2D Anomaly Scan

Sometimes known as a Fetal Anatomy Scan or 20 Week Scan this scan is where the sonographer is able to examine the anatomy of your baby in great detail.

When can I have an Anomaly Scan

The Anomaly Scan can be performed from 18 to 22 week. The reason the Anomaly Scan isn't performed earlier in the pregnancy is because all your baby's internal organs aren't fully formed.

After 24 weeks a full anatomical examination may not be possible because your baby will often adopt a less helpful position to obtain clear views.

 Why is the Anomaly Scan important

The Anomaly Scan is important because it is the best opportunity during your pregnany to examine all the anatomy of your baby in great detail.

It is critical that any abnormalities are detected at this stage so that a management plan can be formulated for the remainder of the pregnancy, for the delivery and if necessary after your delivery if post natal treatement is required.

It also allows the parents sufficient time to prepare or make difficult decisions on rare occasions where a severe abnormality is discovered

If you are having your scans on the NHS this is usually the last scan that you will have in your pregnancy.

How accurate is the Anomaly Scan

The accuracy of the Anomaly Scan mainly depends on how clearly the sonographer is able to see all the important parts of your baby's anatomy.

The Anomaly Scan is a big checklist for the sonographer to complet.It is for this reason that sometimes you may have to be scanned several times and walk around in between to encourage your baby to move into a better position.

Therefore the accuracy of the Anomaly Scan is dependent on the sonographer ability to complete every item on the list.

Your baby's growth and a well being assessment are also part of the examination.

What will I see at the Anomaly Scan
During the Anomaly Scan your sonographer will spend the majority of the appointment looking at various anatomical details that may not be immediately recognisable to the untrained eye.

This can be a confusing or unnerving experience for the parents. The Anomaly Scan is performed in conventional 2D ultrasound so that internal organs may be examined. It is not possible to scan in 3D or 4D nor would it offer any greater accuracy or detail.  If you ask most sonographers will have a quick peek at babies sex, but please remember  the most important thing is making sure all is well with baby and some times the sexing of your baby is not possible.This is usually the time at which most parents really start to  bond with their baby.

How does the Anomaly Scan Scan work
During the appointment your sonographer will:

• Show your baby’s heart beating and check the rate
• Check growth by measuring the head, waist and thigh bone (femur) of your baby
• Look at your placenta and the amount of fluid around your baby
• Examine the structure of your baby’s organs in detail (a checklist of over 30 items)

All the measurements and information will be added into your pregnancy record for comparison with earlier and subsequent later scans

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Gestational Diabetes (During Pregnancy)

Definition:
Gestational diabetes is a type of diabetes that starts during pregnancy. If the pregnant woman has diabetes, her body is not able to use the sugar (glucose) in her blood as well as it should. So the level of sugar in her blood becomes higher than normal. Gestational diabetes affects about 4% of all pregnant women , it usually begins in-between the 24th and 28th week. Most often, gestational diabetes goes away after the baby is born.
Causes of gestational diabetes:
Almost all women have some degree of impaired glucose intolerance during pregnancy because of hormonal changes that occur during pregnancy. That means that their blood sugar may be higher than normal, but not high enough to have diabetes. Usually the mother's pancreas is able to produce more insulin (about three times the normal amount) to overcome the effect of the pregnancy hormones on glucose levels. If, however, the pancreas cannot produce enough insulin to overcome the effect of the increased hormones during pregnancy glucose levels will rise, resulting in gestational diabetes.
Risk factors:
The following factors increase the risk of developing diabetes during pregnancy:
1. Being overweight prior to becoming pregnant.
2. Having glucose in the urine.
3. Impaired glucose tolerance or impaired fasting glucose (blood glucose levels are high, but not high enough to be diabetic.)
4. Family history of diabetes. (If the parents or siblings have diabetes)
5. Previously giving birth to a baby over 9 pounds.
6. Having gestational diabetes with a previous pregnancy.
7. Having too much amniotic fluid (A condition called polyhydramnios)
*Many women who develop gestational diabetes have no known risk factors.
 High-risk women should be screened for gestational diabetes as early as possible during their pregnancies, all other women will be screened between the 24th and 28th week of pregnancy.

Treatment:

You may be offered a scan to indicate the weight of baby.

The goals of treatments are to maintain blood glucose level within normal limits during the duration of the pregnancy, and ensure the well being the baby. 

Recognize labour symptoms and early signs.

First signs of early labour:

 Nesting is an instinct that nearly every new mum tobe experiences. You may find that you go into a cleaning frenzy. Reorganizing the baby's room, cleaning the house from top to bottom. This is completely normal! Its just nature's way of letting you know the baby is coming soon. So, clean as much as you like. Use gloves when using chemicals of any kind. Don't touch the cat litter and avoid areas that harbour black mould or mildew.

Diarrhoea and bowel disturbance:

Nearing the onset of labour your body will produce prostaglandins, a chemical which will cause loose bowel movements.

Babies head becomes engaged:

Engagement is when the baby drops deep into the pelvis and nestles into position ready for birth.

Vaginal discharge in early labour:

You could experience more discharge in the days leading up to your labour. Normally thick and whitish, if the discharge changes to thin and watery it could indicate a leak in the bag of waters surrounding your baby.

Softening of the cervix, mucus plug, or bloody show:

Near labour you may find red streaks and a thick mucous 'blob'. This is the mucus plug that has been in the cervix since after conception to prevent access to the womb from bacteria.

Early Contractions:

If the contractions are mild and only come infrequently they are referred to as False or Braxton-Hicks contractions.

Regular, rhythmic contractions:

When labour begins, those contractions suddenly begin to come in a regular pattern and occur closer together. At first, the contractions may be felt as a hardening of the stomach or very strong menstrual cramps. Women who are experiencing their first labour may have mild contractions for a few days before regular labour begins. Breathing exercises may help with the pain felt during contractions.

Membrane rupturing:

The sudden flow of amniotic fluid happens when the bag of waters around your baby rupture, which may not occur until your in active labour. Occasionally your doctor/midwife may use an instrument to rupture the membranes. If you suspect your waters have broken, tests can confirm whether the leaking fluid is actually amniotic fluid or urine

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