By Pristine Verenga
ACCORDING to the multiple indicator cluster survey of 2019, Zimbabwe has a maternal mortality ratio of 462 deaths per 100 000 live births. That means 462 mothers die per 100 000 babies born alive.
A neonatal mortality rate of 32 deaths per 1 000 live births means 32 babies die per 1 000 that are born alive.
These figures are still too high.
There are several important tests that are used to improve perinatal health.
The ultrasound scan is one of these tests.
This article seeks to improve awareness among women of reproductive age in Zimbabwe, on the importance of getting an ultrasound scan at the right time during pregnancy.
Many families in Zimbabwe are of the wrong notion that an ultrasound scan is meant for checking the baby’s gender only, yet it is a very safe medical tool to diagnose many conditions during pregnancy and has in many instances helped save the lives of the mother and baby or babies.
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Routine pregnancy ultrasound scans
There are basically four stages at which every pregnancy should have an ultrasound scan:
Dating scan (5 weeks to 13 weeks gestation)
This is the best time to get accurate delivery date using ultrasound scan, the delivery date has an error margin less than any later times in pregnancy.
The estimated delivery date obtained in the first trimester will be used as reference in follow-up scans.
This is an advantage as the baby’s growth can be monitored well in later pregnancy. For example, if the baby is not growing well and is too small in the third trimester, it will be easily diagnosed as there is a referral first trimester, ultrasound examination to compare with.
The other advantage of this first scan is making sure that the baby is growing within the uterus and not outside it. When the baby grows outside the uterus, it is called an ectopic pregnancy which is a dangerous condition for the mother as she can bleed to death if it is not treated on time.
Screening scan (11 to 13 weeks gestation)
It is possible at this stage to diagnose certain foetal conditions, for example chromosomal abnormalities, trisomy 21 and Down’s syndrome. The sonographer will look for markers on the foetus that can best be identified at this stage. This, along with maternal blood tests, can determine the chances of the foetus having chromosomal abnormalities.
Foetal anatomical survey (19 to 23 weeks gestation)
During this scan the baby’s body parts are more visible to inspect for abnormalities. This will be a detailed examination, making sure the baby has all body parts and that they are normal. Several foetal abnormalities can be detected using ultrasound scan. For example, anencephaly which is when the baby does not have parts of the brain, skull and scalp. When such gross abnormalities are diagnosed, the family and their doctor will have to make an important decision on keeping or terminating the pregnancy.
This stage is also the best time to check for foetal gender. Other important features will also be assessed, for example the placenta’s position and the cervix of the uterus making sure it is long and closed during pregnancy.
Third trimester scan (35 to 37 weeks)
This routine scan is used to assess the baby’s growth and wellbeing and is good for preparing the mother for delivery day. From this scan, the foetal weight and final presentation can be obtained which are crucial in making a decision on how the baby will be delivered. For example, breech babies at this stage are more safely delivered by caesarean section than vaginal delivery.
Doppler ultrasound scan evaluation during pregnancy can also help assess for preeclampsia. Preeclampsia is characterised by high maternal blood pressure.
It is important for preeclampsia to be diagnosed early as it can cause serious life-threatening complications for both the mother and the baby.
- Pristine Verenga is a diagnostic medical sonographer based in Harare
