When the baby can be examined through the abdominal wall

You can find out here when the abdominal ultrasound is carried out. Also: How many examinations are there during pregnancy?

Are you pregnant and wondering when the first ultrasound scan of your abdomen will be carried out? Then you’ve come to the right place: we explain how long vaginal ultrasounds are carried out and from which week of pregnancy transabdominal sonography – i.e. through the abdominal wall – is usual. You can also find out how many examinations you can expect and what exactly the gynecologist and doctor will check.

When is an abdominal ultrasound possible?

An ultrasound through the abdomen is possible in every week of pregnancy, but is not really useful – because details or abnormalities can only be seen through the abdominal wall from the 10th week of pregnancy at the earliest. Before that, the uterus and the embryo in the amniotic cavity are still very small – and therefore not easy for the ultrasound waves to reach through the abdominal wall. This is better in early pregnancy with a vaginal ultrasound: a vaginal probe with a transducer can be used from the 5th week of pregnancy – i.e. two weeks after implantation – to determine whether you are pregnant. If you have a positive pregnancy test in your hands and want absolute certainty, the pregnancy can be confirmed by your gynaecologist. However, sonography is not always carried out during the initial examination to determine pregnancy; a urine or blood test in the gynecologist’s office is more common.

As part of the first basic examination between the 9th and 12th week of pregnancy (the so-called first trimester screening), an ultrasound is performed in any case, which is usually still performed vaginally. Here, the heartbeat can be detected and also whether there is a multiple pregnancy. If the first trimester appointment is quite late, both can be used: the vaginal probe and the ultrasound through the abdominal wall. You can expect the first ultrasound through your abdomen at the latest at the second major ultrasound examination from the 19th week of pregnancy. This will also reveal the sex of the baby and you can find out whether you are having a boy or a girl – if you want to know.

Ultrasound through the abdomen for overweight patients – is it different?

In fact, a lot of abdominal fat can weaken the ultrasound signals towards the uterus and make the images produced less accurate, which is why vaginal ultrasound may be used for longer or as a supplement. However, experienced gynecologists know special techniques with which they can also scan the abdomen.

How many ultrasound examinations are there during pregnancy?

If you do not have a high-risk pregnancy, three basic ultrasound examinations are carried out for prenatal care in accordance with the maternity guidelines. If you have had a vaginal ultrasound to determine your pregnancy, you will then have four appointments. If anomalies, complications or abnormalities become apparent during the course of the pregnancy, your doctor will also carry out more frequent checks as required, check the blood flow in the blood vessels using Doppler sonography or, if necessary, refer you to a prenatal center for prenatal diagnostics. Particularly thorough ultrasound examinations for fine diagnostics – i.e. for the early detection of diseases or fetal malformations such as neural tube defects – can be carried out there. The costs for all necessary examinations during pregnancy are covered by your statutory health insurance.

What is checked during the ultrasound examinations?

Ultrasound examinations during pregnancy are often special moments for parents-to-be: The first – albeit somewhat abstract – ultrasound images of their baby make it more tangible that there really is a little person growing in their belly. From a medical point of view, screening serves to detect complications or risks at an early stage and to monitor the child’s development. The following points are taken into account during the individual ultrasound examinations:

1st ultrasound (9th – 12th week of pregnancy)

The embryo (the term fetus is only used from the 10th week of pregnancy) is still very small and only visible as a tiny spot in the uterus, which is why the first ultrasound is not usually performed on the abdomen. The main purpose of these weeks is to confirm that the pregnancy is intact and to detect a heartbeat. In addition, the expected date of birth and the week of pregnancy are determined based on the so-called crown-rump length (SSL) of the baby. If desired, a nuchal translucency measurement can also be carried out during the first trimester screening.

The doctor also pays attention to the following things:

  • Has the embryo visibly implanted in the uterine cavity?
  • Is there a heartbeat?
  • How big is the embryo and is it developed in time?
  • Is it a multiple pregnancy?
  • Are any abnormalities recognizable?

2nd ultrasound (19th – 22nd week of pregnancy)

At the second ultrasound scan, the unborn child has already grown considerably and gained weight – it is now clearly visible through the abdominal wall. The age-appropriate growth is checked again, but this time a little more extensively than in the first trimester of pregnancy. In addition, a very close look is taken at how the fetus’s organs have developed – this is why the second ultrasound is often referred to as organ screening. The fetus is examined from head to toe; if desired, the sex can also be revealed at this stage. It is also checked whether the amount of amniotic fluid is normal and where the placenta is located. If it was not visible the first time, a multiple pregnancy is detected at this stage at the latest.

3rd ultrasound (29th – 32nd week of pregnancy)

During the last basic ultrasound, which also takes place via the abdomen, the due date is already within reach. Therefore, in addition to assessing the size and development, the position of the unborn child is also checked: Is it still lying in a breech position with its rump facing downwards or has it already turned its head into the pelvis and is in a cephalic position? Once again, the placenta, the amount of amniotic fluid and the organs are examined.

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