously, we didn’t get a potty shot. I hope you can help. Thanks!

unknown gender, 20 Weeks pregnant

 

wwavb:  This email cracks me up! You are not the first to be annoyed by in-laws who think they are ultrasound aficionados! Everyone is suddenly an expert. You’ll be happy to know gender is nowhere to be found on this image! It’s a great side shot of Baby, but when you get down to baby’s bottom, part of the hip/leg is pictured. So, it’s not a side shot between the legs. Now you can tell your in-laws to mind their own biz!

Best Wishes!
wwavblogger, RDMS

irritated mama:  Brilliant, thank you. That settles it, and I will tell them just that. Haha!

***

So just know, all you pregnant moms out there with in-laws who are driving you to drink…first, I can’t condone escaping your in-laws with wine in your delicate condition. Second, you have to stick up for yourself! There are nice ways to say anything. So, next time your mother-in-law (who doesn’t know what a femur is) attempts to read into your ultrasound image, kindly thank her for her oh-so-professional interpretation, and ask her if she’d like to deliver her grandchild while she’s at it.🤣

Yes, I am a smartass at times, but I blame my brother — the ultimate King of Smartassness, one-liners, and wisecracks. It’s a crown he wears proudly.

You can email me at wombviewerblog@gmail.com with any ultrasound questions you have!

Interested in subscribing? You can do that here🙂

Thanks for reading!

 

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Posted on May 10th, 2014 by wombwithaviewblog.com

Another Male Fetal Gender Pic

It’s a Boy! Male fetal gender on ultrasound is pretty obvious here, wouldn’t you say? Little boys are an easy guess when they pose like this! Not much question here. I love it when your babies cooperate!

male fetal gender, 20 Weeks pregnant

 

This baby was about 20 Weeks. He was positioned perfectly to obtain a great underside view with part of his thighs in the pic. We’re not really seeing Baby’s butt here. Can you guess what the small black oval is just behind the scrotal sac? If you guessed his bladder, you’d be perfectly correct:)

How about more great images of fetal sex? Check out the links below for male and female images:

http://wombwithaviewblog.com/female-gender-on-ultrasound-2/

http://wombwithaviewblog.com/boy-girl/

http://wombwithaviewblog.com/boy-vs-girl/

http://wombwithaviewblog.com/twin-gender-update/

http://wombwithaviewblog.com/third-trimester-male-gender/

You can email wombviewerblog@gmail.com any time!

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Posted on April 11th, 2014 by wombwithaviewblog.com

Wanna See Perfect Male and Female
Ultrasound Images?

 

Look no further!

Here I’ll clarify what constitutes GOOD male and female ultrasound images. If you guys read my blog on a regular basis, you already know how many emails I receive from parents wanting a second opinion on gender images only to get a “huh?” out of me.

Most of the time, their sonographer gave the nod for male or female only to follow that up with an ultrasound image which looks like a snowstorm with a ? in the middle. I’m afraid it’s just not quite the validation I can support!

I’ve posted other great male and female ultrasound images and gender shots throughout the site, but let me add a couple more.

A Beyond-Perfect Male Gender Pic

male and female ultrasound images, male gender, 20 Weeks pregnant

Hello! Any guesses? I’ll give you only one, but I think you won’t need more than that. 🙂 THIS is the boy shot patient’s want to see. This is the holy-cow-look-at-that-wee-wee or he-is-so-proud shot we always try to obtain.

I’ve labeled the parts, but I you probably don’t need that assistance, either. Is there REALLY any question in anyone’s mind here? I didn’t think so. This baby boy is about 2o Weeks in the photo you see here.

 

Perfect Female Gender Pics

Second Trimester

22 Weeks female gender, male and female gender ultrasound images

Anybody not see three lines here? There’s a little dotted circle around the labia and clitoris in the middle depicting the three lines you hear most about. So. Girly. Enough said.

This little Sweet Pea is 22 Weeks here. She really didn’t want to move her legs for us initially, but I could still see well enough to reconfirm Team Pink for this couple!

Third Trimester

And this one I’ve posted before! The female labia are much more plump closer to that due date! This baby girl was about 38 Weeks here and probably THE most clear female gender image I’ve ever obtained.

38 Weeks female gender, male and female gender ultrasound images

 

See the difference?! I never like to guess gender, and these images leave no room for guessing. I love it!

Even the most ultrasound-challenged won’t argue with these textbook images of fetal genitalia.  In my room, it has to be unequivocally wee wee or three lines/labia or you get the dreaded “I’m sorry but I just can’t tell today!”

Do you have great images of male and female gender you’d like to share?
Perfect!

Email them to me at wombviewerblog@gmail.com!

 

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Posted on November 9th, 2013 by wombwithaviewblog.com

Holy cow. Another anatomy screen, another request to call someone, text someone, or seal in a special envelope the special results for your Gender Reveal party. The pressure is on! But David Copperfield, we sonographers are not. And since we can’t reach in there and rotate the little sweat pea, sometimes we just can’t deliver (no pun intended) on the gender surprise.

I hate when this happens! Mostly because they usually leave the room hating me. But what can we do?

I’m sure most of you are familiar with this event? Gender Reveal parties have become a big way to celebrate how parents, family, and friends find out the sex of their baby. I have to admit it’s a cute idea and must be totally fun, especially with all the creative ways expectant parents have discovered to broadcast the news. But a word of caution! Some patients schedule their party for the same night as their sonogram. And even though most people know gender cannot always be determined at the 18 – 20 Week scan, some still hope for the best and plan the party anyway.

Being able to determine the gender should never be a guess. We’ve all heard the stories from our patients…”My cousin, Martha, was told five times it was a boy until a girl popped out. It must have been the thumb or the cord in the way.”

I always tell patients either I’m sure or I just don’t know. Just tossing out a guess isn’t fair to the patient! And a 70% or 80% guess means your sonographer is just not very confident about that guess. Guessing leads to a return of the dearly beloved tutu for a football jersey. I simply do not want to be responsible for all the consequences that follow – especially the emotional ones for mom and dad or partner.

I will say, however, I have enjoyed taking a picture of cleverly annotated gender and wrapping it up in a peek-proof envelope for my patients. It’s a bit time-consuming in this age of electronic medical records, but we do understand the excitement that goes along with such a visit. I am so happy when I CAN share that with you!

I hope all sonographers do their best to give their patients gender information accurately, but in the event we can’t make this determination – don’t shoot the messenger. After all, even though you may say you want us to guess, you’d rather us be correct;)

I know it’s a bummer! But wait to schedule your party. And if Baby’s sex cannot be determined and you decide to visit an elective 3D non-medical business, please do your research! Be sure to ask if their sonographers are formally educated and not some random Joe Blow off the street. (Yes, it happens!) Look for RDMS or DMS credentials after his or her name.

Apparently, nobody likes yellow cake anymore. 🙁

 

 

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