Uzi decoding. Deciphering ultrasound Doppler ultrasound

Regardless of the course of pregnancy, an ultrasound examination at this time is prescribed for all pregnant women.

The purpose of this procedure is the diagnosis of anomalies and malformations of the child, as well as the assessment of organs and systems that ensure the vital activity and development of the fetus (including the placenta).

The study of the state of the placenta is especially important, since by this period it becomes possible to visually recognize signs of placental insufficiency. This state of the body, designed to nourish and protect the baby, is a direct threat to the life, health and development of the child in the womb.

The state of the fetus at 32 weeks of gestation

The state of the skin of the fetus by this time reaches a state close to their state in a newborn. A layer of subcutaneous fat accumulates - this makes the skin smooth and bright. Lanugo (fluff) practically disappears, thicker hairs in a very small amount remain on the head and body. In addition to the respiratory system, internal organs and systems work almost at the level of a newborn. There is an active process of strengthening interneuronal connections.

The position (presentation) of the fetus, which is determined for a period of 32 weeks, is considered final. In the case of breech presentation during the next 2 weeks, it is possible to make an external coup of the child. When the baby is positioned transversely or at an angle, this is not possible. This arrangement of the baby is a sign of insufficient oxygen supply. In this regard, pregnant women are prescribed Doppler study.

At this time, normally, the amount of amniotic fluid has the largest volume. Up to 37 weeks, the volume is maintained, then the amount of water decreases. Therefore, in the period from 32 to 37 weeks, the kidneys of the expectant mother work with overload, in addition, the pregnant uterus mechanically squeezes the surrounding tissues, causing stagnation in them. That is why the pathology of the mother's kidneys manifests itself most often during this period. If there are signs of a difference from the norm in the functioning of the urinary system, a woman may be prescribed an additional procedure for ultrasound diagnosis of the condition of the kidneys.

At 32 weeks, the fetus has almost finished forming, outwardly it already completely looks like a newborn baby. The skin is smoothed, becomes light, subcutaneous fat is evenly distributed throughout the body. During this period, the maximum amount of amniotic fluid in the uterus is noted.

Features of the ultrasound procedure during the final screening

With an ultrasound examination at 32 weeks, the doctor evaluates the fetal data of the fetus, confirms fertility and gestational age, and determines the position of the baby in the womb. If the size of the child is significantly different from the norm, ultrasound diagnostics allows you to determine this. If the size of the baby is 2 weeks behind the lower limit of the norm, this is a cause for concern and an additional examination. In this case, it is clear that for some reason, for example, due to placental insufficiency, the child receives less nutrition and oxygen.

In case of a complicated pregnancy and a suspected fetal growth retardation, an additional examination and urgent measures are required to stop the baby's suffering. Ultrasound is one of the most accurate and safe methods for diagnosing a fetus at any stage of pregnancy.

Ultrasound at 32 weeks: determine the condition of the placenta

At a period of 32 weeks, they look at the placenta with special attention, study its condition, ability to perform functions in full, its structure, location. During this period, the diagnostic procedure for the study of the placenta is most accurate.

The placenta is an organ without which it is impossible to feed and breathe a child in the womb. Any functional impairment or structural defect of this organ entails the suffering of the baby, slowing down its growth and development caused by malnutrition and hypoxia. When decoding ultrasound data, the following indicators are taken into account:

• location of the placenta;
• thickness;
• degree of maturity (from 0 to III);
• the presence / absence of foreign inclusions (calcification), heart attacks.

The main object of ultrasound examination at 32 weeks of gestation is the placenta. This organ provides the functioning and respiration of the fetus, therefore it is vital for its functioning. The doctor must check the readiness of the placenta for delivery, identify its presentation

Of great importance for the normal process of delivery is the attachment of the placenta. Normally, the placenta is attached to the anterior or posterior wall of the reproductive organ (uterus). When the placenta is located close to the internal os of the uterus, there is a risk of bleeding during labor. In some cases, the placenta completely covers the birth canal, making natural delivery impossible. In this case, the surgical resolution of childbirth by caesarean section is performed. After determining the position of the placenta, its thickness is estimated, measurements are taken at the site of attachment of the umbilical cord.

With an uncomplicated gestational process, the thickness of the placenta is within the normal range. In a complicated course, placental insufficiency (insufficient placental thickness), inflammation or edema (excessive thickness) can be diagnosed.

It is not worth interpreting these indicators on your own and comparing them with the norm. It is better to wait for the expert's comments. For reference, you can use the following information: the placenta matures from grade 0 to III. The last stage is III. The placenta should reach this stage at 36 weeks of gestation. Too rapid aging of the placenta requires observation and therapeutic intervention in order to improve blood flow in the placenta.

Fetometric data at 32 weeks with ultrasound diagnostics

The data obtained by ultrasonic scanning are compared with the normative ones during decoding. Normal fetometry at week 36 is as follows:

• sizes: biparietal (from 75 mm to 89 mm) and fronto-occipital (from 95 mm to 113 mm);
• head circumference from 283 mm to 325 mm;
• abdominal circumference from 258 mm to 314 mm;
• lengths of tubular bones: thighs - from 56 mm to 66 mm, lower legs - from 52 mm to 60 mm, shoulders - from 52 mm to 62 mm, forearms - from 45 mm to 53 mm.

The doctor must perform fetometric measurements of the fetus, the data obtained allow you to confirm the correct development of the unborn baby. The circumference of the abdomen and head, biparietal and fronto-occipital size, as well as the length of some bones are measured

Doppler method at 32 weeks

Dopplerography (dopplerography) is one of the most informative, simple and safe methods for diagnosing the state of the blood supply pathways in the "womb-placenta-fetus" system. With ultrasound diagnostics by the Doppler method, a thorough study of blood flow in the vascular system of the uterus, vessels of the placenta and the main vessels of the fetus is carried out. Thanks to the data obtained and their comparison with the standards, the doctor can draw a conclusion about the condition of the child in the womb, the provision of oxygen to him and the work of the myocardium and blood vessels that provide it. The main Doppler indices are shown in the table:

FROM TO	umbilical arteries	2,48 - 2,52
	aortic	4 - 6,5
	internal carotid artery	4 - 6,5
Resistance Index (IR)	umbilical cord arteries	0,52 - 0,75
	uterine arteries	0,34 - 0,61
	fetal aorta	0,83 +-0,72
	internal carotid artery	0,79 - 0,81
Ripple Index (IP)	uterine arteries	0,4 - 0,65
	umbilical arteries	0,64 - 0,89
Average speed (cm/s)	in the umbilical arteries	32 - 39

Additional diagnostic procedures

By week 32, the accuracy of the information obtained by ultrasound increases. This is especially true for determining the amount of amniotic fluid. In the case of a slowdown in fetal development, it is at this time that a diagnostic procedure such as amnioscopy(examination of amniotic fluid).

Excessive or insufficient amount of water may be evidence of a malfunction of the placenta. Thanks to this procedure, you can timely and accurately diagnose:

• hydramnios;
• hypoamnion.

One of the frequently used procedures for direct diagnosis of the heart rate of a baby and indirect for its condition is CTG. CTG or cardiotocography is an ultrasound examination method that allows you to record and even “voice” the work of the baby’s myocardium, in order to then compare it with the standards.

The methods of ultrasound scanning used in obstetric and gynecological practice have a high degree of safety, reliability, and information content. They practically do not need preparation and do not cause inconvenience to the expectant mother. They allow for a comprehensive assessment of the state of the body of the expectant mother and her baby in a non-invasive way.

An ultrasound examination in the third trimester of pregnancy is carried out according to certain medical indications. Typically, such a study is prescribed for a pregnant woman whose fetus has certain developmental pathologies.

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The purpose of the

Performing a study in this period of pregnancy quite often coincides with the time of the third screening. Usually this examination is performed at 30-32 weeks of fetal development.

It should be noted that ultrasound at this stage of pregnancy may not be indicated for all women.

Using an ultrasound examination, doctors can determine main indicators of fetal development. This method allows you to conduct a full-fledged complex fetometry. This study includes quite a few different parameters.

32 obstetric week is the period when the baby's body is almost completely formed. This physiological feature allows you to determine quite a lot of different indicators.

Quite often, doctors prescribe an ultrasound to determine the final tactics of obstetrics. Moms who have a breech presentation of the fetus at this time may also need to repeat an ultrasound examination a couple of weeks before delivery.

Ultrasound at -32 weeks pregnant can also be prescribed in multiple pregnancies. Especially often this situation occurs if one of the fetuses has defects in intrauterine development. In complex clinical cases, doctors may resort to the appointment of an expert-level ultrasound.

Of course, during the ultrasound examination, it is possible to determine the sex of the unborn baby. This is usually done when a pregnant woman has missed a previous screening. In most cases, the sex of the unborn child is determined in the middle of the second trimester.

Ultrasound at this stage of pregnancy can be performed in different ways. Dopplerography is used to determine the pathologies of blood flow. Using this method, diagnostic specialists can determine various pathologies of the placental and uterine blood vessels that feed the fetus.

Dopplerography has also been successfully used to detect emerging heart defects in the fetus.

It should be noted that expectant mothers who, during an ultrasound scan at this stage of pregnancy, doctors found any deviations from the norm, should not immediately start to panic.

One conclusion of the ultrasound test is not yet a diagnosis at all. The interpretation of the result is necessarily carried out by an obstetrician-gynecologist who observes a pregnant woman throughout the entire period of pregnancy.

Main parameters under study

The third trimester is the final stage of the intrauterine development of the baby. To assess pathologies during this period of pregnancy, doctors have developed a number of different clinical indicators.

For a comprehensive conclusion, a comparison of all the results obtained is required.

Fetometry is a baseline study that is actively underway during this period. This method allows you to evaluate the main indicators of the anatomy of the fetus. To do this, during the study, the ultrasound doctor evaluates several parameters. These indicators include the biparietal size and circumference of the fetal head, as well as the circumference of the abdomen.

Must be defined dimensions of the main tubular bones. For this, their length is estimated. Too short tubular bones can be a sign of some genetic diseases or emerging pathologies of the musculoskeletal system.

During the study, which is carried out at this stage of pregnancy, it is also necessary to evaluate abdominal circumference. Doctors have found that this indicator is often associated with head circumference. If the baby's tummy is too large in diameter, then this can be a manifestation of a very dangerous pathology - ascites. It is characterized by the accumulation of excess fluid in the child's abdomen.

At this stage of pregnancy, it is possible to determine and estimated baby weight. An experienced ultrasound specialist will determine how much the fetus weighs with an accuracy of tens of grams. A fetus that is too large is usually an indication for a caesarean section, especially if the mother's pelvis is too narrow. Underweight usually occurs in one or both babies in multiple pregnancies.

Evaluation of the work of all vital systems of the fetal body is a very important step in the ultrasound examination. At this time, the doctor already perfectly determines the fetal heartbeat. Exceeding or decreasing this indicator below normal values ​​indicates the formation of pathologies in the work of the cardiovascular system. Such manifestations are especially dangerous if the mother has a history of heart disease.

Identification of heart defects is necessary. Modern techniques make it possible to detect such defects quite effectively. Pathologies in the development of heart valves and the appearance of pathological blood flows (regurgitation) on them may be an indication for surgical correction immediately after the birth of a child.

With the help of ultrasound at this stage of pregnancy, it is also possible to detect various anomalies in the development of the kidneys and urinary tract in the fetus. Qualified specialists can also determine the emerging pathologies of the pelvis and bladder. Along with the study of the urinary system, the doctor necessarily evaluates the work of the gastrointestinal tract and the respiratory system in the fetus.

An examination of the spine in a baby is carried out only if there is a suspicion of the presence of genetic or chromosomal diseases. To do this, an ultrasound doctor examines a linear section of the spine. The spinous processes are also studied. If during the study, an ultrasound specialist revealed any significant defects and he suspected the presence of signs of chromosomal diseases, he would refer the future mother for a consultation with a geneticist.

The placenta, or "baby place" is a very important organ during pregnancy. Through it, the baby receives all the necessary nutrients, as well as oxygen. This is due to the system of uteroplacental blood flow that is common with the mother.

Assessment of the thickness of the placenta, as well as the tone and structure of its blood vessels, must be carried out during the study during this period of pregnancy.

During any ultrasound examination, the doctor must evaluate and the main parameters of the internal genital organs of the expectant mother. This is necessary for the timely detection of pathologies that can lead to disruption of the course of pregnancy and difficulties during childbirth.

For this, the inner surface of the uterus is examined, and the dimensions of its appendages and ovaries are determined. During ultrasound, neoplasms and cysts can be detected. If these pathologies in a pregnant woman were detected even before the onset of pregnancy, then in such a situation, the dynamics of their growth is necessarily assessed. With an unfavorable course of fibroids or cysts, careful selection of the necessary tactics of obstetric care may be required.

Norms of the studied parameters

Normal doctors consider head presentation. Too active babies can change their position in the womb several times. Usually, by the end of the third trimester, the presentation is already becoming permanent. In some situations, doctors may prescribe a second ultrasound in 2-3 weeks.

The location of the placenta on the back wall is the most optimal. Doctors also determine how high this organ is located from the internal os of the uterus. If the placenta attaches too low to it, then this may be the result of its increment or lead to various pathologies.

During the study, it is also necessary the cervix is ​​assessed. Normally, this figure should be more than 30 mm. Shortening of the cervix is ​​an extremely unfavorable symptom of isthmic-cervical insufficiency. In this case, additional suturing is required to eliminate this pathology.

It is very important during such a study to evaluate and uterine tone. Hypertonicity can lead to premature birth. Also, this condition contributes to the formation of placental insufficiency.

The amniotic fluid index is a very important indicator, which is also evaluated during this period of pregnancy. Too much of its accumulation is a manifestation of polyhydramnios. Normally, this figure is 140-269 mm. A significant decrease in this indicator indicates the manifestation of oligohydramnios.

Deciphering the results

Future mothers should remember that the interpretation of the obtained values ​​​​of the study is carried out by an obstetrician-gynecologist, and not an ultrasound specialist. One conclusion of an ultrasound test is not yet a diagnosis. To confirm or exclude pathology in the fetus, it is also necessary to compare the ultrasound findings with biochemical analyzes that were performed at different periods of pregnancy.

Tachycardia- an unfavorable symptom that may indicate fetal hypoxia. The development of this condition can lead to the entanglement of the baby's neck with the umbilical cord. Also, palpitations occur with some heart defects.

Bradycardia, detected at this time in the fetus, may be the result of a lag in intrauterine development. This symptom also appears in the presence of certain cardiovascular anomalies. A decrease in the fetal heart rate below 130 beats per minute requires a mandatory thorough diagnosis. for the detection of various defects of the valvular apparatus of the heart.

At this stage of pregnancy, the maturity of the placenta is usually of the first degree. At earlier stages, it is zero. With the course of pregnancy, the maturity of the placenta increases. If the placenta does not “ripen” for childbirth, then this is already a pathological condition.

A study of the thickness of the placenta is also mandatory. A smaller thickness of this organ occurs with the possible development of placental insufficiency. Too thick placenta may indicate the development of edema or inflammation. Various viral and bacterial infections lead to the development of such pathological changes.

Modern medicine has stepped far ahead and today has a number of hardware techniques for the early diagnosis of fetal developmental pathologies and monitoring the health of a woman during the development of pregnancy. During the bearing of a child, a woman who has registered with a antenatal clinic or is observed in a perinatal center undergoes an ultrasound examination (ultrasound) three times.

The last such examination is carried out in the period of 32-34 weeks of pregnancy in order to determine the condition of the fetus and the presence or absence of placental insufficiency.

What are they watching?

At 32 weeks of fetal development with ultrasound (ultrasound) focus on a number of key factors.

• The type of presentation of the fetus relative to the birth canal is determined - it can be transverse, head or pelvic. At the same time, a plan for conducting the birth process is formed - whether labor will take place naturally, or whether surgical delivery will be required.
• A more accurate date of the expected birth is determined.
• It is observed how the final formation of the child takes place, in what condition the placenta is and how it is located, whether the fetus has an entanglement with the umbilical cord.
• It is predicted whether or not a newborn child will need surgical or resuscitation assistance.

The third examination using ultrasound in terms of timing can be performed not as strictly as the first two, which are done in the early stages of pregnancy. If the first two ultrasound results were without pathology, then the terms of the third examination, in agreement with the doctor, can be extended and carried out in the period of 30-31 or 34-37 weeks.

Of course, the ideal is to stick to the traditional 32 weeks.

In addition to the parameters described above, the child during the study is given dopplerometry (DPM). This method is one of the varieties of ultrasound diagnostics, which determines the speed of blood flow in the vessels of the fetus, in the umbilical cord and in the uterus of a pregnant woman. The most informative Doppler can be obtained only after the 30th week of fetal development, however, if any pathologies are suspected, the procedure can be prescribed and carried out much earlier.

Dopplerometry helps to determine the following conditions:

• early maturation of the placenta;
• excessive or insufficient amount of amniotic fluid;
• pathology of the formation of the umbilical cord;
• uneven development of one of the fetuses during multiple pregnancy;
• dropsy of the fetus;
• Rhesus conflict or chromosomal pathology.

DPM is not a mandatory procedure, but it is carried out by everyone, since it determines the presence of blood flow disorders between the fetus and the placenta, and also evaluates the work of the child's heart.

If there are any deviations from the norm, this will mean that the further development of the fetus is at risk. Depending on the intensity of the violation of the dynamics of blood flow, both developmental delay and fetal death are possible.

Indicators and their interpretation

By the eighth month of pregnancy, when the fetus has formed, the ultrasound shows that the cardiovascular and central nervous systems, the gastrointestinal tract and the urinary system are already quite well developed, there are all the proper sex signs. The appearance of the baby also undergoes some changes - a hair fluff appears on the head, arms and legs become plumper, pronounced cheeks appear.

It happens that during ultrasound screening, the child turned away from the sensor, then it will be difficult, and sometimes impossible, to confirm the determination of his gender. The decoding of ultrasound screening indicators is divided into subsections, which imply a description of the development of the fetus and the condition of the uterus of a pregnant woman.

Anatomical development of the fetus

This includes the following metrics:

• head part- examine the correctness and integrity of the formed skull and the front of the head.
• brain area- the formation of both hemispheres, the cerebellum, the visual tubercles, as well as other important parts of the brain are assessed. Particular attention is paid to measuring the width of the ventricles of the brain for the presence of hydrocephalus - normally this size should not exceed 10 millimeters.
• Facial department inspect for the presence of defects in the development of the orbit, evaluate the area of ​​​​the nasolabial triangle.
• Vertebral department- look for the presence of a hernia or other pathologies.
• Bronchopulmonary department- determine the parameters of the bronchi and lungs, their level of maturity, the presence of neoplasms in the form of cysts, and also determine the presence of fluid in the pleura.
• Heart area- they check the presence of all four chambers in the organ, the presence of fluid in the area of ​​​​the pericardial sac, determine the condition of the partitions between the heart ventricles and atria, and also look at the position of the aorta and pulmonary artery.
• Organs of the gastrointestinal tract- determine the parameters and position of the stomach, liver, intestines.
• Organs of the urinary system- determine the parameters and location of the kidneys, look at the renal pelvis, ureters, bladder.

The state of the child's place (placenta)

• The place of its attachment in the uterus relative to the cervix. In the normal state of development, the placenta is attached in such a way that its lower part does not reach the level of the internal os by 7 or more centimeters.
• Determined maturity of the placenta- for a period of 32 weeks, it is conventionally designated as the "first" degree, but by the 34th week this indicator changes to the "second" degree.
• Measure the thickness of the placenta. Typically, these parameters can normally range from 25 to 41.5 millimeters.

The state of the amniotic fluid

The amount of amniotic (amniotic) fluid is determined in order to identify their excess or deficiency. There is a so-called amniotic index - a special table, according to which, depending on the period of pregnancy, the norm or deviation from it is determined. So, with a period of 32 weeks, oligohydramnios will be indicated by an index of 76 millimeters or less, moderate oligohydramnios - from 77 to 86 millimeters, the normal amount of amniotic fluid will be indicated by an index of 144-242 millimeters.

An index parameter less than 50 millimeters is considered dangerous for the life of a child.

Umbilical cord condition

Determine:

• the composition of the umbilical cord, which normally should have two arteries and one vein;
• the presence of intrauterine entanglement of the umbilical cord in the fetus, for which 3D volumetric scanning and image transmission sensors are used;
• analyze whether the fetus has intrauterine hypoxia, for which the Doppler method is used.

The uterus and its muscular layer

The following indicators are evaluated:

• determine the length of the uterus, which is normally no more than 29-30 millimeters, and also look at the external and internal pharynx of the cervix, which should be closed until the moment of labor;
• the muscular layer of the uterus is examined for homogeneity of the myometrium - were there scars after surgical interventions, was there any development of neoplasms;
• uterine muscle tone is assessed.

Appendages

The ovaries and fallopian tubes are also subject to examination for the presence of cystic formations in them. The benefits of the data obtained are undeniable, since most pathological conditions in the fetus develop without severe symptoms, and they can be detected only by resorting to diagnostic studies, which include the ultrasound method.

All research data are recorded in a special medical protocol, which is certified by a diagnostician who conducts the examination. This protocol is a mandatory document that a woman takes with her to the maternity hospital. Based on the protocol data, the doctor plans the tactics of childbirth, taking into account all the nuances that may arise during labor.

Fruit size

In addition to assessing the internal organs, their condition and development, at a gestational age of 32 weeks it is already possible to determine the sex, size and weight of the baby. Fetal development indicators are evaluated according to the developed tables containing the parameters and norms taken as a standard.

• Hand sizes- measure the length of the forearm (44-56 millimeters) and shoulder (51-61 millimeters).
• Leg sizes- measure the length of the lower leg (49-60 millimeters) and thigh (54-65 millimeters).
• Biparietal parameters of the head- the length of the conditional line passing between the parietal bones of the skull from the upper edge to the inner surface of the lower edge. Normally, the indicators vary between 74-90 millimeters.
• Fronto-occipital parameter of the head- the distance from the frontal to the occipital bone, normally it is 94-110 millimeters.
• Head circumference- measured for data reliability in three projections, normally this parameter is 279-330 millimeters.
• Abdominal circumference- normally is 254-315 millimeters.

If all the indicators during the examination correspond to the norm, the doctor concludes that the pregnancy is developing normally and the fetus corresponds to the 32nd week of development. These indicators are not a dogma, it is necessary to take into account some family characteristics of certain parameters. However, if the studied parameters have a tendency to hypertrophy, this may indicate a high maturity of the placenta and the danger of its destruction, which in turn disrupts the life support of the fetus.

Timely noticed such a pathology will help to take timely measures to avoid unpleasant consequences for the mother and child.

Fetal weight

With the help of ultrasound at 32 weeks of gestation, you can determine the height of the child and find out how much he weighs. Of course, these results may differ slightly in one direction or another from the real ones, but this error is small. Normally, the growth of a baby at this period of development is 430-445 millimeters, and its average weight is in the range of 1950-2150 grams. These standards are relevant if there is only one fetus in the uterus, but when the pregnancy is multiple, each fetus will have its own parameters.

Normally, both fetuses should develop equally, but it happens that one of the children develops a little faster and more intensively than the other or others. So, for example, with the development of twins in the uterus, the weight of each baby at week 32 will be 1600-1750 grams.

The parameters of the weight and height of the fetus are also necessary data in order to plan the tactics of conducting the birth process. There are cases when the anatomical structure of the pelvis of a woman does not correspond to the normal delivery of a large fetus.

If you do not know the parameters of the fetus in advance, the death of the child or mother may occur during childbirth, since in this particular case, delivery is indicated by an operation called "caesarean section".

Currently, an ultrasound scan of a pregnant woman in the last stages of pregnancy is a mandatory diagnostic procedure for all. It is carried out quickly and painlessly, but its results are invaluable. A woman does not need any special preparation before the examination.

Doctors recommend that women during this period listen especially carefully to their feelings, and if there are changes in their state of health, immediately seek medical help. At this stage of pregnancy, there is a risk of premature opening of the cervix, therefore a woman must wear a special supporting bandage.

If this advice is neglected, the child, under the influence of its own gravity, begins to descend prematurely towards the entrance to the small pelvis, which leads to increased pressure on the cervix, and she regards this as a signal for the onset of labor and begins to open. Thus, provoking premature birth is possible.

In addition to the risks associated with the uterus, in the third trimester of pregnancy, the likelihood of developing late gestosis (toxicosis) of pregnant women increases. This condition is accompanied by an increase in arterial blood pressure, a violation of the kidneys with the appearance of edema and protein in the urine. These symptoms cannot be ignored, since at any moment a formidable complication called eclampsia of pregnant women can begin against their background, when a woman can be in mortal danger.

Doctors advise you to control your diet, monitor the amount of fluid you drink, and lead an active lifestyle as much as possible, avoiding venous congestion and swelling of the lower extremities. In addition, it is necessary to regularly measure blood pressure and monitor the nature of urine excreted for the presence of turbidity.

Ultrasound at 32 weeks of gestation is often prescribed as the last. The procedure allows you to timely identify deviations in the development of the fetus and the organs that surround it. This significantly reduces the risk of an unfavorable outcome of childbirth and helps to determine the optimal tactics.

Assign to , 32 or . The examination is carried out even in the absence of any discomfort or warning signs.

In late pregnancy, ultrasound does not pose any danger. The placenta and amniotic fluid protect the fetus from any discomfort due to exposure to ultrasound. There are no contraindications to this procedure.

Week 32 is considered critical. It is during this period of pregnancy that problems develop that lead to premature birth.

Among them, the most common:

• isthmic-cervical insufficiency;
• placental abruption;
• preeclampsia, eclampsia.

At 32 weeks, the fetus takes its final position. The technique of childbirth largely depends on this parameter. Therefore, such a period in itself is considered an indication for ultrasound.

To view a video review on the topic:

Preparation and conduct of the study

No special preparation for screening in the third trimester (diet or drinking water before the procedure) is required. A woman needs to sign up for an examination and take a shower before going to an ultrasound. You need to have a towel for the couch, disposable wipes to remove the gel and shoe covers with you.

If a woman at 32 weeks pregnant smokes, then she needs to refrain from smoking for 2 hours before the procedure.

Conventional two-dimensional ultrasound lasts no more than 20 minutes. It is carried out as follows:

1. The doctor invites the patient into the office, invites her to lie down on a couch covered with a towel. Under the side you need to put a roller or fist. The belly is exposed.
2. A layer of a special gel is applied to the patient's abdomen. It is cold, so it often causes discomfort.
3. The doctor moves the sensor over the abdomen and examines the image that appears on the screen. In the process, he tells the expectant mother the most important facts about her fetus.
4. After the procedure, the woman gets up from the couch, removes the remnants of the gel, dresses. After 5-10 minutes, she receives a description of the examination and, if desired, a photo of the ultrasound of the fetus.

Three-dimensional and four-dimensional ultrasound is done longer (40-60 minutes). But the expectant mother gets the opportunity to watch a real color film about her baby.

Deciphering the results

During an ultrasound in the third trimester, the doctor examines a number of parameters. Usually, he immediately informs the mother about the presence of deviations. He gives the rest of the parameters in the description. Knowing the decoding, a woman can independently study them.

Table of norms of fetal indicators:

They also look at the weight of the child at 32 weeks of pregnancy by ultrasound, the norm varies between 1.6–2.1 kg. Fruit size 40–43 cm. Small deviation in fetal weight and height is not critical. This indicator is influenced by many factors, including heredity.

Sometimes doppler ultrasound is prescribed. This procedure shows the correctness of the blood flow.

1. Umbilical arteries. SDO - 2.8–3.4. IR - 0.6–0.67. PI - 0.95–0.96.
2. Internal carotid artery. SDO - 2.8–3.4. IR - 0.6–0.67. PI - 0.95–0.96.
3. Uterine artery. SDO - 1.7–1.9. IR - 0.69–0.86. PI - 0.69–0.86.
4. fetal aorta. SDO - 5.7–7.3. IR - 0.8–0.86. PI - 1.76–2.2.

The doctor also checks the condition of the fetal organs. At this stage, the kidneys are already filtering the water and the substances contained in it, the sense organs are fully functioning, the ovaries contain eggs, the baby's face expresses emotions, and his hands make grasping movements. Often by this time the testicles have already descended.

The lungs at 32 weeks are not yet developed enough to function outside the womb. They are similar in density to liver tissue. The doctor examines not only the organs of the fetus, but also the organs of the mother associated with labor.

The list contains indicators of the norm:

1. The position of the fetus in the uterus is head.
2. Umbilical cord. 1 vein and 2 arteries are determined. There is no cord around the fetus.
3. Placenta. It is located on the back or on the front wall. It is located at least 70 mm from the edge of the internal pharynx. There is 1 stage of maturity. The thickness varies between 2.5–4.2 cm.
4. Cervix. Both openings are closed. Size not less than 2.9 cm.
5. Tone of the uterus. It can be observed for a short time when exposed to the sensor. Normalizes quickly.
6. Amniotic fluid. Normally, the amniotic index varies between 70–270 mm.

If there are deviations, a decision is made on the hospitalization of the woman and her treatment. The list contains the most common anomalies:

1. Breech presentation of the fetus is a common phenomenon that can be corrected at this time. The transverse and oblique positions are often associated with hypoxia.
2. Entanglement of the fetus by the umbilical cord.
3. Failure of the scar on the uterus. It manifests itself in the form of thinning or modification of the scar.
4. Central placenta previa.
5. Short neck roll and open pharynx. Signs of isthmic-cervical insufficiency.
6. Tone of the uterus. Talks about the threat of premature birth.
7. Oligohydramnios - oligohydramnios. Polyhydramnios - polyhydramnios.

A large fetus is also a deviation from the norm and can cause a caesarean section.

Also see how the ultrasound looks on the fetus:

How much does an ultrasound cost

By appointment of a doctor, you can do an ultrasound absolutely free of charge in a public institution. A woman needs to get in line in advance and have a referral from a gynecologist with her.

In paid clinics, the cost of the examination varies between 1,700–4,800 rubles. It depends on the pricing policy of the institution.

Ultrasound at 32 weeks is often prescribed as the last examination before childbirth. It is necessary for every pregnant woman, as it allows you to avoid "unpleasant surprises" during childbirth.

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