CREATE Fertility Clinic offers expert 3D/4D ultrasound scanning in pregnancy led by the pioneer of ultrasound diagnostics, Professor Stuart Campbell. Professor Campbell is renowned for introducing new techniques in obstetrics including the routine pregnancy scan, early diagnosis of fetal abnormalities, assessment of fetal growth and wellbeing in addition to ultrasound screening for ovarian cancer.
He introduced real-time 3D (4D) ultrasound scanning to the UK, where he set up CREATE Fertility Clinic, the country's first 4D ultrasound clinic. A complete one hour Pregnancy Scan (incorporating 2D/3D/4D ultrasound and Doppler) at CREATE Fertility Clinic comprises a detailed 2D anatomical survey, estimates the fetal weight, calculates the likely birth weight and measures the blood flow in the placenta.
In addition to providing parents-to-be with a breathtaking memento of their pregnancy to share with others, 3D/4D in pregnancy helps in the detection of many anomalies such as cleft lip, cleft palate and club foot.
We can provide a complete one hour pregnancy scan, which comprises a detailed 2D anatomical survey, estimates the fetal weight, calculates the likely birth weight and measures blood flow to the placenta.
The early embryo and its heart beat can be seen as early as 6 weeks gestation (calculated from the last period) or 4 weeks after conception or egg collection in women having IVF. The growth of the crown-length (CRL) of the embryo and the rise of the embryonic heart rate from about 100bpm at 6 weeks to approximately 190bpm at 9 weeks gestation are key indicators of wellbeing of the early embryo.
An early pregnancy scan is offered free of charge to all women who have conceived following IVF at Create Health. However it is also indicated for women who have bleeding or pain in early gestation to establish whether the pregnancy is viable and to exclude an ectopic gestation. If indicated a blood sample will be taken for beta HCG and progesterone to provide a definitive diagnosis.
In addition to the 4D images of the fetus, we will also have a detailed look at the internal anatomy of the baby with advanced 2D scanning to check for abnormalities and assess fetal growth and well-being. The same probe that takes 4D images can be used to provide advanced 2D images and blood flow measurement (Doppler). Additional important information that will be provided at the various stages of pregnancy is summarised below.
Measuring the fetus from ‘top to bottom’ (crown-rump length (CRL)) will provide an accurate assessment of the gestational age and will provide an estimated date of delivery.
In addition we will carry out a screening for Down syndrome by:
• Measurement of Nuchal Translucency (i.e. The fluid behind the fetal neck)
• Biochemical measurement of PAPP A and Free-BetaHCG in the mother’s blood.
Combining the nuchal scan and the blood test, we will give an individual risk assessment (likelihood ratio) for your risk of having a Down Syndrome baby. We can compare your ‘starting’ risk, based on your age, with the ‘new’ risk, which will help you decide whether you want an invasive test such as CVS or Amniocentesis. If the risk of Down’s is 1:250 or greater, an invasive test is advised.
The combination of these should give an 85% detection rate for Down Syndrome. Other recent markers for Down Syndrome, such as nasal bone identification and blood flow in the Ductus Venosus, may also be performed depending on the particular clinical circumstances.
As this stage, a detailed scan is performed which will detect the large majority of serious fetal anatomical abnormalities. Detailed scanning of the baby’s brain, spine, heart, diaphragm, kidneys, bladder, genitalia, limbs, fingers & toes can be seen in some detail with ultrasound.
Also at this time, blood flow in the uterine arteries is measured using Doppler ultrasound. This can predict whether the placenta will function normally or (if blood flow is impaired) whether the baby’s growth will be affected or high blood pressure will develop in the mother (pre-eclampsia).
In women at risk of premature labour, the length of the cervix can be measured using transvaginal ultrasound (an internal scan): a short cervix indicates an increased risk of early delivery.
Scan 26 weeks onwards
An assessment of baby’s growth and anatomy will be performed at the time of the 4D scan. Measurements of the fetal head, body and upper leg (femur) will be plotted on a graph to show the rate of growth of the baby. Blood flow in the baby’s Umbilical Cord and mother’s Uterine Arteries will indicate if the placenta is functioning normally. If placental blood flow is normal then an estimated prediction of the likely birth weight can be given.
How is 3D ultrasound different from the normal scan?
In conventional 2D scanning the ultrasound image is made up of a series of thin slices and only one slice can be seen at any one time. Although the image is very informative the picture you see does not look like a baby. With 3D ultrasound a volume of echoes is taken which can be stored digitally and shaded to produce life like pictures of the fetus. 4D just means that these life like pictures can be seen to move in real time so the activity of the baby inside your womb can be studied.
What are the advantages of 3D/4D ultrasound?
The examination time should be shorter because the baby’s anatomy can be studied in any plane from the stored computer image.
Some parts of the baby’s anatomy can be seen much more clearly than with 2D ultrasound, especially the face, arms, legs, fingers and toes. For example cleft palate has been shown to be more clearly seen with 3D ultrasound.
In addition, activities of the baby inside the womb can be seen which are difficult or impossible to identify on 2D scanning. For example with 4D scanning the fetus can now be seen to yawn, cry, swallow, blink and perform intricate finger movements. These activities can be seen even in mid pregnancy although they become more common as pregnancy advances.
Bonding between parents and baby has been shown to be stronger when the 3D image is seen compared to the 2D image because the picture of the baby is more realistic. Improved bonding has been shown to improve the mother’s care of herself and therefore her baby.
Will I always get a beautiful picture of my baby?
Usually, but not always. Sometimes if the baby is persistently looking face down, i.e. towards your spine it may be difficult to see the baby’s face. If this happens, a repeat scan in one hour will usually succeed because the baby has turned to a favourable position.
Could 3D/4D scanning be unsafe for my baby?
Despite extensive studies over 30 years ultrasound has not been shown to cause any harm to mother or baby. Indeed routine scanning of all pregnancies is now normal throughout the whole of Europe. In 3D/4D scanning exactly the same type and intensity of ultrasound is used as with conventional scanning. 3D scanning in fact should reduce the exposure time as by storing the data on a computer the baby’s anatomy can be examined off line and not by continual scanning. 4D ultrasound by showing movements will be similar to a conventional scan in terms of exposure.
If I have a 3D scan do I need to have a conventional scan in my own hospital?
It is very important that you go through the hospital routine so that no antenatal test is missed out. By having a 3D scan however, you will have a professional, detailed scan of the baby’s growth and anatomy and this information will be sent to your general practitioner.
When is the best time to have a 3D/4D scan?
Good pictures of your baby can be obtained throughout your pregnancy. In early pregnancy you will see the whole baby moving its arms and legs but details of the face are indistinct. Later in pregnancy you will see clear images of your baby’s features.
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