Having become pregnant, a woman is burning with curiosity: how is her child developing, is everything okay with him and who is there, after all? If the new expectant mother feels well and the pregnancy is proceeding smoothly, the first visual meeting with the baby will take place at 12 weeks. What is a screening test and how screening is done at 12 weeks of pregnancy, you will learn in the article.

During the period from pregnancy to childbirth, 3 screenings are done:

• at a period of 11 - 13 weeks (the 12th week of pregnancy is considered the most suitable);
• for a period of 16 - 24 weeks;
• at a period of 30 - 36 weeks.

All women without exception in an “interesting” position will undergo the procedure. The examination program is comprehensive - consists of an ultrasound and a biochemical blood test for the level of the hormone hCG and the PAPP-A protein. Based on the presence and combination of certain markers, as well as the content of hormones and proteins in the blood of the expectant mother, experts determine the likelihood of giving birth to a child with intrauterine defects and incurable diseases. Early prenatal diagnosis makes it possible to detect the prerequisites for the development of the following pathologies in the fetus:

• Down syndrome;
• Turner syndrome;
• Cornelia de Lange syndrome;
• Patau syndrome;
• Edwards syndrome;
• disturbances in the formation of the neural tube.

It is important for the expectant mother to understand that based on the results of the first screening ultrasound at the 12th week of pregnancy, the baby will not be given any specific diagnoses. The purpose of the event is to determine the degree of objective risk of giving birth to a sick child. If these risks turn out to be alarmingly high, the pregnant woman will be prescribed a series of examinations, based on the results of which a diagnosis will be made.

The results of screening at 12 weeks of pregnancy are the most informative, so it is recommended to do the examination on time. To do this, the expectant mother needs to come to the residential complex at her place of residence and see the doctor with whom she is registered. The specialist will give the woman a referral for a blood test and an ultrasound voucher. The procedure is free.

How to prepare for screening at 12 weeks of pregnancy

The “purity” of test results can easily be distorted by natural factors, such as changes in blood chemistry or excess intestinal gases. To obtain the most accurate information, the expectant mother should prepare for the examination in a special way. For 2 days before the test, it won’t hurt to go on a diet that excludes the standard set of unhealthy foods: fatty, fried, smoked, canned, sweets. 6 hours before blood collection, which is supposed to be donated on an empty stomach, it is better not to eat anything.

2 - 3 hours before the ultrasound examination, it is necessary to use a remedy against the accumulation of gases in the intestines, which can distort the “picture”, since they significantly compress the pelvic organs. Espumisan and Smecta are suitable for pregnant women.

Screening during pregnancy at 12 weeks: procedure

Early perinatal examination requires a strict procedure. Ultrasound and venous blood donation are prescribed to a pregnant woman strictly for one day, with a minimum period of time between procedures. As a rule, first of all, the expectant mother is waited in the ultrasound diagnostic room, and then she is invited to the treatment room to draw blood for analysis. In rare cases, the examination order is reversed.

Ultrasound as part of screening at the 12th week of pregnancy is carried out mainly using a transvaginal sensor, since the second option - in the abdomen - is still not very informative and will not be able to clearly display what is happening inside the uterus.

On the morning of the screening, the examination of the expectant mother begins in the office of the obstetrician-gynecologist: the patient will be weighed, her height will be measured, and all the data will be entered into a questionnaire. In addition, the doctor will certainly talk with the woman to find out other important data:

• previous pregnancies;
• have there been any miscarriages;
• whether there were abortions;
• age;
• presence of bad habits;
• the health status of the future father;
• health status of immediate family.

The more complete the questionnaire, the more accurate the risk calculations regarding the birth of a child with disabilities.

A visit to the doctor is followed by an ultrasound, followed by a blood donation. All information received will be entered into a single form, and then, during a special program, the genetic data of the expectant mother and the results of her tests will be correlated with the established indicators of women who have a real risk of giving birth to a sick child. As a result, the patient receives an individual calculation.

How to do ultrasound screening at 12 weeks of pregnancy

During the diagnostic session, the specialist will visually evaluate the fetus, determine in which part of the uterus it is attached, and also check whether the baby has markers indicating the likelihood of developing genetic pathologies. The photo shows what a fetus looks like at 12 weeks during screening:

The expectant mother will also be able to lift the veil of secrecy and admire her child, hear the beat of his heart, watch his movements, which she herself cannot yet feel.

What does screening show at 12 weeks of pregnancy? When filling out the procedure protocol, the doctor first of all indicates how many fetuses are visible in the uterus, whether they have signs of life, and will also leave detailed information about the parameters of the fetus. Based on these dimensions, the exact gestational age is determined and it is judged whether the baby is developing correctly.

Normal indicators at 12 weeks during screening are as follows:

• the child's head circumference (CH) is from 58 to 84 mm. Most often, the average indicator is about 70 - 71 m;
• coccygeal-parietal size (CPS) - from 51 to 59 mm, most often the figure fluctuates around 55 mm;
• biparental head size (BPR) - from 18 to 24 mm, standard indicator - 21 mm;
• heart rate (HR) - from 140 to 170 beats per minute;
• fetal height - 8.2 cm;
• fetal body weight - 17 - 19 g.

In addition to these indicators, the doctor will certainly check the two most important markers for genetic diagnosis - the nuchal translucency and the presence of nasal bones in the fetus. The presence of gross pathology is usually indicated by an enlarged neck fold due to edema and a flat nose. It will not be possible to examine the remaining fragments of the facial bones at this time - they will become more noticeable in 1.5 - 2 months.

The normal nuchal translucency thickness (NT) on ultrasound during screening at 12 weeks of pregnancy should not exceed 0.7 - 2.5 mm. Slightly increased TVP indicators are a reason for a repeat ultrasound examination after 7 - 10 days. If the parameters of the collar zone are extremely high (more than 3.0 mm), the pregnant woman will be referred for additional examination, since there is a high probability of giving birth to a sick child.

Seeing the bones of the future nose is not an easy task. Firstly, they are not always formed by the 12th week of pregnancy. Secondly, the fetus often turns away from the sensor, showing its back. If you manage to take the necessary measurements, the acceptable length for the nasal bones is considered to be 2.0 - 4.2 mm.

If the doctor finds that this type of facial bone has not yet been visualized or is less than 2 mm, the risk calculation program will automatically increase the likelihood of having a baby with any of the three syndromes - Down, Patau or Turner. However, it is too early to panic, because the child may simply have a tiny and graceful nose, which technology simply cannot transfer to a screen with low resolution clarity.

In addition, during a screening ultrasound, the doctor may be suspicious of the following factors:

• blurry outlines of the face;
• one umbilical artery instead of two;
• hernia near the navel;
• slow or accelerated heart rate.

Is it possible to determine the sex of the baby by screening at 12 weeks of pregnancy?

Despite the early diagnosis, expectant mothers bombard the doctor with questions about who the ultrasound machine shows - a boy or a girl. From a theoretical point of view, the sex of a child at 12 weeks of pregnancy can be determined by screening. The external genitalia have already formed and, if the position of the child allows, the specialist can “spy” who will be born to the woman. From a practical point of view, the probability of accurately determining gender at this time is only 75 - 80%, so the patient will certainly be warned about the impossibility of any guarantees. It will be possible to accurately determine the sex of the fetus later - at 16-17 weeks.

Biochemical screening at 12 weeks of pregnancy

In a study of blood from the vein of a pregnant woman, a laboratory technician pays attention to the concentration of substances in it, such as human chorionic gonadotropin and plasma protein PAPP-A. Since both indicators are of equal importance for the examination, the first screening blood test is also called a “double test”. The results of the study will not be ready immediately; data processing will take from several days to several weeks. This depends on the number of requests for research to the medical genetic laboratory.

The results of tests carried out in different laboratories may vary slightly, since each laboratory has its own normal indicators. The main indicators of biochemical screening at 12 weeks - hCG and PAPP-A, are converted into a multiple of the median. If the pregnancy develops safely, the values ​​of both indicators fit within the range of 0.5 - 2.0 MoM.

Deviation of the level of specific substances from the norm can be due to various reasons.

Elevated hCG levels are usually observed in the following cases:

• Down syndrome;
• multiple pregnancy;
• excess body weight in a pregnant woman;
• swelling;
• gestosis;
• diabetes mellitus;
• arterial hypertension.

The reasons for the decrease in the level of hCG in the blood of the expectant mother are disappointing:

• Edwards syndrome;
• high risk of miscarriage;
• intrauterine growth retardation.

A low concentration of PAPP-A protein may indicate the following abnormalities in the development of pregnancy:

• Down syndrome;
• Edwards syndrome;
• Patau syndrome;
• Turner syndrome;
• fetal malnutrition.

If we talk about increased protein levels, then they do not have much weight during the determination of chromosomal defects. A high concentration of PAPP-A in the blood usually indicates a pregnancy with twins, triplets, or one large fetus.

Determining the risks of screening at 12 weeks of pregnancy

The interpretation of biochemical blood tests and ultrasound screening at the 12th week of the “interesting” position, as well as information about the age and health status of the expectant mother, are entered into a special program. This means that the degree of probable danger is initially determined by the machine, and then all the data is double-checked by geneticists.

Based on a set of indicators, the individual risk for each pathology is expressed in the following fractional formula - 1: 450 or 1: 1300 (for example). In our country, numbers of 1:100 are considered high, and the threshold risk is the range from 1:101 to 1:350. There is nothing complicated here. Let's say that an expectant mother has been determined to have an individual risk of having a child with Down syndrome of 1: 900. This information should be interpreted as follows: 1 baby out of 900 children from mothers with an identical state of health and age will be born with the pathology. The remaining 899 children will not have this pathology. That is, 1:900 - the risk is not high, so there is nothing to worry about.

Positive fetal screening result at 12 weeks of pregnancy: what to do

If an individual calculation for a particular genetic pathology shows a high probability of developing a deviation, the expectant mother is recommended to undergo additional examination. To get more information about the condition of the fetus, a non-invasive DNA test or an invasive test can be done. However, non-invasive DNA analysis, during which fetal blood cells are isolated from maternal blood for research, is not affordable for everyone - the study costs several tens of thousands of rubles. And even if this analysis confirms the presence of pathology, the pregnant woman will still be prescribed an invasive procedure.

Therefore, in most cases, a pregnant woman is offered amniocentesis or chorionic villus biopsy immediately. To collect biological material for analysis, special equipment is used to penetrate the fetal membranes. The procedure is certainly accompanied by an ultrasound and is performed by a competent specialist, since in any case there is a risk of infection of the fetus, leakage of amniotic fluid and miscarriage. The accuracy of the analysis is beyond doubt and is 99.9%.

When a disappointing diagnosis turns out to be real, the woman is recommended to terminate the pregnancy for absolute medical reasons and is given the appropriate direction. If the family council decides to keep the “unusual” baby, the expectant mother still has plenty of time to prepare for meeting him.

Ultrasound is one of the most important diagnostic methods during pregnancy, which, along with high indicators, is also safe. Ultrasound at 12 weeks is one of the components of screening and is recommended, since at this time a normally developing child is already clearly visible and can be assessed by some very important indicators to exclude deviations from the norm.

An ultrasound at 12 weeks of pregnancy is the first ultrasound screening and is recommended for all expectant mothers. However, for some conditions, ultrasound guidance is extremely important. These include:

• pregnant woman's age 35 years or older
• a history of stillbirths, miscarriages, miscarriages, intrauterine growth retardation, genetic abnormalities in born children, or such history data of close relatives, the presence of genetic abnormalities in relatives, marriage with a relative (within four generations)
• risk of impaired fetal development: maternal bad habits, passive smoking, stress, taking certain medications, stress, as this increases the likelihood of the child developing various abnormalities
• diseases of the pregnant woman (infectious ones, such as rubella, play a particularly important role), including chronic, previous life-threatening conditions (shock with impaired blood supply to the fetus)
• social factors that can lead to impaired fetal development: occupational costs (girls whose work is associated with hazards, such as radiation, chemicals (painters, pharmacists)), unhealthy diet, work and rest schedule.

How is the research and preparation for it going?

There are two ultrasound methods during pregnancy at 12 weeks: transabdominal (regular) and transvaginal. Transvaginal is performed by inserting a sensor into the vaginal canal and viewing the uterus and fetus from this angle.

This method is used from the very first weeks until the 14th week of pregnancy. The method is more harmful and less comfortable than the transabdominal one, so it is used only when indicated:

• pain in the lower abdomen (hypogastria)
• bleeding from the uterus
• the appearance of regular full menstruation
• tumors of the female reproductive organs
• surveillance for other diseases

A more convenient and safe method for both the doctor and the expectant mother is transabdominal ultrasound. The ultrasound sensor of the device, pre-lubricated with gel, is installed directly on the anterior abdominal wall of the pregnant woman.

This method is also good because it does not require preparation. The only condition is to drink 2 glasses of non-carbonated liquid (water, juice, green tea, etc.) an hour to half an hour before the test procedure. At the same time, the transvaginal ultrasound method requires a diet for 2-3 days (depending on the functioning of the intestines individually): you need to adhere to a diet that excludes gas-forming foods, such as legumes, cabbage, white bread, and sweets. If, however, there is still a feeling of bloating, then it is necessary to take a sorbent drug that will not harm the child in any way.

Research results: transcript

First of all, when interpreting a screening ultrasound, attention is paid to the location of the fetus to exclude ectopic pregnancy. It is very important to determine the size of the uterus. The general condition of the fetus is assessed. After this, the size of the unborn child is measured, and the condition of the internal organs is assessed (the activity of the cardiovascular system, the location of organs). In addition, at this time it is already possible to find out the gender of the unborn child, although this will not yet be as accurate as possible.

Normal indicators during ultrasound examination, deviations from normal indicators

Fetal screening at 12 weeks of pregnancy is the first and most interesting ultrasound for the mother. At week 12, a fairly highly formed person appears for review. He has almost all the muscles that he learns to move to move, and he becomes very restless, the internal organs are well formed to be able to evaluate them and are anatomically almost identical to those of adults.

The face takes on a human appearance, the child has facial expressions and on an ultrasound scan he can make grimaces, vellus hair appears in place of the eyebrows and eyelashes, and clear ears with lobes appear. The little man can clench his fists and have marigolds on his fingers. He can already swallow fully, but so far only amniotic fluid. At 12 weeks it is already possible to determine the sex of the child, although errors may be made up to 16 weeks.

The 12th week of pregnancy is the most important for screening and ultrasound diagnosis of the baby’s condition. After all, it is at the 12th week that it is possible to fully assess the physical condition of the baby. That is why, at the 12th week of gestation, perinatal screening is prescribed for the first time in all examinations. What is screening? This is a comprehensive examination during which the doctor collects a list of indicators of the child and mother, possible deviations from the norm, in order to exclude intrauterine pathologies.

What is included in the list of parameters for the first intrauterine screening?

The first thing they do is a three-dimensional ultrasound of the fetus. This method allows you to fully assess the appearance of the baby and compare his anthropometric data with regulated standards. At week 12, the baby’s body length should be 6-9 centimeters. Since the skin of the fetus is “transparent” for an ultrasound machine, it is possible to examine not only the condition of the limbs and face, but also the activity and location of the internal organs.

What does a doctor want to see on a 3D ultrasound:

• construction of hemispheres and brain structure (the norm is when a child’s brain shape resembles a “butterfly”)
• location of internal organs such as heart, kidneys, liver, stomach, intestines, rotation of internal organs.
• condition of blood vessels. Particular attention is paid to the umbilical cord (the correct structure of the umbilical cord lies in its composition: two arteries and one vein).
• detection of heart defects and pathologies of kidney development.
• external signs of genetic diseases (for example, trisomy 21, or Down syndrome or disease)
• localization of attachment of the unborn child to the uterus (norms - anterior and posterior walls), size of the cervix and body of the uterus (maximum permissible size - up to 30 mm)

Body parameters norms:

• The weight of the fetus should be 9-13 grams
• Fruit length – within 6-9 cm
• Parietococcygeal size 50-85 mm
• Biparietal (interparietal) size of the fetal head is 21 mm
• Chest (girth) 24 mm
• Femur length 9 mm
• Nasal bone of at least 3 mm (smaller bone may be a sign of a genetic disease: Edwards syndrome)
• The thickness of the collar zone is 1.6-2.2 mm (thickening may indicate the development of Down syndrome)
• Heart rate 150-170 beats per minute
• The symmetry of the limbs and the longest bones is also assessed
• Fetal abdominal circumference is measured

Screening for a biochemical blood test of a woman during pregnancy is also very important. The hormonal background of the expectant mother can directly indicate the condition of the fetus in such a way that changes in the hormone beta-hCG and PAPP-A protein from the norm can indicate various genetic diseases.

Beta-hCG: norm 20,000-90,000 mIU/ml (these indicators must be taken into account when abnormalities are detected on screening ultrasound, for example, an increase in the thickness of the collar zone - suspicion of the development of Down syndrome)

Conclusion

Ultrasound at the 12th week of pregnancy is one of the most important components of screening during pregnancy, which allows the most objective and informative assessment of the condition of the developing fetus for the presence of chromosomal abnormalities and other physical development disorders and deviations from the norm. The results of such screening studies are necessary to formulate further recommendations for the management of pregnancy and the development of a healthy child.

The first trimester of pregnancy is coming to an end. You can breathe a sigh of relief - the most dangerous risks are behind you. It is at this time that pregnancy reveals itself with a slightly rounded tummy, and the woman is ready to tell all her family and colleagues about her happiness.

At this time, the woman begins to feel better and registers at the clinic, where she and the baby will now be under the strict supervision of their doctor, a gynecologist.

The 12th obstetric week is the last week of the 3rd month of pregnancy, the first trimester.

What happens to the expectant mother at 12 weeks?

At this stage, the woman begins to feel a little different than in the first trimester of pregnancy. If toxicosis tormented her in the early stages, now it has either completely disappeared or has become a very rare guest. Frequent constipation is becoming a new unpleasant phenomenon, so you need to be especially careful about your daily diet. During this period, it is advisable to adhere to the regime in everything; rest and nutrition should be adequate.

Strict regime and proper nutrition

You need to start eating right from the very first day of pregnancy. Indeed, in a sense, the future of the long-awaited baby depends on this. You need to try to follow the regime, not to overeat, not to overeat before going to bed. Otherwise, this is fraught with discomfort and frequent visits to the toilet.

Try to eat more fiber. During pregnancy it is more necessary than ever. Now the child takes almost all the beneficial nutrients and vitamins from the mother’s body, and fiber is very important for him. It is rich in fresh vegetables and fruits.

To protect yourself from indigestion, heartburn, constipation and other unpleasant problems associated with digestion, you must completely refuse sparkling water, store-bought juices and say “no” to fast food. It is best to drink regular purified water, at least two liters per day. Regular drinking water helps food to be better absorbed and normalizes intestinal function.

Baby development at 12 weeks

The child’s height is already about 60 mm, which is comparable to the size of a small lemon. The embryo is 10 weeks old from conception and already looks completely like a little person:

• arms and legs are fully formed, although still a bit small;
• the head is still slightly larger than the body;
• The child’s body length is about 60-80 mm, weight – 10-15 grams;
• internal organs are fully formed;
• the child has already developed eyelids and earlobes;
• little fingers have already grown marigolds;
• the brain was divided into two hemispheres.

The baby is already urinating and swallowing the water around him. In addition, he has learned to make some movements: clench his fists, open and close his mouth, he already has quite lively facial expressions, now he can make faces, wrinkle his cute lips, and most likely he already knows how to think.

Hello baby! Screening and first ultrasound

Now is the time to donate blood for biochemistry and go for an ultrasound examination. At this stage, absolutely all examinations are safe for the expectant mother and baby.

Screening in the first trimester is very important. It is he who helps to determine possible congenital pathologies of fetal development: disorders of the rudiment of the central nervous system, the presence of Down syndrome, Edwards syndrome and other abnormalities.

Screening includes a biochemical blood test and ultrasound examination. The time frame for its implementation is limited to 10-14 weeks. It is believed that the ideal time is 11-12 weeks of pregnancy.

Ultrasound: norms and interpretation

The woman is looking forward to her first scheduled ultrasound with great anticipation. After all, she will finally see her little one and find out about his state of health and development. Ultrasound measures the child's height (CT), the circumference of his head, the length of the femur and humerus, the size of the nasal bone, and heart rate. Sometimes at this time they even provide preliminary information about what the gender of the child will be.

Based on the CTE indicators and other measurements, the first ultrasound can indicate the exact number of weeks from conception (fetal age).

Fetal development norms according to ultrasound

Fetal age	KTR	BPR	Heart rate	TVP	Nasal bone
10 weeks	31-41 mm	14-20 mm	161-179 beats/min	1.5-2.2 mm	determined impossible to measure yet
11 weeks	42-50 mm	13-21 mm	153-157 beats/min	1.6-2.4 mm	determined impossible to measure yet
12 weeks	51-60 mm	18-24 mm	150-174 beats/min		more than 2.5 mm

In deciphering ultrasound results, the most important parameter is TVP (thickness of the collar space. By its value, the doctor can assess the risks of developing genetic pathologies of fetal development.

Biochemical blood test

This analysis provides information about the amount of certain hormones in the mother’s blood, which can be used to judge the development of the fetus. The most important of them are: hCG and PAPP-A.

From the first days after conception, the hCG hormone constantly increases and reaches its maximum by the 12th week, after which its amount in the blood decreases and remains unchanged throughout the rest of the pregnancy. PAPP-A is produced by the placenta and its value corresponds to the duration of pregnancy.

What does a deviation from the norm indicate? Decoding

A low hCG level may mean a threat of miscarriage and a risk of developing Edwards syndrome. A significant deviation from the norm to a lesser extent often indicates a frozen pregnancy. An elevated hCG value may indicate the presence of Down syndrome in the fetus. However, do not panic, as a high level of this hormone can also indicate a multiple pregnancy. In addition, its high level is recorded in a number of other cases: the presence of diabetes mellitus in the mother, severe toxicosis, maternal obesity, etc.

Reduced levels of PAPP-A also indicate a risk of fetal developmental disorders. Its increased amount is rare and is quite normal.

By comparing the results of ultrasound and blood biochemistry with established standards, and also taking into account the peculiarities of pregnancy (second pregnancy, multiple, late), the doctor can draw conclusions about how the child’s intrauterine development proceeds.

Frequently asked questions on the forums

Q: Can they tell the sex of the baby on an ultrasound at 12-13 weeks?

O.: They can. But you need to understand that this is only a prognosis, since the child’s sexual characteristics are still at the very beginning of development. The accuracy of such a forecast is usually no more than 60%. Much also depends on the experience of the specialist.

Q: Until how many weeks can you sleep on your stomach?

A: You can sleep on your stomach as long as you feel comfortable. The child is well protected and this will not harm him in any way.

Q: What vitamins should you take at 12 weeks of pregnancy?

A: During pregnancy, folic acid and vitamin E are very important. You should start drinking folic acid from the 1st week of pregnancy. Vitamins A, C and D are also important. It is better to get them from foods, so they are better absorbed. At week 12, vitamin C is important for the mother; if it is deficient, stretch marks appear in the body and the risk of developing varicose veins increases.

General condition and mood of the woman

Mood swings accompany a woman throughout pregnancy. The end of the first trimester is no exception. You shouldn’t be surprised that a couple of minutes ago tears were welling up in your eyes, but now your mood has lifted, you couldn’t find a happier person and life is wonderful. This is quite adequate behavior for a woman expecting a baby at 12 weeks.

The hormone progesterone continues to be actively produced, which can cause troublesome discharge. They become thicker and more abundant, this is quite normal.

A change in the color of the discharge from milky or light beige to yellow may indicate infection or inflammation. Pinkish, brownish and bloody discharge is a reason to panic. Their presence may be associated with the threat of miscarriage and placental abruption. In this case, you should immediately consult a doctor.

At 12 weeks, if the pregnancy proceeds calmly and without complications, and if the doctor allows, you can start gymnastics for pregnant women. Very often it is carried out in special courses for future parents. This will improve your overall condition and lift your mood.

Don't forget to rub your belly and talk to your baby. The child already feels that he is loved and treated with warmth and affection. It also helps normalize the mood of both mother and baby.

At this time, many women switch to loose clothing; pants with elastic take pride of place in their wardrobe. This is because the uterus, whose dimensions have reached 10 cm, does not fit in the pelvis and extends into the abdominal cavity. Changes also occur in the breasts. It fills up and noticeably increases in size. Now is the time to buy a comfortable cotton bra. Its rapid growth can cause itching and cause stretch marks. Therefore, in the store, along with new things for pregnant women, it is worth buying stretch mark cream.

A dark stripe may appear on the abdomen, and age spots may appear on the body. There is no need to worry about this. After the baby is born, everything will return to normal.

The second trimester is considered the safest stage of pregnancy. Therefore, you should fully enjoy your amazing state: walk more in the fresh air, watch interesting and funny films, go shopping and delight yourself with new clothes, spend more time with your beloved husband and future daddy, come up with a nursery design. A pregnant woman actually has a lot to do, so there is no time to be sad.

Pregnancy is a magical time for every woman. Just imagine, two hearts beat inside one person. Isn't this a real miracle?

Week 12 has arrived. The first trimester is coming to an end. You can tell your family and friends about your pregnancy; from now on, the risk of spontaneous abortion is significantly reduced. At the antenatal clinic, doctors prescribe screening. This study is aimed at identifying fetal pathologies and possible genetic abnormalities in development.

Routine screening includes: ultrasound (ultrasound) and biochemical blood test.

Until this moment, the uterus was flat and small in size, at 12 weeks it takes the shape of a pear, the diameter of the uterus is approximately 12 cm. The nausea stops, this is due to the fact that it resolves. The placenta is now responsible for the growth and development of the child. The risk of miscarriage is reduced.

The body works with greater force, so blood pressure may be slightly elevated and heart rate may increase. There is more amniotic fluid, the abdomen begins to grow rapidly, and the uterus rises into the abdominal cavity. Frequent urination is no longer a concern.

As the belly grows, weight gain begins. Over the past weeks, it is normal to gain up to 3.5 kg. Strong weight gain is undesirable. On average, you can add 350 grams every week.

Pigment spots may appear on the face, a dark line from the pubis up to the navel, and the halo around the nipples will become darker. All this is normal and will go away after childbirth. Acne may also appear due to hormonal changes.

During this period, many pregnant women suffer from frequent heartburn. A “no fatty or fried” diet and dividing meals into small portions can help.

There is irritability and excessive emotionality.

What's going on inside? How does the child feel?

All the child’s organs are formed. From now on they will only develop and improve.

The following changes occur in the baby’s body:

• the top layer of skin peels off;
• the thyroid gland produces iodine;
• nails appear on the fingers;
• the kidneys begin to work;
• The pituitary gland produces hormones, the liver produces bile;
• the nervous system is working.

The child can suck a finger, move actively, respond to touches on the stomach, noise, but the expectant mother does not feel this yet. The baby may feel pain, facial features take shape. The fruit is the size of a lemon (weight 14 grams, height 12.5 cm) and becomes like a small person.

Screening ultrasound at 12 weeks

The first screening can be carried out from 11 to 13 weeks of pregnancy. Week 12 is considered the optimal period for ultrasound diagnostics. If screening is done earlier or later than this period, the results may be unreliable.

Screening consists of an ultrasound procedure and a biochemical blood test. First, an ultrasound is performed, then blood is taken from a vein, since if pathologies are detected by ultrasound, the results of blood tests will give a complete picture.

In some cases, blood sampling may not be necessary. For example, in case of a frozen pregnancy or if the fetus has abnormalities incompatible with life.

Recently, this examination has become mandatory and is included in the pregnancy management plan, but there are risk groups that need to be examined more often.

Additional research is needed if:

• previous pregnancies ended in miscarriage (2 or more times);
• the family already has children with Down or Patau syndrome (etc);
• have relatives with genetic diseases;
• in the early stages the woman took medications prohibited during pregnancy;
• woman over 35 years old.

The ultrasound procedure can be performed in two ways:

• transvaginal;
• transabdominal.

In the first case, a thin sensor is inserted into the vagina. This type of ultrasound does not cause pain, but it can be a little unpleasant. Does not require any preparation.

In the second case, the sensor will be moved along the lower abdomen. It is necessary that the bladder is full. Before the procedure you will need to drink about a liter of water. The water should be still. You should not go to the toilet 3-4 hours before the examination.

How does Screening Ultrasound differ from regular ultrasound?

The procedure itself is no different. This can also be done using a sensor. Screening ultrasound is performed for early detection of fetal pathologies at a specific stage of pregnancy. If deviations are found, it is necessary to find out whether treatment is possible.

In other cases, an ultrasound may be prescribed to confirm or refute the diagnosis. It is also possible to conduct additional research at the request of the parents if during routine screening it was not possible to determine the sex of the child.

What does an ultrasound show at 12 weeks of pregnancy?

There are several indicators that the doctor examines. The most important is TVP. The thickness of the collar space is the thickness of the soft tissues around the neck. The norm is considered to be no more than 3 mm. If the indicator is elevated, this may indicate possible pathologies.

Another important indicator is KTR (coccygeal-parietal size).

To determine deviations, these two quantities are required. Measuring TVP makes sense for CTE sizes of 45–85 mm, so it is important to screen no earlier than 11 and no later than 13 weeks.

Increased TVP indicators are not yet a reason to panic. After an ultrasound, blood is donated for biochemistry, the results of which make a conclusion about the health of the fetus.

Main fetal examination indicators:

• TVP (thickness of the collar space);
• KTR (coccyx - parietal size);
• Nasal bone;
• HR (heart rate);
• biparietal head size;
• LZR (fronto-occipital size);
• DB (hip length);
• OG (chest volume);
• AB (abdominal volume).

Things that may cause concern:

• the size of the nasal bone is smaller than normal;
• facial features are smoothed;
• the nasal bone is not defined;
• instead of two umbilical arteries, one;
• umbilical hernia is visible;
• heart rate is reduced;
• frequent heartbeat.

The child is completely included in the frame, his face and body have acquired their usual shapes. He is still too small, so he often changes his position in the uterus. Sexual characteristics are formed, but determining gender is difficult. This can be done at a later date.

In addition to the baby, the ultrasound examines everything that surrounds him, as well as the condition of the mother. The doctor evaluates:

• uterine tone;
• cervical length;
• condition of the placenta, its localization, thickness, size and composition;
• condition of the internal pharynx;
• degree of transparency of amniotic fluid, its quantity.

Blood test

After the ultrasound, a blood test for biochemistry follows. Blood is drawn from a vein. Here, free beta-hCG and protein-A, hormones associated with pregnancy, are tested.

Each week has its own hCG level. Pregnancy test strips work on the same principle - they measure the level of this hormone. Elevated hCG levels at week 12 may be a consequence of toxicosis, multiple pregnancy, or Down syndrome in the fetus. A reduced level of the hormone may indicate developmental delay, fading of pregnancy, and the risk of spontaneous abortion.

High levels of protein-A do not provide any information for diagnosis; a reduced level may indicate, or be observed in the presence of Edwards, Cornelia de Lange, or Down syndrome.

When analyzing the results, doctors use a coefficient such as MoM. The normal level is 0.5–2.5, for a singleton pregnancy, for a multiple pregnancy the figure is higher - 3.5.

The results are influenced by:

• multiple pregnancy;
• taking progesterone;
• woman's weight;
• diabetes mellitus;
• psychological state;
• threat of miscarriage

• 11 weeks – 17.4–130.4 ng/ml (median 47.73 ng/ml)
• 12 weeks – 13.4–128.5 ng/ml (median 39.17 ng/ml)
• 13 weeks – 14.2–114.7 ng/ml (median 32.14 ng/ml)

• 11 weeks – 0.46–3.73 mU/ml
• 12 weeks – 0.79–4.76 mU/ml
• 13 weeks – 1.03–6.01 mU/ml

Interpretation of ultrasound at 12 weeks of pregnancy

The ultrasound report mentions:

• Uterus- this is a “bag” of muscles, the contractions or tension of which are called the tone of the uterus. If the tone is increased, the doctor will prescribe appropriate therapy. This moment cannot be missed; increased tone can lead to...
• Cervix in addition to holding the fetus, it performs the functions of protection against infections. It should be elastic and dense. Only by the 37th week, when the body begins to prepare for childbirth, will it become softer and shorter.
• Zev located on the border of the uterus and the cervical canal, which is located inside the cervix. The throat must be closed. The doctor should pay special attention to the internal os if previous pregnancies ended in miscarriage. A pharynx diameter of more than 1 cm may indicate isthmic-cervical insufficiency.
• Aminiotic fluid protects the fetus from infection and external influences. For control, the amniotic fluid index is used, it is measured in mm. He talks about the amount of water. Each week of pregnancy has its own index and its possible fluctuations. The liquid should be clear. Low water and polyhydramnios indicate possible deviations.
• Placenta at 12 weeks it is not yet fully formed, however, now the fetus receives all the beneficial substances through it. In conclusion, the doctor will indicate the place of its attachment to the wall of the uterus. Also at this time, the degree of maturity of the placenta is determined. There are only three of them. For a short period of time, the norm is zero degree. Thickness is measured at its thickest point.

At this time, screening is supposed to be carried out, including an ultrasound examination and a biochemical analysis of the woman’s blood, which is why the name “double test” is assigned to it. An ultrasound scan at the 12th week of pregnancy should not be postponed until a later period, as you may miss any emerging pathology. At the initial stages, defects can often still be corrected, therefore, the sooner screening is carried out, the better. It is extremely difficult to see the sex of the baby at this stage.

Goals and indications for diagnosis

During the entire pregnancy, a woman must undergo screening, including ultrasound diagnostics, at least three times, once every trimester. If there are indications, additional examinations are done, for example, before birth, the presentation and position of the fetus are examined on an ultrasound scan in order to choose tactics and strategies for labor management.

Prenatal screening is carried out in 2 directions - ultrasound examination and biochemical analysis (human chorionic gonadotropin and a number of other indicators are analyzed) with their subsequent interpretation. For this reason, it is also called "double dough". But such screening is carried out only when indicated. These include:

• the age of the expectant mother is more than 35 years;
• the presence of disorders in the genetic apparatus of a previously born child;
• family history of chromosomal diseases;
• stillbirths in previous pregnancies;
• intrauterine infection during previous pregnancies;
• physiological characteristics of a woman, as well as some other indications.

This is an absolutely safe study, both for the fetus and for the expectant mother. But you shouldn’t abuse it, since everything has its own timing and indications.

A doctor may prescribe mandatory screening for a pregnant woman in a number of cases. Among them are late pregnancy, chromosomal hereditary diseases in the family, a history of a born child or an interrupted pregnancy with pathologies of fetal development

What indicators are being examined?

During the ultrasound procedure at 12 weeks of pregnancy, the doctor evaluates indicators such as:

1. The umbilical cord - its condition and the presence of a vein with two arteries in it. With Edwards syndrome, only one artery will be displayed on the device’s monitor.
2. Condition of the cervix, as well as its walls. Normally, the length of the neck is more than 30 millimeters. If the doctor finds that it is shorter, then it is advisable to treat in a hospital setting and prescribe the woman to bed rest.
3. The place where the baby attaches to the placenta. Options for the location of the so-called “baby spot” on the bottom, back or front wall of the uterus are considered normal. In the case of central placenta previa, the recommendation to perform a cesarean section is quite reasonable.
4. Fruit size. The length of the child’s body, the size of his head and some of the main bones are analyzed.
5. To monitor the normal development of the fetal nervous system, the symmetry of the cerebral hemispheres is monitored. If a child is formed correctly, then his brain looks like a butterfly. With an asymmetrical image, we can talk about a possible disorder in the chromosomal apparatus, namely triploidy.
6. The location of the child’s main organs is determined - heart, kidneys, stomach, liver, and so on. It is very difficult to identify its gender at such early stages.
7. This screening also includes an assessment of the correct formation of brain structures. For example, with a defect of the genetic apparatus such as triploidy, Patau syndrome and a number of other defects, the child experiences a disturbance in the structure, up to division into sections.

Deciphering the results should be trusted only to specialists, as they have sufficient competence, thereby minimizing the risk of error. Usually such screening is done in specialized centers with good equipment. The ultrasound is performed by a doctor of the highest category who has undergone special training. The biochemical screening is deciphered by a geneticist.

The biochemical analysis of a pregnant woman’s blood is deciphered by a geneticist, who takes into account all factors of blood characteristics. The results are communicated to future parents and may influence the further direction of pregnancy management

Sex determination at this stage

The sex of the baby at this stage cannot always be determined, since the differences are barely visible. But sometimes it is possible to notice a developing scrotum (if it is a boy) or 4 parallel lines (in girls). There is also the option of differentiating sex by the genital tubercle - if the angle is less than 30 degrees, then parents need to wait for the birth of a girl.

In most cases, the sex of the fetus becomes known at the second ultrasound, when the baby is better formed. Some children turn away from the sensor, making it difficult to determine their identity. Also, the reliability of the results depends on the thickness of the woman’s abdominal wall, the quality of the equipment, the competence of the doctor and other factors.

The sex of the embryo is determined at the moment of conception and depends on the father, since male reproductive cells - sperm - can carry both XY and XX chromosomes. If an XX sperm penetrates the egg, then a girl will be born, and if XY, then the sex of the baby will be male.

As for errors in sex determination during ultrasound, this usually occurs when the embryo is reported to be male. In this case, during the examination, the umbilical cord loop is taken as the boy’s scrotum and penis.

Completion of the procedure and standard results

The first ultrasound is usually done transvaginally, although an abdominal method is also possible. In the first case, the woman is asked to bring with her a clean diaper and towel, as well as a disposable condom. The pregnant woman takes off her underwear and lies down on the couch, and the doctor inserts a small narrow sensor into her vagina with a condom on and conducts an examination. Abdominal method - a special sensor is passed through the belly of the expectant mother, lubricated with a special substance, and the image is transmitted to the monitor.

Before any examination, you must first carry out hygiene procedures and wear clean and tidy underwear. If the ultrasound is performed using the abdominal method, then 30 minutes before the ultrasound the woman needs to drink about 0.5 liters of water.

When conducting a diagnosis, the doctor writes down all the results in a special document, and a protocol is drawn up in which the identified violations and suspected defects are recorded. After this, they move on to decoding and comparison with normal indicators. So, the weight of the fetus should be from 9 to 13 grams, length - from 6 to 9 centimeters. Other options include:

• KTR (coccygeal-parietal size) – normally 51-81 mm.
• TG (chest volume) of the child is about 24 mm.
• BPD (biparietal size) – 21 mm. This indicator allows you to estimate the size of the baby's head.
• Thigh length – 9 mm.
• The thickness of the collar zone (collar space) is 1.6-2.5 mm. If this criterion is significantly deviated from the norm, then Down syndrome can be suspected.
• The shape and size of the nasal bone is normally more than 3 mm. This parameter is also used to diagnose Down syndrome.
• The fetal heart rate (heart rate) should be 150-174 beats per minute.

What might be discovered?

Using screening, you can identify such serious defects as Down syndrome, Edwards syndrome, Patau syndrome, Turner syndrome, as well as triploidy. They appear on the monitor in a special way.

For example, in Down syndrome, Doppler measurements record changes in the blood flow velocity curve through the venous system. A visual examination reveals a shortened upper jaw and a short nose in the child.

To identify some hereditary diseases and defects, Doppler measurements are also performed. On the monitor, the doctor sees changes in the speed and direction of blood flow and compares these data with the norm

If the fetus has Edwards syndrome, then already in the early stages there will be a noticeable delay in development, as well as bradycardia, that is, a slow heartbeat. The nasal bones are not visible; instead of two arteries, only one is found in the umbilical cord.

In the case of tachycardia (rapid heartbeat) of the fetus, combined with its slow development, malformations of the brain and abnormal enlargement of the bladder, we can talk about Patau syndrome. This is a common disease that is characterized by trisomy 13. Turner syndrome is diagnosed with tachycardia and developmental delay.

With triploidy, signs such as bradycardia, cysts, asymmetry with developmental delay, dilation of the renal pelvis and omphalocele (umbilical hernia) are observed. Anomalies of the telencephalon - holoprosencephaly - are also possible.

What to do next?

Even if fetal defects are detected, do not panic. Minor violations can be easily corrected. If a decision has been made to terminate the pregnancy, then for medical reasons it can be carried out until the 20th week. If parents decide to keep their baby, then it is more important than ever for them to follow all the doctor’s recommendations and instructions.

A pregnant woman should not worry, as stress negatively affects the baby. It is necessary to establish a work and rest schedule and avoid overload. It is worth taking vitamin and mineral complexes as prescribed by your doctor, and eating more fresh fruits and vegetables. If the sex of the baby is already known, then you can prepare for his birth by preparing everything you need - rompers, stroller and crib, toys, diapers, and so on.

If the doctor has prescribed any additional tests, then you should not neglect them or be nervous. Sometimes they are needed simply to make sure that the child is developing normally. There is nothing wrong with screening. Perhaps they will advise you to go into conservation, where the woman will be under observation. Doctors will do everything necessary to ensure that a healthy and strong baby is born to an equally healthy mother.