First trimester
In our practice, a differentiated ultrasound is always carried out as part of the ETS instead of a simple ultrasound basic screening. As part of this we look at your child from head to toe. At the end of the first trimester, eyes, eye lenses, ears, Kidneys, fingers, toes and many other details can be shown. The brain system can be assessed just like the heart. However, early organ diagnostic limits and does not replace malformation exclusion diagnostics in the second trimester (approx. 21st week)
For example the amount of amniotic fluid cannot be used to conclude that the fetus has kidney functions, since urine production is only sufficient later to generate the amount of amniotic fluid solely via its function. In the first trimester, the amniotic cells are the main source of amniotic fluid.
The brain water production also increased later in the 20s (weeks) and a possible congestion (hydrocephalus/water head) can only be diagnosed then. A brain gyration disorder often only occurs in the late 20s to 30s (weeks).
2nd and 3rd Trimester
Differentiated Ultrasound
DEGUM (German Society for Ultrasound in Medicine) has formulated the requirements for advanced malformation diagnostics, the examiner and the device requirements in the second trimester. Https://www.degum.de These go far beyond the Iia screening of the maternity guidelines, which is usually carried out by your gynecologist. As part of this investigation, we can not only examine the sonoanatomy of the fetus, but also uncover disturbances in organ functions. The differentiated diagnosis of malformation exclusion is usually combined with echocardiigraphy. The temporal relationship between the time of examination of both procedures, namely between 24 and 29 weeks of pregnancy , often gives rise to confusion between the routine Iia ultrasound performed by your gynecologist and the differentiated diagnosis of malformation exclusion by a DEGUM II or III qualified ultrasound specialist. (The DEGUM stage concept you find under www.degum.de)
In the event of abnormalities during pregnancy or due to risk factors (see also Doppler examination), you will be referred to a specialist (at least DEGUM II qualified ultrasound specialist, such as e.g. MS. Dr. Achenbach) by your gynecologist for further differentiated diagnosis of anormalies. Without an indication for this examination, the cost of this ultrasound will not be covered by the statutory health insurance. It is then an IGEL service (see costs/ IGEL). Please clarify in advance what costs your health insurance will cover for you during pregnancy.