What is the Early Fetal Scan?
The Early Fetal Scan, which is our signature scan, aims to provide reassurance as early as possible, regarding the health and development of your baby.
This scan provides an advanced examination of the baby’s anatomy from 10 weeks gestation, providing a meticulous top-to-toe examination of the fetus, with special attention being given to the brain and heart.
The reason we developed this scan is that many parents would like to get an early reassurance at this stage. From 10 weeks we can screen for 10 serious structural anomalies, and from 12 weeks we can screen for many more anomalies, with the focus on congenital heart diseases.
10 weeks into your pregnancy, your baby will be the size of a strawberry and grows around one millimetre per day. Remarkably, by this stage of pregnancy, the majority of your baby’s organs would already be formed. Doctors often refer to this stage as the end of the baby’s embryological development. This means that your baby is now a fetus (and strongly resembles a small human!). From this stage onwards, the brain is the only main structure that continues developing throughout the pregnancy.
The majority of fetal anomalies occur as a result of disturbances during the very early (embryological) development and are already starting to show signs at this stage – especially visible from 12 weeks. Our advanced ultrasound technology and the expertise Dr Ushakov has developed allow us to view the baby’s main structures at an incredibly high resolution and detect those anomalies at earlier stages of the pregnancy. Among those are: spina bifida, many severe heart defects, absence and deformities of upper or lower limbs and many other severe anomalies.
What are the main objectives of Early Fetal Scan?
The main goal is to provide early reassurance to the parents and exclude a significant proportion of severe fetal anomalies, such as spina bifida, severe heart defects, lethal anomalies, and other serious structural conditions such as missing limbs.
- Early screening for major fetal anomalies,
- Clarification of inconclusive first trimester findings, such as increased nuchal translucency (NT) or other suspicious findings,
- Confirmation of pregnancy weeks and estimated gestational age – which is a lot more difficult at later stages of pregnancy
This scan alone cannot exclude chromosomal anomalies; a structurally normal looking baby can have serious chromosomal defects such as Down’s syndrome (Trisomy 21). Currently, the best screening option available for these syndromes is the Non-Invasive Prenatal Test (NIPT), which we strongly recommend getting in conjunction with this scan.
To combine the advantages of both these tests, we have developed an Early Fetal Test: a new generation screening test, which includes an Early Fetal Scan, and a Harmony test (NIPT).
This first trimester “reassurance package” provides a unique 10/12-week screening solution, where the combination of two innovative tests: the ultrasound and NIPT, together can exclude the majority of physical (structural) and chromosomal anomalies for your baby.
What anatomical structures do we check on the Early Baby Scan?
Our Early Fetal Scan, which we perform at from 10-16 weeks (12-13 weeks is the ideal time), is used to check more structures than an NHS Anomaly scan at 18-20 weeks. The Early Baby Scan examines the brain, face, neck, chest, heart, the great arteries, lungs, diaphragm, stomach, liver, intestines, abdominal wall, umbilical cord, kidneys, bladder, spine, limbs, hands with fingers, and feet. We also check the umbilical cord insertion into placenta, umbilical cord vessels, and the integrity of the amniotic sac.
When the Early Baby Scan can be performed?
The optimal time for an Early Baby Scan is from 12+0 to 13+6 weeks.
- The scan can be performed from 10 weeks; however, due to the small size of the baby at this early stage, the anomaly detection rate is reduced. For example, some structures, such as the kidneys have a poor visibility before 12 weeks.
- It is also possible to perform the Early Baby Scan at 14 weeks or later; however, by this point the baby will often assume an oblique sitting position in the womb, which poses a challenge in scanning some structures, such as the heart.
How is Early Baby Scan performed?
The best results are obtained by using a combination of the transabdominal (on the surface of your tummy) and transvaginal (a slim transducer will be inserted through the vagina) scan. The visualisation of the different fetal structures depends on many factors, such as the position of the womb, position of the fetus, and maternal abdominal wall thickness. The transvaginal scan is optional, and often the transabdominal scan performed by our high-resolution transducers is enough for a thorough check of the baby. You will always have the option to opt-out of a transvaginal scan.
In about 10 % of women, the uterus is tilted backwards (retroflexed). If this is the case, a transvaginal scan is preferred due to the limited resolution of a transabdominal scan on a retroflexed uterus. In this instance you would be informed of this and given an opportunity to reach your own decision on whether you wish the transvaginal scan to be performed or not.
Do you need to have a full urinary bladder for the scan? In short: NO.
Empty Bladder Policy: Our advanced ultrasound scanner can produce high quality diagnostic images without needing you to have a full urinary bladder. This eliminates the need to feel uncomfortable before or during the scan.
Therefore, there is no need to arrive with a full bladder and we want you to feel as comfortable as possible. We also have a ladies’ room in our clinic, which you can use anytime you need.
Can early Fetal Scan Detect all fetal anomalies?
Unfortunately, there is no one test that can diagnose or exclude all fetal anomalies or diseases. However, we do keep up to date with the latest medical advancements and extract as much information from these as possible in order to provide the best quality of care.
That said, the Early Baby Scan can detect a large proportion of fetal anomalies. Most importantly, it can diagnose some of the more severe abnormalities that can be lethal or associated with severe disability. The early detection of those anomalies increases your options for further management.
However, some anomalies are either not visible or not developed by 12-13 weeks. As a result, these would go undiagnosed. Fortunately, most of these anomalies are treatable after birth, nevertheless, some can be more serious, especially if they involve delayed development of the brain or heart.
Since an Early Baby Scan cannot exclude all anomalies, especially those that manifest later in the pregnancy, we strongly recommend having follow-up scans:
- Anomaly Scan at 20-23 weeks
- Baby Development Scan: 28-34 Weeks
We also strongly advise you to keep your scanning schedule with the NHS.
Baby Scan Package: The best ultrasound solution for every pregnancy
The Early Baby Scan is an integral part of our Baby Scan Package and arguably the most important one. This gives us our edge, as no other clinic performs such detailed anatomical examinations of the fetus at such an early stage of pregnancy. (To our knowledge)
Our Baby Scan Package is all-inclusive and consists of scans, which have been selected using our expertise and current research, to be the most instrumental in detecting abnormalities during pregnancy. As always, our scans and packages can be combined with NIPT, which has a very high detection rate for Down’s Syndrome, as well as, trisomy 18 and 13.
The Baby Scan Package includes four essential scans and can be combined with NIPT:
- The Early Baby Scan at 12 weeks
- The Anomaly Scan at 22 weeks
- The Baby Development Scan at 32 weeks
- The Baby Position Scan at 36 weeks.
What is the difference between a Nuchal Translucency (NT) Scan and an Early Baby Scan?
What we offer differs fundamentally from the traditional Nuchal Translucency (NT) Scan. The Early Baby Scan is an advanced systematic examination of all fetal structures, especially the brain and the heart. This method is very thorough as it uses recent technological advancements of high-end ultrasound probes to produce high-resolution images at an early stage. We check all the baby’s structures, evenits tiny fingers. Ultimately, the aim of the Early Baby Scan is to exclude as many fetal anomalies as possible and provide reassurance to the parents.
On the other hand, the Nuchal Translucency (NT) Scan was developed nearly 30 years ago (1992), during the early days of ultrasound technology. Revolutionary at the time, the NT scan measures the amount of fluid in the back of the fetal neck. Increased NT is a nonspecific marker for chromosomal, genetic, cardiac, and structural problems; however, increased NT is also not an uncommon feature in a normal pregnancy. Conversely, most babies born with other anomalies, may have normal readings of NT.
Currently, NT readings are being used by the NHS as a part of a combined screening risk-assessment for Down’s syndrome (Trisomy 21), and for trisomy 18 and 12. The NT test can currently be done in any NHS Trust and is performed by specially trained sonographers, which have regular external audits.
Because of the importance of NT, we perform meticulous measurements of this marker during our Early Baby Scan; however, we do not use the NT thickness measurement for the assessment of Down’s Syndrome (Trisomy 21) risk. Instead, we use the more recently developed (2011) Non-invasive Prenatal Test (NIPT), which has a superior detection rate and less false positive results compared to the NT quantitative measure.
We use a NT thickness measurement of 3.5 mm as a cut-off for further referral of the mother to her healthcare provider.
An increased NT for a baby with negative NIPT results strongly indicates the need to perform an Early Baby Scan, which in this situation, aims to diagnose or exclude some structural anomalies that could be the cause for the increase NT fluid level (for instance, heart defects).
For more information about the nuchal scan, please click here.