ULTRASOUND

Early Obstetric Ultrasound

Offered at SONOGENES from the time the pregnancy is diagnosed till 11 weeks.

Early obstetric scan is important to know the location of the pregnancy (intra-uterine or extra-uterine), viability of the pregnancy, number of embryos and the status of the ovaries and tubes.

11-to-13 weeks scan (NT Scan)

Our signature scan. SONOGENES claims pride of place in Dhanbad to be the first to provide 11-to-13+6 weeks scan in keeping with the recommendations of Fetal Medicine Foundation, UK.

We recognise and reiterate that 11-to-13+6 weeks scan is of fundamental importance in ultrasound done in pregnancy and provides numerous valuable information.

Apart from viability, number and dating of the pregnancy, NT scan can provide information regarding several structural defects in the fetus or raise a suspicion so that follow-up scan can be scheduled earlier.

Fetal nuchal translucency, nasal bone, intracranial translucency, ductus venosus flow, tricuspid regurgitation, origin of right subclavian artery, appearance of bowels, bladder, hands-these are important markers of chromosomal defects and serve an important role in screening for chromosomal and structural defects.

Also, at present, measurement of nuchal translucency and presence or absence of nasal bone are combined with the results of double-marker biochemical assessment (Serum PAPP-A & beta-HCG) to screen for Down syndrome and other chromosomal defects.

Targeted Scan (Anomaly Scan)

Targeted scan or anomaly scan, done best between 18-22 weeks is a specialised area of obstetric scan that aims to diagnose or rule out structural defects in the fetus. 

There is constant research in the field and it requires in-depth knowledge of the fetal anatomy and normal variations as well as objective and sophisticated methods of diagnosis once a defect is recognised.

Once a defect is recognised, we counsel the parents about the nature of the problem and how to follow-up the pregnancy so that outcome is optimised.

We also provide access to resources if genetic counseling is required.

Growth Scan

Done in the last trimester (7th to 9th month of pregnancy).

Growth scan at SONOGENES is done not only to know the interval growth but also survey the fetus and it’s environment to look for any issue of concern developing late. So it is in a way an extension to the NT scan and Targeted scan done earlier.

Fetal echocardiography

Done  after 16 weeks and  best done between 18-22 weeks.

Fetal echocardiography is a specialised scan of the fetal heart and is done under the following circumstances:-
1) When any cardiac defect is suspected during targeted scan
2) Maternal or family history of congenital cardiac defect
3) Previous baby with congenital cardiac defect
4) Maternal diabetes
5) Maternal iso-immune diseases
6) History of intake of certain medications
7) Presence of other defects
Once an anomaly is detected, we counsel regarding the outcome and further management and guide the couple about the best resources for perinatal and neonatal care of the baby.

Fetal Doppler Ultrasound

Feto-maternal Doppler ultrasound is an important and key adjunct to routine ultrasound.

Specifically, it tests the nature and adequacy of the fetal nutritional and hemodynamic environment and is done at all stages of the pregnancy in various conditions like maternal hypertension,previous baby with IUGR, suspected ant-phospholipid antibody syndrome, fetal growth restriction, maternal Rh-isoimmunisation, fetal infection, twin gestation.

3D/4D Ultrasound (in indicated cases)

3D ultrasound is an area undergoing intense research and expansion and has proved to be an invaluable tool in ultrasound imaging.

Though 2Dscan is and will remain the bulwark of fetal sonography, 3D provides important information when a defect is suspected and needs to be understood better.

As a Fetal Medicine centre, we discourage the cosmetic use of 3D ultrasound and hence we do not accept prescriptions or request to do these scans without indication.

SCREENING FOR CHROMOSOMAL DEFECTS

First-trimester combined screening/ Double-marker screening (Ultrasound with biochemical test)

This is a combined evaluation of the fetus at 11 to 13 weeks using Nuchal translucency scan (NT scan) and maternal serum screening.

The results of both the tests are combined in an algorithm ( NT value and presence/absence of nasal bone from the scan) to deduce if the patient is at a low-risk or high-risk to have certain chromosomal defects like Down syndrome.

If the patient is at low-risk, she can continue with routine Anomaly scan and Growth scan.

If the patient is at high-risk, the couple are counselled to undergo direct testing of the fetus to confirm the diagnosis.

We encourage all patients to undergo the Combined screening as it has the highest sensitivity in the diagnosis or suspicion of defects.

Quadruple-marker screening

If the patient has not undergone Combined screening, she can still undergo Quadruple marker screening for chromosomal defects between 15 to 18 weeks. The sensitivity of Quadruple marker is around 70-75% and the patient can undergo detailed Anomaly scan between 18 to 20 weeks.

DIRECT TESTING

Chorionic villus sampling(CVS)

Chorionic villus sampling signifies examination of portion of the fetal placental tissue.

Under ultrasound  guidance  and  under  strict  aseptic  precautions,  a small amount of fetal chorionic tissue is extracted and subjected to various kinds of genetic tests.

CVS is advised and performed only when there is an indication in the ultrasound or maternal screening or there is a strong family history.

Amniocentesis

Amniocentesis is sampling of the liquor around the fetus as it contains fetal cells and products.

Done after 16 weeks, amniocentesis has the same indications as Chorionic villus sampling and is done under ultrasound guidance.

PELVIC GYNECOLOGIC ULTROSOUND

Pelvic ultrasound is done in suspected gynecologic disorders in all age groups e.g., menstrual disorders, suspected  pelvic tumors,  pelvic pain, failure to conceive, post-menopausal bleeding to name a few.