Routine 18 Week Obstetric Ultrasound Scan - Term Paper Example

RUNNING HEAD: Routine 18 Week Obstetric Ultrasound Scan Student Name Student Number Unit Title/Number Routine 18 Week Obstetric Ultrasound Scan Due Date Unit Coordinator Introduction Obstetric ultrasound refers to the application of sonography to have a clear vision of the embryo or fetus in the mother’s uterus. The ultrasound scan has become an almost universal part of antenatal care in developed countries (Garcia et al., 2002). Ultrasound examination during pregnancy was introduced in Sweden in 1973. It is now considered a kind of fetal diagnosis, offered as a routine procedure after the 18th week of pregnancy and consented to in 97 % of all pregnancies. However, the examination is usually carried out once, between the 16th and 20th week of the pregnancy. Specially trained midwives perform approximately 80% of the examinations. The main purposes of the examination are the confirmation of gestational age and the detection of a multiple pregnancy. The reason as to why most pregnant women undertake obstetric ultrasound scan routinely is a subject of research and attracts a volume of literature in all spheres of research. One of the most important reasons for undertaking the scan is to fulfill the need for reassurance of pregnancy (Gudex et al, 2006). Other reasons for undertaking the scan include the need of finding out the health of the baby in case any malformations or a multiple pregnancy exists (Lalor & Devane, 2007). This reason for malfunctions in babies did not seem so important for women since most of them did not have the knowledge that obstetric scan could detect such malfunctions or multiple pregnancies. However, with the realization that the scan can provide prove of the health status of the baby, obstetric ultrasound scan became a common day occurrence for pregnant women. Ultrasound has had a significant impact on the practice of obstetrics by providing valuable information about many pregnancy complications. There is good evidence to support the benefit of selective ultrasound use for high-risk pregnancies. There has been considerable debate about the value of ultrasound offered routinely for uncomplicated pregnancies. Many women have come to expect an ultrasound screening as a routine part of prenatal care (Lalor & Devane, 2007). Lack of information about the benefits, limitations, risks of the ultrasound process, proper preparation, and women’s expectation during and after the examination may contribute to this expectation. This paper seeks to analyze the importance of the routine 18 week obstetric ultrasound scan and its advantages to women and babies. The paper also seeks to identify any disadvantages of the scan to both babies and mothers. The paper will also seek to identify any benefits of the routine 18 week obstetric ultrasound scan to babies and women and why 18 weeks is the best timing for the scan. The process of the scan will also be described. The Process of Obstetric Ultrasound Scan Just like any other ultrasound scan and imaging that seeks to obtain the image of internal organs, obstetric ultrasound scan involves the process of sending sound waves of high frequency into the womb of a pregnant woman. A professional will then record the echoes of the sound waves as displayed in real-time image format. It is also worth to note that obstetric ultrasound scan does not need the application of ionizing radiation, otherwise known as x-ray. The displayed image is useful in helping physicians and women to have a clear view of the fetus in 4D revolutionary images (Lalor & Devane, 2007). Additionally, the process of obstetric ultrasound scan is based on certain principles that resemble the sonar used by bats, ships, and anglers used by fish detectors. When the controlled sound bounces on an object, there will be an echo in return. The echoing waves are useful in detecting the distance of the image, its size, shape, and internal consistency that include the state of matter. The transducer equipment functions in two ways as a loudspeaker to create the sounds and use a microphone to record the sounds created. As the sound waves echo from the fetus and any other structure in uterus appears, the sensitive microphone of the transducer will keep a reading of small changes in the pitch and direction of the sound. The signature wave will then be recorded, measured, and instantly displayed by a computer (Lalor & Devane, 2007). This will then display a real-time image on the monitor. The images will then be recorded on a videotape for further examination of the fetus and its status. Importance of the Routine 18 Week Obstetric Ultrasound Scan There are various reasons for adopting the routine 18 week obstetric imaging. The importance of the imaging in various aspects touches on mothers and babies. Firstly, the process is important in determining the sex of a baby as early as 18 weeks of pregnancy. In most cultures, parents view daughters as disadvantaged members of the society and parents prefer boys to girls. By knowing, the sex of an unborn baby as early as 18 weeks of pregnancy helps parents to determine whether to keep the pregnancy or terminate it depending on the cultural orientations of the society (Locock & Alexander, 2006). This application is most rampant in countries, notably Asia, where the application of obstetric ultrasound scan is useful for gender checking has led to a widespread gender imbalance. It is therefore important to note that obstetric ultrasound imaging helps parents to identify the gender of their babies as early as 18 weeks of pregnancy. Knowledge of baby’s health status is also another importance of the routine 18 week obstetric ultrasound scans. The technology helps physicians to check if there is any malfunction in the baby and keep monitoring the growth of and development of the fetus. In the event where abnormality is identified, physicians will take the appropriate steps to correct the issue while at the same time having an opportunity to advise expecting women on how to take good care of their pregnancies (Locock & Alexander, 2006). It is also important in providing room for consideration of any special attention of the pregnancy if need be. This point also stresses on the importance of early identification and examination of any malfunction with the fact that it provides room to monitor the development of the fetus and eventual delivery of a healthy baby. Additionally, obstetric ultrasound imaging is important for improvement of maternal and prenatal care. This is because the process allows for noninvasive and radiation-free visualization of the fetus, uterus, and placenta. Depending on the age of the fetus, physicians can carry out several pathological conditions for screening (Locock & Alexander, 2006). At 18 weeks, the routine 18 week obstetric ultrasound imaging becomes useful in detecting the presence of any abnormalities in the mother’s reproductive system and thus offering room for early treatment and prevention of infections that are likely to be transferred from mother to the baby. This is important for the provision of early and clear diagnosis of potential problems at 18 weeks of pregnancy. Pregnancy complications such as placenta pravia and ectopic pregnancy are easily identifiable with obstetric ultrasound imaging and hence improving the quality of life through early identification. Obstetric ultrasound scan also helps in the reduction of infant mortality. Several severe birth defects are responsible for the increased rise of neonatal deaths. Most researchers and academicians argue that approximately 1% of infants have a major congenital anomaly with a greater proportion of it occurs in developing countries where such diseases like syphilis and nutritional deficiencies are responsible for various malformations (Locock & Alexander, 2006). Therefore, obstetric ultrasound imaging is important for identifying structural abnormalities in the fetus while at the same time evaluating prenatal growth. Thus, the use of obstetric ultrasound technology can help physicians in identifying abnormalities and providing room for early intervention. Why 18 Weeks is the Best Timing for Obstetric Ultrasound Scan The 18 weeks of pregnancy is the best timing for carrying out obstetric ultrasound scan for various reasons. At 18 weeks, fetus development is at advanced stage that enables physicians to have a clear view of various features such as gender and health status. At this time also is the need to have clear medical information by expecting women (Boukydis et al., 2006). This will enable women to prepare for delivery and have an elaborate medical advice for health development of the fetus. Finally, the process is also important for the fact that early detection of any malfunction would be easy to treat and control. Consequently, this will help mothers have health babies at birth. However, Ultrasound prior to 17 weeks gestation to rule out anomalies is not advised due to a high false negative rate of detection. Ultrasound after 20 weeks gestation should be offered only for specific medical indications as the subsequent alternatives are usually more limited (Eva, et al, 2010). At 18 weeks gestation there is a sufficient fetal development to facilitate detection of anomalies while allowing for additional information to be obtained and information to be discussed with the patient (couple) to determine available options. Additionally, an 18 week gestational ultrasound may be sufficient to confirm gestational age in patients having prenatal maternal serum screen for aneuploidy and screening for neural tube defects. However, it may be desirable for an ultrasound to be done earlier if the screening test is abnormal especially if procedures such as amniocentesis are required (Boukydis et al., 2006). Finally, offering ultrasound examination at 18 weeks gestation would improve the accuracy of diagnosis of fetal anomalies due to the performance of the scan at a time more appropriate for the diagnosis of anomalies (Boukydis et al., 2006). At the same time, the benefits of gestational age dating, diagnosis of twins, detection of intrauterine growth restriction and placental localization are maintained. Advantages of Obstetric Ultrasound Scan to Women and Babies The tremendous feeling of a mother having a baby growing in her womb is hard to describe. The experience that comes with pregnancy is different yet a wonderful one for every mother and father. The use of obstetric ultrasound imaging brings along various advantages to women and their unborn babies. With obstetric ultrasound scan, couples will have the opportunity to know the health status of their babies and call for early intervention by physicians to prevent and monitor any complications for the safety of the baby and the mother (Eva et al., 2010). A good example of this benefit is when there is a case of genetic or chromosomal defects where a physician may order for more tests that could include sampling of amniotic fluid around the fetus (amniocentesis) or chorionic sampling to supplement the obstetric ultrasound imaging. In the case of such anomalies, physicians will be able to advise on certain control measures to contain the situation. Additionally, couples will have the opportunity to determine the age of the fetus by undergoing obstetric ultrasound imaging. By knowing the age of the fetus, women will have a rough estimation of their delivery dates and thus the opportunity to plan for it (Eva, et al, 2010). Prior planning is also good in the sense that at childbirth, parents will spend a considerable amount of money. Another important advantage of obstetric ultrasound scanning is that of the ability to determine whether the uterus is growing faster or more slowly than expected and identifying the reasons for each case. This is even more important with the need for couples wanting to deliver normal babies (Eva, et al, 2010). A uterus growing at a rate slower or faster than expected can have some devastating implications on the growth and development of the fetus. Therefore, women find it more advantageous to undergo obstetric ultrasound scan as a daily routine in ensuring their health and that of their babies. Another importance of the process is the examination of the baby’s physical development and functions such as breathing, heartbeat, excretion, and excretion (Eva, et al, 2010). Examining such factors at an early stage of pregnancy helps physicians and women to take the right course in providing a humble environment for the fetus to grow and develop. In the case of serious malfunctions, obstetric ultrasound will offer a clear view of the fetus and thus the need for early intervention. There is also the need to image the development of major organs of the fetus and assessing their growth and development. Among the most important organs are those that include the brain and the spinal column. Identifying any malfunction and poor development of such organs at an early stage of pregnancy will help physicians take the right actions to correct the anomaly. Finally, women will have the have the advantage of identifying whether their pregnancy is normal or ectopic in which case medical attention will be necessary. It will also offer women with information on whether they have multiple pregnancies (Boukydis et al., 2006). Therefore, obstetric ultrasound scan comes with a range of advantages for women and babies as it eventually leads to determination of prenatal health care and eventual delivery of a healthy baby. Disadvantages of Obstetric Ultrasound Scan to Women and Babies Despite the advantages that come with obstetric ultrasound scan as discussed above, there are also a number of disadvantages and concerns raised by a number of researchers. Firstly, obstetric ultrasound imaging is highly machine-dependent. This may at some times lead to failure to identify any serious fetal abnormalities (Eva, et al, 2010). On average, ultrasound scanning can miss from one third to half of fetal structural defects. Less commonly, obstetric ultrasound imaging can also detect fetal defects when in the real sense, there is the absence of an abnormality with the fetus and this eventually leads to stress and worries among women. Additionally, although there are no major worries to undergo obstetric ultrasound scan, there is the impending worry of meeting the cost that comes with the process. Undergoing ultrasound scan when it is not medically necessary costs family members and insurance companies a great deal money. Mothers are strongly affected by watching their fetus during an ultrasound examination. Ultrasound examinations have the potential to be a happy experience but a real or mistaken diagnosis of fetal abnormality can also lead to psychological devastation. Women attach value to the usefulness of the information (Eva, et al, 2010). They also value ultrasonography for its own sake, and not as an aid in decision-making. Another important point to put forward is the disadvantage of causing women a lot of worry when they see the images appearing on ultrasound monitors. The majority of the time, there is nothing wrong or if any, then it may be so minor, that is not even worth knowing about. This will cause more worry to women (Lalor & Begley, 2006). To add up to the worries is the use of ultrasound scan results by doctors to offer a proposal for abortion to women whose fetus ‘might’ be having certain defects. Sometimes the ultrasound results may show fatal and mild defects and the use of the images to offer abortion is an abuse. Lastly, there is also the biggest risk of ultrasound over interpretation or missed diagnosis. This could lead to birth complications. Effects of the Ultrasound Examination Obstetric ultrasound scan serves to visually confirm the existence of pregnancy and help in the reduction of uncertainty and feelings of unreality. Women watching the pregnancy on a screen along with the real feeling of pregnancy would make it possible to really believe in the pregnancy (Boukydis et al., 2006). This would help the women to grasp the pregnancy and to release their feelings for the baby. The process of obstetric ultrasound scan would result in connecting with, and feeling closer to the baby. Some feelings already existed about the pregnancy, but it's with obstetric ultrasound scan would strengthen such feelings of being able to see the baby on the screen. Furthermore, the obstetric ultrasound examination is of the view of women as an optional but common procedure after the 18 weeks of pregnancy. Having the examination would be an opportunity to do what almost every pregnant woman does (Eva, et al, 2010). Although some women are, a little uncertain about whether the examination was optional or not, it is picking a worldwide attention to reduce baby morbidity and mortality rates. They had understood that their midwife had told them to have it. Even an adverse result from obstetric ultrasound imaging would provide opportunities to act in different ways. One would be the possibility of terminating the pregnancy if the baby showed signs of being sick or malformed. Although this is a positive idea, it is a very difficult decision and still represents a choice. In various situations of malformation, the choices could either be to have an abortion, to take things as they came, or to prepare to take care of a handicapped baby (Eva, et al, 2010). Conclusion Obstetric ultrasound scan at the age of 18 weeks of pregnancy is an important phenomenon that has been in practice for over three decades. This paper discussed the importance of obstetric ultrasound scan, its procedure, and advantages and disadvantages to women and babies. The importance of the process as discussed includes provision of early medical information by examination of the fetus. The procedure is also important for detection of malfunctions and anomalies in the growth and development of the fetus. This is important because such information is necessary in determining the appropriate course of action depending on the information displayed on ultrasound monitors. Another importance of the 18 week routine obstetric ultrasound imaging is that of determining the due date of delivery. This information will help couples prepare for the birth of the baby in advance. Finally, the examination is also important in determining the sex of the baby. However, despite the aforementioned benefits and advantages of routine 18 week obstetric ultrasound scan, there are also a number of disadvantages presented to women and babies. The most identified disadvantage is that of the process being highly dependent on machines. This puts the level of accuracy in question. Another identified disadvantage is that of increased worries among women. There are also chances that women watching their fetus in an ultrasound monitor can have some psychological devastation. Reference List Boukydis, C., Treadwell, M & Delaney-Black,V 2006, Women’s responses to ultrasound examinations during routine screens in an obstetric clinic. The Journal of Ultrasound in Medicine, vol. 25, p. 721-8, accessed 27 July, 2013 www.jultrasoundmed.org/content/25/6/721.full.pdf Eva, M., Siw, A & Carina, B 2010, Routine ultrasound examination during pregnancy: a world of possibilities. Midwifery, vol. 26, p. 18-26, accessed 27 July, 2013. http://www.diva-portal.org/smash/get/diva2:288467/FULLTEXT01 Garcia, J., Bricker, L., Henderson, J. et al. 2002, Women’s Views of Pregnancy Ultrasound: A Systematic Review. Birth, 29, p. 225-250. Web, accessed 27 July, 2013 https://student.cc.uoc.gr/uploadFiles/1110-%CE%91%CE%9509%CE%9A/Garcia%20et%20al%20Womens%20views%20of%20pregnancy%20ultrasound.pdf Gudex, C., Nielsen, B & Madsen, M 2006, Why women want prenatal ultrasound in pregnancy. Ultrasound in Obstetrics and Gynaecology, vol. 27, p. 145-150. Web, accessed 27 July, 2013 http://www.diva-portal.org/smash/get/diva2:288467/FULLTEXT01 Lalor J & Begley, C 2006, Fetal anomaly screening: what do women want to know? Journal of Advanced Nursing, 55, p. 11-19. Lalor, J & Devane, D 2007, Information, knowledge and expectations of the routine ultrasound Scan, Midwifery, vol. 23, p. 13-22. Locock, L & Alexander, J 2006, Just a bystander? Men’s place in the process of fetal screening and diagnosis, Social Science & Medicine, vol. 62, p. 1349-1359. Web, accessed 27 July, 2013 http://www.academia.edu/333485/Just_a_Bystander_Mens_Place_In_the_Process_of_Fetal_Screening_and_Diagnosis Read More