Expectant mothers in the process of carrying a baby have to go through a large number of examinations, including fetometry of the fetus using ultrasound. This is one of the few non-traumatic procedures that can provide reliable information about the condition and development of the child throughout pregnancy.

Fetometry of the fetus, as a method, is the determination of the size of the baby by means of an ultrasound scan and comparison of the data obtained with the existing standards. This information allows the attending physician to judge the occurrence of developmental abnormalities or the normal process of gestation.

If there are difficulties with establishing the term of conception by the last menstruation, fetometry of the fetus allows you to determine it with an accuracy of 4 days. Therefore, we can say that this method is in demand in the early diagnosis of intrauterine growth disorders and the specification of the timing of pregnancy. All standards for fetal fetometry indicators are brought to world medicine standards and are indicated in tables with average statistical data.

Periods of passing fetometric research

Ultrasound examinations for the purpose of diagnosing the development of the baby are standardly timed to the 12th, 20th and 32nd weeks of pregnancy. There is one diagnostic procedure for each trimester.

The decision about the time of the ultrasound and fetometry is made by the doctor. This is influenced by:

• the general condition of the expectant mother;
• the emergence of suspicions of a violation of the intrauterine development of the child;
• the established timing of fetal fetometry.

Thanks to ultrasound, it became possible not only to assess the main characteristics of the fetus (calculate the weight of the fetus by ultrasound, its height, chest and head circumference) and correlate them with the average statistical indicators for weeks of pregnancy, but also to identify the functional state internal organs child, determine his gender.

Thanks to modern ultrasound diagnostics, the doctor can not only compare fetometric data with the norm, but also assess the development of internal organs and determine the sex of the child.

Key characteristics of fetometric research

The leading criteria for fetal fetometry are:

• CTE (coccygeal-parietal size);
• BPD (biparietal head size);
• OG (chest circumference);
• Coolant (abdominal circumference);
• DB (length of the femur bone).

Table with average fetal fetometry values ​​by week of pregnancy:

A week	BPR, mm	LZR, mm	Coolant, mm	DBK, mm	Weight, gr	Height, cm
13	24	-	69	9	31	10
14	27	-	78	13	52	12,3
15	31	39	90	17	77	14,2
16	34	45	102	21	118	16,4
17	38	50	112	25	160	18
18	43	53	124	30	217	20,3
19	47	57	134	33	270	22,1
20	50	62	144	35	345	24,1
21	53	65	157	37	416	25,9
22	57	69	169	40	506	27,8
23	60	72	181	42	607	29,7
24	63	76	193	45	733	31,2
25	66	79	206	48	844	32,4
26	69	83	217	49	969	33,9
27	73	87	229	52	1135	35,5
28	76	89	241	55	1319	37,2
29	78	92	253	58	1482	38,6
30	81	95	264	60	1636	39,9
31	83	97	274	62	1779	41,1
32	85	100	286	63	1930	42,3
33	86	102	296	65	2088	43,6
34	88	104	306	67	2248	44,5
35	89	106	315	69	2414	45,4
36	91	108	323	71	2612	46,6
37	93	109	330	73	2820	47,9
38	94	110	336	74	2992	49
39	95	112	342	75	3170	50,2
40	96	116	347	76	3373	51,3

Additionally, the following ultrasound indicators can also be determined:

• fetal head circumference;
• frontal-occipital size;
• shin bone length;
• the length of the tibia;
• foot length;
• the length of the bones of the shoulder and forearm;
• interhemispheric cerebellar size (MRM);
• diameter of the heart.

Metrics of nasal dorsum development are very important for assessing the development of a child in the detection of chromosomal diseases and birth defects.

CTE as a characteristic of the physical development of the fetus

Term, week + day	10 weeks	+ 1 day	+ 2 days	+ 3 days	+ 4 days	+ 5 days	+ 6 days
CTE, mm	31	33	34	35	37	39	41
Term, week + day	11 weeks	+ 1 day	+ 2 days	+ 3 days	+ 4 days	+ 5 days	+ 6 days
CTE, mm	42	43	44	45	47	48	49
Term, week + day	12 weeks	+ 1 day	+ 2 days	+ 3 days	+ 4 days	+ 5 days	+ 6 days
CTE, mm	51	53	55	57	59	61	62
Term, week + day	13 weeks	+ 1 day	+ 2 days	+ 3 days	+ 4 days	+ 5 days	+ 6 days
CTE, mm	63	65	66	68	70	72	74

The options for the norm include an increase in CTE by one to two weeks. If Rh-conflict, neoplasms and mother's diabetes are excluded, then such an increase in the size of the baby may indicate that the child will be born large, with a weight of 4 kg or more.

In this case, you need to be careful when using medications that affect metabolism, including complex vitamins. Such drugs can lead to the birth of a very large child from 5 kg.

The reasons that can lead to a decrease in CTE can be both normal variants and a sign of severe pathology.

To the variants of the norm refers to the possibility of a later fertilization in connection with the timing of ovulation. As you can see, the time of conception will be slightly later than that calculated in accordance with the last day of menstruation. In this situation, you just need to repeat the ultrasound in a week.

Pathological reasons:

1. Frozen pregnancy and embryo death. This situation requires immediate intervention and medical attention, because can cause bleeding, impaired fertility of the female body, toxic shock and death of the mother. It is possible to exclude this pathology if the heartbeat of the unborn child is determined.
2. Lack of hormones (more often progesterone) - requires confirmation using additional research methods and hormonal therapy (only a doctor can prescribe it!). Treatment is necessary, because hormonal deficiency can cause self-abortion.
3. Infections, including STIs, can be a factor that can negatively affect your baby's growth. In this situation, additional examinations are required to identify an infectious agent. Then therapy should be carried out within the permitted time frame.
4. Genetic abnormalities (syndromes: Down, Patau, Edwards). If such violations are suspected, a geneticist's consultation and additional examinations are required. Serious genetic abnormalities usually lead to self-abortion.
5. Somatic diseases of the mother, including chronic diseases of the heart and thyroid gland. As a rule, they exert their influence at a later date. And yet, their influence cannot be ruled out from the first week of embryo development.
6. Pathology of the mucous membrane lining the uterus. Erosion, abortion, fibroids, disrupting the integrity of the mucous layer, prevent the ovum from fixing properly in the wall of the uterus and growing fully, which can cause self-abortion.

Insufficient CTE indicators, according to the table of standards, may indicate violations of the intrauterine development of the child, therefore, such a pregnancy needs additional examination

CTE is an important indicator of the development of the crumbs, but do not rush to interpret its value yourself, wait for the comments of the attending physician.

BPD as an indicator of the development of the fetal nervous system

The biparietal index, measured during fetometry, indirectly describes the development nervous system baby and indicates the gestational age with a high degree of accuracy. In fact, BPD on ultrasound is the distance between the outer visible boundaries of the opposite parietal bones of the skull (right and left), which is determined along the line of the eyebrows. Often this parameter is measured in conjunction with the LZR indicator (frontal-occipital size) - the distance between the outer visible boundaries of the bones: the occipital and frontal.

The characteristics of bipolar disorder are used to determine the degree of safety for the mother and the child to pass it through the birth canal during delivery. In the case when the value of bipolar disorder significantly exceeds the norm, operative delivery by the method is indicated. caesarean section.

The BPD indicator in combination with the LHR indicator allows weekly assessment of the characteristics of the brain and the development of the baby's nervous system. A feature of biparietal characteristics is a slowdown in their growth with an increase in pregnancy.

At twelve weeks, the growth rate of bipolar disorder is about 4 mm per week, by the end of the gestation period, it barely reaches 1.3 mm. A competent interpretation of this indicator makes it possible to assess the growth and development of the baby with a high level of reliability throughout the entire period of gestation.

Minor fluctuations in the biparietal and fronto-occipital indicators can be options for the normal growth of the baby. For example, if the fetus large sizes(over 4 kg), then all parameters can be increased for a period from one to several weeks. Also, sometimes the head grows slightly more / less than other organs, because the baby grows unevenly. In this situation, you need to repeat the ultrasound scan after a few weeks, perhaps the indicators will level out.

If the doctor diagnosed the patient with a large-fruited pregnancy, then the indicators of BPD and LHR can naturally be increased in accordance with the size and weight of the baby.

A significant increase in these indicators can be an alarming symptom, indicating the development of neoplasms of bone or brain structures, the appearance of cerebral hernias and the accumulation of cerebrospinal fluid in the ventricles of the brain (hydrocephalus / dropsy of the brain):

• With the development of neoplasms and cerebral hernias, it is recommended to terminate the pregnancy. A fetus with such a pathology is usually not viable.
• Hydrocephalus, in most cases, occurs due to intrauterine infection... The infection must be treated with antibiotics without fail. If this treatment does not work, it is recommended to terminate the pregnancy. If there is no development of hydrocephalus, the fetus, as a rule, is allowed to be saved, but monitoring of its condition through ultrasound should be carried out constantly.

A decrease in the size of the fetal head may indicate insufficient development of certain brain structures, or the absence of such. The absence of any brain structures is a strict indication for termination of pregnancy, regardless of how long this pathology was discovered.

Another reason for the decrease in BPD and LHR is the violation of the timing of the development of the fetus. This phenomenon requires immediate medical intervention and correction, because can cause intrauterine death of the child.

For the entire period of pregnancy, if future mom she got registered in the antenatal clinic on time, she has to undergo several important studies, including an ultrasound scan. Exactly this procedure allows you to observe fetometry and monitor the development of the baby.

Fetometry of the fetus by weeks of pregnancy is an intrauterine measurement of the baby, to determine how the baby's body is developing, to identify possible violations or diagnose other problems.

Fetometry measurement of the fetus is carried out in millimeters, while the data obtained are checked against special tables, from which the state of pregnancy becomes clear. For each week of pregnancy, its own fetometric indicators are determined.

More about the study

Fetometry of the fetus - absolutely safe method studies by weeks of pregnancy, since it is carried out using ultrasound waves, which do not have a negative effect on the body of the fetus and the pregnant woman;

This method is non-invasive - that is, it does not require breaking the integrity skin, mucous membranes, or blood sampling;

Can be performed as many times as required by medical indications;

Fetometry of the fetus makes it possible to dynamically monitor its growth by weeks and the state of the organs;

Also, the study allows you to determine indicators indicating a violation and developmental anomalies, genetic diseases in the fetus during a routine ultrasound examination of a pregnant woman.

How to prepare for the study

Fetometric measurement in utero developing baby performed during an ultrasound scan. This study can be performed both with a transvaginal probe and through the anterior abdominal wall.

If the procedure will be performed through the vagina, there is no need to prepare for fetometry. If transabdominal is planned, then in the early stages of pregnancy you will need to drink about half a liter of water before the study an hour before the study and not go to the toilet after that.

This is necessary so that through a full bladder, like through a window, you can look into the uterine cavity. In terms of more than 12 weeks, this is no longer required, since the necessary "window" is created by amniotic fluid.

When and how does the study take place?

Fetometry is performed as planned three times, as well as ultrasound diagnostics:

• in the first trimester (at 11-12 weeks);
• in the second (at 20-22 weeks);
• in the third (mainly at week 32).

If there are indications or any reasons for additional examinations, then the doctor will refer you to an unscheduled procedure.

I trimester

In the first trimester, as part of a fetometric examination, the diagnostician will confirm the due date as suggested by your gynecologist. The main task of the doctor at this stage is to exclude chromosomal abnormalities and gross malformations. The most important indicators now will be the coccygeal-parietal size (CTE) and abdominal circumference.

Also, during the screening ultrasound examination, both the thickness of the collar space and the length of the nasal bone are measured.

II trimester

Ultrasound examination in the second trimester is carried out in order to check the absence of intrauterine growth disorders. For this, the main measurements are taken: biparietal size of the fetal head, CTE, head circumference, tummy circumference, frontal-occipital size.

Perhaps other indicators will also be taken: the length of the baby's thigh and the length of other bones (tibia, shoulder, elbow). On this visit to the doctor, you have the chance to find out the gender of your unborn child.

III trimester

Diagnostics in the third trimester no longer sets itself the task of looking for any vices or violations, because until that time the baby is already fully formed and is preparing for birth.

Now it is important for the doctor to check his health and state of health. He will also measure the circumference of the head and abdomen, see how symmetrically the child's limbs develop, determine his weight and height.

These indicators will be important for the choice of the method of childbirth (too large a fetus, the first pregnancy, a narrow pelvis and other features may cause referrals for a cesarean section). If everything is in order, the procedure is no longer assigned.

Forms of developmental delay

Several forms of fetal growth retardation have been identified, which can be determined by fetal fetometry at different weeks of pregnancy

1. The symmetrical shape is fixed when all indicators of a fetometric study are lower than normal values ​​for this period of pregnancy;
2. With an asymmetric form, the diagnostician will observe the norm in relation to one parameter, and the predominant decrease in some other indicators.

Also, there are three degrees to determine the lag in fetometry parameters:

• 1st degree means a difference from the norm of two weeks;
• 2nd - at 3-4;
• 3rd - more than a month.

Sometimes the doctor repeats the procedure after a while, and the parameters return to normal, so you shouldn't just be alarmed if the numbers of your research differ from the book indicators.

In the case of a big difference, additional diagnostic methods will be prescribed in order to exclude all kinds of pathologies and defects, developmental disorders, arrest or delay in life.

What is measured - fetometry of the fetus at different weeks of pregnancy

There are several growth parameters related to the state of the baby's skeletal system. The main indicators for the age assessment of a baby are:

• CTE (coccygeal-parietal size), which corresponds to the length from the crown of the child to the coccygeal region and indicates the state of the growth rate of the fetus.
• BPD (biparietal size), which corresponds to the width of the baby's head between his parietal bones of the cerebral skull.
• LZR (frontal-occipital dimension), which corresponds to the width from the frontal bone of the child to the most prominent point of the occipital bone.
• DB (thigh length).
• Coolant (abdominal circumference), which is also used to assess the growth rate.
• OG (chest volume).
• The lengths of the various bones of the skeleton (forearm, femur, and humerus).

Fetal fetometry table by week

As a standard, a young mother is recommended to undergo this examination closer to the end of the 1st trimester, in the middle of the 2nd and closer to the time of childbirth, therefore, women are often very interested in the rate of fetal fetometry at 20 weeks and at 30, as the most important milestones. This data can be obtained from the table below, which shows the desired values ​​for each week, starting with the 12th and ending with the 36th. All parameters, except CTE, are indicated in mm.

It should be said that, although these norms of fetometry by week are given in the form of a specific number, in reality they have a certain corridor of values, because all organisms cannot be brought to a single denominator. Each of the parameters has its own number of units by which it can shift in the direction of decreasing or increasing: for example, for the abdominal circumference it is about 14 units in each direction, and for the bipariental head size - only 3-4 units in each direction.

Concerning possible deviations from the norm, then they are mainly checked by the CTE parameter - if it does not coincide with the specified value for a certain week, it is possible that the gestational age was measured incorrectly. Or, in case of his serious lagging behind or ahead, as well as lack of dynamics, the doctor may talk about:

• frozen pregnancy;
• pathologies in the development of the baby;
• deficiency of progesterone in the mother's body;
• infectious diseases that affect the development of the fetus;
• pathologies of the uterine mucosa.

Conclusion

It should be borne in mind that the average values ​​are recorded in the plate, and the sizes of each baby may differ. It depends on many factors, including heredity. Therefore, if the child is a little less than the norm - this is not a reason to worry, you need to track his growth in dynamics. If it is positive, it may be an individual feature of the child's development.

Information from fetal fetometry tables by week of pregnancy is for informational purposes only. You should not interpret your screening results yourself. In case of non-compliance with the norms, the doctor individually determines how critical it is. If the deviations are undesirable, then there is an opportunity to correct the situation by taking the necessary measures in a timely manner. You can read about what other tests pregnant women need to undergo.

When studying the development of the fetus in the II and III trimesters of pregnancy, the main focus is on measuring the biparietal size of the head, the average diameter of the chest and abdomen, and the length of the thigh.

It was found that with the development of the fetus, all four of these main indicators progressively increase. However, by the end of pregnancy, their growth rate gradually decreases. Thus, the rate of increase in the biparietal head size decreases from 4 mm / week at 14-15 weeks of gestation to 1.3 mm / week by the end of pregnancy, the length of the thigh - from 4.8 mm / week to 1.7 mm / week.

Table 2 shows the changes in fetometry data in the II and III trimesters of pregnancy, taking into account individual fluctuations.

Table 2. The main indicators of fetometry at different stages of pregnancy

Pregnancy period, weeks	BPR, cm	Chest diameter, cm	Belly diameter, cm	Thigh length, cm		Pregnancy period, weeks	BPR, cm	Chest diameter, cm	Belly diameter, cm	Thigh length, cm
14	2,4 2,1-2,8	2,4 2,0-2,9	2,4 1,9-2,9	1,2 1,0-1,5		28	7,1 6,5-7,5	7,2 6,7-7,8	7,4 6,8-7,9	5,3 4,9-5,7
15	2,8 2,5-3,2	2,8 2,3-3,2	2,8 2,3-3,2	1,6 1,1-1,8		29	7,3 6,9-7,7	7,4 6,9-8,2	7,6 7,1-8,3	5,5 5,1-5,9
16	3,2 2,8-3,6	3,2 2,7-3,7	3,2 2,6-3,6	2,0 1,6-2,4		30	7,5 7,1-8,0	7,7 7,2-8,4	7,9 7,3-8,7	5,7 5,3-6,1
17	3,6 3,2-3,9	3,6 3,1-4,0	3,6 3,2-3,9	2,4 2,0-2,8		31	7,8 7,3-8,3	8,0 7,4-8,7	8,2 7,5-9,0	5,9 5,9-6,3
18	3,9 3,6-4,3	3,9 3,5-4,4	3,9 3,5-4,3	2,7 2,3-3,0		32	8,0 7,5-8,5	8,2 7,2-9,0	8,5 7,8-9,3	6,1 5,7-6,5
19	4,3 3,9-4,7	4,3 3,8-4,8	4,3 3,8-4,7	3,0 2,7-3,4		33	8,2 7,7-8,8	8,5 7,8-9,3	8,7 8,0-9,7	6,3 5,9-6,6
20	4,7 4,3-5,0	4,6 4,2-5,2	4,7 4,3-5,1	3,3 2,9-3,6		34	8,4 7,9-9,0	8,7 8,0-9,6	9,0 8,2-10	6,5 6,1-6,8
21	5,0 4,6-5,3	5,0 4,6-5,5	5,0 4,7-5,5	3,6 3,2-4,0		35	8,6 8,1-9,2	8,9 8,2-9,8	9,2 8,4-10,5	6,7 6,2-7,1
22	5,3 4,9-5,7	5,3 4,8-5,8	5,4 5,0-5,9	3,9 3,5-4,2		36	8,8 8,3-9,4	9,2 8,4-10,2	9,5 8,6-10,8	6,9 6,4-7,3
23	5,6 5,2-6,0	5,6 5,2-6,1	5,7 5,4-6,2	4,1 3,7-4,6		37	8,9 8,5-9,6	9,4 8,6-10,5	9,7 8,7-11,2	7,1 6,5-7,4
24	5,9 5,5-6,3	6,0 5,5-6,5	6,1 5,7-6,5	4,4 4,0-4,8		38	9,1 8,6-9,8	9,5 8,8-10,8	9,9 8,8-11,5	7,3 6,6-7,6
25	6,2 5,8-6,6	6,3 5,8-6,8	6,4 6,0-6,8	4,6 4,2-5,1		39	9,3 8,8-10,0	9,8 8,9-11,1	10,1 9,9-11,9	7,4 6,7-7,8
26	6,5 6,1-6,9	6,6 6,1-7,2	6,7 6,3-7,2	4,9 4,5-5,3		40	9,4 8,9-10,4	9,9 9,0-11,5	10,3 9,1-12,2	7,6 6,8-8,0
27	6,8 6,3-7,2	6,9 6,4-7,4	7,0 6,6-7,6	5,1 4,7-5,3
The biparietal head size (BPD), the average diameters of the chest and abdomen are given according to L.S. Persianinov and V.N. Demidov (1982), thigh length - according to A.N.Strizhakov and M.V. Medvedev (1984).

It is also important to calculate the estimated length of the fetus by measuring the length of the thigh to determine the degree of maturity of the fetus. It was found that at the end of the prenatal period of development during ultrasound examination it is possible to visualize the secondary ossification point in the lower epiphysis of the thigh (Beklar's nucleus). With sufficient maturity of the fetus, the total length of its thigh is 7 cm or more, the size of the Beklar nucleus ranges from 5-7 mm. The relationship between fetal length and femur length is expressed by the following equation:

D = 0.508B 2 - 0.56B + 28.68

where D is the length of the fruit, cm; B - fetal thigh length, see

Using this equation makes it possible to predict the length of the newborn with an accuracy of ± 1 cm in 71.4% and ± 2 cm in 88.6% of observations.

Ultrasound examination is one of the most objective methods for diagnosing fetal growth retardation syndrome. Ultrasound diagnosis of developmental delay is based on a comparison of the photometric data obtained during the study with the standard indicators of a given gestational age.

Distinguish between symmetrical and asymmetric forms of fetal growth retardation, which are characterized by different ratios of the main indicators of fetometry, the timing of occurrence and etiological factors.

With a symmetrical shape, all fetometric indicators (biparietal head size, average chest and abdominal diameters, thigh length) are below the normal values ​​of individual fluctuations for the corresponding gestational age.

The asymmetric shape is characterized by a predominant decrease in the size of the abdomen and chest. Biparietal head size and fetal femur length remain within normal values.

Consequently, it is these two indicators that can serve as criteria for differentiating the forms of fetal growth retardation syndrome.

Lagging parameters of fetometry

• I degree - there is a 2-week lag in fetometry parameters,
• II degree - for 3-4 weeks
• III degree - there is a decrease in size by more than 4 weeks of pregnancy.

An important indicator for assessing the effectiveness of the therapy is the growth rate of fetometric indicators. The cessation of the growth of indicators, as well as the presence of a symmetric form of the syndrome of delayed fetal development of the III degree, indicates a significant violation of its vital activity and serves as an indication for early delivery.

The interpretation of the ultrasound indications is carried out by two specialists - the doctor who conducts the ultrasound examination and the leading gynecologist. The ultrasound doctor issues a conclusion with the established gestational age and information about the existing pathologies of fetal development or their absence. The gynecologist assesses the degree of pathologies and decides what to do next for the pregnant woman.

What is an ultrasound scan for during pregnancy

Ultrasound analysis is caused by the need to examine the child in the womb for his pathologies or their absence.

Early ultrasound is carried out to establish the presence of pregnancy and its duration, the number of fetal eggs. This path of research is useful in that it can reveal ectopic pregnancy- a dangerous condition that requires the immediate intervention of doctors, up to surgical methods. If, with the help of ultrasound, this pathology is detected at the initial stages, the pregnant woman has the opportunity to avoid surgical intervention.

At the stage first screening (11-13 weeks) the walls of the uterus, the uterus itself and its appendages are studied, and the following indicators of the growth of the embryo are considered:

• chorion - it contributes to the development of the placenta;
• the yolk sac is an important component for the development of the embryo.

At subsequent stages of ultrasound helps to identify existing pathologies, such as the threat of miscarriage,. It is the timely diagnosis of deviations that helps to eliminate them and avoid subsequent complications.

At the second screening a number of indicators are being investigated, which will then need to be deciphered:

• the uterus, fallopian tubes and the state of the ovaries are examined;
• fetometry is carried out, with the help of which the sizes of individual parts of the fetus are established and their compliance with the terms of pregnancy is assessed;
• the state of the organs connecting the child with the mother (placenta, umbilical cord) is studied, the structure is assessed amniotic fluid;
• the state of the child's internal organs is analyzed.

On this ultrasound, some pathologies can be traced, such as oligohydramnios or too low attachment of the placenta. Thanks to ultrasound, it is possible to establish both curable and incurable fetal defects.

Third screening is carried out for the following purposes:

• identification of serious fetal malformations that cannot be detected in the early stages;
• determination of fetal presentation (gluteal or cephalic);
• determination of the child's body weight;
• assessment of the risk of malformation of the brain;
• examination for the subject;
• fetal heart rate assessment - rapid or rare;
• fetal growth assessment;
• assessment of the risk of developing heart defects in the fetus.

On an ultrasound scan in the third trimester, you can already see the baby's lungs and their readiness to work in a normal environment in case of premature birth. At the last screening, a lot of attention is paid to the skull, abnormalities such as cleft palate, cleft lip, etc. are monitored.

On the eve of the birth itself, ultrasound allows you to find out some of the nuances that may be important for the very process of childbirth. In particular, only thanks to ultrasound it is possible to see the entwined umbilical cord with 100% accuracy, and this is a very important aspect in the birth process, because it can become a threat to both the baby's health and his life.

Some pregnant women are prescribed Ultrasound more often than expected. These pregnant women include those who have: diabetes mellitus, diseases of the blood and lymph, negative Rh factor.

Decoding ultrasound of the fetus

Already starting from the 11th week of pregnancy, the detection of fetal pathologies is allowed. In Russia, two main standard protocols have been identified, according to which data decryption is carried out.

These studies are conducted at 11-13 weeks of gestation and 19-22 weeks. In order to more accurately decipher the data, you need to know the norms of fetal development at different stages of gestation.

At this time, a detailed examination of the collar zone of the fetus is carried out - the area between the tissues and the skin in the neck area. The thickness of the collar zone is designated by the abbreviation TVP. Normally, the TVP should not exceed 2.7 mm.

The nasal bone is another parameter that is being investigated at this time. Normally, the bone should be visualized.

Another indicator that is measured at this stage is the CTE (coccygeal-parietal size of the fetus).

For a baby at 11-13 weeks, the CTE is considered the norm in the range of 45-80 mm.

In addition to CTE, the doctor assesses the biparietal and frontal-occipital dimensions of the fetus. The first is the distance from one temple of the head to the other and is normally up to 28 mm. The second - the distance from the frontal to the occipital bone - normally does not exceed 31 mm.

* Percentile is a descriptive statistic term. The average value is indicated in the column "50th percentile", in the columns "5th percentile" and "95th percentile" - the minimum and maximum allowable values, respectively.

Separately, the doctor assesses the diameter of the ovum ...

... and calculates your heart rate (HR).

If the indicators do not correspond to the norm, the pregnant woman is recommended to undergo a consultation with a geneticist and additional examination.

Second fetal screening

The rates of fetal development in the second trimester are shown in the table:

If there are any changes in these indicators, abnormalities in the development of the child in the womb can be assumed. By the way, at the second screening, the fetus is seen much better than at the first, so the doctor can judge not only about genetic abnormalities, but also about other defects (they are recorded separately in the examination protocol).

As part of the third screening, such parameters of the baby as height, weight, biparietal head size, hip and chest length are assessed. The norms of the listed parameters are described in the table above. Below are the normal indicators of BPR and LHR.

* Percentile is a descriptive statistic term. The average value is indicated in the column "50th percentile", in the columns "5th percentile" and "95th percentile" - the minimum and maximum allowable values, respectively.

During the 3rd screening, the doctor assesses the state of the placenta, its degree of maturity and thickness... The placenta is the link between the mother and her baby. It remains for the entire duration of the pregnancy. It exists in order to nourish the child with the necessary nutrients.

IAI (amniotic fluid index) rates

Fetal size by week of pregnancy

In each trimester, its own research is carried out and its measurements are made. The interpretation of ultrasound indicators helps to establish the size of the child at the time of his development.

Below is a table of sizes and weights of the fetus by week. It is worth saying that the readings are average and may differ from reality. This is especially true in the last months of pregnancy.

A newborn can be born with a weight of 2300 grams, or it can be born with a weight of 4500 grams. And in fact, and in another case, he can be absolutely healthy.

Term in weeks	Height in cm

Ultrasound examination of the placenta

Ultrasound of the placenta determines its size, echo structure, development.

When the placenta can be hyper-thickened:

with detachment;

with Rh-conflict;

with dropsy of the embryo;

slight thickening may occur in women with diabetes mellitus;

if during gestation the pregnant woman has suffered an infectious disease.

The placenta has the same functions as the human body - it tends to arise, mature and wither. All these moments are absolutely natural. But if it happens, it is a pathology.

Exists 3 degrees of maturity of the placenta:

Idegree of maturity. Until the 30th week of pregnancy, the placenta is at zero maturity. At this time, it increases in size, feeding the baby with all the useful elements. The structure is normally homogeneous, smooth. After 30 weeks, specks and waves may appear on the placenta, which indicate the beginning of maturation of the placenta. If the appearance of these signs is detected earlier, then this process is called "premature aging of the placenta." In some cases, women are prescribed medication. The first degree should last up to 34 weeks.

IIdegree of maturity. This degree comes from 34 to 37 weeks. It looks already more embossed, wavy, ultrasound shows an echo structure with specks. If the second degree is indicated at an early date than 34 weeks, then more detailed diagnostics and CTG of the fetus will need to be passed. All analyzes as a whole will show if there are any fetal pathologies. If the child suffers from hypoxia, then outpatient treatment may be prescribed.

IIIdegree of maturity. This degree is established already during full-term pregnancy. The placenta prepares for childbirth and its functions decrease, and its natural aging begins. There are large waves and salt deposits all over the surface.

If the placenta does not meet its due date, then there is a risk of premature birth.

Ultrasound of the umbilical cord of the fetus

The umbilical cord passes between the placenta and the embryo, which connects them together. At ultrasound examination the number of vessels in the umbilical cord, their condition, structure is determined.

The umbilical cord has two arteries and one vein that feed the fetus. The vein saturates the fetus with oxygen, and the arteries serve as an outlet for processed foods.

The length of the umbilical cord should normally be at least 40 cm.

An ultrasound scan allows you to see the entanglement of the umbilical cord, if any. The establishment of the entanglement is not yet a reason for a cesarean section.

Ultrasound examination of amniotic fluid

During the ultrasound process, the amniotic index is calculated, which indicates the amount of water. The index is measured according to a certain scheme:

the uterus is divided by two perpendicular stripes, one goes along the navel, the other longitudinally;

in each sector, measurements are made of the free distance between the fetus and the wall of the uterus;

the indicators are summed up.

Normal values ​​at 28 weeks will be an AI reading of 12-20 cm. An increase in the value may indicate polyhydramnios, a decrease in indicators, respectively, of low water.

* Percentile is a descriptive statistic term. The average value is indicated in the column "50th percentile", in the remaining columns - the minimum and maximum allowable values, respectively.

In any case, this or that deviation speaks of disturbances in the blood supply to the placenta.

Ultrasound of the uterus during pregnancy. The size of the uterus by weeks of pregnancy

When conducting an ultrasound of the uterus, its size is measured, its appearance is examined for the presence of myomatous nodes, muscle tone, the thickness of the walls of the uterus is measured.

Before pregnancy, the thickness of the walls of the uterus is 4-5 cm, by the end of pregnancy, the uterus is stretched, its walls become thinner and are approximately 0.5-2 cm.

The norm for the length of the cervix is ​​3.5-4.5 cm.

Marianna Artemova, obstetrician-gynecologist, specially for site

Average values ​​of the size of the fetus and uterus by ultrasound

Ultrasound diagnosis of pregnancy.

The average size of the ovum in the first trimester of pregnancy

The relationship of the coccygeal-parietal size (CTE) with the gestational age (according to the last menstruation)

Relationship between the biparietal size (BPD) of the fetal head and gestational age (by the last menstrual period)

BRGP (BPR) - biparietal head size. DB is the length of the thigh. DGrK is the diameter of the chest. Weight - in grams, height - in centimeters, other indicators in millimeters.

The size of the fetus at 32 weeks may differ from the average, which is not worth worrying about if other indicators are normal.

At 32 weeks of gestation, the average fetal weight is 1800 g and the height is 42 cm.However, this period is already quite late, the indicators in each case can differ greatly from the average values. This can be caused by many factors, the main among which are: heredity, the state of health of the mother and her nutrition, the course of pregnancy.

Why you need to determine the size of the fetus

Knowledge of fetal growth and weight plays an important role in choosing the best type of delivery in the case of a large fetus, and is also important in diagnosing developmental abnormalities or malnutrition. In addition to developmental pathologies, the size of the fetus is needed to approximate the size of the fetus directly during childbirth.

Normal fetal size at 32 weeks gestation

At 32 weeks, the size of the fetus can be very different from the average, which does not pose any threat to the life of the fetus, if the other indicators of the mother and child are normal. Starting from 32 weeks, the child gains weight much faster, while his growth in length slows down. In the case of multiple pregnancies, it is normal to lag in the size of the fetus by 1-2 weeks from the average.

The size of the fetus at 32 weeks of gestation can be found very approximately by the formulas based on measuring the circumference of the pregnant woman's abdomen. Most accurately, these indicators can be found out as a result of ultrasound. An ultrasound will also show whether the biparietal head size is normal, which at 32 weeks of gestation should be 82 mm, the length of the thigh is 63 mm and the diameter of the chest is 83 mm.

If the size of the fetus at 32 weeks is very different from the average in the smaller direction, this indicates fetal malnutrition. With fetal malnutrition in late pregnancy, normal growth can be maintained with insufficient body weight due to insufficient development of internal organs. Treatment of hypotrophy, depending on the severity of the degree of underdevelopment of the internal organs of the fetus.

Continued on the next. page

We decipher the results of ultrasound at 32 weeks of gestation

An ultrasound or ultrasound scan helps doctors examine the fetus throughout the pregnancy. Thanks to him, doctors can see not only the sex of the unborn child, but also how the fetus itself develops, the correspondence of the embryo to the gestational age.

It must be said that all these indicators are approximate, or generally accepted, the development of the fetus can occur in a completely different way, depending on physiological factors. Therefore, you should not immediately worry and go into a panic.

This is very important when a woman is pregnant, because in the early stages you can see some pathologies that can be eliminated before pregnancy. In addition, an ultrasound scan allows a mother to see her unborn child, listen to how his little heart is already beating, examine tiny arms and legs, fingers. Ultrasound is the first meeting of a mother and a baby, so it is always very important and reverent.

Such examinations should be carried out 3 times during the entire pregnancy. The gynecologist conducts routine examinations at 10-12, 20-22 and 30-34 weeks. But, if the mother expresses a desire, then an additional examination can be carried out at 28 weeks, although if the pregnancy is going well, then this does not need to be done. Examinations in the last trimester are among the most important, namely at week 32.

The last ultrasound scan at 32 weeks of gestation, as already noted, is one of the most important and indicative. It is at this time that the doctor can see the deviations and pathologies that may occur in the baby.

Sucking movements of the fetus for 32 weeks.avi

The research process itself during this period does not differ in any way from the previous two. On such an ultrasound, the doctor looks at the number of the fetus, its position, measures the indicators of the head, abdomen, the length of the legs and arms. At the end of the examination, the doctor determines the exact duration of pregnancy and the correspondence of the size of the embryo to the set date. Also, at this time, the estimated date of birth is set, so that by this time the mother is completely ready.

At this stage, the doctor determines all the indicators of the placenta, its thickness, location and degree of maturation. The amount of amniotic fluid is determined, which is also very important during this period.

It is very important at this stage to find out the state of the placenta, which will be shown by an ultrasound scan of 32 weeks of pregnancy. The norm for the distance of the placenta from the wall of the uterus is 6 centimeters. If this distance is less, then it may indicate a low placentation. Also, 32 weeks is the 2nd degree of maturation of the placenta, if this is so, then the mother is doing well and she does not need to worry at all. Also, its thickness should not exceed 30-34 mm at this stage. After conducting all the data, the doctor can see the condition of the placenta and notice whether it is peeling off, which can affect the level of oxygen supplied to the baby.

The specialist, after examining the fetus, compares the results with the development table. If the development of the baby deviates by 1 or 2 weeks, then this is not scary, this can happen.

It is very important when an ultrasound scan passes 32 weeks of pregnancy. Moreover, the doctor himself knows how to do it, it is important that the mother also knows this. Usually, abbreviations are used to denote indicators.

Decoding and normal fetal indicators at 32 weeks:

LZR or LZ (frontal-occipital part) - 95-113 mm

BPR (biparietal sizes) - 75-89 mm

OG (head circumference) - 283-325 mm

Coolant (abdominal circumference) - 258-314 mm

Forearm and key bone - 45-53 mm and 52-62 mm, respectively

If such indicators turn out to be significantly less, then the doctor indicates what is happening intrauterine retention development and growth of the fetus. If this happens, then an additional course of examinations is prescribed, which determine the blood flow in the uterus, umbilical cord and embryo, as well as its heartbeat. In any case, you should not decipher all the data yourself, this should be done by a specialized doctor and only he can give the most accurate and correct conclusion about the development of the fetus, and indicate if there are deviations and pathologies. At the stage of ultrasound of 32 weeks of pregnancy, the indicators are very important and the doctor compares them not only with tabular data, but also finds the progression with which the fetus grows, so he will be able to give accurate results of its development.

It is important not only the development of the fetus, the state of the placenta, but also the amount of amniotic fluid in this period. Often, diagnoses such as oligohydramnios or polyhydramnios can be made. But, often, such diagnoses are incorrect and only very extreme cases can be serious deviations from the norm. When a woman has oligohydramnios, it can lead to childbirth at early date that can affect the life of the baby. Polyhydramnios cause some infections that also affect the baby. the best way, and even more so if 32 weeks of pregnancy have already passed. The parameters of ultrasound of amniotic fluid are considered normal when they show at least 2 centimeters of a free area of ​​water. This indicator is determined in the uterus.

A very happy and wonderful moment in the study at this time is that the mother clearly sees her baby, can see every detail, even see small marigolds. Also, ultrasound at 32 weeks allows you to take a clear photo of the baby, his first photo, where the face, arms, legs, fingers will already be visible.

Thanks to rapid technological progress and new opportunities, parents have the chance to take a three-dimensional photograph of their unborn child. This is a very important stage for most mothers, because getting a photo of the fruit of your love even before it is born is great.

In any case, if there are any deviations, then you should not worry if the whole pregnancy went well, the previous ultrasounds did not bode well either, which means the baby is developing in its own way, and nothing threatens him, especially since such indicators are not clear ...

When the amount of amniotic fluid changes in one direction or another, they talk about polyhydramnios and low water.

Polyhydramnios is often found in women with infectious diseases, diabetes mellitus, and multiple pregnancy, some malformations of the fetus, Rh sensitization (incompatibility of the blood of the mother and the fetus for the Rh factor). The condition requires compulsory treatment: antibiotic therapy, drugs that improve uteroplacental blood flow.

Low water is a pathological decrease in the amount of amniotic fluid less than 500 ml. The causes of this condition are still unknown. If there is very little water, this may indicate a severe malformation of the fetus: complete absence of kidneys. There is practically no treatment for oligohydramnios, all therapy is aimed at supporting the child.

The ultrasound specialist also evaluates. Normally, they should be transparent. If there is turbidity, mucus, flakes in the amniotic fluid, there is a suspicion of the presence of an infectious process. The woman is tested for hidden infections and is being treated.

1. ... Ultrasound examination can detect the entanglement of the umbilical cord around the fetal neck. But in the second trimester of pregnancy, it does not cause alarm. The baby is in constant motion and the umbilical cord can unwind.
2. ... Normally, the neck should be at least 3 cm, and only closer to childbirth does it begin to shorten and smooth out. The internal pharynx must be completely closed. Shortening of the neck or opening of the throat is a sign of isthmic-cervical insufficiency. The woman must have cervical stitches or an obstetric pessary (a mechanical device in the form of several rings that is inserted into the vagina and protects the cervix from premature disclosure).

Third ultrasound at 32-34 weeks

The third planned ultrasound scan is performed for a period of 32-34 weeks. Its tasks are:

1. Determination of the position and presentation of the fetus... At this time, the child is already large enough and his mobility is limited. The position in which he is during the ultrasound will remain until the end of labor. Determination of these indicators is important for resolving the question of the mode of delivery. Allocate the longitudinal, transverse and oblique position of the fetus. With the longitudinal position of the child, a woman can give birth naturally, the transverse and oblique position is a relative indication for a cesarean section. Natural childbirth is also possible with a normal cephalic presentation of the fetus, the pelvic position is an indication for operative delivery.
2. ... These metrics help you understand how your child is developing. If the size of the fetus lags behind the average, you can suspect a delay in the intrauterine development of the child. Determination of fetal malnutrition requires the initiation of treatment for the pregnant woman. If the fetus, on the contrary, is ahead of the indicators, then we can talk about a large fruit. The birth of a child with a large weight (over 4 kg) is likely. This can significantly complicate childbirth, therefore, a woman is often offered an operative delivery.
3. Study of the placenta, its size, degree of maturity and the place of attachment. Migration of the placenta in this period has already been completed, it will occupy the same position for childbirth. It should be borne in mind that with full presentation, childbirth is possible only by caesarean section. With a low position of the child's seat, it is possible to give birth to a child through the natural birth canal, but this is fraught with a high risk of bleeding during childbirth.
4. Assessment of the quantity and quality of amniotic fluid(see topic: normal indicators of the second planned ultrasound scan at 20-24 weeks).

The rate of ultrasound before childbirth

Ultrasound examination before childbirth it is not obligatory for all pregnant women and is carried out selectively according to indications. Its main task is to resolve the issue of the method of delivery. During an ultrasound scan, the following is determined:

1. The position and presentation of the child;
2. Estimated weight of the fetus at birth;
3. The position of the umbilical cord to avoid entanglement.

• Fetometry data at various times

The cost of an ultrasound scan during pregnancy in the 3rd trimester (from 27 to 40 weeks) is 400 hryvnia. The price of ultrasound during pregnancy in the 3rd trimester includes: fetal biometry (all measurements according to protocols), ultrasound of the fetal heart, Doppler of the umbilical cord and uterine arteries, ultrasound of all internal organs and structures of the brain. The higher price compared to ultrasound during pregnancy in the first and second trimester is due to the fact that a doppler of the fetal vessels, a more detailed echography of the fetal heart and brain structures are added to the ultrasound examination protocol in the third trimester. Also, in the third trimester, it is more difficult to conduct high-quality 3D / 4D imaging due to the relative decrease in the amount of amniotic fluid. These features require more time for ultrasound examination and more qualifications of the doctor. Therefore, the price of an ultrasound scan in the third trimester is 100 hryvnia higher.

Your baby has a fetal ultrasound scan at 32 weeks of gestation.

The final touches remain to be completed, and the masterpiece is ready! The little miracle in your belly already has real eyelashes, eyebrows and hair on your head. The lanugo-fluffy coating on the body of the fetus is gradually disappearing, which is one of the signs of the child's gradual maturation and preparation for an out-of-uterine existence. Lanugo may remain on the shoulders and back by the time of delivery, this is normal.

With an ultrasound of the fetus at 32 weeks of pregnancy, the hair is not visible, but very soon you will be able to contemplate with your own eyes whether you have a blonde, brown-haired or redhead.

With an ultrasound of the fetus at 32 weeks of gestation, the weight is about 1800 g, the height is 29 cm from the coccyx to the crown of the head. The child is gaining weight very quickly now. \ a month ago, it was half as much, and by the time of delivery, the baby will almost double!

From this time on, the child gains weight much more intensively than it grows in length. Right now, it is very important to eat right, not to eat a lot of high-calorie foods (sweets, starchy foods, etc.), since an additional 300-500 g can be added to the genetically determined weight of a child at birth with excess high-calorie nutrition of the mother (provided that the placenta is working normally) ... These 300-500g plus are more difficult to give birth!

If you carry twins or more, weight gain is somewhat slower than with singleton pregnancies, since several babies have less room to grow and need to share their nutrients equally. With an ultrasound scan of a fetus at 32 weeks of gestation, if you have twins, a mandatory moment of diagnosis is a detailed measurement of all sizes of two fetuses to exclude twin steal syndrome, when one of the children receives more nutrients and oxygen than the other. If a discrepancy in the size of one of the fetuses is detected with an ultrasound scan at 32 weeks of pregnancy, detailed monitoring of the intrauterine state is carried out using a Doppler. Umbilical arteries, uterine arteries - left and right, middle cerebral artery, fetal aorta are examined without fail with fetal ultrasound at 32 weeks of pregnancy. With satisfactory values ​​of the indicators, a similar ultrasound of the fetus with a Doppler is carried out every 2-3 weeks to exclude intrauterine suffering of one of the babies.

When carrying out an ultrasound of the fetus at 32 weeks of gestation with single pregnancy, a mandatory screening test is to assess the blood flow using a Doppler in the umbilical cord arteries. When deviations from the normal Doppler values ​​of the umbilical arteries are detected, there is a suspicion of intrauterine suffering (hypoxia) of the fetus. In this case, Doppler is also performed on all other vessels (uterine arteries, middle cerebral artery, fetal aorta).

Fetometry (fetal size) with ultrasound of the fetus at 32 weeks of gestation is normal:

• BPR (biparietal size). With ultrasound of the fetus at 32 weeks of gestation, the biparietal size is 75-89 mm.
• LZ (frontal-occipital size). With ultrasound of the fetus at 32 weeks of gestation, 95-113 mm.
• OG (circumference of the fetal head). With ultrasound of the fetus at 32 weeks of gestation, the head circumference corresponds to 283-325 mm.
• Coolant (abdominal circumference of the fetus) - with ultrasound of the fetus at 32 weeks of gestation is 258 -314 mm.

Normal sizes of long bones with ultrasound of the fetus at 32 weeks of gestation:

• Femur 56-66mm,
• Forearm bones 45-53mm,
• Shin bones 52-60mm.

With an ultrasound scan of the fetus at 32 weeks of gestation, especially with the use of 3D-4D ultrasound during pregnancy, you can see the baby's eyes. They are almost always closed, since in the aquatic environment it is not very pleasant for the fetus to keep its eyes open. But this does not mean that your baby is constantly sleeping! The color of the eyes in all children from a given gestational age to the time of delivery is dark gray. Does the true color appear after a while? from 3 weeks to 12 months, it is individual.

With an ultrasound scan of the fetus at 32 weeks of gestation, you can see how the baby continues to exercise in order to be ready for out-of-womb life very soon! He swallows amniotic fluid, performs breathing exercises for the lungs (breathing movements), sucks a finger, pushes with his legs and arms.

Subcutaneous fat continues to be deposited, the child's skin is no longer transparent.

With an ultrasound of the fetus at 32 weeks of gestation, the position of the fetus in the uterus, its position is assessed. In most cases, the fetus, at a more or less long gestation period, more often from 32 weeks of gestation, turns its head down, booty up. Is it because the uterus is pear-shaped? pear turned upside down. Therefore, the head is more comfortable at the bottom than the pope. In addition, the head is heavier, so it rushes down. Cephalic delivery is safer for both the baby and the mother. If at the time of childbirth the child lies across or down with the booty, this may be due to abnormalities in the structure of the uterus, abnormalities in the location of the placenta.

The placenta with ultrasound of the fetus at 32 weeks of gestation most often has zero or first degree of maturity. The second degree of maturity is also the norm, provided that the Doppler performance is satisfactory.

Changes in the mother's body at 32 weeks of pregnancy

After 32 weeks of pregnancy, you see your doctor 2 times a month. Be sure to inform if you notice swelling of the hands and face, a sharp weight gain (more than 1 kg per week), headache, any visual impairment. It can be preeclampsia or late toxicosis, a very dangerous condition for the mother and her baby. The doctor will take blood pressure measurements and order a urine test to detect protein.

If your baby is in a booty down position, you can do exercises to help the fetus roll over. Check with your doctor about these exercises. They are contraindicated, like any physical activity with the threat of premature birth.

• Lie on your back on a flat, fairly hard surface, preferably on the floor with a cushion. Bend your legs at the knee joints, rest your feet on the floor and lift your buttocks up. Stand in this position for 10-15 minutes several times a day.
• Place a small radio or telephone at the level of your pubic bone with pleasant soft music. In this case, your position does not matter. Try to do 3-5 such concerts a day for 15-20 minutes in different positions of your body: standing, lying, walking, sitting.
• Ask dad or someone close to ask the baby to roll over directly, facing your belly, so that the lips practically touch your tummy.
• Lie on the side of your baby's back. The baby's back is on the opposite side of active fetal movements. That is, if you feel more movement on the right? you need to lie on your left side. The legs are bent at the knee joints and brought as close to the stomach as possible. Use your fingertips to lightly tap the lower abdomen for 5-7 minutes 3-5 times a day.

Ultrasound examination, or ultrasound- This is a survey method that is widely used during pregnancy in any of its stages. This diagnostic research relatively simple, highly informative and safe for both mother and child. The main tasks of ultrasound during pregnancy are:

The following tables show the fetal biometrics that are measured at each. They are presented in the 10th, 50th and 95th percentiles. Most often they are guided by the 50th percentile, and the rest are considered normal fluctuations.

Fetal head sizes by week of pregnancy

Pregnancy period, weeks	Frontal-occipital size (LZR), mm			Biparietal size (BPR), mm

Circumference of the abdomen and head of the fetus

Pregnancy period, weeks	Abdominal circumference, mm			Head circumference, mm

The length of the shin bones and femur fetus

Pregnancy period, weeks	Shin bones, mm			Femur, mm

Length of the humerus and forearm bones of the fetus

Pregnancy period, weeks	Forearm bones length, mm			Humerus length, mm

Norms for the first ultrasound at 10-14 weeks

The first screening ultrasound is performed for a period of 10-14 weeks. Its main tasks are:

• Studying the thickness of the collar zone(area between soft tissues covering the spine and the inner surface of the skin filled with fluid). Assessing the size of the cervical fold is very important because is a fairly accurate way of timely diagnosis of various chromosomal diseases, in particular Down's syndrome. In the presence of an enlarged collar space, the doctor should refer the pregnant woman to a geneticist for a consultation. The woman is assigned additional examination methods: a blood test for alphahetoprotein and chorionic gonadotropin, invasive diagnostic methods (amniocentesis - the study of amniotic fluid, placentocentesis - the study of placental cells, cordocentesis - the study of blood taken from the umbilical cord of the fetus).

Normal values ​​of the collar space (TVP) in the first trimester of pregnancy

Pregnancy period, weeks	Collar space thickness, mm
	percentile	50th percentile	95th percentile
10 weeks 0 days - 10 weeks 6 days
11 weeks 0 days - 11 weeks 6 days
12 weeks 0 days - 12 weeks 6 days
13 weeks 0 days - 13 weeks 6 days

• Measurement of the coccygeal-parietal size (CTE). This is an important indicator by which you can determine the size of the fetus and the approximate gestational age.

Coccygeal-parietal size values ​​by gestational age

Pregnancy period, weeks	CTE values ​​percentile, mm
10 weeks 1 day
10 weeks 2 days
10 weeks 3 days
10 weeks 4 days
10 weeks 5 days
10 weeks 6 days
11 weeks 1 day
11 weeks 2 days
11 weeks 3 days
11 weeks 4 days
11 weeks 5 days
11 weeks 6 days
12 weeks 1 day
12 weeks 2 days
12 weeks 3 days
12 weeks 4 days
12 weeks 5 days
12 weeks 6 days
13 weeks 1 day
13 weeks 2 days
13 weeks 3 days
13 weeks 4 days
13 weeks 5 days
13 weeks 6 days

Heartbeats should normally occur at regular intervals, i.e. be rhythmic. Arrhythmia may indicate the presence of a congenital heart defect or fetal hypoxia. The heartbeat should sound very clear and distinct, in the presence of muffled tones, intrauterine oxygen deficiency can be suspected. An important indicator is the heart rate.

Heart rate by gestational age

Tachycardia is an increase in the number of heartbeats more than normal, bradycardia is a decrease in heart rate to 120 beats per minute or less. Most often, such changes in the heartbeat occur during fetal hypoxia as a reaction to a decrease in oxygen in the blood. In such cases, the pregnant woman must be prescribed treatment, which is often carried out in a hospital setting. Therapy is prescribed, aimed at improving uteroplacental blood flow, improving intracellular metabolism.

• Assessment of the development and presence of various organs (Bladder, kidneys, liver, stomach, heart), spine, also upper and lower limbs fetus. If anomalies in the development of organs are detected, the woman is sent to a genetic consultation. A geneticist, after a detailed examination, decides on the viability of the child and the possible termination of pregnancy.

Normal indicators of the second ultrasound at 20-24 weeks

The doctor prescribes the second scheduled ultrasound scan at 20-24 weeks. At this time, the following are investigated:

1. Biometric indicators(biparietal size, frontal-occipital size, length of tubular bones, circumference of the abdomen and head). These indicators are measured to assess the growth of the fetus and its fit with the gestational age.
2. Identification of various fetal malformations... Exactly at this period diagnostics will be the most informative, because at the first examination, the child is still too small, and at the third planned ultrasound it will already be too large, in addition, for long periods of time, the placenta may interfere with a thorough examination if it is located on the anterior wall of the uterus.
3. The structure, thickness, location and degree of maturity of the placenta... This is the most important organ that supplies the fetus with all the nutrients necessary for its normal development.

The normal thickness of the placenta, depending on the duration of pregnancy

Pregnancy period, weeks	Permissible fluctuations	Normal values, mm

With an increase in the thickness of the placenta, the doctor may assume the presence (inflammation of the placenta). Making such a diagnosis requires additional examination for the presence of infection and subsequent treatment in a hospital.

Ultrasound also evaluates maturity of the placenta... This is an important indicator characterizing the ability of the "child's place" (synonymous with the term "placenta") to provide the fetus with the necessary substances.

Placenta maturity

Pregnancy period, weeks

Degree of maturity Doppler analysis, tests for possible infections. In the future, the woman must undergo a course of treatment. Prescribed drugs for the treatment of fetal hypoxia, vitamin therapy, antispasmodics to reduce, in the presence of infection - antibiotic therapy. An equally important task for the doctor of ultrasound diagnostics is to study places of attachment of the placenta... Most often, the "baby seat" is attached, less often - and even less often - in the bottom area. Normally, the placenta should be 6 cm or more from the internal os of the cervix. If it is located below and overlaps the internal os of the uterus, they speak of. This is a serious type of obstetric pathology that threatens the life and health of women and children. Often this anomaly occurs in women who have multiparous, after inflammatory diseases of the uterus, uterine myoma, after abortions. The pregnant woman is carefully monitored in a hospital or at home, where she must observe complete rest and abstain from sexual activity. If bleeding begins, immediate hospitalization is required. Amniotic fluid quantity and quality Average Normal Amniotic Fluid Index Pregnancy period, weeks Possible fluctuations Average rate When the amount of amniotic fluid changes in one direction or another, they talk about polyhydramnios and low water. Common in women with infectious diseases, diabetes mellitus, with, some malformations of the fetus, Rh sensitization (incompatibility of the blood of the mother and the fetus for the Rh factor). The condition requires compulsory treatment: antibiotic therapy, drugs that improve uteroplacental blood flow. Is a pathological decrease in the amount of amniotic fluid less than 500 ml. The causes of this condition are still unknown. If there is very little water, this may indicate a severe malformation of the fetus: complete absence of kidneys. There is practically no treatment for oligohydramnios, all therapy is aimed at supporting the child. The ultrasound specialist also evaluates amniotic fluid quality... Normally, they should be transparent. If there is turbidity, mucus, flakes in the amniotic fluid, there is a suspicion of the presence of an infectious process. The woman is tested for hidden infections and is being treated. Assessment of the umbilical cord... Ultrasound examination can detect the entanglement of the umbilical cord around the fetal neck. But in the second trimester of pregnancy, it does not cause alarm. The baby is in constant motion and the umbilical cord can unwind. Grade... Normally, the neck should be at least 3 cm, and only closer to childbirth does it begin to shorten and smooth out. The internal pharynx must be completely closed. Shortening of the neck or opening of the throat is a symptom. The woman should be stitched to the cervix or (a mechanical device in the form of several rings that is inserted into the vagina and protects the cervix from premature disclosure). Third ultrasound at 32-34 weeks The third planned ultrasound scan is performed for a period of 32-34 weeks. Its tasks are: Determination of position and... At this time, the child is already large enough and his mobility is limited. The position in which he is during the ultrasound will remain until the end of labor. Determination of these indicators is important for resolving the question of the mode of delivery. Allocate the longitudinal, transverse and oblique position of the fetus. With a longitudinal position of the child, a woman can give birth naturally, the transverse and oblique position is a relative indication for surgery. Natural childbirth is also possible with a normal cephalic presentation of the fetus, the pelvic position is an indication for operative delivery. Estimating the size and weight of the fetus... These metrics help you understand how your child is developing. If the size of the fetus lags behind the average, you can suspect a delay in the intrauterine development of the child. Determination of fetal malnutrition requires the initiation of treatment for the pregnant woman. If the fetus, on the contrary, is ahead of the indicators, then we can talk about. The birth of a child with a large weight (over 4 kg) is likely. This can significantly complicate childbirth, therefore, a woman is often offered an operative delivery. Study of the placenta, its size, degree of maturity and the place of attachment. Migration of the placenta in this period has already been completed, it will occupy the same position for childbirth. It should be borne in mind that childbirth is possible only by caesarean section. With a low position of the child's seat, it is possible to give birth to a child through the natural birth canal, but this is fraught with a high risk of bleeding during childbirth. Assessment of the quantity and quality of amniotic fluid(see topic: normal indicators of the second planned ultrasound scan at 20-24 weeks). The rate of ultrasound before childbirth Ultrasound examination before childbirth it is not obligatory for all pregnant women and is carried out selectively according to indications. Its main task is to resolve the issue of the method of delivery. During an ultrasound scan, the following is determined: The position and presentation of the child; Estimated weight of the fetus at birth; Position of the umbilical cord for exclusion.

An ultrasound examination performed at 32 weeks of gestation belongs to the category of mandatory screenings. It allows you to determine pathologies in the development of the fetus, placenta. It is especially important to decipher the ultrasound scan of the 32nd week of pregnancy, which allows you to make sure that the baby is in normal growth.

What is the research for?

An ultrasound scan at 32 weeks of gestation is performed for the following purposes:

• Identification of somatic abnormalities of the fetus.
• Definitions placental insufficiency.
• Revealing the presentation of the baby, which at this time is often final.

Decoding the results

In addition, at this time, it is possible to assess the proportions, sizes of the child, which are also an indicator of his normal development. First of all, during the diagnosis, the size of the arms, legs, head, chest, and abdomen is assessed. Many parents-to-be are wondering what are the rates of ultrasound at 32 weeks of gestation. A healthy baby should have the following parameters:

• shoulder length from 52 to 62 mm;
• forearm length from 45 to 55 mm;
• thigh length from 55 to 65 mm;
• leg length from 50 to 60 mm;
• biparietal head size from 75 to 90 mm;
• frontal-occipital head size from 95 to 110 mm;
• head circumference from 280 to 330 mm;
• girth of the abdomen from 255 to 315 mm.

The listed indicators are relative, since crucial role in the size of the fetus, it is given to genetic characteristics, which at this time are already clearly manifested. However, if during the procedure the parameters of the child were found that are very different from the norms, then there is a risk of developing hypertrophy, which is an indicator of impaired maturity of the placenta.

The heartbeat of a child at 32 weeks should be in the range of 140-160 beats per minute. The altered number of heartbeats indicates the pathology of the fetus, the possibility of premature birth.

Fetal size chart depending on the duration of pregnancy

Baby weight

At 32 weeks, the baby is no longer at the embryonic stage, it has a rather impressive weight. The weight of the fetus at this time reaches 2000. However, if a woman is thin, then the norm of weight can be from 1600 to 1700 g. In large women, a baby can reach up to 2100 g. In this period, hereditary predisposition already plays a large role. In addition, for mothers who have had infectious diseases during pregnancy, the baby's body weight may be less than average.

This does not apply to a pathological phenomenon. There are cases of low fetal body weight in women with hormonal disruptions. If a woman is carrying twins or triplets, then the parameters of the body weight of the children will differ significantly. It directly depends on how many babies the pregnant woman is carrying. There are times when the weight of babies varies greatly. This is due to the fact that one fruit develops more intensively than the other. Normally, the weight of twins, usually at 32 weeks, ranges from 1650 to 1700 g.

Woman study

In addition to diagnosing the fetus, ultrasound at 32 weeks of gestation allows you to assess the condition of a woman's reproductive organs. The normal thickness of the placenta should range from 25 to 42 mm. Moreover, the placenta should not adjoin the uterine pharynx, it should move 7 cm away from it. This indicates 1 degree of development of the placenta. On ultrasound examination, this degree of maturity is determined by shallow depressions, the appearance of a few echogenic foci.

If ultrasound determines the 2nd degree, then this is a sign of premature aging of the placenta. This condition entails:

• late toxicosis;
• infections;
• diabetes.

In this case, early treatment of pregnant women should be started, which can improve the situation and prevent the development of serious fetal pathologies. The thickness of the placenta should be no more than 45 mm. If in the course of ultrasound diagnostics large parameters were determined, then this is a sign of intrauterine infection, sizes smaller than average indicate premature aging of the placenta.

During the procedure, great importance is given to calculating the volume of amniotic fluid. During the calculations, the doctor conventionally divides the woman's belly into 4 parts vertically and horizontally. Further, all four indicators are summed up. The norm is the amount of amniotic fluid from 20 to 80 mm. Going beyond these boundaries is low water or polyhydramnios, respectively, and requires medical intervention.

During the assessment of the umbilical cord, the number of vessels, the presence of loops, knots, entanglement around the neck of the fetus is determined. The doctor examines the uterus, determines if there is an increased tone, which often leads to premature birth... If a woman is diagnosed with fibroids, then the blood flow is analyzed. At this time, the cervix must be completely closed, otherwise there is a risk of premature birth.

Three-dimensional scanning allows you to see the actions of the fetus at the time of diagnosis

Doppler ultrasound

There are cases when a Doppler study is performed at 32 weeks at the same time as an ultrasound scan. It allows you to assess the condition of the arteries, the functioning of the baby's cardiac activity, the vessels of the uterus, and the umbilical cord. The indication for a Doppler examination is:

• woman's condition... This category includes the presence of arterial hypertension, renal diseases, diabetes mellitus, late toxicosis, Rh-conflict in a pregnant woman;
• state of the woman-child system... This situation includes lack of water, premature aging placenta, impaired blood flow through the arteries of the umbilical cord;
• the condition of the fetus includes an abnormal heart rhythm, diagnosed heart disease, hypoxia.

In addition, Doppler-equipped ultrasound is performed in multiple pregnancies, as multiple fetuses can lead to uneven blood flow. Also, women who previously had miscarriages, frozen pregnancies are subject to this diagnosis. Doppler diagnostics can be performed more than once. This is especially important to control the quality of the prescribed treatment.

Doppler study rate depending on the gestational age

Diagnosed pathologies

The third screening can diagnose the presence of the following pathologies:

• fetoplacental insufficiency, which occurs when the placental maturity does not correspond to the term;
• entanglement with the umbilical cord. This condition does not pose a threat to the fetus if it does not cause impaired blood flow;
• inconsistency in the size of the baby, breech presentation;
• predisposition to premature birth, which manifests itself in a shortened cervix;
• altered volume of amniotic fluid, which can be manifested by both polyhydramnios and oligohydramnios;
• in the presence of a scar, identify its inconsistency;
• oxygen starvation of the fetus.

An ultrasound performed at 32 weeks allows you to assess the condition of the baby and the woman. This diagnosis is important because it makes it possible to improve the condition of the baby.