My Ultrasound

Today is the 5th anniversary of the one and only ultrasound I have ever had during both of my pregnancies (not counting the numerous Doppler u/s to check the baby’s heartbeat prenatally and during labor, which I didn’t realize at the time was ultrasound). One of the cool things about midwives (at least, the midwives I’ve chosen, although perhaps not most/all midwives are like this), is that they didn’t act as if my medical record were somehow a secret file that I shouldn’t know about. In fact, as I reached the end of my pregnancy, they gave me a copy of my whole record up to that point (and copied the most recent page at every visit, to make sure my record at home was as complete as theirs), just in case I needed to go to the hospital without them — that way the hospital personnel would have my complete prenatal file, if they had any questions or needed any clarifications. So, I have a copy of the ultrasound exam, both the hand-written scrawl of the doctor as well as the type-written one from that information. Just for kicks, I’ll put both of them up, so you can see the notoriously horrible “doctor’s scrawl”, as well as the one you can actually read.🙂

u/s scrawl

u/s typed

I’m not totally sure what the different abbreviations are, but will comment on most of them anyway. I think it’s funny that “Indication” says that the baby is LGA or Large for Gestational Dates; however, the estimated fetal weight was 7 lb 3 oz at 37w5d, and his birthweight (nearly two weeks later) was 7 lb 5 oz. So they were both wrong; and unless I’m greatly mistaken, 7.5lb is about normal for a full-term baby. There was “none” comparison because I hadn’t had any other ultrasound; he was correct that there was one fetus who was in cephalic position. “BPD” is biparietal diameter — the measurement of the top of the baby’s head from side to side. I wasn’t sure about FL, HC, and AC, so looked it up — femur length (which I guess correctly), head circumference and abdominal circumference. As you can see, he estimated “GA” (gestational age) from each of those different measurements (I presume there are some sort of averages the computer is programmed with), and came up with remarkably consistent dates to each other as well as my actual due date — in fact, they are identical. But notice that it says “+/- 22 days” — three weeks give or take, from the ultrasound’s best estimate. This is why you should be wary of late ultrasounds used to determine your actual due date, particularly if they overthrow previous due dates based on accurate ultrasounds, known date of conception, regular menstrual periods, etc.

Not sure what the CI is that is 85%, but the rest of the things are ratios of the previous measurements, and are all within NR (normal range). “WNL” means “within normal limits” (had to look that one up too!); and the rest looks pretty straightforward — checked to make sure that the baby had kidneys, bladder, stomach, etc.

Note that the AFI (amniotic fluid index) is 19.8cm, which the “impression” says “is high for this gestational age.” I’ve read that a normal AFI is anywhere between 5-25 cm, so not sure why 19.8 is high. I guess it’s still within normal parameters, even if most babies/mothers do not have this much at 37 w 5 d?

The reason for the u/s was that my midwife, at that day’s appointment, thought she heard two heartbeats. She spent probably 90 minutes with me that day, with a large portion of the time trying to ascertain for sure that she was hearing only one heartbeat — at one point, she called in her labor assistant (who ended up being the one who was on call when I went into labor), and they were both listening to my belly, with an EFM aimed at one quadrant and the Doptone or fetoscope or whatever aimed at the other quadrant where she was also hearing a heartbeat loud and strong, and both were tapping their fingers in time with the baby’s heartbeat, trying to see if it was indeed one baby (just echoing), or two babies with two heartbeats. Not being able to satisfy the question to her liking, and being unwilling (or perhaps legally unable) to attend a twin homebirth, my choices that day were to have an ultrasound or plan a hospital birth. Oh, yeah, big choice. I weighed my options for like half a second.😉 Anyway, after the u/s was complete, she said that it was probably the extra fluid that allowed the baby’s heartbeat to echo and sound like two different heartbeats.

One Response

  1. CI is cephalic index. I had to look that one up!
    http://www.fetalultrasound.com/online/text/3-172.htm

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