Ultrasound scans (echography) and monitoring

Ultrasound scans

Echography is a medical imaging technique which uses ultrasound to see the foetus in the mother's womb. The procedure is risk-free for both mother and child.

Typically, a gynaecologist moves an ultrasound probe over the woman's tummy, after applying a gel to her skin. Sometimes, an endovaginal probe, inserted into the vagina, is used to view the foetus.

Women will generally have three ultrasound scans over the course of their pregnancy. Some gynaecologists will refer pregnant women to a physician specialising in echography for a second scan if needed.

The insurance fund will reimburse the cost of 3 ultrasound scans over the course of a pregnancy.

First ultrasound scan

The first scan is performed between the 10th and 13th week of amenorrhoea.

This examination enables the doctor to:

• confirm the pregnancy,
• check if there is more than one baby,
• measure the length of the baby in order to date the pregnancy,
• check the baby's cardiac activity,
• detect certain deformities or anomalies.

Second ultrasound scan

A second scan is performed between the 20th and 24th weeks of amenorrhoea. It is also known as a morphology scan.

By viewing the foetus at this stage, the doctor can perform a complete morphological assessment: a study of the foetus' shape, appearance and organs.

This second scan also allows the doctor to determine the child's sex.

During this scan, the gynaecologist or sonographer can check the following:

• the foetus' head circumference and diameter, also known as the biparietal diameter (BPD),
• abdominal circumference,
• femur length,
• presence, position and shape of organs and limbs,
• the presence of the four chambers of the heart,
• the aortic arch (curved part) and the aorta (a major blood vessel),
• the arteries.

A doppler ultrasound or echo-doppler scan can be used to monitor blood flow. The echo-doppler reveals the blood flow in the umbilical cord, which carries blood from the mother to the placenta. The placenta is an organ through which the foetus and mother are connected, by means of the umbilical cord, giving nourishment to the foetus.

Third ultrasound scan

The third scan should generally take place between the 32nd and 34th week of amenorrhoea.

At this scan, the doctor will:

• check the growth and vitality of the foetus,
• detect the location of the placenta and the baby's position (head-down, breech or transverse), which gives an indication as to the likely type of birth.

Monitoring

A foetal heart rate monitor is used to monitor the baby's heart, using cardiotocography (CTG).

The device records and monitors the foetus' heart rate and uterine contractions before and during birth.

This information can indicate foetal distress. A CTG should generally be performed once a week between the 8th and 9th month of pregnancy, up until the birth.

It is carried out, either

• at a consultation, by your gynaecologist, or
• in the maternity ward of the hospital where you will be giving birth, by a midwife, who will liaise with your gynaecologist.