Posted on September 4th, 2017 by wombwithaviewblog.com

Pregnancy Labor Isn’t Loved By All

Don’t worry that you’re all alone in this boat. Pregnancy labor and delivery isn’t fun for every mother. Some conquer it like Wonder Woman while others vow to never go down that road again. It’s all personal and relative, and no feelings are wrong or right…just your own! ūüôā

I ran into a patient of mine who recently delivered her first baby. She couldn’t wait to show her off. “She’s finally here!” She was so sweet and told me how much she loved having me as her sonographer every week. I love it! And, of course, her baby was absolutely beautiful.

She took a minute to vent about her L&D experience, of which she was NOT a fan. She said, “Nobody told me what it was REALLY going to be like. I’m never doing this again!” I laughed and expressed I was not a fan of mine, either, but that it’s different for everyone. Some people actually call it easy or loved the experience. I guess this is why some beloved souls do the pregnancy thing over and over! Well, that and¬†they must either have really good babies or the patience of a saint. God bless the fruitful mothers, but my personal limit was two.

Moreover, they’re incredibly expensive! After diapers, extra-curricular activities, cars, insurance, and college, it all adds up to a luxury house in the end. But I digress…I love motherhood, love my kids, and I wouldn’t trade them for a thing in this world. Change that. Between the ages of two and four, I did consider either

selling my younger daughter on the black market or duct tape for her mouth. Alas, I opted for the duct tape, and (what do ya know?!) she became a hard-working, compassionate, and loving young woman.

You can read her blog post here!

pregnancy labor

We seriously have no idea where she puts all the food she consumes…

 

And for those of you who don’t know me, said daughter would be laughing hysterically at this last comment. She can attest to the lack of duct tape for discipline…though it would have been effective. If what goes around comes around, I have no doubt she’ll need it for her own kids one day!

We go through pregnancy for ourselves, our spouses, and to create that family unit for ourselves. It’s the love we put in and the love we get back that makes it worthwhile. And when our kids are bad, we stick them in a corner because we sure can’t shove them back where they came from.

I sometimes say I’ve made my contribution to Mother Earth with my twice-inhabited uterus. For my patient and many like her, it’s one and done! So many of my 3rd Tri patients begin to express anxiety at the thought of labor. It’s understandable. Every labor can be entirely different from your prior experiences, and we always fear the unknown. My advice to them?

Nature has a unique way of preparing us to take on the unknowns of labor ~
the complete exhaustion of pregnancy!

Well, that and finally seeing our babies in living color:)

3D fetal face, pregnancy labor

Happy and healthy labor and delivery, Everyone!

You can email your ultrasound and L&D stories to wombviewerblog@gmail.com!

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Posted on April 29th, 2017 by wombwithaviewblog.com
Ultrasound results, twins

8-Week Twins!

Ultrasound Results – What’s the Big Deal?

Your ultrasound results must always come from your physician! But why¬†can’t your sonographer just tell you if everything looks okay? It’s so irritating when she won’t talk, right?

The most frequent question a patient asks is if everything looks okay, healthy, or normal. Usually, to the patient’s dismay, this is something we just can’t discuss with you. Read on for details about why we have to be so doggone tight-lipped!

Ultrasound Results Have to Come from the Docs

My usual response when a patient asked this question is “Your doctor has to look at all of these images and he/she will discuss your ultrasound when you see him/her next.” Only¬†your physician has the legal right to give you this information.

Yes, it is my job to know what I am seeing and to recognize it when something does not appear normal. However,¬†sonographers are not physicians. We are trained to perform your ultrasound examination; we don’t manage the health of you and your baby. Your doctor studied for many years learning how to do just that. And only your doc or other healthcare provider can answer the multitude of questions you will positively have in the case of a suspected problem.

Our job is to share what we see with your doctor. Your doctor examines the information and concludes whether he or she agrees with our findings. The doc then shares his/her interpretation of the information with you along with what options he/she recommends next.

But, But…

Occasionally, I will have a persistent patient or spouse who will say, “Yeah, but you KNOW whether you see something wrong or not.” I’ll admit that I do, but I always defer to the physician’s interpretation. We just have to stick to our guns! I know it simply comes from a place of parental anxiety. We do understand.

For the nervous patient, waiting for ultrasound results can feel like a lifetime. I do empathize. A previous pregnancy loss or abnormal ultrasound is enough to scare serious fear into the hearts of anyone. I want expectant moms to understand that if your sonographer says something inappropriate, she could lose her job. Only your doctor can calm your fears and reassure you about your pregnancy issues in a way that no one else can. Your results are part of the sacred and private relationship between you and your doctor!

Finally, on to end on a positive note, most of us are more than happy to educate you about what you see on the monitor (minus a diagnosis!). I loved sharing how we measure and pointing out all your Baby’s parts for any inquisitive parents or family.

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Your questions and comments are welcome at wombviewerblog@gmail.com!

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Posted on April 27th, 2017 by wombwithaviewblog.com

General Ultrasound Facts

 

Patients have asked me these questions on a regular basis for years. Let’s get some ultrasound facts straight, shall we? I hope it’s helpful!

What’s the difference between ultrasound and sonogram?

Technically speaking, ultrasound is the study of the subject (the field of ultrasound) and a¬†sonogram¬†refers to the examination itself. Although we’re really not picky about what you call it.

 

Is ultrasound safe?

Biohazard testing over the past forty years reveals no ill effects of ultrasound on the fetus, mother, or sonographer. However, increasing levels of heat after scanning for several hours in one area can cause cavitation or the creation of bubbles. This is much longer than the time required for performing a diagnostic test. Since no one can predict the long-term effects, only the prudent and diagnostic use of the technology is recommended by ACOG, AIUM, and ACR. The benefits of the information from diagnostic exams for patient and physician currently outweigh any known risk.

 

Is Ultrasound radiation?

Ultrasound technology uses sound waves, NOT radio waves. I dedicate an entire post to just that subject in the link above.¬†No radiation is emitted by ultrasound equipment or Dopplers utilized by your physician to detect Baby’s heartbeat. X-Ray emits radiation which is¬†why, for example, your pregnant belly would be covered with a protective shield at your dentist’s office for X-Rays on your teeth.

 

Can my baby hear ultrasound? 

Nope, Baby cannot hear the sound waves:) Ultrasound is just that…sound waves that operate at a frequency far beyond human hearing. Human hearing ranges from 20Hz to 20,000Hz. Diagnostic ultrasound operates in the millions of Hertz. Ultrasound probes range from about 2 – 13MHz.

True story ~ I became a little distressed once when a patient asked me if ultrasound sounded like a jet to a fetus. She had just read this in a pregnancy magazine in our waiting room! I reassured her this was inaccurate. This experience marked one of the many reasons I wanted to start my blog–to get reliable info to new moms like you!

 

What’s the difference between 2D, 3D, and 4D?

Almost everyone has seen the gray clouds of 2D ultrasound at one time or another. 2D allows us to see through organs and inside your baby.

Most people are familiar with 3D imaging as a fun way to see the outside of their baby. Additionally, the best and cutest 3D images are obtained later in the 2nd Trimester or early in the 3rd. Baby’s skin has developed more fat at this point which makes for chubbier cheeks!¬†Occasionally, a high-risk practice (MFM or Maternal Fetal Medicine) will usually also use 3D to assist in visualizing a fetal abnormality. We also frequently use the technology for GYN scans to attempt a better look at uterine shape and/or IUD placement.

4D can be described as 3D in motion or a live 3D image. So, where 3D is a still image, a 3D video of Baby moving is actually 4D.

 

ultrasound facts, 3D, 9 Weeks pregnant

3D 9-Week Embryo

Ultrasound Credentials for Sonographers

 

What’s your title? Are you a nurse or in X-Ray?

We’re not nurses, though some of us do cross over from RT (X-Ray) or other areas of Radiology. Sonographer, Ultrasonographer, or Ultrasound Technologist are a few of our titles. We are specifically and formally educated in the field of Ultrasound.

RDMS stands for Registered Diagnostic Medical Sonographer. A sonographer earns these credentials through ARDMS when he or she has passed a registry examination in Ultrasound Physics as well as his/her ultrasound specialty. A certified sonographer typically has at least two years of experience under his/her belt.

DMS refers to someone who has completed some sort of formal or on-the-job ultrasound training but has not yet taken/passed the registry examination.

 

What do you think of those 3D places?

Having posted on this often, I understand a patient’s desire to go, but I’m not a fan.¬†Not everyone who scans an expectant mom in a 3D non-medical business is a certified OB sonographer. Some have no formal ultrasound training whatsoever! I know you may be surprised by this little-known fact, and so was I.

These businesses are not regulated like medical practices. They may not be knowledgeable of or follow guidelines for equipment maintenance. Ultrasound equipment that is not properly maintained can be an electrical hazard for mother and/or fetus! Do your research and at least ensure your sonographer possesses RDMS or, at least, DMS credentials. Please read the post in the link above!

 

Performing Your Exam

 

When can I expect to have sonograms in my pregnancy?

Every practice is different. Most physician’s order a first-trimester ultrasound examination to date the pregnancy. This is usually performed with a transvaginal probe. If no other problems necessitate another scan, you’ll receive your next exam around 18-20 Weeks. Most women know this scan as the anatomy screen where we evaluate fetal and maternal parts for abnormalities.

*Your doc does not order this exam to determine fetal sex!* However, most sonographers will happily provide the info if at all possible (as long as policy allows)!¬†Also, important to note here is that determining sex is never a guarantee nor should it be an expectation. Sometimes, those Little Sweet Peas just won’t cooperate! You can read more here about those limitations. Note of advice for moms: Don’t pre-plan your Gender Reveal party for the same day as your ultrasound!¬†The health of your pregnancy determines whether you will receive more ultrasound scans later in your pregnancy.

 

Can you predict how much my baby will weigh at birth?

While we can measure your baby’s head, belly, and femur for an educated (called EFW or Estimated Fetal Weight)¬†guess for weight at the time of your scan, a large discrepancy for weight determination exists due to fetal position and sonographer skill. We can typically track a trend for large or small babies. We know the average gained weight in the last few weeks is about 1/2 lb per week. However, every baby is different!

 

Ultrasound Facts About Fetal Sex

 

Most expectant moms today already know this little fact. The ultrasound machine is never “wrong” in determining fetal sex. Actually, it is the observer who is incorrect!

Guessing the wrong sex can be due to one or a combination of many factors. It is possible your baby was in a difficult position to see well. Maybe you were too early in your pregnancy for an accurate guess. In addition, an overall poor view can also limit fetal sex determination!

 

Facts About Your Results

 

Yes, the sonographer can read your examination. However, your OB/GYN physician or radiologist must ultimately interpret the images and report we create. Consequently, only your physician can legally give you results! Read more about why here.

However, most of us are more than happy to educate you about what you see on the monitor (minus a diagnosis!). I loved sharing how we measure and pointing out all your Baby’s parts for any inquisitive parents or family.

~*~

Feel free to email me at wombviewerblog@gmail.com with your comments or questions!

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facts delivered directly to your inbox!

 

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Posted on April 25th, 2017 by wombwithaviewblog.com

Oh, the adventures of becoming a sonographer!


sonographer, ultrasound technologist

Isn’t this facial profile precious? But it’s not just any profile; it’s a technically perfect 2D ultrasound example of a simply beautiful fetal profile. It’s what we sonographers strive to obtain on every baby we scan and reminds me of how I fell in love with the technology…with my own first baby ūüôā I was well into my college career at the time, but nothing else had quite piqued my interest like my first exposure to ultrasound. Boy, I had no idea what challenges lay ahead!

Becoming a sonographer, aka ultrasound technologist, was one of THE biggest challenges of my entire life. The training was challenging, but finding myself in a new field and technology where I was painfully ignorant and unsure? Healthcare is not a place for the timid.

A Sonographer’s Start – Whoa! (What a Challenge)

If I was going to work with physicians, I better learn what I was doing fast or go home. It took a while for the puzzle pieces to fit…a good 6 months to 1 year. Thereafter, little light bulbs of realization would flicker every time I put two and two together. It was a marriage of all things unfamiliar. I was learning to read patient charts, learning about labs and correlative examinations, interaction with the physicians and with my patients. All of these things were a recipe for growing my new career as well as learning the technology. In the beginning, it was more about “How do I not screw up?” rather than “Wow, that was a great case!”

I promise you, it’s not for the squeamish. If another person’s urine, vomit, or blood bothers you, Ultrasound may not be for you. I cannot emphasize that enough! It was a hard year, and I felt like I was walking a tightrope for the vast majority of it. Brutal.

A Sonographer’s Fear

All new sonographers will miss pathology. It’s a fact of the modality. Initially, you are too concerned with getting all the right images. You’re too inexperienced to notice minor pathology. This is why it is so imperative that a newly-trained sonographer has direct supervision from someone very experienced. With lots of experience comes confidence. After a while, a newbie will start to get a feel for his/her scanning ability and stop second-guessing herself. Was I not seeing an organ because it can’t be seen or because I¬†just couldn’t find it? It’s an awful feeling. However, it is one that can be overcome with time and, again, experience.

The more normal examinations a technologist performs, the sooner she will know when a case is¬†not¬†normal. Ten to fifteen scans per day over the course of a¬†year equals a good bit of experience. After the first few months of constant supervision (if you don’t have it, ask for it!), you will start to become a little more comfortable with the examinations. You’ll then only need a supervisor’s help when confronted with abnormal cases. You may not be able to pinpoint a diagnosis, but you know it’s not what you normally see. This is very important in your early career. Eventually, you will be able to put together differentials to possibly explain what you are imaging. It’s a good feeling when you get to this point!

A Sonographer’s Advice

It was a slow learning process, at least for me, anyway. Over the years, it became easier to work with the docs. More importantly, I learned how to better communicate with my patients, which has been the most rewarding. It feels really good to correctly diagnose a case. But it feels even better to have a patient sincerely thank you for your help…or give you a hug in appreciation. It feels good to know I’ve made a small but, hopefully, significant difference. It’s been a good career. And for those who are going into it, hang in there because it gets better. For those who have practiced a long time and feel the flames of burnout, take a vacation! We all need to step back and take a breather once in a while.

Every case is someone’s health and life at stake, and not a week goes by still without learning something new. What a sonographer sees (or misses!) will either lead that patient to other tests or lead to a missed diagnosis. It is sometimes intimidating to think that a patient is on your table and yours alone. It’s up to you to find the problem in question.

I always say I would never want to relive those earlier years, yet they have shaped who I am. They helped me become a better sonographer. So get out there! Become a sonographer, become good at it, research and read, and ask questions of co-workers and docs alike. Make a difference in someone’s life. Make a difference in your own ūüôā

For more information about becoming a sonographer and ultrasound stories subscribe!

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Posted on October 11th, 2016 by wombwithaviewblog.com

What Your Sonographer is Thinking

Ever wonder what your sonographer might be thinking as she calls you back for your ultrasound exam? While I cannot speak for all, let me give you some insight into some of the heavyweights at the forefront of my thoughts with each new patient.

What’s in a Job?

Firstly, we have a job to do. While the patient may be wondering why she wasn’t called back at her exact appointment time, your sonographer is already very busy with the business of having you as a patient. We are busy with a checklist of items that must be completed before we ever call your name! We are examining your chart and looking for your doctor’s order (we cannot begin without this!). We have to determine why you are coming to see us in the first place, so we have to know what type of exam needs to be performed. Oh, yeah! Your prior pertinent medical history and testing are pretty important, too. In other words, we have to be able to answer the 5 W’s…Who, What, When, Where and Why:

    • Who are we scanning? Who (what provider..doc, nurse practitioner) ordered this exam?
    • What type of ultrasound exam are we performing? (Diagnostic ultrasound? Transvaginal?)
    • When was she scanned last and what was found? Do we have that report(s)?
    • Where are we targeting the examination?
    • Why are we scanning this patient?

Patients or Patience?

After spending so many years in the healthcare field and encountering a challenging personality type or two along the way, we sonographers wonder whether our next patient might be naughty or nice? The Rolodex of mental questions might look something like this:

  • Will my brain get picked for some interesting ultrasound facts or will I get the silent treatment? It is¬†a bit awkward when a patient has nothing to say…I mean zero words.
  • Will she need to beat her dueling children because they won’t let her focus on Baby #3 (who may turn into Baby #1 if they don’t quit fighting)?
  • Siblings are sometimes the most comical addition to an exam, but will I have to listen to “Let It Go” on a tablet for thirty minutes – again?
  • Will her family sound like my Italian kin at Thanksgiving in that tiny. enclosed. room?
  • Will it be standing room only with Grandpa breathing down my neck for the whole exam? Gramps is really nice, but he’s gotta mosey on over to the other side of that table.
  • Will I have to ask Dad to take their screaming toddler back to the waiting room? We hate to kick anyone out. But our eardrums can’t take it, and admin typically frowns upon keeping rum in our exam rooms.
  • Will I get the evil eye if I say that I cannot determine what sex she’s having? And will she then rant on Facebook that I have no idea what I’m doing? I hate when this happens.
  • But seriously, and most importantly, will this baby look normal?

The Questions Sonographers Get Almost Every Time

Does everything look okay? Do you see anything wrong? Is my baby growing well?

These are all valid questions, to be sure! But as most patients know, they are ones that only your doc can answer. Legally, only your doctor can review the exam and determine its results. Only she/he can discuss these results with you even if they’re negative. Why is this? So that they can also provide you with the comfort and answers in the face of concerning findings.

My answer was always relatively the same. “So far so good, but your doctor has to review the ultrasound images and give you the results.” Every blue moon, a patient express that I must know what I’m seeing. I would always agree but reiterate the rules.

There are times and extenuating circumstances where you may know what your doctor is following. In these cases, we have to be careful with our words. Every practice is a little different with respect to how much your sonographer can say. It’s a fine balance! Too little, and we cause you to worry. Too much, and we lose our jobs!

Of course, every sonographer on the planet is happy when they enjoy the time they have with their patients and families and kids. Some of my favorites have also been the loudest, most fun, and the funniest! One thing is for sure…I can definitely sing the “Frozen” theme song with your kid the next time you visit:)

Many blessings and happy, healthy babies to you all! Feel free to email me at wombviewerblog@gmail.com with any questions or comments!

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Posted on February 25th, 2015 by wombwithaviewblog.com

I can scan them all day long but, I can promise you, no woman in this world would want me at home plate wearing the catcher’s mitt. That being said, MOST docs (granted, not all) do not make the best sonographers.

Some docs try to scan a little more than others and feel comfortable in some aspects of the modality. ¬†At the end of the day, however, most call on their sonographers for reliable ultrasound information. Unless they are perinatologists (high-risk OB docs), most obstetricians are not vastly trained on the equipment to the extent of an experienced sonographer nor do they know how to obtain particular images. We have an aviator’s panel of knobs and buttons that help us in obtaining quality ultrasound images.

Read an email below from a reader who was scanned by her doctor as he attempted to determine gender:

mama-to-be: First of all, I love your blog. It took me forever to find it! I am a mother of three and expecting. I have two boys and one girl. I went in for my 17 week u/s scan just to make sure I was not further along. My doctor said that by how the baby was positioned, he could “guess” 80% that it was a BOY. But it could also be the umbilical cord that’s in the way. Baby was giving us his back at all times and my question to you is, based on these u/s pictures, can you tell gender?????!!!

one doc's images one doc's images

wwavb: ¬†Thanks for reading and I’m so happy you are enjoying my blog! I hope you’ll subscribe for future posts. First, if you do a search for gender determination on my site, you’ll find several topics on the subject…especially ones that say if the image isn’t a good one, I can’t tell a thing. I am sorry to say these images for gender certainly fall into that category! Physicians are not always the best sonographers, so don’t go painting blue yet. And I can provide that advice with 100% confidence!

Please feel free to send me images again later in the pregnancy if they are able to get a great potty shot.¬† I’m sorry I couldn’t help you more!

Best wishes,
wwavblogger, RDMS

***

I really hate it when I can’t help someone who has taken the time to write me for my opinion but, holy cow, let me count the ways in which these images stink. Any seasoned OB sonographer reading this is laughing hysterically. Oh, well, we’ll give her doc a C for effort, but I am 100% confident that he should never be 80% confident about his scanning abilities and 100% confident that she should not paint her nursery in blue whales and sailboats just yet. I’m also 100% confident that he has a good 50% shot at being correct:)

I always joke with my doctors and tell them not to get too good at ultrasound because I need my job. Make no mistake about it, I sure can’t do theirs. And with images like the ones above, we’re talking serious job security for good sonographers everywhere!

 

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Posted on January 24th, 2015 by wombwithaviewblog.com

I’ve written it a hundred times..or seems like it! Someone sends me an image and wants to know if I can confirm gender. Sometimes I can tell, sometimes it’s clear as mud. I usually have to write back and give my spiel about unclear gender on ultrasound and how, because I wasn’t the one who scanned, I can’t see the whole uterus. Some images are just bad!

In ultrasound, we have either images that are beautiful which belong in a textbook and anyone with an eye for the modality can tell you what is pictured. Then there are terrible images where we just shrug our shoulders and wonder what someone was thinking when she snapped the image.

I’ll share this email from a reader and her image and attempt to give you an example here of clear vs not.

unsure mama: ¬†Hello! I’m on my 4th pregnancy and my first 3 were clear as day regarding genders, all done after 20 weeks. But this one, however, my sonographer seemed like she was struggling to get a potty shot. I’m not sure of real fetal age due to bleeding the entire time until 14 weeks. My sonographer said the baby was breech and sunny side up? Baby was also measuring at 17weeks 4days. She hesitated but then said girl. I didn’t ask questions but I didn’t see lines or a turtle. Here’s the pic she gave me. What would you say? Any information will be greatly appreciated. I have one girl who is oldest and two sons.

image

wwavblogger: ¬†Thanks for reading and I hope you’ll subscribe! So, like I typically say, if it’s not a perfect picture, I just can’t sign off on gender. That being said, it could very well be a girl and this just isn’t a great image. It looks like the view is one of baby crawling away from you, if you can put your imagination to work. Right above the arrow is where you would see the 3 dots, however, the dots can blur together if the image is not entirely clear.

I’ll include a link below where I show a baby girl in a similar position, just a little more to the side. Idea is the same. This one is clear and you can clearly see 3 dots here. You can also compare it to the twin brother shot in the same post, too!

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

I don’t see obvious boy stuff hanging down like I would expect to see here!

Good Luck!
wwavblogger

***

So, girl? Maybe! Boy? Sure can’t say it’s not!

My image in the link above that I sent her of girly parts you’ll find below. Which can you¬†see better?

female gender

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Posted on January 21st, 2015 by wombwithaviewblog.com

When you bring family for your sonogram, your smallest ultrasound exam guests sometimes provide the best entertainment for us sonographers! I have posted some “kids say the funniest things” in the past. Most of the time when parents bring small children, especially for a lengthy ultrasound exam like the anatomy screen, it truly can be very distracting and disconcerting.¬†Every once in a while, however, we have a child in the room who is simply entertaining…like the one who thought his baby sister looked “weally weird” from one of my most recent posts. He said, he was NOT making the mistake of going to another sonogram. Hilarious.

A totally precious little girl was in today with her Latino family. She must have asked me a million questions. The exam I had to do was pretty short and sweet, so it didn’t require too much brain power. Fortunately, I could indulge her a little. Every time Grandma thought she was talking too much, she would tell her in Spanish to stop and pay attention. That would work for about thirty solid seconds before the onslaught of more questioning. She was so cute and smart and SO well-spoken for only four!

For those of you who have had a sonogram later in the third trimester, you know how big Baby looks on the monitor. My little guest sees the baby’s abdominal circumference fill the image. Out of total quiet she exclaims, “My baby cousin has a really big head…and her butt is GRANDE!”

Any kid who can make me laugh out loud can visit me any day of the week! ūüėČ

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Posted on August 6th, 2014 by wombwithaviewblog.com

Young kids are always accompanying their parents to the ultrasound to see their new sibling on the monitor. Honestly, unless they are over the age of four, interest steadily declines and sometimes rather quickly as soon as the lights shut off. Mom and Dad want them to be more interested than they truly are. ¬†At 2 and 3 they simply are in the age of “me” and actually could care less about whether their new baby sister or brother, the one they’ll torment for years to come, can be seen on the “TV”. ¬†Furthermore, if they do comprehend what a baby really is, the one on the monitor sure doesn’t look like any baby they’ve ever seen!

Parents try to come as prepared as possible with iPads in hand, games and snacks. Sometimes none of it matters and they scream and carry on until it’s over or grandma hauls him out. Every once in a while I’ll have a little visitor who is so cute, I just want to keep him with me all day. Today I had one such little guy. He was 3, barely understandable and so stinking cute. The kids who are quiet are usually intimidated by the surroundings and are fearful Mom is going to be hurt. I usually break the ice by offering them to feel the gel. I hold out a gloved finger with a big glob on it. I’ll make a game out of it and even if they are grossed out initially, very soon they are asking for a squirt.

Little man did just the same today. After a bit he got comfortable with me and asked what his baby sister was doing in there. I replied she was swimming. I didn’t understand most of anything he said…except that his baby sister was a fish. He said it over and over and over again. And the more we laughed, the more he said it. Of course, he knew he had a baby sister in there before anyone else did. ¬†I swear I just think they have a connection with one another! We confirmed it was a sister and he kept reiterating “Baby sister a fish.”

I gave him his very own picture of Baby Sister to keep for himself. Kids just love that and I made a new little friend. He walked out of my room and looking up at me with a big smile kept repeating all the way down the hall that his baby sister was still indeed a fish. Too darned cute!

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Posted on July 19th, 2014 by wombwithaviewblog.com

Ultrasound Advice for New Sonographers

New sonographer ultrasound advice is a topic that needs addressing for anyone new to the field. It’s a tough place out there for you. I know, I lived it, too.

A Fine Example of Negligence

I felt a bit distressed to learn something recently. It is an important lesson for any new sonographer, especially. A recent graduate of a sonography program landed her very first job out of school with a temp agency. With essentially no work experience, her recruiter advised her to “Fake it ’til you make it.” I thought I’d faint. She lied saying her recruit had one year of experience and placed her in an OB practice to work alone. The lack of responsibility of this recruiter left me surprised and horrified. The quality of exam a patient receives was obviously of no importance. This is unfortunate.

Moreover, the horror this new sonographer experienced is another story. Even though she had a brief period of training by the sonographer going on leave, she was uncomfortable with scanning or reporting anything on her own. With no experience to call on, she did not possess the confidence to call a case normal or abnormal. Where does someone even begin to construct a report when she is unsure of what she sees on the monitor? This is unfortunate and a precarious circumstance for all involved.

Don’t get me wrong. Everyone has to learn, and all new sonographers need the opportunity to become better. But, like so many things in life, there’s a right way and a wrong way to accomplish this task. It has to be fair to both the sonographer in training as well as the patient. Therefore, the following is a message to all sonographers who have just stepped out of the classroom and into the real world of practice.

Turn the Table…

From a slightly different perspective, please consider the following ultrasound advice. If it were you, your daughter, your mother, or your sister on the examination table, wouldn’t you want to know if it was the first exam performed by your provider? We all like to feel as though we are in good hands, competent hands when we seek medical attention or advice. Wouldn’t it be disconcerting to know the person scanning you is new, overwhelmed, and lacks the knowledge in all ways to perform your exam properly? Every patient deserves to have their examination performed by someone who is knowledgeable and properly trained. After all your hard work in school, you deserve to be properly trained!

Just in Case Your Instructors Didn’t Tell You…

You are not qualified to work alone. You need direct supervision from someone with qualified experience. You need direct supervision for all of your exams performed for at least three solid months. After that, you need to ensure you work in an environment with at least one other experienced go-to sonographer for questions..because you will have them. You will have a lot of them. We all did.

You should never lie about your experience, even if a recruiter tells you to do so. Potential employers need to ensure how much they can rely on your skill and experience outside the classroom. Your class time and clinical rotations count as experience toward taking your registry examinations, but it doesn’t go far toward real-world experience. You were in school and learning. You will still be learning volumes over the next few years. No one ever knows it all, and this is a field where you will continue to learn your entire career.

Students and new technologists, once you have scanned about twenty-five normal cases (give or take), you will be able to scan a normal exam on your own pretty easily. Tackling pathology is a whole other ball game. You will feel more comfortable you taking on the challenge of an unfamiliar process when you develop more confidence in your skill and ability. Everyone’s learning curve is different. If you learn new things quickly, you may feel more confident in your skills in less time. If you have a no-fear personality, you’ll have less problem jumping in with questions or presenting cases to physicians when you are unsure of a diagnosis.

What About a Private OB Practice?

Sonographers in a private practice need a great deal of experience. They need to be able to work independently and have enough confidence in their skills to tackle a challenging case without breaking a sweat. They should feel very comfortable scanning patients in every week of pregnancy with no question regarding the protocol of any exam. Do we still turn to our co-workers for a second eye from time to time? Of course, we do. It’s all part of continuing education and proactively learning where we have the opportunity to grow. It’s imperative. Remember, we never know it all!

In our office, we do not hire anyone who is not registered in OB/GYN with less than three years of full-time OB/GYN experience. How can a physician trust your work if you don’t trust it yourself? A physician relies heavily on the experience and ultrasound advice of his/her sonographers to provide competent and thorough examinations. How can they properly treat their patients otherwise?

Your job as a sonographer is to find pathology. You can’t diagnose what you don’t recognize, and you won’t recognize what you’ve never seen. This is just the nature of the beast.

Be Your Own Advocate!

I’m sorry if your educators failed you. They have a responsibility to not only teach you in the classroom, but what to expect outside of it. This is not your fault. It reminds me of an old adage which says that you can’t know what you don’t know. So, before you take your first job or any job thereafter, ask yourself if you are experienced enough to commit to it. Then ask if you will have supervision. Start out in a teaching hospital. Sonographers are thrilled to share their knowledge with you in such facilities! Learn what you need before you think about branching out on your own. You owe it to yourself in order to become a better sonographer. You owe it to your patient to provide a quality examination.

Patients: if this is overly concerning to you, it should be. You can always inquire as to the experience of your healthcare providers!

Subscribe to the blog for more ultrasound advice for new sonographers and expectant mothers!

Comments: 2 Comments »

Posted on July 4th, 2014 by wombwithaviewblog.com

Early gender pics can be deceiving. Many of you who want to know your Baby’s sex as early as possible with ultrasound may be tempted to believe the tempting promises of your street corner 3D ultrasound business. Before you pay your money to one of these places, I encourage you to first read the above link!

The early fetal parts of external genitalia look nothing like they do later on, just as an embryo doesn’t look like a baby or an embryonic chick look like a chicken! It’s also the ¬†reason we do not perform the screening of anatomy until 18 Weeks. Structures like the brain are ever-changing until about that time. Even at 17 Weeks, the brain looks a little different. The same applies to external genitalia – later is most always better.

Because these parts are just starting to develop at 12 Weeks, boys and girls can look alike. Over the next month, your baby’s external genitalia are still developing and changing in appearance. That is to say, boy tissue starts to get bigger and girl parts shrink. Eventually, the scrotal sac and penis take a more recognizable shape, and the labia and clitoris take on the appearance of three tiny white dots or lines. Fetal boy parts can appear different from other boys, just as girls can appear different from other girls. We’re all different!

Please take my word for it. Any guess at 12 – 14 Weeks is simply a guess. You may as well flip a coin. At 15 – 16 Weeks, it’s still a guess.¬†Now, have I guessed gender at 16 Weeks? Definitely! But it had to be someone I was scanning personally, baby had to be lying butt-up in a perfect position with legs wide open, and I had to have a clear image otherwise. There are many factors that play into how well we can see at any point in a pregnancy. It just all has to be textbook perfect and not every patient/fetus is a textbook scan. I might feel confident enough to provide a second opinion of your baby’s gender if you are 17 Weeks with a perfect potty shot!

Links for Great Images of Fetal Sex/Gender

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/

The Nub Theory and Genetic Testing

Even if the parts appear very straight-forward based on the nub theory, it’s only a theory and only about 73% accurate. That’s a lot of room for error. So, just because a girl might look like a girl based on the nub, don’t be surprised to find a penis at your anatomy screen! Only genetic tests like first-trimester blood tests for DNA or amniocentesis are 99+% accurate for fetal sex.

***

All that said, you are welcome to email me with questions at any time in your pregnancy. However, sending me pics with a request for gender confirmation earlier than 17 Weeks will probably get an “it’s just too early” response. As much as I would love to, I just can’t provide you with helpful information in most of those cases. I can never be more confident than the person who scanned you! Especially if your sonographer said she couldn’t get a great shot, I likely won’t be able to tell, either.

If you’re greater than 17 Weeks and your sonographer has given you a potty shot where she’s annotated boy or girl, subscribe and email me your pic. I’ll be happy to try and provide a second opinion!

Good luck at your next scan!

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Posted on June 18th, 2014 by wombwithaviewblog.com

I would love to share this really funny experience with one very over-protective Dad.

A couple of years ago, I had a patient who was coming in every week for BPPs or Biophysical Profiles as they are called. I explain this exam in greater detail in the link above, but it is simply a way to determine the well-being of a fetus by scoring the baby on his/her movements. We also measure Baby’s amniotic fluid and monitor Baby’s weight, as well.

During these scans, babies are sometimes napping…or maybe lazy. Sometimes we have to “force” a little movement by nudging baby which we accomplish by poking at mom’s tummy. If Baby is REALLY asleep, we sometimes have to poke quite a bit. I, of course, always ask Mom if I am hurting her. And I’m surely not hurting Baby. Your Little Love Bug is well protected by the amnion and fluid and mom’s uterus which is, essentially, one big muscle. But Dad, on this particular day while joining Mom for the visit, felt that I was — and he let it be known.

I start poking around on Baby and Dad pipes up saying, “You need to stop that. You’re pushing too hard.” I assured him that I wasn’t and asked Mom again if I was hurting her. She actually laughed a bit, stated she was fine and instructed me all to just continue doing what I needed. She also tried to calm Dad, but he wasn’t having it. After a little more vigorous poking, Dad said, “You’re gonna cause Shaken Baby Syndrome!” Some Dads joke about this, but this one was serious. Mom laughed out loud, and I reassured Dad that Baby was well-protected in there. We certainly would never do anything to, intentionally or otherwise, cause harm to his little one.

He eased up but wasn’t happy about it. He was starting his job early…over-protective of his baby girl before she ever even arrived.

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Posted on June 15th, 2014 by wombwithaviewblog.com

First, I’d like to extend a huge congratulations to a reader who recently delivered!ūüĎ∂¬†I love answering your ultrasound questions. I love it more when I actually help a reader. This is what she had to say…

Hi! I hope you had a lovely time on your holidays. Just had to say I had a little boy at 38+5, and he was a MASSIVE 8lb 7oz :)  Not half as bad as I imagined. Many thanks for your help to me!

Feedback and Your Ultrasound Questions…

I’m always excited to get your feedback! The whole point of my blog is to answer questions you have about ultrasound accurately. Considering the vast forums on pregnancy where everyone chimes in on their personal experiences, taking to heart unreliable information has the potential to do harm to you or your baby. Everyone is an expert; everyone has an opinion. Though I believe most genuinely care and try to help, I have found much about ultrasound to be misleading or incorrect in some way.

I have loved breaking the news to expectant parents about whether they would be shopping for pink or blue! And I’ll still be happy to try to decipher someone else’s images for my readers. In my effort to bring to you factual and truthful information about your ultrasound examinations, part of that truth is doing my best to help you understand your exam. Ultrasound will always be, first and foremost, a medical examination of mother and child. Your sonographer needs enough quiet and concentration to ensure your baby appears healthy! Afterwards, break out the party hats, and let’s have some fun!ūüéȬ†Of course, the level of fun completely depends on how photogenic your new addition is feeling that day. Poo, sometimes, it just isn’t what you expected, even when you lost sleep in anticipationūüėę

That said, the highlight of many workdays revolved around very happy couples who were mindful of why they were there, so happy to be expecting, and loaded with ultrasound questions! I love to impart  ultrasound knowledge to anyone willing to learn it. If I could also deliver a few awesome keepsake images of their future addition and enjoy a few laughs in the process, all the better. I still feel honored to have been a third objective party who was privileged to orchestrate it all!

Best wishes for a beautiful experience!

Email wombviewerblog@gmail.com with your comments, questions, pics and suggestions!

I’ll do my best to answer them for you!

 

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Posted on May 24th, 2014 by wombwithaviewblog.com

Today’s post is all about ribs but not the kind we love to bathe in barbecue sauce. It’s all about fetal ribs today.

Bone on ultrasound shows up white because it is very dense. Water, on the other hand, is the opposite and shows up black. Ultrasound cannot travel through bone, so as your baby’s bones become more dense, they cast a shadow behind them. Viewing certain parts behind them become a challenge, like the heart.

Next time you have a scan, notice the appearance of ¬†baby’s bones. Look for the perfect black lines of the shadow behind the bone. Notice we cannot see anything in that shadow. Therefore, anything that lies behind bone is not well seen.

Take a look at the image of this baby’s ribcage below. Notice the arrows pointing to the white dots which represent the fetal ribs and the black shadow that follows each one. Ultrasound 101. You’re quite welcome!

SONY DSC

 

 

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Posted on May 17th, 2014 by wombwithaviewblog.com

Ultrasound – One Mom’s Opinion

I love receiving uplifting emails from readers! Your positive feedback inspires me to continue blogging and to look for more ways to inform you about your fetus and you! Accurate ultrasound information and the safety facts that you need to know for the health of mom and baby make up my highest priority for my blog!

facial profile, 18 Weeks pregnant, ultrasound

Additionally, your questions offer great content to share with other readers. I encourage all my readers (subscribers or not) to share your ultrasound stories, comments, images, photos of your fetus, and ultrasound questions at wombviewerblog@gmail.com. Furthermore, your experience may even help another mom-to-be with her search. I hope you’ll read, enjoy, and subscribe to my blog to find answers for all your ultrasound questions!

An Ultrasound Opinion from One Fellow Healthcare Worker to Another

nurse and mom-to-be: ¬†Hello!! I must say I love your blog and wit!! Patients are so lucky to have such a skilled sonographer like you. I must say I’ve experienced both. My last one we met ¬†(18 Week ultrasound) was great, 20+ years experience and worked with higher-acuity patients, too. She respected our wishes and wrote down the sex with a picture for us to open later. She asked us to leave the room so she could analyze the image. We also asked her track record and she says she does not reveal if not sure. She labeled every body part for us and thoroughly educated us, as I’m sure you do, too!! I’ve been a nurse for 10 years so I can only imagine the questions you get! ¬†Love the idea of your site – you really utilize your talent and help us crazy pregnant ladies!!

Best wishes and I’m now a subscriber (and huge fan), yay!

wwavb: ¬†Hi! Thank you so much for reading and your kind words! AWESOME!! I’ve worked two years on content, and I would love to make my site into a book one day!! ¬†I think it would be an entertaining read for anyone and a great shower gift for new moms:) Your great feedback was a great Mother’s Day gift, by the way!

Subscribe for more accurate, reliable ultrasound facts and information for moms to be!

 

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Posted on May 8th, 2014 by wombwithaviewblog.com

I LOVE IT! ¬†What a breath of fresh air I received from a reader – someone who actually wants to avoid fetal sex determination! Now, don’t get me wrong. Though I held off on the potty shot for my first, I was a full-time certified sonographer working several years by the time the second came along. I personally couldn’t wait to see for myself. I even scanned myself in the process (we all do this, by the way)!

This post comes from someone who definitely fits into Club Minority. She wanted to wait for The Stork, but that was just not good enough for everyone else in her family!

distressed mama: ¬†Hello, I’ve really enjoyed reading your blog. From everyone’s posts, I can see that I am in the minority — my husband and I want to be surprised with the sex of the baby on the day I deliver.
We got the anatomy scan a few weeks ago, and the tech was very respectful of our wishes. She didn’t reveal the sex to us, and we left with the attached pictures.
We sent my sister the top picture in a text message. Upon seeing it, she immediately said, “I think I know what it is…,” and blurted out her guess. That really bothers me because it seems that the rest of my family believes her and is taking her opinion as fact. I still don’t want to find out, but I don’t want anyone else to be so certain that they know, either!
Based upon the first picture in the set of 3 I’m sending, is the sex of the baby obvious to you? I figure that if you can’t tell, then my sister who is NOT a trained ultrasound tech can’t tell, either!
Thanks for your blog, it’s always fun to hear what you think about these ultrasounds from “the other side” of the wand!
fetal sex determination

wwavblogger: ¬†I LOVE IT!! ¬†First things first. Absolutely, positively NO genitalia in that shot whatsoever! The black oval in the pelvis is baby’s bladder and I’m guessing she thinks she sees something just above that which is a very small section of umbilical cord at abdominal insertion. Either way, you are totally correct in that if I can’t see parts, neither can anyone else! Tell your fam they have a 50/50 shot at guessing;)

***

Everyone the expert, right? And, yes, the desire is overwhelming for patients to know gender as soon as the pee stick shows +. However, sometimes the desire comes more from the family than the patient!

From the other side of the wand, I can tell you people often believe what they want to see, not what’s really there. Distressed Mom, be sure to let us know what The Stork drops at your door!
Thanks for reading!
Have a similar story? Do you desperately want a surprise?
Is your family driving you nuts with constant harrassment to find out?
If so, email me with your experience at wombviewerblog@gmail.com!

For your most reliable ultrasound information, subscribe here.

 

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Posted on May 7th, 2014 by wombwithaviewblog.com

The Pregnant Belly Comes in All Shapes

Pregnant bellies are as different as the people to whom they are attached. You just can’t compare your pregnant belly to anyone else’s, and no one else should, either. But that doesn’t stop some people from comparing pregnant belly size to their standards for small or big.

Why is it that one of the most sensitive times in a woman’s life is also the one total strangers choose to flood you with unsolicited opinion? Bank, grocery store, public restroom – you just want to pee, but someone you’ve never laid eyes on touches your belly, asks your due date, and (last but not least) chimes in on how your doc must have gotten it wrong. And just when you wonder from which aisle they found the nerve, co-workers and your not-so-favorite uncle aren’t much better. Considering we humans come in all shapes and sizes, why would our pregnant bellies be any different? Furthermore, if with age comes wisdom, why haven’t more people figured it out?

How Bellies Are Different

In my career, I’ve scanned bellies of every shape, size, and gestational age. No one can predict how far along you are by how you look. If we see them everyday and we can’t tell, neither can anyone else! There just is no perfect belly model into which to squeeze yourself. My experience with pregnant belly size can lend a few general observations. Hopefully, they’ll help you feel a little better about your own morphing baby belly.

Pregnant Bellies on the Small Side

If you are fortunate enough to be tall and lanky with a long torso, your uterus will have more room to grow up instead of out. This sounds like a blessing to most, but it usually results in women who don’t show very much. They end up getting hit with a barrage of questions like “Are you sure you are eating enough?” or “Is your baby too small?” or “Are you sure your baby is growing right?” These patients come in for their ultrasounds worried about their Baby’s growth and asking for confirmation of normal weight for Baby’s age.

Pregnant Bellies on the Bigger Side

Conversely, if you are one who is shorter in stature or with a short torso, your poor little uterus has only so much “up” room before it has no choice but to grow out. These patients are usually miserable by the end of their pregancy (of course, not always!). Your belly may feel heavier and can appear farther along. Sometimes, having too much amniotic fluid in the third trimester (quite common) can make your belly look bigger, too. Let me guess – you tend to get hounded with comments relating your belly to popping or exploding and questions like the old “Are you sure there aren’t two in there?” “Huge” is not a compliment.

Patients Vent Their Frustration

I always empathized with my patients when they expressed this frustration and worry. They end up questioning diet, weight gain, and their baby’s health. Maybe you’ve lost sleep or internalized someone’s thoughtless comments, too. I do genuinely believe most people mean well, however, they just don’t often consider the impact of their words. Of course, they should, but I guess that’s too much to hope for – a Utopia where everyone thought first and spoke second?

If you’re also inundated with insensitive comments, you should simply discuss any concerns with your healthcare provider. If your doc says you and Baby are just fine, let that be all the confirmation you need.

I jokingly suggested boxing therapy for my patients. What exactly is that, you say? I say if anyone is bold enough to hit you with unflattering, unsolicited, and unwanted comments, you have the right to blacken an eye, relative or not! Apologize profusely, and tell them hormones made you do it. Blame it on pregnancy reflexes (is that a thing?). I guess I really can’t encourage violence, but the thought is nice, right?

On the other hand, if you’re not into smackdowns, maybe a clever comeback will make them think twice. Hmm…how about something like, “Hey, how about that! My baby is almost as big as your beer gut.” Hopefully, the future sighting of any expectant mom makes them turn and run for cover.

I hope this helps!

Feel free to email me with your questions or stories!

 

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Posted on May 1st, 2014 by wombwithaviewblog.com

Early Sex Determination

I find it comical when people ask me my opinion about gender and then don’t believe it. Especially regarding too-early sex determination. They keep asking. And asking. But too early is just. It just leaves too much room for error!

Fetal sex is not well-developed until about 17 Weeks. In fact, too early in the pregnancy, they both have itty bitty parts that stick out and can all look the same. That said, 12 Weeks is way too soon.

Read the emails from the grandma-to-be below who didn’t want to take “it’s too early” for an answer!

g-ma: ¬†Hi,¬†I subscribed to your blog. I love it.¬†These are my grandbaby at 12 weeks 2 days. Any guesses? The baby’s legs were crossed at the 16 Week ultrasound.

12 Week Fetus, early sex determination

12 Week Fetus

12 Week Fetus, early sex determination

12 Week Fetus

 

wwavb:  Hi! And thanks for reading and subscribing! So glad you are enjoying the info!

Okay, so if you’ve read any of my posts on the subject, you know that guessing at 12 Weeks is like flipping a coin. Just too early. An accurate guess can be made at 18 Weeks IF baby is cooperating! Any guess any earlier is simply a guess, and I just wouldn’t invest in paint!

Best wishes for a healthy grandbaby!

g-ma: ¬†Thank you for your response! It’s just driving me crazy wondering what those two white ovals are between the legs. Doesn’t look girl or boy. Could it be fingers or an umbilical cord?

wwavb: ¬†It’s definitely external genitalia, but boys and girls look the same at that age! Over the next several weeks, girl stuff shrinks to form labia and all her girly parts; boy parts get bigger to form the scrotal sac and penis. It’s all still developing on the outside even though chromosomally it’s already determined on the inside.

g-ma: ¬†Thanks for being so helpful. I would think it’s a boy for sure if it’s genitalia! But, not if they look alike at 12 Weeks.

¬†wwavb: ¬†Sounds like you’re not too far off from finding out. Happy shopping!
g-ma: ¬†Really…No guesses? I know it would be a guess. I thought the pics looked pretty clear. Everyone thought boy.
~*~
This grandma earned a spot in my post for her persistence! But it doesn’t change the facts. The professional verdict was not boy or girl but too early to know. It’s just not all formed yet!
People have a tendency to believe only what they can see or understand. As long as sonographers guess too early and continue to be wrong, I will have to persistently defend my stance on “too early” until the cows come home. It’s especially difficult when someone else delivers a “beyond sure” pink or blue guess to excited expectant families.
I’ll say it again. Weeks 12 – 15 are just too early for a guess that’s accurate enought to invest in paint – unless you’re going yellow!
Email wombviewerblog@gmail.com with your questions!

Comments: 3 Comments »

Posted on April 29th, 2014 by wombwithaviewblog.com

Great 3D Ultrasound Images

Sometimes, beautiful 3D ultrasound pics are just effortless! Well, when I was finally able to get this baby girl to flip over, she was more than happy to pose for the camera. We asked; she listened. What a good baby girl! Let’s hope she listens as well when she’s two! (My youngest one didn’t — such a little pill!)

The result this day was just great imaging. Mom was 27w3d here which proves an optimal time for a 3D scan. Of course, all the other factors have to line up, as well. Every mom hoping for some great 3D pics needs to have a nice pocket of fluid in front of Baby’s face.

2D facial profile, 3D ultrasound pics, 27 Weeks pregnant

Notice the black in front of her face here. This is one of the reasons we can see it so well with 2D imaging. But it’s also why we were able to obtain the beautiful 3D images you see below.

Babies have begun to develop some fat in their skin, so cheeks look a little more plump now.

3D ultrasound pics, 27 Weeks pregnant

 

3D ultrasound pics, 27 Weeks pregnant

 

Mom was happy to share:) Thanks, Mom! She’s a keeper!

Email your great 3D ultrasound pics! I’d love to post them on my site!

FYI – Before you visit a non-medical 3D business for your images, please read more on how to educate yourself before making your appointment and paying your money!

Comments: 2 Comments »

Posted on April 22nd, 2014 by wombwithaviewblog.com

Mistaken Fetal Gender Guesses

It’s possible. We’ve all heard a story or two, right? Being too early in gestational age is one way to ensure mistaken fetal gender guesses. Baby insisting on keeping still in a difficult position doesn’t help, either. There’s more at stake here than just being “wrong.” Parents start to identify with being a mom or dad to a new baby girl as soon as you speak the words. Thoughts jumpstart to dance recitals and her wedding day. Dads immediately daydream of the fishing partner they always wanted, or they run out to buy his first tiny baseball glove.

These are strong emotional ties that often get broken when someone casually throws out the gender card on ultrasound. Beyond the need to return some beloved items, comes the sometimes feelings of guilt or loss when the true gender is identified.

How “Mistaken Identity” Affected One Mom:

reader: ¬†¬†This is my second pregnancy and I am 18 Weeks. At my 20 Week ultrasound of my first pregnancy, I was told by the head ultrasound doctor (radiologist?) that it was definitely a girl, and I picked out a girl’s name. I ended up going into labor early at 30 weeks.

At the hospital while an ultrasound was being done, I kept asking if she was ok. The poor tech said, “Why do you keep saying she? Were you told it was a girl?” We said yes. She said, “Well, I see a scrotum. I’m going to get the Dr.” So, it turns out we were the first time this head doctor ever got it wrong, and now we are legend at his hospital.

We were already calling the baby by the girl’s name we picked, and I had a really hard time with the news. The only way I can describe it is like I had to grieve this little girl I had in my head that was suddenly gone. I wouldn’t change a thing about the amazing toddler boy I have now. But at the time, I was a wreck. Needless to say, I don’t want to go through that again. I was told today that the baby is a girl (again), and it is hard for me to believe. So, I just want to see what you think!

18 Weeks pregnant, female gender, mistaken fetal gender

 

wwavblogger:  Wow! Your story is EXACTLY the reason I implore sonographers to give careful and cautious consideration when determining gender!

I learned many years ago that even if I say I am not sure but give a “possibly,” parents are already thinking ballet slippers and pink tutus or sailboats and whales! It’s so true. ¬†It’s just an emotional attachment you begin to develop as soon as an inkling of pink or blue is mentioned.

¬†Now, not having scanned you real-time myself, looking at one single image can be tricky. By this image only, it looks like dance recitals may be in your future! It does appear like the typical three lines we see in a baby girl. Just know that I can’t guarantee it, though! PLEASE, send me another image of gender every time you have another scan in this pregnancy, especially since she already has the perfect name!
***
Did you or someone you know experience a case of mistaken identity by ultrasound?
If so, feel free to email all about it at wombviewerblog@gmail.com!

Comments: 5 Comments »

Posted on April 8th, 2014 by wombwithaviewblog.com

Terrible images of fetal sex like these kill me. First, I know they could be as easily wrong as right. In other words, the best rate for accuracy for this particular guess is 50% – as good as a coin flip but cheaper! Second, these moms get so excited for what they’re told. It’s just not right!

I still can’t believe some of the emails I receive from expectant parents who’ve been promised the gender-equivalent of the moon and stars based on crappy images…and I don’t mean a little¬†crappy. Who taught these people to scan? Hmm, maybe they weren’t taught? Read more on elective ultrasound businesses here; they’re not required to hire real sonographers. Moreover, most moms are WAY too early in their pregnancies to make such big commitments regarding Baby’s sex.

Read below an email from a reader who has experienced this very situation:

reader: ¬†Hi! I just found your site, and I love it! I was hoping that you could just reassure me that what we are having is a little girl? My ultrasound tech said that he was 100% sure it’s a girl because there were definitely no boy parts. But I just wanted a second opinion!¬†Thank you so much!

15 Week gender 15 week gender

 

All the Reasons Why This 15 Week Gender Guess is Just Bad

No sonographer with any level of adequate experience, especially those who specialize in OB, would ever dare to label this a girl OR a boy, much less to seal it with a “100%.” We all know that a lack of seeing anything that looks like a penis can hardly be declared a girl. Furthermore, with a bit of a projection between the legs here, wouldn’t you think he would err on the side of male? Regardless, of all the images I would dare tack a label of 100% to, these fall super short.

All I could advise is that she not paint a nursery based on these images! And I would be leery of any sonographer who calls anything 100%. The first cardinal rule of ultrasound is that nothing in medicine is ever 100%. It makes me crazy when patients are given images like this and told it’s a definite. This is precisely how mistakes with gender determination are made.

¬†I didn’t want to burst her bubble, and I couldn’t guarantee that her baby wasn’t a girl. Simply put, I wanted her to know that determining girl by those images alone was impossible. I did not see ¬†her scan live, however, these images are not textbook images for girly parts at any age.
I can’t teach the world to scan. But maybe I can nip some mistakes in the bud…one crappy disheartening image at a time. Once again, my goal is to educate and inform!
You can email me with your stories here!

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Posted on April 6th, 2014 by wombwithaviewblog.com

Studying ultrasound is no easy task. Actually, it was the most difficult and challenging thing I’ve ever done. Check out the email I received from my ambitious Aussie reader below:

reader:  Hi there, I just wanted to start off by saying I love reading your blog!

I especially wanted to message you because, whether I’m the first person to say so or not, mothers aren’t the only readers you have!
I am not pregnant, (or even anywhere near the ballpark of having children!), rather, I am extremely eager to pursue sonography as a career, specialising in Obstetrics and Gynecology so I can do what you do. Showing parents their children for the very first time is such a special moment that it would make all of the hard work and waiting worthwhile.
You truly inspire me and keep me motivated, as currently I’m only starting my path towards becoming a sonographer. That’s because sonography is a post-graduate course, and I am new to university this year. (Thus, about 3 years before I can even begin studying ultrasound)
I hope that you take pride in knowing that your blog is bringing comfort and joy to parents as well as inspiration and motivation to people like me. I really do see you as a role model for the type of professional that I would like to be in the future. Please keep up the amazing work!
You are blessed to have such a rewarding career, even with the ups and downs of pregnancy. I am not so blind as to think that pregnancy is always complication free, especially as a reader of your blog, but I know that the smiles on the faces of just one happy couple could make any day a great day.
I’ll be silently cheering for you to continue blogging!
***
I wish her and every other aspiring sonographer the best in their ultrasound endeavors. Best advice?
¬†Don’t be afraid to ask questions for as long as it takes to reach clarity.
I’d love to add a message for sonographers, especially those who are new to the field. A quality exam is important. Your thoroughness, accuracy and attention to detail can determine whether your patient goes to surgery or goes home. Ultrasound, being the most operator-dependent modality, requires great experience. I recommend all newly-certified sonographers work in a busy hospital where education and supervision are emphasized. You should NOT try to work in a clinical setting alone right out of training! It will take time for you to recognize pathology on your own. You WILL miss pathology, and it will be a disservice to your patients. I cannot emphasize this enough. Ask questions of your supervisors and physicians. Ask for supervision while scanning. Look up answers. Become informed. Details matter. Talk to your patients and listen. It’s important they feel you care about why they are seeing you. Don’t just be a good sonographer, be a great one. Your patients deserve it. Good luck in your ultrasound career where education and the opportunities to learn are endless. We never know it all so keep challenging yourself!

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Posted on April 2nd, 2014 by wombwithaviewblog.com

..This is how you know you should NOT begin decorating Baby’s room after your ultrasound.. If your sonographer can’t decide whether you are having a boy or a girl like your 3-year-old can’t choose between strawberry jam or grape jelly for a pb&j, DON’T PAINT YOUR NURSERY! (No contest..grape, definitely, grape.)

Read on from a patient who experienced just this scenario:

reader: ¬†Here is my 17 week ultrasound. The tech went back and forth between boy and girl and finally decided on boy after 10 minutes. She was also still in training. What do you think? Oh and the cord was between the legs. I’m so confused by this image. I go back tomorrow to look again. I love ur blog by the way!

unnamed

wwavb: ¬†Oh, wow. ¬†I see why you have to go back! lol There truly is no way to tell from that image what you are having…I can see legs. And I’m doubting tomorrow is going to be any better – because you’re still early and the student in training is still learning. She shouldn’t guess but, instead, have someone with more experience come in for a peek.

Tidbit of advice…even if she guesses, hold off on that favorite paint color! Feel free to send me another image tomorrow, but, hopefully, you’ll have someone more experienced?? If she is training, there should be someone with more experience there supervising her! Ask for that person.

Thank you so much for reading and subscribing to my blog! I hope you find it fun and informative and thanks for emailing me:) Please pass it along to all your expectant friends and fam!

Wishing you a healthy fetus,
wwavblogger

***

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Posted on March 31st, 2014 by wombwithaviewblog.com

I commonly get questions about the report as I pull up this page on the monitor when I am revealing Baby’s weight after taking a biometry (that is, the measurements of Baby’s head, belly and femur). ¬†Patients usually want to know why the measurements I took differ from the current gestational age. ¬†The fact is they can..this is not an exact science so even a difference of a week can be totally normal. ¬†Sometimes, a large difference can simply reflect a dating issue, meaning you are either farther or less along than you thought. ¬†Your doctor knows how to differentiate between the two.

Check out part of the report below.  This is an old exam on a Baby B who was growing just fine!

SONY DSC

First, notice GA.  This is the Gestational Age of Mom currently.  EDD of 8/15/2007 is the Estimated Due Date determined earlier in the pregnancy which corresponds with the GA.

Below that, you’ll see AUA or Actual Ultrasound Age. ¬† ¬†It says 19w3d, a couple of days farther along. ¬†This is merely an average of all four measurements taken and is considered consistent with GA, meaning her due date will stay the same.

The biometry consists of the BPD (width of the fetal head), HC (head circumference), AC (abdominal circumference) and FL (femur length).  The names in parentheses refer to the physicians whose charts for these measurements are programmed into the software.  The values are taken in centimeters and each one represents a GA based on that measurement.  You can see that the BPD measured 8d larger.  This is totally normal.  All the other measurements were pretty close to GA within a couple of days.  Again, these all demonstrate normal growth.

Below the dimensions you’ll see EFW or Estimated Fetal Weight calculated in grams with a small standard deviation and also displayed in ounces. ¬†This is determined by the four above measurements entered into the system by the sonographer.

Below that are ratios of these measurements. ¬†If baby isn’t growing properly, it will reflect here but we will also see that in the individual measurements.

Below that is an M-Mode or Motion Mode which demonstrates the fetal heart rate (HR) taken.  120 Р160bpm or beats/minute is totally normal.

This is only a small portion of a report on twins but enough to explain Biometry.  This concludes Ultrasound 101.

Have a great day, people!

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Posted on March 23rd, 2014 by wombwithaviewblog.com

The Worst Place for a Latex Allergy?

You guessed it. If you think setting your feet in stirrups and scooting to the edge isn’t your idea of a good time, discovering your latex allergy in all the wrong places would definitely rain on your parade. It’s terrible when patients have to learn about this the hard way! You seek medical attention and end up with a terrible reaction to latex that you didn’t even know about.

Alternatively, you may know¬†you have just such a sensitivity. You may not, however, realize you¬†that latex would be your intimate examination companion. This is precisely why the burden rests on us providers to ask! Whether the unwanted outcome is hives, swelling, or itching…none of it is welcomed anywhere on our person —¬†much less below the belt.

Universal Precautions

Of course, we exercise universal precautions when performing ultrasound examinations. This includes wearing gloves with every patient and washing our hands before and after. Most providers usually post signs throughout their facility reminding patients to speak up when latex is a problem. Most patients typically find this out early on in life, so we take extra precautions by highlighting the reaction in a patient’s chart.

The Dreaded Transvaginal Examination

Most of you ladies find yourselves all too familiar with transvaginal ultrasound exams. Though easy and fairly quick, they aren’t met with much excitement.¬†Yes, these probes are a bit invasive, aren’t they? Pregnant or not, if you’ve ever needed a pelvic evaluation with ultrasound, it has likely been performed via this approach. Naturally, the probe is covered for each use.

Your sonographer or other healthcare provider can never assume you don’t experience such a reaction.¬†Quite often, patients alert me well in advance. However, on many occasions, the patient warned me after I had already begun the exam. “That’s not latex, is it?” Thankfully, it wasn’t.

Today, practices can utilize many other options to avoid this potential problem. Enter vinyl! These latex-free gloves and probe covers can be made of other materials, as well. And using them exclusively takes the guesswork out of the equation, avoiding any possible unwanted exposure. The photo below is an example of what your probe might look like on exam day.

latex allergies

Transvaginal probe cover

Sometimes, I’ll use a glove instead of a probe cover. My patients usually watch with a little curiosity as I gel up a middle finger and slide in onto my probe. I have to admit the sight prompts a little laughter from both of us. Hey, we have to create a little comedy in medicine wherever we can find it, right?

Next time you find yourself about to come in close personal contact with a transvaginal probe, be sure to ask your sonographer about the probe cover if you have a latex allergy. An allergic reaction isn’t fun anywhere, but I believe all women can agree. The last place we’d choose for hives is the “South Pole!”

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