Skip to main content

Tag: scan

Choosing Your Scan

Choosing Your Scan ?

It can feel a difficult decision knowing when to book in for your ultrasound scans, but truth be told there is no right or wrong time. Whether you are seeking general reassurance, a comprehensive check of your baby’s structures or an NIPT we have scans to suit your individual needs. Your baby is developing at such a pace and week by week there is visible growth. We offer scans for each and every stage of your baby’s development so you can feel assured at every step of the way.
For the best diagnostic performance, we have created a comprehensive breakdown of our scanning options and the prime time to have them done:

?6-9 weeks – Viability Scan

?10-16 weeks – Early Fetal Scan

?20-23 weeks – Anomaly Scan

?28- 34 weeks – Baby development Scan

?36-40 weeks – Baby Position Scan

?8-40 weeks – Scan Upon Request

To find out more details regarding the above scans please check out our website which has a breakdown of everything included in each scan.

Fred Ushakov – Teaching

One of Dr Fred Ushakov’s passions is teaching and training other professionals in the field of Fetal Medicine and the applications of ultrasound screening. Prior to the pandemic Fred lectured in countries such as the US, Australia, Italy, Sweden, Peru, Egypt, Romania, Ukraine and China, where the picture below was taken. Fred has also collaborated with GE Healthcare in live masterclass demonstrations in their Brussels HQ.

During the pandemic, Dr Ushakov was one of the pioneers to start broadcasting his lectures online. His lectures are mainly focused around his field of interest of early anomaly detection and the Early Fetal Scan. In the past year alone, over a thousand ultrasound professionals have attended his courses online.

8 Week Scan in 3D

3D at 8 weeks?! ???

We always like to test the capabilities of the latest ultrasound tech. This is a real 3D image of an embryo at just 8 weeks when it is typically just 3/4 of an inch long (just short of 2cm – the size of a raspberry.)

By 8 weeks the embryo will already have tiny hands and feet as well as distinguishable fingers and toes. The respiratory system is also starting to develop at this stage and the heart is beating at a rapid rate of 150-170 beats per minute to help facilitate the exponential growth of the embryo early in the pregnancy.

The baby’s structures are too small at 8 weeks to be able to properly examine them using ultrasound. NIPT (Harmony Test) is also not reliable at this stage due to the small fetal fraction in the mother’s blood – you will have to wait until at least 10 weeks.

That’s why at 6-9 weeks we recommend coming in for a Viability Scan:

  •  Confirm the baby’s heartbeat
  •  Date the pregnancy
  •  Check for single/multiple pregnancy
  •  Check main structures of the gestational sac, which include the baby (the embryo), the yolk sac, and the future placenta

Cerebellum

Incredible shot of the Cerebellum at just 11 weeks in our recent instagram post!

This fetus is just 4cm long, but our advanced transvaginal probes are able to get this high resolution image of the cerebellum. Latin for ‘little brain’, the cerebellum is an important structure at the back of the human skull. The cerebellum is responsible for coordinating our voluntary movements, as well as motor skills, balance, coordination and posture.

It consists of two major structures namely the Cerebellar cortex and Cerebellar nuclei. Despite only being 10% of the human brain, the ‘little brain’ contains up to 80% of the brain’s neurons, mainly in the cortex. Neurons are important cells in the human body that are the building blocks of the nervous system.

You can see why it is important to check the development of the brain. Dr Fred Ushakov is a specialist in neurosonography and conducts a comprehensive examination of the brain with every scan from 11 weeks until the 3rd trimester.

The Umbilical Cord

The Umbilical Cord is an important structure, it is essentially a tube that connects the baby and the placenta. The tube usually starts developing from 5 weeks of gestation and grows until the beginning of the third trimester at ~28 weeks.

The umbilical cord consists of 3 blood lines; 2 arteries and 1 vein and basically acts as a supply line between the placenta and the baby. You can see why it is an extremely important structure as it delivers nutrients and oxygen to the baby and removes the baby’s “waste” materials.

The cord can grow up to 80cm, but the average is ~55cm, a longer cord can be associated with entanglement and possibly some complications during labour. Some potential complications in the pregnancy are related to the umbilical cord, such as Vasa Previa. The umbilical cord is cut at birth and the residual usually dries and falls off within 2-3 weeks.

In the video attached you can clearly see the umbilical cord attached from the placenta to the baby at just 12 weeks of gestation!

At City Ultrasound, the umbilical cord is just one of the important structures we check at any scan from 12 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!

We Are Moving!

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

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)

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

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]

Fetal and Maternal Heart Rates

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.