Fetal developmental abnormalities lead to serious diseases - heart defects, neural tube defects,
How technologies for monitoring the course of pregnancy have changed
For monitoring the condition of the fetus and diagnosticsmalformations from the first quarter of the XX century used X-ray. This imaging method was invented in 1885. For the first time, the technology of imaging the bone structures of the fetus using X-rays was presented in 1923 at the Ninth Annual Meeting of the Radiological Society of North America (RSNA) in Rochester. With the help of X-rays, the position of the fetus, gestational age were assessed, and pathologies in the structure of the bones were identified. The study also showed deformities in the mother's pelvis, which could interfere with childbirth. Radiography remained the main method of fetal examination until the 1960s.
But as we study the effects of X-rayson a person there were fears that they could harm the fetus. Doctors found a large number of serious abnormalities that appeared due to the frequent use of radiography in obstetrics. For example, microcephaly - a condition in which a child is born with a small head or the head stops growing after birth, a delay in fetal development has been observed.
Animal studies have shown that the embryosusceptible to radiation even in low doses, especially during early formation - from 4 to 8 weeks. By 1975, scientists had gathered evidence that radiation exposure during pregnancy caused miscarriage and had serious consequences, such as an increased risk of developing cancer in the fetus. The specialists abandoned X-rays and switched to a more convenient and safer diagnostic method - ultrasound, which developed in parallel with X-ray.
Doctors and scientists were looking for ways at the same timeimproving methods for detecting abnormalities in the development of the fetus. In the 1980s, they pioneered magnetic resonance imaging (MRI) in obstetrics, a technique discovered in 1973. The new technology has helped to obtain images faster and has become an important addition to the diagnosis of pregnancy complications. Especially those diseases that cannot be seen during ultrasound examination. MRI has proven to be particularly effective in examining fetal central nervous system developmental disorders. The method is still used today - for example, it helps in assessing lung volume in a fetus with chest abnormalities.
But the main tool of prenatal diagnostics to this day is ultrasound. Advances in technology have made the method truly irreplaceable.
Ultrasound diagnostics to guard the health of mothers and children
Ultrasound waves in diagnostics beganused in the late 1940s - 1950s. In the early 1960s, the technology also took root in obstetrics. Professor Ian Donald, who ran the Glasgow Medical Center, pioneered the development of ultrasound techniques for the management of pregnancy. In July 1955, he began experimenting with abdominal tumors in patients. He found that tissues respond differently to ultrasound and concluded that the new method could be used to examine the fetus.
Initial ultrasound examinationswas carried out using the amplitude mode. The high-frequency sound wave was transmitted to the body, the signals from the reflected wave were recorded and plotted on a graph. This method has proven to be accurate for measuring the fetal head and locating it.
In the mid-1960s in ultrasonicresearch has appeared a mode of movement. This method made it possible to visualize the work of internal organs, for example, the heart, or the movements of the fetus itself. In 1972, doctors first saw fetal heart activity using ultrasound.
Major breakthrough in ultrasound imagingoccurred in the early 1970s when a method of rendering in brightness mode was developed. Doctors obtained the first 2D images of the uterus and embryo. The signals reflected from the sensor created a monochrome image on the monitor, where each shade of gray corresponded to a certain wave amplitude. With the technical development of the brightness mode, it became possible to distinguish between different types of fabrics with its help.
By the late 1970s - early 1980s, imagingin real time replaced the static image. It made it possible to obtain a picture without distortion by movement and to conduct a more accurate assessment of the condition of the fetus. Intracranial structures, spine, kidneys, stomach and bladder became visible. Thanks to a clear picture, the parameters of the fetus were measured. But the results of ultrasound diagnostics were only available in 2D.
The next step in the development of ultrasounddiagnostics - the appearance of a 3D image. In the 1980s, 3D imaging technology appeared only for computed tomography; it was rarely used in ultrasound studies in the 1990s. Low image resolution and low speed of computer processing slowed down the development of visualization and, as a result, the diagnosis of fetal anomalies. It wasn't until the 21st century that 3D and 4D imagery finally became widely available.
What do we see during ultrasound examinations today?
Modern ultrasonic solutions allowget images quickly and accurately. High-tech prenatal diagnostics allows you to identify malformations of the fetus in the early stages, helps the doctor choose the optimal tactics for managing pregnancy and advise parents correctly. For example, ultrasound imaging with a virtual light source produces amazing photorealistic 3D images.
Ultrasound innovationopen up new possibilities in the diagnosis of the fetus in the first, second and third trimesters, increase the accuracy of early detection of malformations, give doctors even more confidence in the diagnosis and decision-making on the management of pregnancy.
Studies in early womenpregnancies are transforming right now: the processes have changed with the advent of high frequency monocrystalline linear sensors. Already at the sixth week, an embryo with a size of only 3 mm is well defined through the anterior abdominal wall. If earlier accurate data could be obtained only with the help of a transvaginal study, which caused discomfort, now a transabdominal scan (the sensor is driven over the patient's abdomen) with a high-frequency monocrystalline sensor is sufficient. Thanks to this imaging method, detailed fetal anatomy is available already in the first trimester. And by using these sensors in combination with Philips Microflow Imaging High Definition technology, you can examine the anatomy of the smallest vessels and assess whether the fetal circulatory system is developing normally.
Visualize splitting as early as possiblespina bifida, often accompanied by spinal cord defects, pelvic dysfunction and paralysis of the lower extremities, are enabled by monocrystalline sensors such as the Philips V9-2 monocrystalline volumetric sensor, which is able to provide doctors with detailed 2D, 3D and 4D images.
High resolution instrumentsallows you to study in detail the structure of organs and tissues of the fetus in the second trimester of pregnancy. Many nuances are noticeable that were not visible before or became apparent at a later date. For example, in the nineteenth week, you can get images of the septum of the nose of the fetus, the muscles of the tongue, the diaphragm. At the twentieth week, the membranes of the spinal cord are clearly defined. And at the twenty-fourth week, the root of the lung, grooves and gyrus of the cerebellum are well differentiated.
The second trimester is the most important period for assessmentcardiovascular system of the fetus. Color Doppler ultrasound can diagnose life-threatening heart conditions.
In the third trimester, the latest technologyimaging and supersensitive sensors make it possible to obtain clear and informative images of the lungs, liver, intestines. Previously, technical difficulties arose when examining women after the thirtieth week of pregnancy, since the image quality at a depth of more than 10-12 cm dropped sharply. Modern convex sensors avoid these problems and obtain a highly informative image of the fetus, even in late pregnancy.
One of the important stages of ultrasoundresearch - fetometry to assess the growth rate of the fetus and its estimated weight. These data are needed to select tactics of pregnancy management and method of delivery. Advanced ultrasound systems are able to automatically measure fetal parameters: this helps specialists and shortens the examination time.
Introduction of modern technologies into the processPregnancy management not only allows doctors to conduct examinations, but also expands opportunities in related areas. For example, Polish cardiologists under the guidance of Professor Joanna Dangel perform minimally invasive operations on the fetal heart, revealing cardiovascular pathologies at the early stages of its formation. New imaging technologies enable cardiac surgeons to capture images from multiple angles. This data helps cardiac surgeons plan fetal heart surgeries. Moreover, all interventions are carried out under the control of ultrasound.
Thanks to innovations in obstetrics in the 21st century, a new group of babies has appeared - these are children who were born healthy after heart surgery performed before their birth.
The future of ultrasound diagnostics
Pregnancy monitoring innovations are becominga universal solution for clinics around the world. They bring beneficial innovations to the entire maternal health ecosystem. Like other medical technologies, ultrasound systems continue to improve. The quality of imaging will continue to improve, thanks to which doctors now identify the smallest fetal defects in the early stages. This means that even more children will be born healthy.
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