Skip to main content

Tag: baby

We Are Moving!

Written by London Pregnancy Clinic on . Posted in Blog.

Dear Valued Patient, 

We have some exciting news to share with you! We have moved to the following address which is in close proximity to our old clinic:

36 Spital Square, London E1 6DY

City Ultrasound is pleased to announce a long awaited relocation to Spital Square, just a few minutes’ walk from the iconic Spitalfields Market and adjacent to the famous Galvin La Chapelle restaurant. We are proud to be able to offer our patients a fantastic new clinic equipped with the latest ultrasound technology, a spacious and light waiting room and much more (sneak peek photos attached!)

The relocation is effective immediately, and we have closed our Finsbury Circus clinic permanently. The new location is conveniently located within 3 minutes’ walk from Liverpool Street Station. Additionally, paid street parking is available in front of our new building.

I would like to take this opportunity to thank you, our valued patients, for supporting our newly established service. When opening our doors for our first patient in April 2020, it took us almost a year to prepare for the launch. It has been a long and challenging journey but we would not have been able to expand and get to where we are now without your support.

Finally, if you would like to share your experience with City Ultrasound, I would really appreciate if you could kindly leave a comment on Google Reviews. We hope to see you at our new clinic soon!

Kind regards,

Dr Fred Ushakov & Team

Amniotic Sac

Written by London Pregnancy Clinic on . Posted in Blog.

In today’s video you can clearly see the baby resting in the Amniotic Sac at about 11 weeks and even see its brain!

The amniotic sac is a pair of membranes (basically a filter that lets some things pass but stops others) where the baby is developing. The inner membrane is known as amnion, while the outer membrane is known as chorion. The amnion is filled with a fluid suitably called amniotic fluid which transfers essential substances such as oxygen from the umbilical cord to the baby. The chorion contains the amnion and is part of the placenta.

During labour, the amniotic sac breaks resulting in the ‘water breaking’ when the baby is ready to come out. In some cases, the amniotic sac doesn’t break during labour and the baby is born in a transparent bubble, this is quite rare and only happens in 1 in 80,000 cases- known as en caul birth!

At City Ultrasound, the amniotic sac is just one of the important structures we check at any scan from 8 weeks. On our website, we have in-depth information about our process and types of scans, but if you do have any questions at all, please feel free to get in touch with us!

Transvaginal Scan (TVS)

Written by London Pregnancy Clinic on . Posted in Blog.

What is a transvaginal scan (TVS)?
“Transvaginal” means an internal examination through the vagina. TVS probes have extraordinary resolution and may provide unique information regarding the fetal anatomy, placenta, womb, cervix and other important structures.

Technically, examination by TVS during pregnancy is identical to gynaecological ultrasound. The special high-resolution probe is aseptically cleaned, covered with a sterile cover (like a condom) and sterile lubricating gel. The transducer inserted is no larger than a finger. It is gently passed into the vagina to generate images of the baby, while you lay on your back. This may cause some slight discomfort but should not cause any pain. It is important you let us know if you have a latex allergy, in which case we will use latex-free probe covers.

The operator performing the transvaginal scan in pregnancy must have a high level of expertise and experience. TVS scan represents a significant challenge for the doctor or sonographer because of difficulties in obtaining correct images. As such, there are only a few specialists in London performing transvaginal assessment of the early fetus, including Dr Ushakov.

Please empty your bladder immediately before the transvaginal scan. Even a small amount of urine in the bladder will change the position of the womb and will reduce the quality of image. A trained chaperone is also available and present for internal examinations and may be requested for any of our other scans.

Is TVS safe?
TVS uses the same safe ultrasound waves as transabdominal scans to obtain the images of the baby and womb. The probe cannot get into direct contact with the fetus. Normally, due to better resolution the time of TVS imaging is shorter in comparison to a transabdominal scan (approximately 10 minutes). We use rigorous aseptic technique for preparation of the probe and there is no risk of infection.

Visit our Instagram account for comparison of transvaginal (TVS) & transabdominal scans for the SAME pregnancy. Can you see how much better the resolution of the TVS scan (1st video)? This is generally the case for ultrasound scans up to 11weeks when the fetus is still very small, less than 1.6 inch!

Folic Acid

Written by London Pregnancy Clinic on . Posted in Blog.

What is folic acid? 

Folic acid is a synthetic (man-made) form of the Vitamin B-9 (folate), which naturally occurs in some foods such as asparagus, peas and broccoli. Folate supports generation of healthy new red blood cells, which carry oxygen around the body.  The deficiency of red blood cells may be conditions like anaemia, which often causes weakness and fatigue.  

Why is folic acid often recommended to women during their pregnancies? 

Prior to conception and within the first trimester (around week 12) it is often recommended that women take this artificial supplement to reduce the risk of a neural tube defects and ensure the healthy formation of red blood cells. Taking folic acid Folic acid also supports maternal tissue growth and increases maternal folate to reduce risk of neural tube defect. Can reduce the risk of developing neural tube defects by up to 70% (WHO, 2015).  

What is a neural tube defect? 

The neural tube is an embryonic structure that lays the foundation for the central nervous system (consisting of the brain and spinal cord). Neural tube formation begins just three weeks after conception, and proper formation is vital for brain development. Neural tube defects occur when the formation of the neural tube does not develop or form correctly. These may result from a lack of folic acid in the first 28 days of pregnancy, causing the neural tube to poorly develop. Typically, the neural tube closes in the 4th week following conception. Neural tube defects include birth defects of the skull and brain like acrania or encephalocele, spine and spinal cord, such as spina bifida.  

How much folic acid is recommended? 

It is recommended that those who are planning to get pregnant take 400 micrograms supplement daily (NICE, 2014) both prior to pregnancy and for the first 12 weeks. The NICE recommend taking this supplement regardless of whether you are eating folate-rich foods.   

Your GP may prescribe or recommend a higher dose if you have a BMI over 30, have diabetes, anaemia, sickle–cell disease, coeliac disease, take medication for epilepsy or have a history of neural tube defects.  

What foods contain folic acid? 

Asparagus, peas, broccoli, oranges, bananas. Green beans, kale, spinach, yeast extract and fortified cereals.  

Can you detect neural tube defects by ultrasound?

Yes – Dr Ushakov has been developing new methods for detecting these anomalies in the first trimester from as early as 10 weeks.  

For support for spina bifida and hydrocephaly: Shine Charity 

Sources: 

NICE (2014). Maternal and Child Nutrition [Online] [link] 

NICE (2021). Neural Tube Defects (Prevention in Pregnancy) [Online] [link] 

SHINE (2021). Folic Acid. [Online] [Link] 

Ushakov, F., Sacco, A., Andreeva, E., Tudorache, S., Everett, T., David, A.L & Pandya, P. P. (2019). Crash Sign: New First‐Trimester Sonographic Marker of Spina Bifida. [Online] [Link] 

World Health Organisation (2015). Prevention of Neural Tube Defects by The Fortification of Flour with Folic Acid: A Population-Based Retrospective Study in Brazil. [Online] [link]

COVID-19 Vaccine and Pregnancy

Written by London Pregnancy Clinic on . Posted in Blog, Covid-19.

We have collected some information and official guidance from the government and relevant professional bodies about the Covid-19 Vaccine, Your Pregnancy and Fertility:

RCOG – Royal College of Obstetricians and Gynaecologists

JCVI – Joint Committee on Vaccination and Immunisation

Who can have the vaccine?

Currently the vaccine has yet to be tested on pregnant women, and so the vaccine is not recommended to be provided routinely to all pregnant patients. At present, the Covid-19 vaccine is only being offered to the following groups of pregnant women who are at a higher risk of catching the virus:

  • Those working in the health and social care sectors.
  • Those considered clinically extremely vulnerable* (RCOG definition)

If you fall into one of these two categories, you may be offered the vaccine and have the choice to accept it or alternatively wait for more data to be published regarding its effects.

I am eligible for the vaccine – will it affect my baby?

The RCOG have previously reassured pregnant women that since the vaccine cannot replicate (unlike biological viruses) it cannot cause infection in the mother or baby.

I am breastfeeding – will the vaccine affect my baby?

The RCOG and JCVI have stated that there is no known risk associated with giving non-live vaccines such as the Covid-19 vaccine to breastfeeding patients. At present there is no data available on the effects of the vaccine on breastfeeding or the breastfed child. However, the JCVI recommend that you receive the vaccine whilst you are breastfeeding, based upon the vast benefits that breastfeeding provides for your growing child. If you have any concerns, you may decide to wait until you have completed breastfeeding before having the Covid-19 vaccine.

I have had my first dose of the vaccine but have become pregnant since, should I have the second dose?

The JCVI recommend that you delay your second dose until you have delivered your baby, unless you fall into the high-risk categories described above.

Can the Covid-19 vaccine affect fertility?

The Royal College of Obstetricians and Gynaecologists (RCOG) and Royal College of Midwives (RCM) have recently published a joint statement in response to misinformation spread about the Covid-19 vaccine’s effect on fertility. The RCOG and RCM state that there is no evidence to suggest that the vaccine may affect fertility. The RCOG President expands: ‘There is no biologically plausible mechanism by which current vaccines would cause any impact on women’s fertility.

Evidence has not been presented that women who have been vaccinated have gone on to have fertility problems.’ – Edward Morris, President of RCOG (2021) The RCM and JCVI recommend that you speak to your midwifery/primary healthcare team regarding any queries or worries you may have about the Covid-19 vaccine.

For more information on who may be eligible and further details on the above statements, please visit the referenced links below:   References: RCOG (2021). I am Pregnant and Have Been Offered a COVID-19 Vaccination. What are My Options? [Online] [Link]

RCOG (2021). The RCOG and the RCM Respond to Misinformation Around Covid-19 Vaccine and Fertility. [Online] [link]

RCOG (2020). Updated Advice on COVID-19 Vaccination in Pregnancy and Women who are Breastfeeding [Online] [link]

JCVI (2021). COVID-19 Vaccination: A Guide For Women of Childbearing Age, Pregnant or Breastfeeding [Online] [link]

Fetal and Maternal Heart Rates

Written by London Pregnancy Clinic on . Posted in Blog.

Did you know that your baby’s hear rate during pregnancy is in the range of 110-160 beats per minute? Your baby’s heart is working extra hard while it is growing and developing. The mother’s heart rate also increases during pregnancy as the amount of blood it pumps increases by 30-50% during gestation and can average at 70-90 beats per minute.

Studies have shown that the average heart rate rises steadily through pregnancy. At 10 weeks GA, the average heart rate is ~79 BPM. By 40 weeks GA, the average rate was ~89 BPM.

In today’s video you can see a 2D video of the so-called 4 chamber view (4CV) of the fetal heart at about 14 weeks. Ultrasound is an important tool for the screening of Congenital Heart Defect (CHD) which is the most common type of anomalies that could occur during pregnancy. According to the NHS website: “Congenital heart disease is one of the most common types of birth defect, affecting up to 8 in every 1,000 babies born in the UK.”

At City Ultrasound our approach is to monitor the fetal heart function and development at every scan we do. Echocardiography is the examination of the fetal heart using ultrasound and is included with every scan where possible.

Tricefy – Secure Cloud for your Baby Images

Written by London Pregnancy Clinic on . Posted in Blog.

We know that sharing your pregnancy scan experience is important, especially in light of the current pandemic restrictions. That’s why we’ve partnered with triceimaging to be able to send you the images, videos and scan report straight to your mobile phone (as well as giving you some printouts…)

From @triceimaging: Don’t have a belly to show off yet? Ultrasound pictures will do!

With a push of a button – The Tricefy Patient App allows you to send patient images directly to your loved ones. Click on the link in our bio to refer your provider (and try our demo?!) and we will set them up with a free trial so that they can start sending quick, secure, high-resolution links of your ultrasound scans directly to your mobile phone!

Hosting BBC at City Ultrasound

Written by London Pregnancy Clinic on . Posted in Blog.

Featuring on the BBC ??

We are extremely honoured to have been approached by the BBC to take some stock images and videos for their archive! The BBC producers came across some of our ultrasound images and were ‘really impressed by the outstanding quality and clarity of the images’.

We enjoyed hosting the BBC producers and camera crew at our clinic and talking about the importance of prenatal ultrasound screening and especially Dr Ushakov’s areas of expertise in echocardiography and neurosonography.

This means that going forward you will see our images on BBC news on items related to fetal medicine and pregnancy. We would like to clarify that, to date, City Ultrasound is not related to any of those news items.

What is Nuchal Translucency (NT)

Written by London Pregnancy Clinic on . Posted in Blog.

Nuchal Translucency (NT) 

You probably heard the above term mentioned in the context of pregnancy scans, but what does it actually mean? Nuchal Translucency is a sonographic phenomenon which can be seen best at around 11-13 weeks of gestation. It refers to the thickness of the liquid that can be seen on an ultrasound image behind the baby’s neck.

Why is it important? Research has shown that an increased NT thickness can indicate a higher chance of occurrence of certain chromosomal or structural anomalies. The key word being CAN; in some cases the excess fluid will dissolve further along the pregnancy and the babies will be born completely normal.

The NHS cut off for normal NT thickness measurement is anything below 3.5mm. It is measured as part of the Combined Screening where a blood sample as taken as well to assess the chance of 3 chromosomal anomalies; Down’s Syndrome, Edward’s Syndrome and Patau’s Syndrome. Being a screening test, it is not diagnostic meaning that it cannot give a definite yes/no answer. In case of higher chance results, further investigation is required.

More recently, a new screening test known as Non Invasive Prenatal Test (NIPT) was developed. It involves a simple blood sample taken from the mother’s arm and is capable of detecting Down’s Syndrome with a 99% accuracy, vs 76% accuracy of the Combined Test and 69% accuracy for the Nuchal Test alone. You should take these percentages with a pinch of salt, given Down’s Syndrome in itself is a reasonably rare anomaly which is becoming more likely with age; 1:1250 for a 26-year-old pregnant woman rising to 1:100 for a 40-year-old.

Conclusion:

NT can be a useful indicator for certain anomalies, but should be used very carefully for screening purposes. An increased NT measurement warrants a further investigation such as examination of the baby by ultrasound to exclude certain structural anomalies (especially heart defects) and possibly diagnostic invasive tests such as CVS or Amniocentesis. These invasive tests carry a small risk of miscarriage; an alternative to avoid these invasive test is screening using NIPT such as the Harmony Test.

At City Ultrasound we also perform an examination of the fetal heart (echocardiography) with every scan from 12 weeks, to screen for potential heart defects.

Please note – ultrasound itself cannot exclude all anomalies/complications that can occur during pregnancy.

In the video, Dr Ushakov demonstrates how the NT is measured using ultrasound. This video from 2011 has ~370,000 views on YouTube. Read more about Nuchal Translucency on our website.

https://www.youtube.com/watch?v=9c2LimtE2UY

Ultrasound Gel

Written by London Pregnancy Clinic on . Posted in Blog.

What is it and why do we need it? As you may remember from our post about how ultrasound works, you’ll recall that ultrasound tech utilises sound waves.

Those waves travel through the mother’s tummy and are reflected to the transducer when they reach the surface the clinician would like to examine. Ultrasound waves struggle to travel through air, so when transabdominal ultrasound is performed, we apply a gel to remove any interference from air particles in between the mother’s tummy and the transducer.

This is also the reason why in older ultrasound equipment a full bladder is required to enhance the imaging quality – this is not the case with our advanced Voluson E10!

What are the ingredients you ask? Mainly water and propylene glycol, which is substance often used in food, cosmetics and hygiene products. It is designed to be sticky to allow it to be spread on the tummy without running off.

At City Ultrasound we use a purposely designed ultrasound gel warmer to avoid the unpleasant sensation when a cold gel is applied. Because the small details matter…