Siegfried Rotmensch, MD, and his team at Cedars-Sinai are using high-resolution ultrasound equipment to screen for fetal abnormalities within the first trimester of pregnancy.
Women's and Children's Health
A Revolution in Prenatal Care
by Deirdre Ezra - September 29, 2009
When most people hear the term “high-resolution”, they imagine things like flat screen televisions or vacation photos snapped with a digital camera. But for Cedars-Sinai’s Department of Obstetrics and Gynecology, high resolution is now a key feature of ultrasound equipment. The technology makes it possible to screen for fetal abnormalities in the first trimester of pregnancy—a mere 10 weeks after conception.
Ultrasound technology, the streaming of high-frequency sound waves into the body to produce dynamic images of internal organs, is best known for its role in prenatal diagnostics. During the test, clinicians pass a small instrument called a transducer over the abdomen to generate images of developing fetuses in the womb. Parents anxiously await the results of these ultrasound tests, which are often the first indication of the health of their child.
Although second trimester diagnosis (18-20 weeks) has been the norm for the past two decades, “anomalies of the fetus can actually develop as early as two weeks after fertilization,” says Siegfried Rotmensch, MD, director of the Division of Maternal-Fetal Medicine at Cedars-Sinai Medical Center. “In the past, though, babies had to be large enough for physicians to pick up the anomalies with an ultrasound transducer.”
Not anymore.
The new generation of ultrasound equipment is transvaginal—a small device is inserted directly into the vaginal canal, enabling physicians to view the fetus from only an inch away. Because the equipment is capable of producing images at a resolution that far exceeds that of a regular ultrasound, one can clearly view the development of key organs like the brain, spine, and heart in great detail at only 12 weeks gestation. “With transvaginal ultrasound, we frequently can see more in the first trimester than we can in the second trimester, using traditional ultrasound,” says Dr. Rotmensch. “The high-resolution technology will help us diagnose and possibly address problems two months earlier than we used to.”
The benefits of this new technique to parents are numerous. It is particularly useful when evaluating overweight mothers, who aren’t always able to obtain a good image of their baby via traditional ultrasounds performed over the abdomen. Early diagnosis can also bring peace of mind to parents with health concerns at a much earlier stage of pregnancy, or help them make informed decisions about their pregnancy sooner rather than later. This is particularly important when lethal or untreatable fetal anomalies requiring further management are identified.
While promising, this complete fetal anatomic survey by transvaginal ultrasound is still in its early stages: Cedars-Sinai is one of only two hospitals in the U.S. to offer it to interested patients within the first trimester of pregnancy. Dr. Rotmensch and his team are hopeful that it will become the new standard of care for prenatal ultrasound at Cedars-Sinai.
“We are at the beginning of a conceptual change in the way we assess prenatal diagnosis,” says Dr. Rotmensch.
Copyright 2009, Cedars-Sinai.
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