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.

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Posted on November 19th, 2015 by wombwithaviewblog.com

“How sure are you?” I’ve heard this question probably more than any other in my career! 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 ultrasound is so subjective, there will be always be incorrect guesses. 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!*

And if you haven’t yet seen them, check out the links below for my images of fetal sex! They depict perfect examples of textbook, classic, no-guesswork-needed images of both male and female sex.

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/

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

wwavblogger, RDMS

wwavblogger, RDMS

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Posted on October 20th, 2015 by wombwithaviewblog.com

I think most of you reading probably would believe that most of the emails I receive have to do with parents wanting me to confirm fetal sex..sometimes desperately so. And sometimes determining fetal sex is an impossible task.

I try to explain in my replies that my guess is only as good as the images they send me. I don’t believe it is quite understood what I mean when I say that ultrasound is entirely subjective but the person scanning has total control over the images obtained. The sonographer creates these images utilizing a number of controls to optimize the image and uses her own discretion to determine a good angle with the probe she is holding. Yes, there is a standard here but I have to brutally honest. Just as people excel in some areas of life and/or profession, some are also bad. There are good docs and bad, good nurses and bad, good cashiers and bad. That being said, there are sonographers who just do not do it well. This is a painfully obvious fact when I open these image attachments.

In addition, I sometimes use many angles, holding the probe in different places to obtain a different angle of the same area in order to determine sex. At times, just one angle is not enough to see well but only one angle can be depicted in one image at one time. I wasn’t there during your scan so I don’t know anything about the variables that could have made imaging difficult. You’ll find one of my last posts on this subject below:

http://wombwithaviewblog.com/fetal-sex/

I just know a technically bad image when I see one. Sometimes, I can tell measures to improve the image weren’t utilized. In those cases, I can only that someone did not know how to use them correctly or even at all. If the person scanning you is new to ultrasound or is a physician who isn’t trained on how to use the equipment fully (this is not unusual-docs are trained to deliver babies, not scan them!), the image may not appear optimal to someone who is experienced in sonography.

Great Images for Determining Fetal Sex!

Below are some great images of fetal sex that I’ve taken myself.

female fetal sex, 18 Weeks

The above depicts an underside view of typical-appearing female parts from about 16 – 22 Weeks pregnant. The side arrows point to labia, the middle to the clitoris.

 

female fetal sex, 3rd trimester

Female labia in the 3rd trimester

 

male fetal sex, 28 Weeks

Male genitalia, late 2nd trimester

 

male fetal sex, 3rd Trimester

The above demonstrates a side view of typical appearing male parts from about 27 Weeks on.

 

So, all that being said, if the image you send is not an optimal one, I may not be able to take a guess on fetal sex. Even if your sonographer felt sure of her guess, I may not feel I can agree based on limitations of the image. That doesn’t mean your sonographer got it wrong, just that I cannot concur with the former guess because the image quality is not there. If I didn’t observe the scan myself, I am unable to see your baby’s parts from many different angles!

Below are the links I typically email on my posts regarding fetal sex:

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

I hope this gives you some understanding and a little more insight! Ta-Ta for now!

 Until next time, feel free to reply, comment or email with your questions at wombviewerblog@gmail.com!

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