Compulsory and Optional Pregnancy Scans In Singapore
Do you which scans you need to take during pregnancy, mums?
Pregnancy brings many changes to an expectant mum’s body. Not only are there random cravings, and morning sickness, but there are also lifestyle changes that are important to ensure the little one develops normally. How can you ensure that your little one develops as normally as you would want him to?
You really don’t have much of a choice since you do not know what is happening to your baby inside your womb. However, there are different ways to take a peek at your baby’s health and activity. Here’s a list of scans during pregnancy that all expectant mums should know of.
List of Scans During Pregnancy: What Is an Ultrasound Scan?
An ultrasound is made of high-frequency sound waves that you can’t hear.
These ultrasound waves pass through your body and when they bounce back, they are detected by the imaging machine and form images of the organs inside you. By being able to see these images, a radiologist can understand the condition of your baby.
Ultrasounds scans require you to lay down on a flat surface in a dim room. The doctor applies some gel on your abdomen that is used to easily spread the ultrasound waves. He will use a probe and start moving it around your abdomen, which will show images of your baby in the computer connected to the probe.
The gel is then wiped off and you can resume your normal activities once the image appears.
Although uncommon, medical professionals may also use a vaginal probe if you have been pregnant for approximately five to six weeks.
Rest assured that ultrasound scans – whether on the abdomen or through the vagina – are painless and completely safe for both the expectant mum and the baby.
List of Scans During Pregnancy That Are Compulsory
1. Dating and Viability Scan
This scan is the first scan you will need to take in your pregnancy. Your first ultrasound scan is usually performed while you are in the first trimester of pregnancy (i.e. weeks 1-12), and normally during the first five to six weeks of your pregnancy. Detailed scans can be taken when you are eight to twelve weeks into pregnancy.
By undergoing this scan, you and your doctors can have an idea of what the baby looks like.
Normal pregnancies should show an early pregnancy sac in the uterus with the fetus floating inside it. Your doctor should also be able to see your little one’s heart beating by the sixth week of pregnancy.
Why Do You Perform This Scan?
The dating and viability scan offers important information such as:
- How long you’ve been pregnant. Doctors have a way of measuring how much your baby has grown and can estimate how long you’ve been pregnant.
- Your expected date of delivery (EDD), which is critical for your doctors to advise and guide you along your pregnancy journey better.
- Knowing your EDD also makes it easier for you to manage your own life. A dating scan can help you handle employment commitments, such as maternity leave and organise baby care ahead of your due date.
- Whether you are pregnant with twins or triplets
- Whether your pregnancy is occurring in the right place. While most pregnancies develop in the womb, they can also occur in the Fallopian tubes. This is an ectopic pregnancy and there’s a 1-2 per cent chance for it to happen.
2. Nuchal Translucency Scan
The nuchal translucency scan is performed when the fetus is between 77 to 97 days old (i.e. 11 weeks to 13 weeks 6 days). Or when your baby measures around 45 mm (1.8 inches) to 84mm (3.3 inches).
The scan uses nuchal translucency (NT), the collection of fluid beneath the skin at the back of your baby’s neck, to measure the scan.
It’s performed with a probe over the abdominal area. Still, if your little one is positioned differently such that his physical traits cannot be observed, doctors may opt to carry out the scan through the vagina instead.
While it’s perfectly normal for all babies in the womb to have some fluid in the back of their necks, a baby with Down Syndrome has more fluid. This is why this scan is mostly used to check if a baby has Down Syndrome.
Other Reasons To Perform This Scan?
This test is also performed to examine any physical irregularities or genetic issues.
Doctors will use the information obtained from this scan to determine whether the baby has a genetic condition, such as congenital cardiovascular defects, Down Syndrome or other rarer genetic conditions such as Patau or Edward’s Syndromes.
Here are some of the things the test looks out for:
- Being able to see the nasal bone or baby’s nose bone is a good indicator of whether the baby has Down’s Syndrome or not. A baby missing its nose bone carries a higher risk of Down Syndrome.
- A baby with a skin fold that is thicker than normal may be a sign that your little one has Down Syndrome.
- If your baby has more than the normal range of fluid in the back of his neck. An NT of less than 3.5 mm is considered normal when your developing baby is between 45 mm (1.8in) and 84 mm (3.3in) in length.
This test has a success rate of about 80% and is completely safe for your little one.
3. Foetal Anomaly Scan
Performed between 18 to 20 weeks into your pregnancy (about the fifth month), it is also called a mid-pregnancy scan. This is also when you can learn about the gender of your child if you wish.
During this time, your unborn baby has grown sufficiently large for his major organs to be carefully observed. The main aim of this pregnancy scan is to check whether your little one’s organs are developing properly, and if not, to understand how to manage the situation properly.
A sonographer or obstetrician executes the procedure. They will use ultrasound machines that are different and more advanced than your previous scans, as these machines have an outstanding resolution for imaging, and are 70 per cent accurate in revealing all abnormalities.
Why Do You Perform This Scan?
The Foetal Anomaly scan is a necessary scan to check whether your unborn baby has any congenital defects.
This scan also checks whether your baby has any anatomical irregularities. Your doctor will check the:
- outline of the head
- largeness and uniformity of the heart chambers and heart valves
- how the great blood vessels are oriented
- to check if the spine straightens normally and is covered by skin
- bones in the legs or arms
- hands and feet
- fingers and toes
- sex of your child
- facial features for conditions like cleft lip or cleft palate
- location of the placenta and if the amniotic fluid is enough
The physical appearance of these organs is a good indicator of genetic conditions in the baby. More tests can be applied to further understand whether your baby is suffering from such conditions or not. If your baby is suffering from any issue, then doctors will take the necessary action to manage the progression of further damage.
The diagnostic accuracy may not be 100 per cent accurate and can vary due to multiple factors, such as maternal obesity, abdominal scars, foetal position and reduced amniotic fluid.
4. Growth Scans
It’s normally done when you are 32 to 36 weeks (or eight to nine months) pregnant. This scan is important in that your doctor can keep track of how your little one is growing. Expect some baby height measurements during your visits to the doctor during this time, too.
Why Do You Perform This Scan?
As you end the second trimester and enter the third, your baby should be growing properly, and this scan affirms the same.
The doctor will check:
- That the amniotic fluid levels are enough, which sheds light on if the baby is healthy or not.
- The position of the baby in the womb and the location of the placenta. This information will be important in helping medical professionals decide the best possible way for you to give birth to your baby – either as a normal delivery or a C-section.
List of Scans During Pregnancy That Are Optional
1. Foetal Echocardiogram
Fetal echocardiograms are very alike to ultrasound. The main difference is that it is much more specific. The sound waves are projected to plot out what the heart looks like. The scan is usually between 18 to 24 weeks of pregnancy and allows the medical professionals to:
- Analyse your little one’s internal heart structure. This helps determine if the heart has grown properly.
- Check if the heart is functioning properly. They will check whether blood is flowing irregularly through the heart or whether it is beating abnormally.
2. Colour Doppler Scans
Your doctors can also employ a more special ultrasound scan called the Doppler ultrasound. Colour Doppler scans are undertaken during the second trimester (between 20-22 weeks of pregnancy) and the third trimester.
You can use this ultrasound to check for information, such as:
- If your baby has delayed physical growth or development
- To confirm whether the baby has anaemia (below-average haemoglobin levels) or not
- The current state of blood flowing through the placenta
- The general health and biophysical profile of the baby
3. 3D/4D Ultrasonography Scans
Using special imaging software, these scans provide a clear, lifelike, 3D image of the baby, and may have quality like that of photos.
Such scans aid your doctors in observing your little one’s heart and interior organs. These scans are mostly done 24-28 weeks (or about seven months) into your pregnancy to determine if any anatomical deformities are present.
Note that 4D scans are simply the 3D version of your bundle of joy as he moves around in your womb.
Why Do You Perform This Scan?
There are two main reasons why expectant mums might choose to take a 3D/4D scan:
- A 3D/4D ultrasound scan helps medical professionals to check any malformations seen through a normal ultrasound
- Parents-to-be are treated to the beautiful sight of their baby’s face and physical appearance (especially with 4D scans) while still in the womb
However, 3D/4D scans aren’t perfect, either. Not everything (primarily structures and facial features) can be visualised if there isn’t enough amniotic fluid bathing the unborn baby. It’s also concerning if the baby is oriented backwards in the uterus. Many hospitals in Singapore provide 3D/4D scanning.
Scans And Tests Needed In The Post-Pandemic Era?
The COVID-19 pandemic has changed the face of healthcare and we now need more firewalls in place to keep the health risks to a minimum. For expecting mums, the pandemic has brought a certain degree of uncertainty as to what changes on the medical front.
While we now need to follow all kinds of precautions right from wearing a face mask to maintaining social distancing, there’s no change in the number of tests and scans that we do. There is limited clinical information and data available to see the long-term effects of the COVID-19 virus. And so, the consequences of the infection on pregnant women are uncertain.
However, expecting mothers have restricted respiratory capacity and are in an immunosuppressed state, which makes them susceptible to viruses and infections. The coronavirus puts them at a higher risk of having a lung infection or congestion that will put the mother and the baby’s life in danger.
Your doctor will recommend minimising visiting public space. A COVID-19 test may be necessary on a regular basis if you frequently travel. Please speak to your healthcare provider for more details and to gauge a clear understanding of how to proceed forward.
You need to take a COVID-19 test if you show any of the following symptoms:
- loss of smell or tastes
- high temperature
- shortness of breath
Meanwhile, you will need to stay under quarantine for at least seven days until your test results arrive, and your doctor can then decide the course of action depending on the results.
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