Posted on July 6th, 2017 by wombwithaviewblog.com

Gender Determination in an Ultrasound Report?

I’ve received questions lately regarding where to find fetal sex or gender determination in an ultrasound report. Can you always find this information in a report?
The short answer? No, not always.
Actually, we mostly do not record fetal sex, and it’s mostly not important to your doc. Typically, fetal sex is not pertinent information to the examination. Though parents may desire it, physicians don’t need the gender determination to manage your care and that of your baby if both are healthy. The above is true for most general OB practitioners in the US. However, every physician practices a little differently, and one can certainly dictate if he or she wants this info on all patient reports (if possible to determine). The case may be different if you are seeing a high-risk OB doc, aka a perinatologist. Their reports consist of much greater detail and may possibly include a fetal sex/gender guess.

Example of a Blank Report

gender determination
In the images of a sample report taken from a monitor, you’ll notice there is a whole host of blanks to fill, but fetal sex is not one of them. On the first page where you see Sex: Other, this refers to the patient. Patient demographics were not entered here, so the Sex option defaulted to Other. We always include your LMP or EDC/EDD – aka baby due date. The larger blue space would be filled with fetal measurements, estimates of gestational age, and fetal weight as they are obtained.

OB ultrasound report

OB ultrasound report
In the pages above, you’ll note the list of fetal organs and structures we attempt to document on a mid-pregnancy anatomy screen. We only fill out the section called BPP in the third trimester when your doc orders this particular examination. And the CVP is usually only filled out when performing a Fetal Echo or detailed heart examination.

Exception to the Gender Determination Rule

There always seems to be at least one exception to every rule. Because the responsibility of a sonographer is to search out structural malformations, we also have to report suspicions of abnormal external genitalia. In other circumstances, we may see particular abnormalities that we might group together, as in the case of certain syndromes. Sometimes, knowing fetal sex helps physicians either support or rule out a particular chromosomal or structural problem. Some of these are gender specific. In the pic below, we have a designated space on a Comments page to expound on our findings. We can add fetal sex here if we feel it is pertinent information to the findings.
OB ultrasound report
In some countries, fetal sex is neither reported nor discussed with parents due to the cultural preference of one sex over another. And some facilities are beginning to incorporate policies against providing parents with this news due to litigious reasons. Unfortunately, such is life in the good ol’ US. Facilities want to limit their liability for guessing incorrectly by simply not allowing their sonographers to guess at all.
So, if you don’t want to know your baby’s sex (or even if you do!), don’t expect your ultrasound report to disclose that information. Your sonographer creates the images and report. We only include what is needed and leave out what is not!
Best wishes for happy and healthy! As always, you can email me with your comments and questions at wombviewerblog@gmail.com.

Subscribe for more information about gender determination and ultrasound!

Comments: No Comments »

Posted on July 5th, 2017 by wombwithaviewblog.com

Baby Gender, How Do We Know?

Determining baby gender by ultrasound is not as easy a task as most think. Actually, gender misconceptions pertaining to ultrasound are so common that I thought it worthy of yet another post.

Making a male vs female determination requires far more expertise than just sticking probe to belly. And babies do not just automatically cooperate! Baby’s legs need to be wide open and other parts cannot be covering over external genitalia. If so, the chances of holding that “reveal” party are slim to none.

Another common misconception is that we can force Baby to move. I promise you that every sonographer on earth would use a magical “make Baby flip” button. A girl can a dream, but I think this technology lies in our distant future. Unfortunately, babies get comfy and only move into another position if they get the urge. And not a moment sooner!

Determining sex accurately is all about angles. Being far enough along with Baby in the right position is only part of the task..when I’m the one scanning, that is! Most of my emails come from people who want a second opinion. However, most of the time, it’s one I cannot give! Either Baby is too early or the image is just plain, well..terrible. In these scenarios, the truth is I just can’t comment on what I can’t see.

Most sonographers don’t mind telling you your baby’s sex, by the way! The problem for us comes when we can’t see what our patients want to know.  Even if we explain all the reasons, patients sometimes become upset or angry. I have scanned tens of thousands of babies. Anyone who has scanned as much can recognize when this information is obtainable and when it isn’t.

Tips For Your Baby Gender Ultrasound

So, here are a few recommendations for you to follow before your next ultrasound. No guarantees! But if you are busting at the seams to find out what you’re having, these tips just might work!

  • Try eating or drinking something about 30 minutes prior to the exam. Baby typically becomes more active after eating. Now, I’m not condoning a double espresso and Snickers combo (yummy, yes; smart, no). We don’t want your fetus launching into orbit. Instead, try enjoying a hearty and healthy lunch or breakfast prior to your scan.
  • Keep an open mind! Understand that not seeing the sex is definitely a real possibility. Whatever you do, not planning a gender reveal party for the same day is a smart idea.
  • Don’t shoot the messenger! In other words, your sonographer can only tell you what she sees. If that is an uncooperative fetus or if visualization is poor, she may not want to risk a guess. Remember, that you want an accurate guess, not just any guess. Most importantly, an experienced sonographer knows when not to guess. I so hate it for parents when they get excited about one sex, only to discover differently on a future scan!

Believe me! We would love to do our part to help you plan your party, shop for baby clothes, or decorate a nursery. It’s the most fun when we can! And when we cannot, it’s a real bummer – for you, because you leave disappointed and for us, because we’re (sometimes) blamed as the party poopers.

Textbook Baby Gender Images

I’ve posted these before, but below are a couple of really great images of external genitalia, first boy then girl.

male baby gender determination ultrasound

male fetal sex, around 28 Weeks

female baby gender determination ultrasound

female fetal sex, mid-second trimester

Also, if you send an email asking for a second opinion earlier than 18 Weeks, you may receive the links below to other posts containing very easy, no-mistake pics of boys and girls!

Female Gender Scan

16 Week Ultrasound

Boy vs Girl Ultrasound

Twin Gender Ultrasound

3rd Trimester Ultrasound – Male

Thanks for reading! You can email me with your comments at wombviewerblog@gmail.com!

You can also subscribe to receive a little something special (and free!) when my book on first-trimester ultrasound is published!

Comments: 2 Comments »

Posted on March 13th, 2017 by wombwithaviewblog.com

Deciphering fetal sex can be a very difficult job, especially when trying to read an image taken by someone else.  Sometimes, it’s a piece of cake!

So often, when readers send me their images for a second opinion on fetal sex, I just cannot provide a confirmatory guess. This is either due to too early gestational age, too poor an angle, or too poor an image. Sometimes, it is a combo of all three!

Ultrasound is such a different animal because it is nothing like a photograph. In a photo, you can see what’s in the distance or up close to the camera. With ultrasound, we cannot. We can only see exactly what is directly under the probe. It is a 2D (two-dimensional) image only, and we have to move the probe around to obtain different angles to create that “photograph” in our minds. And there are so many variables that go into creating a good ultrasound image.

Since ultrasound is completely subjective and observer-dependent, some sonographers take great images and some…well…don’t. It’s much like comparing a professional photograph to an out-of-focus, too dark, cell phone group portrait where everyone has red or white eyes. You know, the ones you always see posted on social media?

I am too much of a perfectionist. This wasn’t always a good thing when trying to take keepsake photos for patients because it caused me to run late on more than one occasion! And everyone knows people don’t like to wait in a medical office! Factors to take into consideration are maternal and fetal position, angle, magnification, depth, as well as brightness and contrast of the image. It’s a learned skill and some are simply better at it than others. Some just don’t tweak all the knobs as much as they should. Maybe they were never really taught how to do so very well.

A Poor Image Can Limit a Fetal Sex Guess

Some factors that cause a poor image are just beyond a sonographer’s control…like an uncooperative fetus, extra weight around a patient’s abdomen, or a gassy patient. The laws of ultrasound physics dictate that the further sound waves have to travel, the poorer the image. Also, sound does not travel well through air or gas. I’ve scanned heavier patients where I could see pretty well and thinner, gassy patients where I struggled to see at all!

That said, I can tell when someone else’s image is not great or when she didn’t work with all the knobs. This can make reading an image snapped by someone else extraordinarily difficult. One image represents only one angle. Scanning real-time allows me to look from all angles possible, where I can subjectively determine my confidence in fetal sex – or whether a guess is too risky at all.

ALL that said, sometimes taking a second guess is easy-peasy! Check out the email I received from a reader about whether her baby is a boy. Her images didn’t leave much of a question in my mind:) She was just over 20 Weeks along. Can you tell what she’s having?

mama: Hello, I’ve been following your blog, and I was wondering if you could take a look at my baby’s scans and give me your opinion on gender. We were told it’s a boy, but I’ve read that girls can have parts that look similar to boys? I agree that it looks like a boy, but wanted a second opinion. Thanks!

male fetal sex

male fetal sex

wwavblogger: LOL No ma’am! Little girls don’t normally look like that at 20 Weeks! I will wager my bet on a baby boy:) Congrats!

mama: Lol! I wasn’t quite sure but I’ve had a feeling it’s a boy from the beginning of the pregnancy!

Reader mom: I forgot to mention in my reply to you that, yes, girls and boys can indeed look similar, but that is truer between the 12-16 Week range when parts are small, just developing, and when combined with other factors that come into play which result in limited visualization!

Did you guess boy? If so, I agree! Compare the images I’ve edited below.

fetal sex, male gender, ultrasound, second trimester, 2nd trimester

 

male fetal sex, male gender, second trimester, 2nd trimester

Even though it would be quite unusual for this to be a baby girl, I’m still always a bit cautious about guessing fetal sex based on someone else’s image. When I’m casting a vote for Team Blue, I like to ensure I see a scrotal sac which requires a slightly lower angle. Sometimes, you can obtain both scrotal sac and penis in the same image, sometimes not. I get a slight impression of a scrotal sac here where I placed the circle. The sac at this age can appear quite small, and testicles are not expected to descend until about 26-28 Weeks. This is why scanning real-time helps; it allows me to see Baby at all angles possible while moving and stretching and opening his legs more.

Stay tuned! My next post will be one where a questionable and poorly technical image comes into play. Mom wrote back saying she delivered the opposite sex. Oops!

Email me at wombviewerblog@gmail.com!

wwavblogger, RDMS
wwavblogger, RDMS

Comments: No Comments »

Posted on December 30th, 2015 by wombwithaviewblog.com

One hormonal mama (self-proclaimed) wrote me to ask about The Nub Theory. If you want to know all about it, too, read on!

Mom’s Email Regarding The Nub Theory

hormonal mama:  Hello!! 🙂 I just wanted to let you know that your blog has been a complete saviour to me and my sanity over the past few nights. It is brilliant and informative and just what I needed in my hormonal state.

I have one question that I have been searching the web for a definitive answer to, and I was hoping you could shed some much needed light.

We had our 12 Week NT scan, and the US machine seemed to be a LOT better than the photos I have seen posted, videos I have watched, etc. We could see extraordinary detail of the baby. The sonographer was checking all the usual parts and suddenly without warning he showed us the perfect potty shot (I was 12w1d). Now I know from reading that people say they all look the same at this stage. But what I cannot get over was how much the image showed a perfect little penis poking out the top of a round bulbous structure.

I’ve googled and you-tubed 12 Week girl vs boy potty shots, and I just cannot get a girl scan that looks like an actual penis.

I’m clinging to the smallest shred of hope that I may still get my girl after seeing this, but it was just so obvious and so so so clear.

Thank you so much in advance for any advice or insight you can give me. I’m so disappointed in myself for feeling gender disappointment. I didn’t realise how much I wanted a daughter (this is our last baby) until I saw that potty shot.

Please tell me honestly; I can take it!!

Yours very gratefully,
🙂

PS. I think what you are doing for ladies like me is fantastic. I cannot believe I found you after all my searching for answers! An actual professional who answers silly, hormonal women’s questions! Not a forum full of people who claim to know it all and actually know very little! 🙂

 

My Nub Theory Response

wwavb:  Thank you for all the nice things you’ve sent my way;) I appreciate it and am so happy you are enjoying reading my blog!

So, maybe you haven’t yet come across my posts on the subject. Click away! Boys and girls can look EXACTLY alike early on.

The links below will give you more information:

http://wombwithaviewblog.com/early-gender-pics/

Check out the links below for my images of fetal sex which are textbook, classic, no-guesswork-needed images of both male and female sex later in pregnancy:

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/

All that said, it’s okay to have a preference, but we all get what we need in the end. Having another boy means you needed one another for whatever reason! I hope you’ll subscribe and keep reading at wombwithaviewblog.com😉

Best wishes!
wwavblogger, RDMS

 

Second Nub Theory Email

hormonal mama: Thank you for replying. I’m so grateful! I have posted a link to your blog on our pregnancy group page. I hope it gives some other ladies peace of mind. (And a good giggle!)

I was recently told by an US tech in the group that there is a “nub” on my image. But I am notoriously useless at seeing them. Would you be able to confirm (or deny) if there are any genital parts visible? All I’m seeing is legs and a cord. I know the angle of the dangle is not a reliable theory (from your blog!) but for someone to say she can see it on my scan, it would be helpful if I knew if it was even visible!

Many thanks again and again 🙂

12wk fetus/nub theory

wwavb: Thanks so much! I, too, hope they get some useful info and a giggle, also;)

Does the sonographer in your group practice OB? Experienced or new to OB? I question because I entirely disagree. Every baby has a nub at this age, but one cannot be sure whether the nub represents boy or girl. If she is referring to the thing sticking out near the butt, that is too large to be the nub in question so my thought is it’s baby’s cord.

And actually, to see the nub, the plane needs to be centered between baby’s legs which means you would not be able to see the legs in this view. See the image below:

Suspected Baby Girl at 12wks/nub theory

No legs here! That could be a tiny foot way above the arrow, however.

This tells me the angle on your baby is not perfectly centered and is a little too far lateral whereby the leg is included in the image. I hope this makes sense! What a cutie, by the way;)

Keep me posted!
wwavblogger, RDMS

Final Advice?

It’s entirely possible to get excellent images at 12 Weeks, and this theory is reported to be about 73% correct. If you do the math, that leaves 20+% with potential gender guilt. I only recommend finding out on your NT scan if you can remain mentally neutral!

You can email me also, at wombviewerblog@gmail.com!

 

Comments: No Comments »