Tidlig ultralyd i svangerskapet


Tekst: ultralydjordmor Anne Kathrine Solhaug

Det er en del kvinner som ønsker å ta ultralyd tidlig i svangerskapet. Det kan være flere grunner til det, f.eks  tidligere spontanaborter, missed abortions, blødninger eller generell engstelse.


I Norge tilbys det én ultralydundersøkelse i regi av det offentlige, der en fastsetter termin, og hvor man har en orienterende gjennomgang av fosterets anatomi.  Denne ultralydundersøkelsen blir foretatt mellom uke 16-20.

Det er stor variasjon på når den gravide ønsker tidlig ultralyd. Noen ønsker kun å se at det er hjerteaksjon. Hjerteaksjon er mulig å se fra uke 6, selv om det kan være lurt å vente til ca. uke 7-8 i tilfelle graviditeten ikke er kommet så langt som en tror. Det er fysisk umulig å se hjerteaksjon før uke 5+3 dager.

En tidlig ultralyd rundt uke 7 kan fortelle oss om det er en intakt graviditet med hjerteaksjon, samt antall fostre.  Ved en tvillinggraviditet kan vi på dette tidspunkt se om fostrene ligger i hver sin graviditetssekk (gestasjonssekk), eller om de deler morkake og/eller fostersekk (amnion). Avhengig av hva vi finner, kan en planlegge senere kontroller ut fra risiko. I de tilfellene der alt er adskilt, er det mye mindre risiko for komplikasjoner enn der fostrene deler morkake og eventuelt fostersekk. Noen kvinner ønsker å se armer og bein i tillegg til hjerteaksjon, og det er mulig fra uke 10.

I Norge er det ikke tillatt med fosterdiagnostikk – dvs. en målrettet ultralydundersøkelse med tanke på å finne avvik. Dette er kun mulig der det foreligger en indikasjon. Det er fem klinikker som kan utføre den type undersøkelse i Norge, og da er det et spesielt medisinsk opplegg i hvert enkelt tilfelle.

Som privat aktør får jeg noen ganger spørsmål om å foreta en undersøkelse for å finne tegn til f.eks trisomi 21 (Downs Syndrom). Det betyr en målrettet undersøkelse hvor en måler nesebein og nakkefold. Jeg svarer alltid at jeg ikke kan utføre den type undersøkelse da dette er fosterdiagnostikk. Det jeg kan gjøre, er å se at fosteret ser ut som det pleier, for det er det som er mest vanlig. Det er kun der jeg får mistanke om at noe avviker fra slik det pleier at jeg måler nakkefold. Da kan jeg henvise til en spesialklinikk som for meg betyr Fostermedisinsk seksjon ved Rikshospitalet.

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