Once we have performed fetal morphology of the fetus in 20-22 weeks of pregnancy /WOP/, we need to follow the growth and viability of the fetus in the next few examinations. These examinations should be in 28, 32, and 36 WOP.
The aim is to track the dynamics of how the fetus grows, the sequence of the growth of the individual indicators, the relationship between them, and the sequence as a whole. Again, we look at the placenta for position, structure, and maturity. We measure the presence of amniotic fluid, maternal blood flow to the placenta, from the placenta to the fetus, and blood flow of the fetus. We observe breathing movements, body movements and the limbs of your baby. All of this shows us the viability of the fetus, the discovery of early signs of suffering of the fetus of different nature and the possibility of making a follow-up plan.
Of course, within this period, we are doing biometric measurements of the fetus to track its growth. Deviations from the norm may be in one direction or another and signal a different pathology. It is important to identifiy not only whether it is in the norm but also the system of growth, i.e. whether it follows a growth sequence or has deviations from that trend. A complete idea of growth needs to be built up to draw conclusions. If there are any deviations, the reasons are sought with further examinations and more frequent follow ups of the fetus with an ultrasound are needed.
After 28 WOP the fetus already occupies almost the entire space of the uterus and there is not much room left for movement, but still a baby can change its position from a transverse lie to head presentation and vice versa. Ultrasound scans allows us to look at the individual organs and systems, but not the whole baby. If there is enough amniotic fluid, we can make 3D and 4D ultrasound scan of the baby’s face and you can enjoy it before birth. This is a very emotional and joyful moment for you, future parents, but also for us doctors.
In the 32nd WOP the baby is already about 2000 grams and we expect it to be head down approximately at this time. Now is a great for 3D and 4D pictures. The most suitable moments for 3D and 4D ultrasound are between weeks 28 and 32 because the fetus has accumulated enough subcutaneous fat and there is still some fetal space in the uterus and enough amniotic fluid. Of course the baby should turn it’s face up so we can see it.
In the 36th WOP the fetus can only move its limbs and make breathing movements, but changing it’s position is rare - though not impossible. Within this time, only individual organs of the fetus are visualized and the entire examination may look completely incomprehensible for the inexperienced eye.
After the week 36 we can track the amount of amniotic fluid and the fetal blood flow. It is important to determine the position of the fetus. As you know, the most favourable birth position is head down. When establishing another position, a plan for your delivery should be prepared with your attending obstetrician-gynecologist.
Of course, during these examinations, the anatomy of the fetus is also examined. This examination is not as comprehensive as the ones between the 20th-22nd WOP, but anomalies can be found during these periods that were not detected earlier. Unfortunately, not all abnormalities can be found during the examination of fetal morphology, and later. Here’s another reason for fetal tracking. Fortunately, most of these anomalies are compatible with life. Adjustments may be necessary for some of them after birth.
After completing 37 WOP the fetus is fully viable to be born. The baby has enough mature lungs to breathe independently. You and your relatives must be emotionally ready for the birth and have a plan to get to the hospital at any time of the day. It’s good to have a bag prepared with everything you need to stay in the hospital, not packing at the last minute. In order to know what you need, you have to know where you are going to give birth and to ask the staff of the respective healthcare facility what to prepare. Do not forget your ID documents and the whole set of medical records you have.
I wish you success and good luck!!!