Welcome to the 1st Trimester!

Here you’ll find posts all about Weeks 4 – 13.

Expecting? Learn what to expect to see with ultrasound every week in the 1st Trimester. You won’t find it in pregnancy books, but many of your questions about ultrasound can be answered here. Congrats and thanks for reading!


Elective 3D Ultrasound Businesses

What You Get With Elective 3D Ultrasound Businesses

The answer might surprise you. They sure aren’t going to tell you, so I will! This post calls out to all the expectant moms looking for early gender ultrasounds from elective 3D ultrasound, privately-owned, non-medical businesses. Regardless of what they advertise, please read this first before scheduling your visit! Moms, do your homework. You have a right to know before you go!

3D ultrasound, 3D fetal face, 33 WeeksJust look at this shot! It’s so precious, isn’t it? Who couldn’t fall in love with their little one more and more with every great sweep of the probe? Heck, I fall in love with your baby with every image like this that I take.

We, in OB/GYN healthcare, understand expectant parents’ desire for images like this or early gender determination ASAP, but the safety of you and your baby is the greatest concern for all of us in the field. And because I know your baby’s safety is of utmost importance to you, there are a few important factors to take into consideration before having your scan performed by a non-medical facility.

They are not required to meet the same standards of care as those who practice medicine. Their staff may not be properly educated, and they take your money for promises of gender guarantees WAY too early in pregnancy … when they know it may not be accurate. You have a right to understand that you may not be paying for the quality and expertise you may think you are receiving. Please read on for your own awareness, and pass the message!

Why I Cannot Endorse Most Elective, Non-Medical Ultrasound Businesses

Uneducated Staff

The biggest issue I have with these business is something that may surprise you. They are not required to employ certified staff. Anyone can buy a machine, start a business, and charge you to scan your baby, but they don’t have to be a formally-educated or certified sonographer themselves or hire them.😲😤

Scary, isn’t it??

Some years back, I was mailed a flyer from an elective 3D ultrasound business. The goal? To sell you your own entertainment ultrasound business by offering a franchise and ultrasound education in a matter of days–for anyone off the street with no prior ultrasound knowledge or training. Before this, I had no idea such a business was even legal.

As a certified OB sonographer for 25 years, I can vouch for the level of knowledge and skill we learn initially and acquire over time, through clinical experience and performing diagnostic examinations. Most importantly, our education and experience also applies to the equipment we use to scan you. Anyone performing OB ultrasound should be utilizing the ALARA principle–and any formally educated sonographer knows what this is. Basically, we learn how to optimize power settings in order to use the lowest level needed to obtain a good image. This is recommended by the medical community because long-term effects of ultrasound are still being researched. Someone who is not formally-trained likely has no knowledge of how to do this or even know it exists.

Ask about RDMS credentials (or DMS, meaning they have recently graduated).

Unrealistic Promises for Gender

Now, let’s address fetal sex. After all, most of you who are super anxious to find out if you can shop for pink or blue want to know as early as possible! Most of these places advertise 100% accuracy of fetal sex guesses from 12 or 14 Weeks. This is irresponsible and something they actually cannot do.

They can’t guarantee a gender guess is 100% accurate.
They can only guarantee you a refund if they’re wrong.

I’m sure you many of you wouldn’t consider handing over your money if you knew this is what they meant by their “guarantee.” A guess too early in pregnancy is a toss-up. You are paying good money, and in some cases, a lot of it. More on early gender determination here.

Furthermore, how qualified is the guess if the person scanning you isn’t certified with a level of OB ultrasound experience? Any obstetrician or radiologist will tell you that no ultrasound can be considered 100% accurate. As a matter of fact, even DNA blood tests for first-trimester genetics or amniocentesis cannot boast of 100% accuracy–these tests are 99+% accurate. Ultrasound cannot come close to this degree of accuracy in the first trimester.

My advice to a mom- or family-to-be is to keep an open mind regarding a sex guess too early and to wait for your anatomy screen before investing in paint! Many women talk about the guilt and loss they (and spouses and children) feel when true gender is later determined. Read what one mom had to say here!

That said, anyone can guess incorrectly! But when far enough along and with truly experienced OB sonographers who know when the circumstances are ripe for guessing (and when they’re not!), the chances for an accurate guess rise dramatically!

Equipment Maintenance and Safety

They are not required to maintain safety standards for their equipment. Machines need maintenance to ensure they are performing properly and safely. Cracked probes and cords that are worn, old, and/or not properly cleaned or maintained can be an electrical hazard to their customers. Maintenance is costly, and I just have to wonder how many of these businesses elect to bypass it because they can. You may not necessarily know whether their equipment is safe.

No Physician on Site

Though not a diagnostic exam, a physician is not on site in case a problem is detected. And detecting an obvious problem is much less likely for someone not formally trained.

They Do Not Perform a Diagnostic Exam 

But sometimes they say or advertise that they do. Some of them even call themselves a diagnostic imaging center. They’ll tell you that they’ll scan a little to make sure Baby is okay. I believe this gives the expectant parent a false sense of security. No sonographer can legally tell you your baby appears normal by ultrasound.

Please be aware that no one can call an elective ultrasound scan “diagnostic” in any way! Your healthcare professional must order a diagnostic exam. You must be scanned by a certified sonographer in a medical facility where at least one physician is on site. Finally, an official report must be generated for a physician’s interpretation and signature.

No one scanning in an elective 3D ultrasound business can promise a diagnostic test!

Undisclosed Information

Finally, they don’t have to advertise any of the above! They have no requirements to inform you of any of the issues above. If you ask, they have to answer honestly. So, be sure to ask!

A Message To Those Who Are Not Qualified to Scan!

Make no mistake about it. Waiver or not, if you scan a pregnant woman for fun and miss a problem, you are still liable. You are not trained to recognize these problems or how to handle them. How would you handle seeing something you feel is abnormal or that you cannot explain? What would you say? If you cannot call yourself a formally-educated sonograper, you have no business picking up a probe. Most of us who practice OB every day only get slightly better at breaking terrible news. This unfortunate experience will inevitably be yours at some point.

Moreover, you don’t know how to use the equipment safely or optimally. It takes a bit of artistry, (again) proper training, and experience to be able to create good 2D images–also needed in order to create good 3D images. Providing sub-standard images takes advantage of the customer paying for it, especially when they assume you know what you are doing.

Anyone can set up a 60″ monitor and some comfy seating. Anyone can show you how to press a few buttons. It doesn’t mean you can call yourself a sonographer. If this is your goal, go to school and learn how to do it the right way. Also, it doesn’t mean you are providing a fair service for the money.

Parents, Please Do Your Research on These Businesses!

My best advice for all expectant parents who want to pay for an early gender ultrasound is, first and foremost, to ask yourself if you can truly remain open-minded regarding a gender guess. If you hold a strong preference for one sex over the other, you may want to wait until your diagnostic anatomy screen at 18-20 Weeks for a better chance at accuracy.

Know before you go, people! Call in advance to ask if the person scanning you is a certified sonographer with OB experience and not a former used-car salesman. Don’t assume he or she is qualified to scan you. If not, you would be better off with this elective scan at your doctor’s office instead. A sonographer there is far more likely to detect an obvious problem. And your doctor or another physician would be in-house to discuss it with you and answer your questions.

I’ve made it no secret in my past posts that I’m not a fan of these cash cows. I believe that non-medical personnel should not be scanning pregnant women or utilizing medical equipment.

For the safety of the expectant parent, ACOG, ACR, and AIUM do not recommend elective scans at these sites. 

These businesses were borne of the expectant parents’ desire to see their baby at will, to bond with their baby, and to share with their families a special event. We understand this movie theater experience isn’t something you can receive at your doctor’s office, but the first and foremost concern is the health of you and your baby. I think any parent would agree.

Even though this can be a fun experience for the family, the potential for serious issues is real. We can’t tell you not to go, but please do your homework first! If nothing else, ensure the person scanning you is qualified to do so! Educate yourself, and make an informed decision.

Best wishes for happy and healthy!

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The Yolk Sac–What to Expect on Ultrasound

What is the Yolk Sac?

the yolk sac

In this post, I’ll explain the yolk sac, its role in your pregnancy, what you should expect to see, and when we can expect to see it. Additionally, I’ll share an email I received from an anxious mama regarding an image her doctor gave to her. She didn’t see a yolk sac and was concerned one may not be there.

anxious mama: I recently received an ultrasound at 7 Weeks 5 Days. My doctor said everything looked great, and we were able to see its little heartbeat. When I got home and looked at the photo a little closer, I couldn’t find a yolk sac. Would you mind looking at it and letting me know if you can see a yolk sac or anything else you may notice? Thank you so much. This is my first pregnancy after having a miscarriage and I am slightly protective. 🙂

***

In short, if there’s an embryo, a yolk sac must exist! I didn’t see a yolk sac in her image, either. That said, it may be positioned on either side of the embryo, in which case you may not be able to see it in your particular image.

What’s the Role of the Yolk Sac?

The job of the yolk sac provides nutrients for the embryo until the placenta develops. No yolk sac, no baby. Your baby cannot develop without it! When this happens, we’ll often see only a gestational sac with no yolk sac or embryo. This is called a blighted ovum. Of course, this is not a good pregnancy and must end. Though many women have said they felt so much better knowing this–it can be much more difficult to accept knowing a heartbeat started, then stopped.

So, if your doctor said all looks good and you see a heartbeat, there has to be a yolk sac in there somewhere.

When Can We See a Yolk Sac?

The yolk sac is typically seen somewhere after 5 Weeks gestational age, before we ever see an embryo at Week 6. We normally continue to see the yolk sac every week until somewhere around Week 12 or so, maintaining its same appearance. As we near the end of the 1st Trimester, however, we are less concerned about identifying the yolk sac. As long as Baby is growing appropriately, documenting it is not as important as it is in early pregnancy.

What Will You Expect to See on Ultrasound?

A yolk sac looks like a tiny white circle. Most often, you will see your embryo cuddling up against it. Below is an image of an embryo at 9 Weeks and a great image of the yolk sac right up against Baby’s bottom.

 

9 Weeks, 9 Weeks pregnant, pregnancy Week 9, yolk sac

Embryo – 9 Weeks

However, sometimes we are not able to obtain the yolk sac in the same image with the best view of your embryo or fetus. Check out the image of the twins’ yolk sacs below.

Yolk Sac, twins, twin yolk sacs

Twins’ Yolk Sacs – Week 6

Here you can see an image below of the same scan with just the embryos shown.

6w6d Dichorionic/Diamniotic Twins, 6 Weeks pregnant, 6 Weeks, 6 Week Twins

Twins – Week 6

I will also add here that I understand how frightening and what an anxious time it is for women to try again for Baby after a pregnancy loss. No matter how early someone miscarries, it’s still a loss and emotionally draining.

When a miscarriage happens very early in one’s pregnancy, we call it nature’s way of taking care of something which was not developing properly. From a human, spiritual, or emotional viewpoint, I like to think that Baby decided he or she needed a little more time! I always say our babies come to us when they are ready, not always when we are ready for them. They have to be ready for this great big world, too!

As providers, we don’t take special pains to give you an image of the yolk sac. It’s just not as doggone cute as your Little Sprout! 🙂

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~ * ~

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Twins at 6 Weeks–What You’ll See on Ultrasound

Twins, 6 weeks, 6 weeks pregnant

Ah, twins–are these babies precious or what? SURPRISE! Man, I just love seeing the look on people’s faces when I give them this news. It’s the best! The shock. The disbelief. The fainting spells. It’s so funny when we have to call a code for smelling salts for Dad! 😂

Whether we see one embryo or more, we have great expectations for what we expect to see during your ultrasound at Week 6. Not everyone can expect to have a sonogram at this early gestational age. If you do, however, the first thing you can expect is a transvaginal ultrasound. Yep. Babies are just too tiny as you’ll see below, so we need the magnification and better resolution of the vaginal probe. Hopefully, you won’t be required to float into your ultrasound exam with a full bladder. They’ll likely end up letting you hit the restroom and performing the vaginal scan anyway.

Either way, we expect to see some pretty amazing changes brewing! This post is dedicated to 6 Week babies x 2, aka twins!

Twins at 6 Weeks

If you have followed the twin pregnancy from Week 5, this post is a continuation. Did we see two babies? Two heartbeats? YES! Yay! This was a great milestone! This is a dichorionic pregnancy, meaning both babies came from two separate eggs. This particular pregnancy produced “fraternal” twins. This, of course, means these babies can either be the same sexes or one from each camp, Teams Pink and Blue. Woohoo–that would be a fun (and expensive) shopping trip!

The gestational sacs at this particular 6 Week ultrasound were still discrepant from one another. We could not explain why the gestational sac of Baby A was smaller or why that of Baby B was larger. This finding still concerned us. However, the fact that we saw two strong heartbeats and two babies who measured essentially the same were both very reassuring! See the images below for measurements of the embryos.

6 Weeks, 6 Weeks pregnant, twins 6 Weeks

Baby A Embryo

You’ll note here that Baby A was measuring a whopping 3.5mm!

 

6 week ultrasound

Baby B Embryo

Baby B measured about the same at 3.4mm.

Now check out the heart rates!

6 Weeks, 6 Weeks pregnant, twins 6 Weeks, heartbeat 6 Weeks

Baby A Heart Rate

This is the heart rate for Baby A. Note that it measures just over 100bpm which is a great start!

 

6 Weeks, 6 Weeks pregnant, 6 Weeks twins, heartbeat

Baby B Heart Rate

Baby B’s heart rate was just a tad faster at 109bpm. Both heart rates were just what we want to see–strong, steady, and rhythmic.

If you want to follow these twins, check out Week 7 and Week 8. You will be impressed at how much bigger they look in only one week’s time!

I know you might be feeling overwhelmed right now, but you’ve got to always look for the positive, the silver lining. Two at once is a lot to take in, but just keep two healthy babies your focus. Remember, siblings have been coming into this world together for a long time … if their parents can do it, so can you!

Just look at how much fun this will be in a couple of years!6 weeks pregnant, 6 Weeks, 6 week twins

~*~

Best wishes for healthy, and feel free to comment below!

~You can email me here with your question~

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Ectopic Pregnancy–Understanding What We Look For

Ectopic Pregnancy Explained

An unfortunate circumstance of pregnancy, especially a desired one, is the ectopic pregnancy. In this post, I’ll talk a little about what we look for with transvaginal imaging, and how they can sometimes be extraordinarily difficult to diagnose.

What’s An Ectopic Pregnancy?

An ectopic (pronounced ek-top’-ik) pregnancy is one that is displaced. This type of pregnancy is one that implants somewhere other than within the lining of the uterus – where it’s supposed to be. An ectopic frequently occurs within the tube, commonly referred to as a tubal pregnancy. I’ve also seen them within the adnexa, usually the area between the ovary and uterus. Very rarely, a pregnancy attaches abdominally. (Rare and bizarre!)

How Do We Know to Look for an Ectopic? Your low hCG Levels

One sign that leads us to look for an ectopic with ultrasound is a very low hCG level. Now, this alone is not alarming. It is, however, when combined with other factors. Your level of hCG should essentially double every two days in a normally-progressing pregnancy. If this isn’t happening, we become concerned that your pregnancy is not a good one.

LMP Dating Doesn’t Measure Up

Many women are unsure of their LMP. Maybe their periods are very irregular. However, if your periods are like clock-work and you are very sure of the first day of your last period, not seeing a pregnancy within the uterus at a time when we would expect to see one would worry us. For example, from about Week 5 on, we would expect to at least be able to confirm the presence of a gestational sac within the endometrium (lining of the uterus). See the image below for a super-early (~4 1/2 Weeks), normal intrauterine pregnancy:

ectopic pregnancy

If You Have Pain

If the above factors come into play and you also have pain, we increasingly become concerned for the possible presence of an ectopic. Too early in your pregnancy, even with an ectopic, you may not experience pain immediately. Even if you don’t, the other factors are enough to raise an eyebrow and spark the hunt. Typically, the pain occurs on the same side as the ectopic. You may be watched very carefully and followed with blood work and serial ultrasounds until we’ve either proven or disproven the ectopic. Physicians want these patients treated as soon as possible because they can pose a serious health risk for mom.

If We See Bleeding in the Pelvis

Another characteristic of an ectopic via ultrasound is the presence of free fluid or bleeding in the pelvis. A large collection of blood can be seen around the uterus and ovaries when the ectopic starts to bleed. We tend to raise both eyebrows when we see this and all the other factors mentioned above are part of the equation. The extra fluid tends to cause an increase in pain.

If We Find an Unexplained Mass in the Adnexa or Tube

Most of the time these pregnancies present as a mass somewhere outside of uterus, usually in the tube between the uterus and ovary. Either the pregnancy implanted in the tube on its journey to the uterus or it never made it to the tube at all. In these cases, the egg was released, but the “fingers” at the end of the tube failed to catch the little guy. Most often, these masses do not look like the typical normal pregnancy. The masses can be vague and difficult to see depending where in the pelvis they are located.

If You Have a History

Moreover, your doc may consider you at an increased risk of an ectopic if you present with all the above findings and a history. Your chances of having an ectopic may increase if you also have a previous history of an ectopic pregnancy, a history of endometriosis, a history of a tubal ligation, or get pregnant with an IUD in place. This may not be a complete list of risk factors.

My Experience as a Sonographer with Ectopic Pregnancy

I have had patients in the past where we just knew she MUST have an ectopic but try as we might, we just couldn’t see it right away. After a second, third, or even fourth scan were we finally able to confirm what we suspected.

I have also had the misfortune, only a couple of times in my whole career, of finding an ectopic pregnancy with an embryo and a heartbeat. Unfortunately, these pregnancies cannot be saved. They have to implant on their own and can’t just be “placed” inside of the uterus.

These scans can prove very challenging and definitely put one’s ultrasound ability and expertise to the test. Knowing what to look for and where is the biggest piece of the puzzle for all you newbie sonographers! (Google images of ectopic pregnancies. They will definitely help you if you’ve never scanned one before.)

What To Do

As I’ve said many times before, I cannot give specific pregnancy advice. However, I can confidently advise this . . .  If you know you are early pregnant and begin feeling pain in your pelvis or back, call your doc ASAP! They will determine how soon they want to see you!

Best wishes for a healthy pregnancy!
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Want to share a story about your experience with ectopic pregnancy?
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Ultrasound Safety–Is It Radiation?

Ultrasound Misconceptions!

ultrasound safety

Ah . . . one of my favorite things on this beautiful planet of ours is a beautiful sunny day at the beach. I love almost nothing more than that warmth on my skin and my toes buried in sugar-white sand. How about this shot, huh? Taken by yours truly on just such a day! However, because there is no good without its constant bad companion, our basking near the shore also leaves us susceptible to waves of radiation. Shoulder burns. Skin cancer. But let’s not confuse these waves with the sound waves of your diagnostic ultrasound! This post is dedicated to ultrasound safety, what ultrasound is, and what it isn’t.

First, let me help some of you moms out there relax right off the bat. The idea that ultrasound is a form of radiation is a complete untruth, rumor, or misconception. The technology behind ultrasound has long been documented–since its inception for medicine in the early 1900s. Anyone who has studied ultrasound, as well as every physician, engineer, and manufacturing company in relation to the technology can attest that ultrasound emits sound waves, not radiation waves. Those who have conducted biohazard testing in the field over the past forty years can do the same.

Despite what you may have read or heard, regardless of where, please do not believe this garbage! I hope you’ll read more about it here below. And please do not let this scare you away from your diagnostic scans. Your obstetrician is in the business of taking care of you and your baby–not to willingly subject you to radiation . . .

What Exactly is Ultrasound?

Ultrasound is just that. Ultra Sound, or sound waves that work at a frequency far beyond human hearing.  Like a fish-finder one might use on a boat. Or sonar used by the military. Human hearing ranges from about 20Hz (Hertz) to 20,000Hz (or 20kHz). When it comes to creating an ultrasound image, we work in the MHz range or millions of Hertz. An OB probe ranges from about 2MHz – 13MHz.

Ultrasound is a department of Radiology within a hospital, but it does not emit radiation.

Someone Is Spreading the Wealth

The heading is meant to be facetious. Unfortunately, someone is spreading only fear and proliferating ultrasound misinformation. Apparently, she is also someone who hasn’t done her homework. I was floored recently while doing research for my book when I came across a very popular pregnancy book (which will remain nameless) who actually wrote that ultrasound is radiation. If you have read this book, you know who I am referencing here.

She also claims that the Doppler used by physicians to obtain heart tones emits more radiation than scanning equipment! Wrong again, Doppler is ultrasound.

How does this happen? After all, she supposedly had the help of “knowledgeable” medical resources to write the book. Are they the only healthcare providers on the planet who don’t know Ultrasound is not X-Ray? And if not, why not?

I am unaware if this author has since recanted her falsehood. If she did, I give her credit. If not, she owes an explanation and apology to her faithful readers and social media followers. She is incorrectly influencing millions of parents-to-be with this misinformation, and it’s not okay. She is adding needless fuel to the fire, and moms worry about enough as it is.

Additionally, she then goes on to advise moms to only have an ultrasound if they really want one but to not have more than they need. To me, this begs the question…is it radiation or is it okay?

I would like to think she did not intentionally mislead her readership. But as a published author, ignorance is no excuse.

What is Radiation?

It is a transfer of energy that also travels in waves. As I mentioned at the start, radiation is found in light from the sun, microwaves, and X-Rays. But not sound waves. And, yes, exposure to radiation can cause cancer. One example is skin cancer from too much sun exposure.

Consider this. When you go to the dentist, what is the first thing asked of any woman? “Is it possible you might be pregnant?” If the answer is “Yes” or “I’m not sure,” they shield your belly to protect Baby from the minuscule dose of radiation from the super quick X-Ray of your teeth.

If an obstetrician’s job is to manage the health and care of Mother and Baby, and it is, why then would docs expose their patients directly to radiation? And what about sonographers? We all would be directly exposed numerous times a day, every week for the duration of our careers. None of us, patients nor sonographers times decades, have died from cancer due to ultrasound exposure.

Is Ultrasound Safe?

So far, with the prudent use of commercial technology, there have been no known bioeffects on the fetus, mother, or sonographer. Biohazard testing over decades has demonstrated the creation of heat in fetal tissues during higher than recommended settings and extended scanning times. The long-term effects are still being studied. Therefore, it is the feeling of ACOG (the American College of Obstetricians and Gynecologists, ACR (American College of Radiology), and the AIUM (American Institute of Ultrasound in Medicine) that the benefits outweigh the risk, and they justify the use of ultrasound only for diagnostic purposes.

They do not endorse the private entertainment ultrasound scan in the strip mall near you. These facilities are not regulated to maintain the same standards as medical practices for patient safety. They are not required to hire formally-trained and credentialled sonographers or to properly clean or maintain ultrasound probes or equipment. Be sure to do your research prior to scheduling your appointment in one of these facilities!

My Two Cents

One of the reasons I started this blog five years ago is because patients were misinformed – by Dr. Google, family, or friends. I expect as much from a random non-medical blogger, and I became even more enraged to find misinformation doled out on popular pregnancy sites. But in a published book? Unforgivable!

It’s one thing to express one’s opinion. But when you’re making tons of money by persuading expectant moms to adopt your line of thinking, you have the responsibility to get your info right. No one says anyone has to be a fan of ultrasound. And as a mom, you have the right to decline. Before you do so, speak with your provider. You need only to understand your choice. Any mom who ever delivered a baby with serious problems was happy to know about it in advance for planning and educational, emotional, and delivery purposes. This, in fact, is the purpose of obstetric ultrasound.

And if you’re all about moms and choices, and those choices are power? The power only comes from a parent who makes an informed choice, not one based on misinformation. It is my wish and goal to simply and accurately explain ultrasound for moms-to-be and stamp out the misconceptions. Understanding is also power. 🙂 I hope this helps you expectant mamas-to-be sleep a little better tonight.

Here’s to a happy, healthy, and informed pregnancy!

As always, thanks for reading!

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Ultrasound Images–If You Got ‘Em, Share ‘Em!

Email Your Ultrasound Images!

ultrasound images

3rd Trimester Feet!

Got Some Precious Ultrasound Images?

Okay, so what do all you moms-to-be out there do before Baby gets here? Show off your great ultrasound images, right?!

Well, I’d love to see them, too. Email me those shots near and dear to your heart, and show off your little punkin’ to the world at the same time. Baby’s face, profile, 2D, 3D, hands, feet, or even your 4D video clips would all be perfect to post. And if you also have great shots of male or female fetal sex, send those, too!

I’ve personally taken some really great pics over the years. Baby yawning, sticking out the tongue, puckering those lips, and even flipping the bird! Who doesn’t love a cute set of baby toes? How about a ton of hair? If you got it, flaunt it! We moms like to brag on our cute kids, so it may as well start before they even get here.

(Full disclosure! Uploading your images means you consent to my using them for promotion of my blog or future books. As always, I keep your privacy private omitting all identifying info. Can’t wait to see them!)

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Video of Diagnostic Ultrasound

To Video or Not to Video Your Ultrasound?

That is the question. Depending on the facility where your exam is performed, the decision to take a video of your diagnostic ultrasound may not be left up to you. If your fetus doesn’t have one of these in there …

video of diagnostic ultrasound

… you may not be able to, either.

You might not like it very much, but your doctor’s office or other medical facility performing your diagnostic scan may have policies against it. And, boy, have I had my share of disgruntled patients because of it.

Why Can’t I Video My Diagnostic Ultrasound?

The answer is plain and simple.

In the modern-day world of social media, doctors and administration alike don’t want any part of an unread examination floating about the web. Exams aren’t read by a physician until the scanning portion is complete. Unfortunately, in the litigious U.S., they must take certain precautions to protect their examinations. And, yes. It is your baby, but the exam itself legally belongs to them.

Regardless of the medical implications, these policies just drive the pregnant population to private scans. If you’re an avid reader of mine, you know I’m not a fan. I think it’s always better to have any ultrasounds with your doc’s office (or other facility recommended by her/him).

Another option to consider is to simply ask your physician if he/she will allow you to record the heartbeat while listening with the doppler. Maybe your doc will be the one performing a scan; it doesn’t hurt to just ask. Usually, they don’t mind, and they make the rules for their practice. We sonographers just have to enforce them!

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Early Fetal Sex Determination

The Myth of Early Fetal Sex Determination

early fetal sex determination

As a sonographer of many years, I know that ultrasound is subjective. But expectant moms seem to continue to be surprised by incorrect early fetal sex determination. And I seem to be receiving more and more emails about this ever-growing problem. Nothing makes me angrier than when another sonographer tries too early to hand out a sex guess! I get angrier still when some businesses make this promise as a marketing ploy.

It just isn’t fair to the patient or customer. I feel these facilities take advantage of pregnant anxious moms who have a desire to know the sex of their baby as soon as possible. After all, it is one of the most anticipated events in pregnancy! However, these mothers-to-be wouldn’t spend their money on an ultrasound if 3D non-medical businesses didn’t exploit that desire. They advertise a promise or guarantee for early fetal sex determination at 12+ Weeks! So, what is the public to believe except that they can deliver on that promise? The truth is they know it’s only a guess. If they guess right, they got lucky. If they guess wrong . . . oh, well. Here’s some of your money back.

Too Ambitious?

I think developments in the technology have yielded a little too much ambitious guessing in the fetal sex department. Resolution has improved so greatly over the years that we see better than ever with the most modern equipment. But just because we can see “a little something” sticking out, in no way or shape or form, means you’ll be investing in blue paint.

I want to educate every fertile, human-growing woman or parent-to-be out there that even the best
ultrasound equipment on the planet cannot differentiate a boy from a girl.

To this day, determination of sex is still dependent on the experience and skill of the person holding that probe to your belly. But also know that a sonographer’s skill doesn’t mean squat when external genitalia has just begun to grow. It’s anyone’s guess!

We have all heard a similar story. A customer pays for an early scan and is told one sex. “Congratulations! I’m 100% sure!” Lo and behold! At the mid-pregnancy anatomy screen (or later), the penis has magically fallen off and now all the sailboat motif and cute suspenders have to go back. Or vice versa. The question I always get is, “How did this happen???”

Loads of Room for Error

So, just how DID this happen?

Easy. It’s the scanning observer’s opinion, but it’s still just a guess. You assume he or she is experienced in making this determination…maybe, maybe not. Especially when this person displays such confidence in his/her guess, you feel sure that they must be correct in their guess. But it doesn’t mean they are; they can still be very confidently and entirely . . . wrong.

This is why!

External genitalia is just starting to develop later in the first trimester, and it will continue to morph and change in appearance over the next several weeks. All babies have a little something sticking out at 12 Weeks. But if Baby is a girl, that tissue will shrink and become recognized as a clitoris later on, with labia seen on each side. If a boy, this part grows a little larger and becomes a penis. The scrotal sac develops over the next few weeks but is still quite small. And we cannot see testicles until somewhere around 28 Weeks (or maybe slightly earlier).

The Nub Theory

early fetal sex determination

12 Week Fetus

Most readers ask if this test has any validity. The answer is “some.” If (and, again, subjectivity comes into play here), if an observer knows what fetal angle to obtain and how to read the angle of the nub, you might have a 70% accurate guess. But that’s a few IFs. The observer also has to know when the angle is equivocal, meaning the protruding part is not one way or the other but somewhere in-between. In these cases, a guess cannot be made. Keep in mind here that even if the angle is perfect, there is still a ~30% chance of an incorrect guess! In other words, it’s not a hugely reliable predictor.

So, What’s the Best Advice?

Later is better! Wait for your mid-pregnancy anatomy screen at 18 – 20 Weeks. Below are great images of typical and normal-appearing external genitalia of each sex at this age:

male gender, 2nd Trimester

Male Fetus

female gender, 2nd Trimester

Female Fetus

If Baby isn’t cooperating, don’t put the heat on your sonographer to guess anyway. Part of a good sonographer’s job is also to know when NOT to guess.

The truth is that no one should be providing a guess for sex determination much earlier than this in pregnancy, especially for a fee. And certainly not with a 100% positivity attached.

Just because someone says she is 100% sure, doesn’t mean she is right.

Business is business. As long as parents will pay for it, someone will take your money and offer a guess. This is the unfortunate bottom line in the non-medical ultrasound business. I’m not saying you shouldn’t go to one of these places. Maybe you just want to see a heartbeat and bond. This is understandable. But I caution you to pay for fetal sex determination earlier than 18 Weeks.

Advice Regarding Early Fetal Sex Determination

All you moms who are thinking about paying for an early scan at a strip mall near you (or anywhere!), please first consider the above info. It might just save you a few bucks and some disappointment later. Alternatively, if you are the kind of person who can remain entirely neutral about any sex guess and just want to have some fun watching Baby move, go for it. Have a blast.

The biggest issue here is our own nagging, relentless, compelling need to know as soon as possible. But more of the same will keep happening. Businesses won’t quit selling early fetal sex determination as long as pregnant moms are buying. Let’s pass the word around, ladies. Just don’t buy what they’re selling!

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Ultrasound Results–Why Can’t Your Sonographer Just Tell You?

Ultrasound results, twins, 8 week twins

8 Week Twins!

What’s the big deal about giving ultrasound results?

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 Must Come from the Docs

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

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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Amniocentesis–The Amniotic Fluid Test

Amniocentesis

 Do All Women Need One?

amniocentesis, amniotic fluid

  • Who needs an amniocentesis?
  • When should an expectant mother consider an amniocentesis?
  • What factors help a patient decide if an amniocentesis is right for her?

Some women may need one of these tests to determine fetal lung maturity if your doctor feels you need to deliver early. However, only your doctor can help you make this decision when it comes to first-trimester genetic testing. You can find out a little more about an amnio performed during this stage of pregnancy (some very basic information) here.

The internet is filled with all kinds of misinformation, right? I think most of us realize this and, hopefully, take forums of personal opinion with a grain of salt. However, I read an article last night on a popular parent/child site that I felt was a bit disturbing. We expect more credibility from these sites, but we don’t always get it. Their information should come from a knowledgeable source. Maybe it did, but the author should have been more careful with her words, especially when publishing important recommendations for pregnant women.

So, the article was all about ultrasound . . . a subject with which I’m pretty familiar. She had a few tidbits of information incorrect. But one statement I vehemently disagreed with was one regarding amniocentesis. The author stated that any expectant woman over the age of 35 or with a family history of genetic abnormalities should have an amniocentesis. Should? This statement should have never been printed. Women faced with this option may search the internet for information to help them decide. I would like to think their decision would not hinge on an article found on the internet. In the same respect, I’m sure their readers consider them a reputable site filled with only accurate information.

The truth is that no woman should just hop aboard the amnio train (we use “amnio” for short in the field) without a serious discussion with her obstetrician. Granted, no obstetrician would perform an amnio without discussion and signed consent from the patient. However, I would hate for this article to automatically sway any pregnant woman to believe she needs it. The test and its results are not without repercussions. With that, I felt my next post should expound on the topic to the extent of my experience with it.

Things to Consider Prior to Amniocentesis

Genetics gets quite complicated, and some patients find it difficult to understand all they’re told. For this reason, I won’t go into too much detail about the different types of testing and what they can detect. This is mostly because I do not have this information–I’m not a geneticist. However, your doctor does. Most patients don’t just jump right into having an amnio. A patient is usually first asked whether she wants chromosomal testing.

Desiring this testing is typically based on a patient’s “need to know.” Why do you want the information?  If your mentality is such that you will have this baby no matter what and you don’t need to know anything in advance, your doctor may say first-trimester testing is not for you.

However, if you are the type of patient who NEEDS to know normal vs abnormal, a host of other questions opens up for you. Will you abort this pregnancy depending on results? Or is abortion out of the question? If so, do you simply want to educate and prepare yourself and family for what is to come? If so, this testing may be for you.

What’s Included in Genetic Testing?

Some genetic testing includes bloodwork and/or ultrasound, the NT or Nuchal Translucency test which are all usually performed somewhere around 10 weeks to 12 weeks. It does not always include an ultrasound; that depends on what type of testing your doctor offers. The NT scan requires certification of the sonographer who takes special pains to measure a fold of skin behind your baby’s neck.

amniocentesis

NT test

This measurement, IF it can be obtained, then goes to a lab with your bloodwork. Sometimes the measurement cannot be obtained if Baby is not in a good position or if the image is not clear enough. Recent developments in bloodwork have become more reliable than performing an NT. Some physicians, therefore, no longer offer the NT and only offer the bloodwork. Some docs still offer both.

What Do the Results Mean?

If you elect to move forward, the next thing your doctor may explain is that this testing only determines your RISK for certain abnormalities; it does not confirm an abnormality. It is a risk assessment only. Your obstetrician’s office may perform this testing, or she/he may refer you to Maternal Fetal Medicine (a perinatologist, otherwise known as a high-risk OB doc).

If your results come back as low risk, GREAT! It means the chance that your baby actually has these abnormalities is low. Your next test would then be your anatomy screen at 18-20 Weeks to rule out structural malformations.

If your testing comes back as high risk for a particular problem, it will state which problem along with your risk level. This is where amnio comes into play. The amnio WILL confirm whether your baby really has this problem. You will have to decide whether you want to have this procedure or not. Your doctor will explain the risks and benefits of an amnio. The risks may be almost non-existent for infection and (last I knew of) around 1% or less for miscarriage. The risk may be significantly less, so be sure to discuss this with your doctor. The benefit, of course, is determining exactly what kind of abnormality you are dealing with so as to help you prepare in whatever way you feel is best for you and your family.

How Is an Amniocentesis Performed?

Basically, a sonographer will scan you to look for an adequate pocket of fluid. The doctor performing the amnio will determine whether you have a pocket with sufficient fluid in an area she/he feels is safe to attempt the procedure. Typically, they like to stay away from Baby’s head and your placenta, depending on where it is located. A nice pocket of fluid might look like the image below.

amniotic fluid test

Pocket of Amniotic Fluid

The sonographer will measure your baby’s heart rate and anything else the physician requires. The physician will then clean off the area of your skin with betadine over the desired pocket of fluid (as long as you’re not allergic to it!). You might know it as the orange stuff that stains your skin, but it takes care of the germs. This is a good thing.

amniocentesis

Sometimes she may use a numbing agent for the skin, sometimes not. If not, it’s because she can only numb the skin and not down deep. The numbing agent feels very similar to the needle used to withdraw the fluid, like a stick and a burn and a lot like a bee sting. Since this is the case, some docs would rather stick you only once and elect not to numb the skin.

If you have an aversion to needles, you may want to look away. The needle is long because it has to reach the fluid. Sometimes, your physician will use ultrasound guidance to insert the needle into the pocket of fluid. Once there, the doc will attach a syringe to withdraw the fluid.

This is an example of a syringe.

amniocentesis

Once she has enough fluid, she’ll remove the needle and push the fluid into a vial. The vial goes off to the lab for testing. If all goes according to plan, the whole procedure of performing the amnio will take about ten minutes or so. Pretty quick!

Your sonographer or doc will clean off your skin and add a band-aid over the site. Many times you may even have a hard time seeing on your skin where the needle inserted! Your sonographer will usually measure Baby’s heart rate one more time, and your doc will give you instructions on receiving results.

What If I Really Don’t Want an Amniocentesis?

It’s important to note here that if you do not elect genetic testing and your ultrasound later reveals significant abnormalities, your doctor may strongly recommend an amnio. She/he may also do so in the case where you don’t really want an amnio, but your testing came back as high risk. Your doctor cannot force you to have an amnio. However, knowing what is at stake helps them manage your pregnancy and delivery more safely and effectively.

What to Ask Your Doctor about an Amniocentesis

It’s hard for us to ask questions about something if we don’t fully understand it. We can’t know what we don’t know, right? Some questions you can ask your doctor are:

  1. Why is the testing recommended?
  2. What kind of genetic testing do you offer?
  3. What will the results tell me?
  4. Will my insurance cover this testing?
  5. Who will perform these tests? (Your doc or a perinatologist)
  6. Where is testing performed?
  7. When will I get results?
  8. What are my options after receiving results?
  9. What are my options if I choose not to have an amnio?

Having a thorough conversation with your doctor about these issues and how you feel about them is of utmost importance. And, yes, some genetic testing today can determine your baby’s sex with greater than 99% accuracy. However, your doctor will not allow you the option for sex only. No one should take genetic testing lightly. Opting for these tests brings about other serious implications that you must weigh, as you can see by the above explanation. If you have a sincere interest in the testing (knowing that you may face serious future decisions), genetic testing may be for you.

So, for all the above reasons, one should be careful when throwing out recommendations to pregnant readers about what they need and don’t need, about what they should do or not do. In short, ladies, rely on your doctors for pregnancy advice! No pregnancy site or blog, including my own, can take the place of an informative and knowledgeable conversation with your obstetrician.

Here’s to your happy and healthy pregnancy. 🙂

***

You can email me at wombviewerblog@gmail.com with your questions or comments.

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Week 10 Ultrasound

How Big Is Baby at Your Week 10 Ultrasound?

10 week ultrasound, week 10 ultrasound, week 10 fetus, week by week pregnancy

10 Week Fetus

Congratulations! Your baby has a new name. After so much hard work, Baby is now a fetus. Wow, already excelling in so many ways. So, without further ado, let me introduce your fetus and what you can expect to see during a Week 10 ultrasound examination.

If you recall, the start of Week 9 has Baby’s CRL measuring around one inch and 10w2d (above). He or she is about 3.4 cm (2.5 cm = 1 inch). This means your little nugget is still not quite two inches from its large-appearing head to its teeny weeny bottom. Baby’s forehead still appears quite prominent and facial features are still quite limited. If we can obtain an absolutely perfect side view of Baby, you can appreciate a profile including the tiniest of noses and lips. Of course, arms and legs are longer and feet are barely appreciated.

Just a note of caution here! You will likely still have the dreaded vaginal ultrasound at this point. I know, I know. Stirrups are never fun. But the image obtained with this method still yields the best quality for Baby’s peanut size. This is part of our job–utilizing whatever method is going to produce the best image.

You are in for a show, Mom. Your baby can look like quite the jumping bean at this point. It’s entirely possible Baby might not move at all during your scan, but they do demonstrate periods of stillness combined with periods of crazy movement. Don’t be alarmed if your baby is very still and quiet during your scan, especially if your scan is super quick.

Only four more weeks until you reach the second trimester! Exciting stuff. 🙂 Wanna check out Week 11 right now? Click here.

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Fraternal Twins Question

Fraternal Twins on Ultrasound

Let’s talk about twins today, how we see them early on, and when we diagnose them. I’ll answer a reader’s email about her fraternal twins and their placentas.

Merry Christmas or whatever you celebrate this holiday season! I know it means something different to every person but, for our family, this is a time to spike the egg nog, decorate the “Griswold Family Christmas Tree,” and recite too frequently from our favorite movies. “He’s an ANGRY elf!” 😂 Most importantly, we count our blessings.

For all of you expecting a new addition, and especially for those of you planning to hang up more than one extra stocking, this post is dedicated to you. It’s a question from a reader about first-trimester fraternal twins.

mamax2: Hello there! I am having twins, and I’m currently 13 Weeks! This ultrasound was transvaginal at 11 Weeks when we found out we were having twins. I had an earlier ultrasound where we only found one baby (8 Weeks and 3 Days). I’m shocked and amazed that my body has done this. I’m now concerned that my babies could be sharing a placenta or a sac (I really shouldn’t Google!). I see the white line between them, but what does that actually indicate? Also, the lighter line (bubble) around the top baby, what is that? I guess I just need clarification on what I’m looking at.

11 week twin sacs, fraternal twins

My OB has yet to tell me if we have one or two placentas, but said he thought they were fraternal.

I should mention I had a miscarriage at 20 weeks of a singleton boy in Feb 2016. After genetic and placenta testing, it was deemed an unexplained loss. I’m very anxious about this pregnancy as I know the risks are higher with a twin pregnancy.

Thank you for your time! Have a blessed day!

wwavb: CONGRATS x 2!! Wow, so much to cover here … I’ll try to answer all your questions!

First of all, yes! It’s an amazing thing our bodies can do! You had two babies who decided to go along on this amazing journey together! I always told my patients with a history of miscarriage that it’s quite possible your last baby decided he is ready to start on this journey again and just wanted a companion! Our babies have to be ready for this big old world, too, right? They have to come when they are ready–not always when we are!

So, that said, I am so sorry for your previous loss because it is such a terrible and painful experience. I know it will make you a lot more anxious in this pregnancy, but just try to remain positive. It’s a good thing nothing terrible was found, even if it doesn’t provide you a physical reason. Maybe these babies will give one another strength!

Only one baby was seen at 8 Weeks because whoever scanned you missed the other one! We have to scan entirely though the uterus from one side to the other or we can miss multiples–i.e. your experience!

And, no, you should not be consulting Dr. Google. Mistake! You’ll never find the answers to your questions, only anxiety and more questions.

To address your question, your babies are not sharing a placenta or a sac! Yay! This is the safest scenario for twins. Dichorionic/diamniotic.

11 week twins

The white line between them is the wall between the two main sacs (yellow arrow). The very thin line you question is the amnion, the sac immediately around Baby (five straight yellow lines). (Please note, readers, the baby in the top sac is not well seen–this is a better image of the bottom baby). Later in the pregnancy the amnion adheres to the chorion and you won’t see it separately.

Because each baby lies within its own separate main sac, you likely ovulated twice, each baby will have its own placenta, and they can be opposite sexes! This is why your doc said your babies are fraternal. He knows they have their own placentas, and I’m sure he would have told you if you asked him. I recommend keeping a running list of all your questions for your doc and next visit!

As a high risk pregnancy, please keep in mind that billions of women have had normal twins forever, and you can, too. See your doc regularly, and follow all advice–basically, take care of yourself!

I’m so happy for you three, and I wish you a multitude of blessings and all things uneventful in this pregnancy! I have a number of posts on twins, so please look them up! I hope I helped:)

mamax2: Oh, my goodness! Thank you so much for your quick response! I appreciate it far more than you know! I feel relieved knowing they are not sharing a placenta or sac! That first ultrasound just really made me wonder!

You’re such a sweetie, and I appreciate your uplifting words towards my pregnancy and my loss. I’ve struggled with fertility and never imagined my body would/could release 2 eggs without fertility meds!

Again, THANK YOU! I can breathe a little easier now! ❤️️

In summary…

I was so happy to answer a few questions for her! This mama emailed me again a couple of weeks later with an update..

mamax2: I just had to message you back to let you know … YOU’RE CORRECT! We have fraternal boy/girl twins! Thanks again for easing my mind and fears! We are now 16 Weeks! Thank YOU!

***

I was so happy to hear both babies were still growing well at 23 Weeks! Now THAT is a Christmas blessing. 😉

Got any questions or stories about your twin pregnancy?

If so, please share; you may help another expectant mom in the process!

Embryonic Movement–Watch Baby Go!

Embryonic Movement at 9 Weeks!

In the embryonic movement department, what a difference a week makes! Your baby is still an embryo at 9 Weeks, but he/she only has one week to go before “fetus” status at Week 10!

When is the Earliest Detectable Embryonic Movement?

How early can we detect your baby’s movement with ultrasound? The earliest signs are typically seen around 8 Weeks of gestational age. Baby, who is only about 15 mm now, starts to demonstrate the slightest intermittent wiggle. It may very well be hard to catch, but your sonographer can possibly show you with stillness and a little patience! Of course, transvaginal imaging is by far the best way to see this early in most everyone due to its magnification.

9 Weeks is an entirely different story! Below is an image of an embryo at 9 Weeks taken with transvaginal imaging. Baby is right about one whole inch now, and tiny arm and leg buds can be seen slightly larger than just the week before!

embryonic movement at 9 weeks, 9 weeks embryonic movement, 9 weeks pregnant, 9 week embryo

Now, below is a video of embryonic movement of this same little tidbit breakin’ it down which is quite entertaining! Shall we dance?! She (or he) is making up a jazzy little tap routine right before our eyes. Just click the link below to watch her go!

Embryo Movement 9 Weeks

Isn’t the degree of movement incredible? Of course, none of it is well-thought-out choreography but instead demonstrates the nervous system hard at work. What an amazing work of art we are. 🙂

I hope you found this entertaining!

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Thanks for reading!

 

The Nub Theory–What’s in a Nub?

What’s This Nub Theory Thing?

12 Week, Nub Theory

12 Week Nub Theory

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

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 Response to My “Hormonal” Reader!

wwavb:  Thank you for all the nice words 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 link below will give you more information:

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

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!

Reply from Hormonal Mama

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! 🙂

12 weeks pregnant, nub theory, male and female ultrasound

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.

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:

12 weeks pregnant, nub theory, male and female ultrasound

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!

Final Advice?

I’m so happy this mom realized that everything you read on forums are expressly the opinions of other moms and that they may not be the most reliable source. They can only share their image and their experience–and it’s just not yours!

Moreover, it’s entirely possible to get excellent images at 12 Weeks. If you are one of the lucky ones with these incredible pics, you WILL see something protruding between your baby’s legs. This is because external genitalia is just beginning to develop. This protrusion doesn’t necessarily mean you’re having a boy.

Finally, the angle of this protruding part creates the basis of the Nub Theory, but it is reported to be about 70+% correct. If you do the math, that leaves 20+% with clearly-defined guesses which turn out to be the opposite! I only recommend asking about a guess on your NT scan if you can remain mentally neutral!

Good luck on your NT test! (for healthy, that is!)

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9 Week Embryonic Heartbeat

Ever see a 9 Week Embryonic Heartbeat?

If not, just click this link! 9 Week Embryonic Heartbeat Video Clip

This clip demonstrates a quick video of Baby with transvaginal imaging. First, we see the head, then we see a long view of baby’s body and the incredible flicker of cardiac activity in the chest. The fetal head lies to the left of your screen and the small circle near baby’s bottom represents the yolk sac. Also, notice the thin white line around Baby. This is the amnion or amniotic membrane. Looking carefully, one can make out the beginning of arm and leg buds.

Aw, it’s so cute already!

Annotated 9 Week Embryonic Images

Here, I have added annotated still images from the video above:

9 week embryo, 9 week embryonic heartbeat

9 week embryo, amnion, 9 week embryonic heartbeat

Can anyone guess what the black represents?
Yep! Amniotic fluid. You guys are so smart. 😉

Hope this was entertaining and informative! Please feel free to email me with your questions or comments at wombviewerblog@gmail.com!

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Early Pregnancy Questions–Ultrasound Gender

Your Early Pregnancy Questions Answered
… or Not

You know, I just don’t have all the answers. I know you may not be terribly shocked by this revelation! That said, I get emails all the time with partial tidbits of relative info from which I am supposed to glean an opinion or diagnosis. Sometimes, it’s just not enough to read between the lines, especially with regard to early pregnancy questions or early gender. See the emails below to understand why I just cannot answer some of them!

Early Pregnancy Questions (1)

Vague Mama:  Hi My name is _______.
Here’s my ultrasound.
Thank you in advance.

***

The subject of this email read 12w6d ultrasound. I can only assume this reader was curious about gender, but she didn’t really ask the question. Below you’ll see the images she sent. Can you tell that they are super bright?? Take my word for it; they are! These are the epitome of poor quality. Believe me when I say someone didn’t learn how to scan well.

early gender, early pregnancy questionsearly gender, early pregnancy questions early gender, early pregnancy questions

Now compare those to an image I took below. Even though the baby here is a lot further along (about 20 Weeks), I’m sure you can appreciate the difference in brightness. Even a new sonographer would appreciate the contrast, and you don’t have to be able to read ultrasound to see how different they appear. It’s very likely her images were taken by someone with little ultrasound training.

early pregnancy scan

Great ultrasound imaging can only be taught. Truly. I can only speak from experience! We all were terrible in the beginning of our education! Unfortunately, she was just too early, and the images were too poor to take a crack at fetal sex. I hate when that happens.

Early Pregnancy Questions (2)

Twin Mama:  Wow! So glad I found you. Can you please help with my twin ultrasound? We are confident that baby B is a BOY! However, baby A is leaving us confused. We were told possibly boy, as well. All guesses on other sites say girl. Just so confused. Thank you in advance for your help. Sincerely . . .

***

Nice! This one clearly asks the gender question. However, she didn’t include gestational age, so I have to guess based on how big the baby looks in the image. If you guys know me by now, I do not guess gender before 17-18 Weeks. I’ve only guessed at 16 Weeks a handful of times in my entire career.

Too early = too much guesswork = a wrong guess.
I hate it when this happens, too.

The above represents my professional and very scientific formula on how to incorrectly determine fetal gender. Turns out these babies were 14w4d. In other words, flipping a coin might give you the same percentage of accuracy. And it’s free! There’s not much worse than paying someone to be wrong. Right?!

Early Pregnancy Questions (3)

Concerned Mama: I just have a couple questions I’m hoping you wouldn’t mind helping me with. I just had my first ultrasound abdominally and also had the internal, as well, for dating. My period is very irregular, so I don’t know my LMP. I had gotten lab work done the day before the ultrasound to check my HCG levels. The nurse said they were pretty up there but not yet 14 Weeks.

During my tests, my sonographer would not give me any info. I understand they formally cannot give an official diagnosis, but she wouldn’t even show me the screen. Is it normal that they don’t give you a picture, either? If you could try and answer these questions the best you can, I would greatly appreciate it. 🙂 Thank you so much!

***

So, a non-medical mama may not understand the difficulty here. But, unfortunately, I just don’t have all the information to tell her what she wants to know most. With no images, no measurements, no LMP (Last Menstrual Period), and without her medical chart, I cannot tell her anything she doesn’t already know about her case. I cannot even be sure a heartbeat was seen. And without that all-important data, I can assume nothing.

The only opinion I could really offer her is that it’s really tough to have to wait for results in such circumstances. In this case, my reader had to wait an entire weekend for some answers. Not. Okay! It turns out the pregnancy wasn’t a good one which is likely why her sonographer didn’t turn the monitor her way. This is always a terrible position to be in for the sonographer and the patient.

I really believe patients should never have to wait days for this kind of result. However, giving results depends on protocol–and every facility does this differently. Usually, a radiologist reads the scan and sends a report to her obstetrician. Maybe she went to the ER, in which case the report would have gone to the ER doc first, then to her obstetrician. Alternatively, the scan could have been performed in her obstetrician’s office. But if her doc wasn’t there that day, it’s possible that her doctor needed to review the ultrasound prior to giving the patient her results.

More on Your Early Pregnancy Questions

So, Ladies, just know that sometimes I can’t help you very much, but I always try! Include as much information as you can about your experience, and I’ll do my best to help you make sense of it!

‘Til next time, here’s wishing you a happy healthy sonogram. 😉

Please email me at wombviewerblog@gmail.com with your questions or comments!

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First Ultrasound Worries–Blighted Ovum Concern?

The first worries about our kids presents with the very first ultrasound.

One of the greatest events in the first trimester, next to the pee-stick plus sign, is seeing Baby in the first ultrasound and the little flutter of cardiac activity! One of the worst events is not seeing it at all. A blighted ovum is where the gestational sac of a pregnancy develops but a yolk sac and embryo do not. You still get the positive test, hormones, and symptoms of pregnancy, but a baby does not develop. The whole scenario, naturally, makes for a very anxious mom-to-be the next go-around.

The image below is an example of what a blighted ovum might look like:

first ultrasound worries, blighted ovum

Blighted Ovum

Read below an email I received from one such anxious mama.

Nervous Nellie:  I had a blighted ovum a couple months ago, so I’m very nervous about my new pregnancy miscarrying.

I’m 5 weeks 5 days and had my first ultrasound today. We saw a healthy yolk sac and a heartbeat (couldn’t hear it though), but the gestational sac was oblong. I know an ideal sac is perfectly round, but I don’t know how normal it is to see an oblong sac. Given everything else was normal (CRL: .25 cm), I want to hope for the best.

This puts us at 5 weeks 2 days. Is this anything to worry about?

WWAVB:  This sac is beautiful!!! Congratulations on your pregnancy! These are all good things–a good sac, the presence of a yolk sac, and an embryo with a heartbeat. Did they give you a heart rate? Not hearing it only means they did not use the Doppler feature which allows the sound. This should not be a concern.

And, no, the sac does NOT have to be a perfect circle! I see oblong gestational sacs all the time, and strong walls are most important. If you look at the longest measurement of the sac, it measures 1.6cm. If you add 4 to this number, you get 5.6, right? This is another way to calculate gestational age via a sac measurement. So, I would say the sac size is consistent with a 5w6d pregnancy.

Now, once an embryo and heartbeat are seen, gestational age should be calculated by embryo size. This is because sac size can vary quite a bit and is not as reliable for dating. Very early in the pregnancy and before we see an embryo, it’s all we have! Typically, a heartbeat is seen at about 6 Weeks, not 5, so their measurement could have been off a little.

I know it’s very hard to face another pregnancy after a loss. It takes lots of courage! I hope these posts below help. When it doesn’t progress so early on, usually there was something very wrong from the beginning but it in no way means this one won’t be great!

A Conversation About Miscarriage

Pregnancy Loss Perspectives

I wish you the best for a happy and healthy pregnancy! Try to enjoy it! Thanks for reading and emailing. I hope I helped a little. 😉

Nervous Nellie:  You are such a wonderful help! THANK YOU for responding, and thank you for having this ability to check on little concerns. I can’t tell you how much you have put my mind at ease in these early weeks. You really are a blessing!

WWAVB:  You are so welcome! You know, I have to say that no one is out of the woods until that 1st Trimester is done–13w6d. The further along you go in this beginning phase with Baby showing great growth and a good heart rate, the greater your chances of miscarrying decrease. If a demise happens after that point, you know something was very wrong with the pregnancy. At this point, however, there’s no reason to have any less hope than anyone else!

***

I also want to add here that a 2.5mm CRL equates to a 6+ Week gestational age. Her doc probably just did not change her due date based on her ultrasound.

No one can ever predict the outcome of a pregnancy unless we see very definitive signs early on, like a blighted ovum. It is one of those pregnancies we know will not progress or grow an embryo. However, like I said in my email to this reader, it in no way defines the outcome of future pregnancies!

Best wishes to all you for happy and healthy babies!
Feel free to send comments or questions to wombviewerblog@gmail.com!

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9 Week Embryo on Ultrasound

A Mother’s Day Wish

My blog is nothing without paying homage to the celebration of life and the incredible women who help to create it!  Hopefully, you are training them right. Because you have a little one on the way, you deserve breakfast in bed and whatever else you command with the tinkle of your handy-dandy little bell (or foghorn, whichever your prefer). All moms deserve to kick back from time to time – and this day is one of those times! Let’s talk about what we can expect to see in a 9 Week embryo.

The 9 Week Embryo

Below is a 3D image of a 9 Week embryo:

9 Week embryo in 3D, 9 week embryo

You can see little arm buds and leg buds getting bigger. What looks like a tiny lump on the top of the belly is just part of the cord.

Below is a 2D image of a 9 Week embryo:

9 Week embryo in 2D

Baby is upside down here, and you can see from the dimension taken that it is measuring just about a whole inch now!

A scan at this gestational age will very likely be performed transvaginally. At least, this method will provide the best image, by far!

Below is a video of the kind of movement you might see at Week 9: Movement at Week 9

Pretty amazing, right?

I don’t think it’s too much to ask to spend one day a year sans the multiple hats that come with motherhood … chef, chauffeur, maid, teacher, referee (for those of you blessed with more than one little angel). It’s the most difficult, most enjoyable, and most important job any woman will ever have. Shaping and molding our future generation of leaders is no small task! And it’s a pretty exhausting one, too.

To carry them (or not!), raise them, care for them, discipline them, and love them defines us as Mothers. Any woman who puts her all into this job deserves to spend this day any way she pleases! Enjoy it! And for those first-time moms-to-be … relish the peace and quiet now–while you still can! 😉

If you want to see a post about our embryos at Weeks 7 and 8, just click the link.

Thank you to all moms for reading and subscribing!

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

Your 8 Week Ultrasound Scan

What Can We See on Your 8 Week Ultrasound?

First, a Peek at Week 7

If you’re following week-by-week pregnancy, you may know we’ve covered what you should expect to see at 6 Weeks. This pregnancy is a set of twins with great cardiac activity! So, let’s check out a few changes. The images below are of the twin embryos at a nearly 7 Week scan and about a week later at an 8 Week ultrasound.

7 Week embryos, 7 Weeks pregnant, 7 Week ultrasound

Almost 7 Weeks!

You don’t really need a measurement here to see how much bigger they look compared to just one week prior! You’ll notice that the gestational sacs are bigger, too. The yolk sacs keep the same general size and appearance, although they are not pictured here.

Since I didn’t have much to post about Week 7, let’s skip ahead a little and look at your embryo at the 8 Week ultrasound, also!

8 Week ultrasound, 8 Weeks pregnant, pregnancy 8 Weeks, 8 Week embryo

8 Week Embryo!

Can you believe the difference in just 13 days? Baby A is a whole 12mm bigger! The more rounded area on the right-hand side represents Baby’s head. We can even make out little arm buds! Also, the little white lines you see on each side of Baby represents part of the developing amnion (or sac of fluid around Baby).

Now check out Baby B below!

8 week fetus, 8 Weeks pregnant, 8 Week ultrasound

Baby B is now a whopping 13mm bigger! What an animal!

8 Week twins, 8 Week ultrasound, 8 Weeks pregnant

The changes seen every week of the first trimester are really quite unbelievable, and it truly is one of the most favorite aspects of my job. I love it! It makes me realize what a privilege and honor it is to be able to catch a glimpse into this incredible universe on a regular basis.

One day they’re 3mm; you blink, and they’re driving! Our kids just grow up so fast! (sniff, sniff)

 

 

Shoot me an email with your questions or comments to wombviewerblog@gmail.com!

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5 Week Twin Ultrasound Scan

What Would We See on a 5 Week Twin Ultrasound?

To start, still no babies or heartbeats. Not yet. This is precisely the reason why your doc will not perform an ultrasound at this gestational age. Below is a 5 week twin ultrasound performed transvaginally in which the yolk sacs are fully visible! In the case of this dichorionic/diamniotic pregnancy, these sacs are about 5 1/2 Weeks gestational age.

5 week twin ultrasound

5 1/2 Week Twin Gestational Sacs & Yolk Sacs

This is exactly what we would expect to see regardless of whether we are looking at a twin or singleton pregnancy! Small, nicely-rounded yolk sacs. If you were scanned prior to this point, the gestational sacs should be bigger! And depending on when your last scan took place, you may or may not have seen a yolk sac. FYI:

At Week 4, the gestational sac(s) are very small, starting at about 3-4mm.

At Week 5, the gestational sac(s) are bigger, and the faint impression of a yolk sac may appear.

What’s Next?

What your healthcare provider will do next depends on many factors. If your obstetrician feels your dating is on target, if the gestational sacs and yolk sacs appear normal to your doc, and if you are doing well otherwise (no pain or bleeding), you may be given instructions for a follow-up ultrasound examination to ensure an embryo and heartbeat are seen. The earliest we can see this is at 6w0d, or 6 Weeks 0 Days. However, because Baby is still so small even then, your provider may wait a little longer until about Week 7 or Week 8. This is not unusual!

Your doc may possibly perform this scan him/herself, likely another transvaginal scan. What can I say? It’s just the best way to see this early. 🙂 If your doc refers you out for your next scan where a radiologist will read/interpret the study, you may have to fill your bladder. Poo! I sincerely hope not for you, as it can be very uncomfortable. You may end up emptying your bladder, so they can do a transvaginal after all!

Why do they not start with the stirrups? If it was up to me (and it’s not), I would ban filling the bladder altogether. I think it’s archaic! Alas, you have to do what they require.

Radiologists feel they can see your whole pelvis better with a full bladder, so many start with that approach first. If they can see well enough to measure Baby and heartbeat, they’ll stop there. If not, they’ll have you empty and do the old and trusty TV exam, also.

Thanks for reading!

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

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5 Week Twin Gestational Sacs

Continuing from the last post about our 4 Week gestational sacs?
Great! Keep reading to see what changed …

What Can We See When Scanning 5 Week Twin Gestational Sacs?

Not a whole bunch. It’s important to state here that very few women are scanned with ultrasound at Week 5. Why? Because there is relatively little information your doctor can tell you this early in the 1st Trimester. Unless you experience problems such as pain or bleeding, your healthcare provider will want to wait until you are further along, probably Week 7 or 8, to order your first scan.

Hopefully, by Weeks 7 or 8, your doc can send you home with a confirmation that your pregnancy appears off to a good start. An embryo at Week 6 can prove hard to see in some patients. Unless you are experiencing unusual problems like pain or bleeding, don’t expect to be scanned at Week 5!

What Can Be Seen At Week 5?

5 week twin gestational sacs

5+ Week Twin Gestational Sacs

I have to label the image 5+ Weeks because what we see and measure at this gestational age is not an exact science. The measurements are accurate within a few days. These sacs measured between 5 Weeks and 1-2 Days. I could barely appreciate what I guessed was a very tiny yolk sac within each sac! These are the little circles outlined in white along the bottom wall of each gestational sac. The yolk sac provides nutrients for the growing embryo until the placenta is developed enough to take over the job.

How Do We Determine Gestational Age This Early?

There’s a general rule of thumb we use when measuring a gestational sac. We take the one biggest dimension and add 4 to determine gestational age. Applying that rule here, the smaller sac measured 4.5 Weeks. The larger sac measured 4.9 Weeks. Considering all these measurements are only general estimates until we can see and measure an embryo, I could assume 5+ Weeks GA (gestational age) based on the presence of the developing yolk sacs.

What Do We Know at This Point?

That’s a good question! But not much. All we can determine here is that there appear to be twin sacs located in the right place, and that’s about all! Your doctor cannot predict at 5 Weeks whether this pregnancy will be a normal one or not. Thus the reason he or she will want to wait a bit longer to see a baby and a heartbeat!

I hope this helps you understand early 1st Trimester ultrasound!

The Early Gestational Sac on Ultrasound

Early Gestational Sac–About 4 Weeks Pregnant!

Most women never get to witness this most amazing part of their pregnancies–the ultimate genesis of a pregnancy as we can see it by ultrasound. It’s the early gestational sac. No one has an ultrasound performed every single week in the first trimester, so I will share with you the astounding changes one can expect to see on a weekly basis!

I feel it’s important to address the topic of early pregnancy and the role of ultrasound. So many women do not understand why their physicians will not perform an ultrasound as soon as they discover the first missed period and the faintly-positive pee stick. This post explains what we can and can’t see so early. Most importantly, discover why the long wait to your first scan is a must!

How Early Can We See An Early Gestational Sac?

Between 4 and 5 Weeks of gestational age–but your doc will not order a scan this early! Why? Because there simply is no way for your doc to confirm your pregnancy is off to a good start at this point. Until we can see a yolk sac, an embryo, and a normal-appearing heartbeat (Week 6), no one can say for sure! A vast number of very early pregnancies end in miscarriage at this point … sometimes without a woman ever knowing she was pregnant at all! I’ve heard my doctors say this is usually nature’s way of taking care of something that was genetically abnormal. Each week a pregnancy progresses successfully, the higher the chances it will continue.

Even at Week 6, an embryo is only about 3mm. So tiny! Seeing Baby easily this early can be very difficult in some people, especially if the uterus tilts backward. For this reason, most docs will wait until about Week 7 or 8 before scanning you for the very first time. Oh, I know! The wait feels miserably loooooooong!

LMP

Your gestational age is determined by the first day of your last menstrual period or your LMP. For example, if you are 4 Weeks pregnant today, you would have conceived about two weeks ago if you have a normal period about every 28 days. I know it seems two weeks off, however, ultrasound software is calibrated according to gestational age, not fetal age. Very few women know when they actually conceived versus when their last period started.

Sometimes a woman’s “dates” are off meaning you are really further along or not as far along as you thought. Maybe you gave us the wrong LMP, or maybe you ovulated very early or very late. This can change what we would see on ultrasound. Most women ovulate between days 10 and 14.

If you come in for your ultrasound too early, earlier than 6 Weeks gestational age, there’s not a whole lot we can tell you about your pregnancy. We may be able to see and measure an early gestational sac, but your doc cannot tell you if everything appears normal until we can see an embryo which measures 6 Weeks or larger with a normal-appearing heart rate!

Growth of the Early Gestational Sac

The timeline goes something like this:

  • <4 Weeks–we may see only a thickened endometrium and no gestational sac
  • 4-5Weeks–only a gestational sac
  • Just over 5 Weeks–possibly a faint yolk sac
  • about 5w2-6d–larger gestational sac including a yolk sac
  • 6 Weeks–larger gestational sac, yolk sac, and embryo with a heartbeat!

The changes we see every week are dramatic and essentially the same in every normally-progressing pregnancy. For instance, we know that if we see a sac that measures 5 Weeks and you come back two weeks later, we should very well see an embryo that measures about 7 Weeks. The embryo measurement is the important one for dating here! The early gestational sac can vary in size by a few days or more. Therefore, until we can actually measure an embryo at Week 6 or later, gestational age is only a guess.

Week 4

At Week 4, we begin to see the very start of a pregnancy as demonstrated by a tiny little sac of fluid called the gestational sac. Check out the image below.

early gestational sac, 4 weeks pregnant

 

This gestational sac measures 5.7mm or about 4 1/2wks. One criterion we note of a gsac is a brighter ring around the sac (the small black circle). This ring is called a decidual cast or reaction which is inside the single arrows. It should also be seen within the endometrium as you’ll see outlined by the double lines.

 

Below is a dichorionic pregnancy or TWINS!

4 Weeks pregnant, 4 Week twin gestational sacs

This just means that these babies each started off in their own gestational sacs. Those sacs will merge together later, and they will likely each have their own placenta. But genetics gets a little tricky, and fraternal versus identical may not be known until they’re born. If mom ovulated twice in the same month, they’re fraternal–they can be the same or opposite sexes. It’s like two completely different human beings who just so happened to be conceived and born at the same time. So, how do we know that mom’s ovary released two eggs? Well, this is the assumption we can make if they are boy and girl!

If only one egg was fertilized, then whether they are identical twins will depend on when that egg split into two. These babies may or may not share a placenta, but they will be the same sex. They have to be! They both came from the same fertilized egg. I am not a geneticist, and the formation of multiples can become quite complicated. So, if you have multiples and question identical versus fraternal, ask your doc!

What to Expect If You’re Scanned Too Early?

If you show for your first long-awaited appointment only to discover your dates are off somehow, it can feel disconcerting. What happens is if all you see looks like the images above? Well, if your doctor deems all else normal, he may determine that you are simply earlier in your pregnancy than expected. But what does that mean for you? Usually, an even longer wait.

If your doc believes you to be around 4 or 5 Weeks pregnant, he may request a follow-up scan in anywhere from one to four weeks. I know. The wait is miserable and completely anxiety-inducing. You have to wait to see if a heartbeat develops. This may very well feel like the longest and most sleep-deprived weeks of your life.

I already know the questions on your mind:

  • Will I see a baby next visit?
  • Is this a normal pregnancy?
  • Will I see more than one baby next ultrasound?
  • Will I see heartbeats next visit?
  • What if I don’t see a baby or heartbeat?
  • Can’t I come in sooner for my next ultrasound?

And I already know your doctor’s answers–we don’t have all the answers just yet; I can’t predict; we have to just wait and see; don’t expect the worst; we have to allow enough time to pass. Unfortunately, Mother Nature cannot be rushed. Only time will tell if the pregnancy is progressing properly, and we just can’t speed up the process.

The Final Word

We live in an age with thousands of internet results at our fingertips in .25 seconds. We carry smart phones so we never have to miss a call, a text, or a voice-mail message. A universe of information sits in our back pockets or our purses. There just isn’t much we can’t know yesterday. So, the idea of waiting weeks for something as big as a new addition to your family can feel torturous.

Finally, please know I wrote this post in an effort to prepare you for the call to your obstetrician with your happy news. After learning what we won’t yet see, I hope you’ll understand the reason for the potential delay of your first pregnancy appointment. It’s not because your doc wants to agonize you with a long wait. On the contrary, she’d rather send you home with all the answers and spare you the anxiety that comes with not knowing!

Thanks for reading!

You can send your questions and comments to wombviewerblog@gmail.com.

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11 Week Ultrasound | Ultrasound Blog

Big Brother Meets Sibling at 11 Week Ultrasound

We all know kids say some of the funniest things! And when Mom is here for her 11 week ultrasound, Big Brother enters my ultrasound examination room with SO many questions!

We realize, as adults, just what a different perspective of life they have when, on hilarious occasion, they express to us these tiny pearls of realism in a way we never considered. They see the world in such simple terms; it’s unfortunate how we grow out of that over time. Oftentimes, we can actually see those mental wheels spinning, trying to make sense of the ultrasound monitor with their limited knowledge.

11 Week Ultrasound – A Kid’s Precious Perspective

So, last week as I am scanning Mom, Big Brother of about 6 or 7 is watching intently. He was very excited to see “his” baby and had lots of questions about everything I was pointing out to him. I typically start with the head, try to demonstrate a great profile of the face and, of course, I make a point to include hands and feet. It takes a minute for older children to really appreciate that it’s a baby on the monitor. After all, that black and white and gray blob on the screen doesn’t look like any baby they’ve ever seen!

If I can obtain a decent shot of the arm and hand, I’ll annotate on the monitor “hi!!” and tell the excited on-lookers that Baby is waving to them. It’s just one of those fun aspects of my job and the reactions are always cute.

11 week ultrasound

11 Week Fetus

As I did just that, Mom laughed. But Big Brother was quiet, and we could tell he was deep in thought. After a few seconds he finally spoke up and asked, “Mom, the baby can already spell?!!”

Mom and I had a great laugh over that, and Big Brother was happy to learn that his baby wasn’t smarter than him just yet!

I would love to read YOUR funny stories.  Email me at wombviewerblog@gmail.com and tell me all about it!  Yours just may be my next post!

 

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Early First Trimester Sacs

Technology has its pros and cons. We THINK we want to know the second we conceive…but do we really? When all we can see is early first trimester sacs, your doc cannot confirm the pregnancy is off to a good start. At least not until we can see an embryo and strong heartbeat at 6 Weeks. Some patients find out that (often times) ignorance is bliss. The wait is long and miserable! This is why your doc will elect to scan you around Week 7 or 8.

Early First Trimester Sacs – Week 4

Very early in the pregnancy, less than 4 Weeks gestational age, we can’t see a thing. To clarify, we start to see a gestational sac at around 4 Weeks. This sac will measure only about 2mm and will literally appear as a tiny black blip within the uterus. All we can report at this time is that we think it’s an early sac.

Week 5

Monumental changes are happening every week!  At 5 Weeks pregnant, we see a much bigger sac. However, it’s only enough information to say, yes, the sac has grown, it measures around 5 Weeks, and that is good. Around 5 1/2 Weeks, we should see the presence of a yolk sac. It looks like a little circle inside of the sac and provides nutrients for Baby who is still too tiny to see by ultrasound. Below is about a 5 1/2 Week pregnancy of twins (obviously! Dichorionic/Diamniotic or fraternal).

Yolk Sacs, 5 Weeks pregnant, twin pregnancy, early first trimester sacs

 

Week 6

6 Weeks pregnant, 6 Week ultrasound, 6 Week embryo

By the next week at 6 Weeks gestation, an embryo measuring about 3.5mm with cardiac activity should be seen! A nice, round yolk sac and a bigger gestational sac factor into what we expect for this exam. Baby is still very tiny, and it can be difficult to visualize well if the embryo is lying against the wall of the gestational sac.

At 7 Weeks we can see a little better, and Baby is a few mm larger. But 8 Weeks usually gives us a great image of what we want to see!

Week 8

Baby, on your 8 Week ultrasound, is much easier to measure at this point.

8 Weeks pregnant, 8 Week ultrasound, early first trimester

Isn’t the growth in two weeks incredible?!!!

It’s all a process of Mother Nature. It can’t be rushed, and only time will tell if your pregnancy is growing appropriately! If you think you are farther along by your LMP (last menstrual period) dates, we perform an ultrasound, and we don’t see what we expect, it can feel like such a long wait! There’s no way to know whether the pregnancy may not be progressing normally or whether you may just be too early!

It’s so hard to wait. And it may feel like the longest week or two of your life before your doctor orders another scan!

What most women do (and I caution you to not!) is to talk to friends and family and search Dr. Google furiously for what to expect. Only no article or blog post can predict the outcome, and only that next scan will (hopefully!) give you answers.

Here’s sending you best wishes and much-needed patience to all you expectant moms out there!

Email me at wombviewerblog@gmail.com with your questions or comments:)

 

Internet Pregnancy Advice–Dr. Google Doesn’t Know You

Internet Pregnancy Advice Isn’t Always So Reliable!


internet pregnancy advice

I know it’s such a difficult temptation to resist, but Dr. Google really isn’t the best doc to consult when you’re experiencing questionable symptoms–especially not when it comes to pregnancy. Practices across the country see it every week. Relying on Dr. Google for internet pregnancy advice only opens up Pandora’s box of fear and worry … and more questions.

We’ve probably all done it at one time or another. Isn’t it just so easy to click on a Symptoms Checker or post your question onto your pregnancy group’s community forum? Maybe someone else has experienced the same thing, it turned out to be nothing, and your fears can be put to rest? The problem with this sort of self-diagnosing is that no one else in the world is you–or your baby.

We would see this quite a bit in the practice where I worked. A patient is given ultrasound results by her doctor, she goes home to Google the information, and then calls back to the office in a panic over what she’s read. The internet is filled with more information than we need and more than applies to you in your pregnancy. And, unfortunately, some of it is completely inaccurate. You don’t want to cause yourself unnecessary worry!

TMI

What you’re getting in your internet searches is the whole spectrum of findings and worse-case scenarios. Every blog and medical site, no matter how credible you think they are, still cannot represent the thoughts, feelings, and advice of your personal physician.

Moreover, many expectant parents turn to online community forums for emotional support and advice. Though these forums can be a place to share experiences with other pregnant moms, their problems and results should never dictate how you react to your own symptoms. At the end of the day, twenty people experiencing pain or bleeding (for example) may yield seven potentially different outcomes. And because people gauge their symptoms differently, there’s no way for you to accurately compare theirs to your own. The last thing you want to do is to read something which convinces you not to call your doctor when you really should have.

You know, as humans, we can be a bit flawed in our thinking. We tend to convince ourselves of what we believe to be true, whether that information holds water or not. Don’t convince yourself a problem isn’t real; let your obstetrician’s staff ask the important questions and determine whether you need to be seen!

The Best Advice!

Your doctor (or other healthcare provider) makes the best resource for managing your pregnancy and any potential problems which may be associated. Only she/he holds your chart full of pertinent medical information about you and your baby. Your obstetrician can examine you and listen properly for your Baby’s heart tones or order an ultrasound exam, if needed. Only your doc can advise you on what the next step should be or determine if ordering further testing is warranted. Whatever your concern, discuss it with your obstetrician or other healthcare professional managing the care of you and Baby.

And in case you’re more concerned with bothering your doctor after hours, this is precisely the reason for on-call staff around the clock! Your physician is your best advocate. He would rather you ask him (or his qualified staff) than your friends or family.

internet pregnancy advice

*FYI*

If you begin to experience your symptoms early in the day, don’t wait to call until midnight! (To clarify, this doesn’t mean not to call because it’s midnight, just not to wait!)

Don’t wait to see if your problem will go away. They’ll want to know about it sooner than later! Also, you don’t want to put off treatment if you need it.

Remember this. Dr. Google cannot lay hands on you, examine you with his handy-dandy speculum, advise you, console you, or discuss test results. This is why you have an obstetrician. Moreover, Dr. Google didn’t attend so many years of medical school and surely won’t be the one to catch your precious bundle of joy on his or her birthday.

Direct all your concerns to one who will be!
That’s why she’s in the baby business!
👶

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

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