When Your Baby Has Real Problems (the Sonogram)

Woman having ultrasound

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Most pregnant women volition take at least one ultrasound scan during her pregnancy. Typically speaking, the OB/GYN will order one around the eye of the second trimester, usually between weeks 16 to 20, to bank check the baby'south measurements and screen for any problems.

While modern ultrasound technology is relatively reliable, a scan that shows the all-clear sign doesn't necessarily mean that everything is okay. Similarly, a scan that raises a scarlet flag could very well be a false alarm.

As with all imaging tests, ultrasound results are discipline to interpretation and decumbent to man fault. Any misreading is unfortunate as it tin can cause farthermost emotional distress for the parents and expose the baby and pregnancy to unnecessary interventions.

Accurateness in Detecting Nativity Defects

Congenital defects, both major and minor, occur in around three percent of all births. Of these, roughly three out of four volition be detected past ultrasound. The accuracy of these tests, even so, is closely related to the stage and blazon of pregnancy involved.

For obvious reasons, 2d-trimester ultrasounds tend to exist more than authentic in detecting fetal abnormalities than those done during the first trimester. With that being said, first-trimester ultrasounds can often provide the most information about the likely course of a pregnancy.

A 2016 review of studies conducted by the University of Oxford and Université Paris Descartes concluded that early ultrasounds were able to discover fetal anomalies in around 30% of low-chance pregnancies and lx% of high-gamble pregnancies. While closer surveillance may business relationship, in part, for the higher rates in the latter grouping, the types of defects also tended to be more serious or involve multiple organ systems.

At the aforementioned time, some defects are only easier to spot than others. Past way of instance, a multi-heart study coordinated by the Washington University School of Medicine in St. Louis reported that a positive detection rate for the post-obit limb defects:

  • Extra fingers (polydactyly): 19.1%
  • Hand deformities: 76%
  • Joint rigidity and deformity (arthrogryposis): 81.3%
  • Limb length defects: 76%

While greater effort has been made to raise the imaging clarity of ultrasounds, finer details can yet be lost. If a woman is obese or has a multiple pregnancy, the clarity of the ultrasound may be further diminished.

While an ultrasound showing no signs of trouble is definitely a good matter, information technology is not an outright guarantee your baby will exist built-in costless of health concerns. In the end, the skill of the attending technician plays a major role in the accuracy of the ultrasound. If ever in doubt nearly the skill of a technician, do non hesitate to ask for your OB/GYN or a specialist perinatologist to be present during the exam.

Imitation-Positive Diagnosis

On the flip side, ultrasounds are non infallible when it comes to making a positive diagnosis of a birth defect. In some cases, the imaging results may exist misread (misclassified) or turn out to be nothing at all.

Ane French report conducted in 2014 reported that 8.viii% of congenital defects picked upwardly by an ultrasound were wholly incorrect (false positive) and that nine.two% were misclassified. This rate was mirrored in other studies and accounts for why ultrasounds are never used lonely when making a diagnosis.

With that beingness said, major malformations were far less likely to be wrongly diagnosed when compared to small ones.

In some cases, an ultrasound may enhance concerns about a problem just not offer enough data to make a definitive diagnosis. One such example is when Down's syndrome is suspected. If a sonographic exam suggests the defect, a secondary amniocentesis tin usually confirm the chromosomal bibelot with a high degree of accuracy.

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  • Karim, J.; Roberts, N.; Salomon, L. et al. "Systematic Review of First Trimester Ultrasound Screening in Detecting Fetal Structural Anomalies and Factors Affecting Screening Functioning." Ultra Obstet Gyn. 2016; 50(four):429-41. DOI: 10.1002/uog.17246.

  • Debost-Legrand, A.; Laurichesse-Delmas, H.; Francannet, C. et al. "Fake positive morphologic diagnoses at the bibelot scan: marginal or real problem, a population-based cohort written report." BMC Pregnancy and Childbirth. 2014; fourteen:112. DOI: ten.1186/1471-2393-fourteen-112.
  • Dicke, J.; Piper, S.; and Goldfarb, C. "The utility of ultrasound for the detection of fetal limb abnormalities–a 20-year single-center experience." Prenat Diagn. 2015; 35(4):348-53. DOI: x.1002/pd.4546.

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Source: https://www.verywellfamily.com/diagnosing-congenital-birth-defects-2371407

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