Ultrasound scans for expectant women are done for various reasons, but the most common one is to find out the sex of the baby. However, medics say although checking for the child’s sex might be important for a mother, monitoring the overall growth and looking out for abnormalities on the foetus is equally vital.

They point out that determining the size, age and the location of the pregnancy, as well as ruling out genetic anomalies that may prove fatal is best done through an ultrasound scan. Detecting abnormalities of the uterus and cervix are just some of the other reasons that should make a mother schedule for a scan while they are pregnant.

Why and when should mothers go for an ultrasound scan?

According to Emmanuel Semwanga, a gynecologist/obstetrician at La Croix Du Sud at Kisementi, Kigali, every pregnant woman should consult a gynecologist to establish the status of the baby, and to find out if the mother herself has any problem or diseases without her knowledge that could interfere with the pregnancy.

"Apart from other lab investigations, an ultrasound scan is also one of the confirmatory tests that are supposed to be done on every pregnant woman, depending on the stage of pregnancy.

"For instance, during the first trimester (first three months of pregnancy), to confirm if the mother is pregnant or not, an ultrasound scan is the major confirmatory test that will prove the pregnancy apart from urine and blood tests,” he says.

Semwanga, however, notes that from the first trimester, an ultrasound scan is done to determine with precision how far the gestation is.

He says that after the second trimester, the mother should go for another scan to rule out any abnormality on the foetus, noting that this should take place between the 13th and 18th week of the pregnancy.

Semwanga says the other major reason why an ultrasound scan should be done within that period is to assess the growth rate of the baby.

In the second trimester, he says it’s also important to carry out an ultrasound scan in order for the mother to know if all the organs have developed or are developing well.

"In case of any deformity, such as a baby having a severe abnormality like microcephaly (baby with small head) or anencephaly (absence of major portion of the brain), a gynecologist has to have intensive discussion with the mother, provide counselling and with their consent, help them understand why the foetus has to be  terminated where necessary,” he says.

"If the doctor thinks that even if the baby is born the abnormality will compromise their life, there is no need for the mother carrying the pregnancy until its due date.”

 On the other hand, Iba Mayale, a gynecologist at Doctors Plaza Clinic Kimironko, Kigali, says that some abnormalities such as urethral stricture (a narrowing of the urethra caused by injury or infection) can be corrected after confirming through an ultrasound scan.

"After ruling out such cases, there is a possibility that the doctor can wait until the baby is born then the abnormality is corrected after, or if the pregnancy is around eight months, the mother can have induced labour so the abnormality is fixed before it can lead to further complications,” he says.

Mayale explains that in general, in obstetric cases, there must be ultrasound scans for the mother.

"It’s  very vital because this is not only a matter of monitoring the baby alone, but also consists of checking the perimeter which supports the baby, for example ascertaining if the placenta which is meant to feed the foetus is in good condition or if the amniotic fluid is enough or not,” he says.

 Depending on what an obstetrician has found out, Mayale says they can decide to terminate the pregnancy, especially if there is less amniotic fluid because there is a high probability of the baby suffering from the amniotic burn syndrome, which will further lead to severe abnormalities like hypoxic pulmonary, when not terminated.

Checking if the life of the mother is at risk

John Muganda, a Kigali-based gynecologist, says the reason why an ultrasound scan is important to any pregnant woman is that there can be cases where the foetus has developed outside of the uterus, in the fallopian tube, for instance. In such cases, a scan becomes very vital to confirm the condition.

"In cases where the mother has some signs such as pelvic and stomach pain, severe virginal bleeding, fainting and dizziness, among others, an ultrasound scan helps in confirming if the pregnancy is ectopic in nature (in the fallopian tube),” he says.

Muganda adds that most of the time such signs are related to foetus being implanted outside the uterus (ectopic pregnancy), in which case the life of the mother can be saved by terminating the pregnancy.

He also notes that ultrasound scans help in knowing the baby’s age.

"This is important because it aids in determining when exactly the mother is likely to give birth, which helps them to get prepared earlier and ensure they are in a health facility before labour to avoid complications during delivery. This scan is even more important for mothers living upcountry where health facilities might be far from their homes,” Muganda explains.

Again, cases of a mother carrying more than one baby can be determined by only an ultrasound scan, according to Francis Kazungu, a general practitioner in Kigali.

He notes that after the scan has confirmed twins, the mother is supposed to visit a dietician to help her in order for her body to meet the nutritional demands. Besides, with twins one is supposed to have more and regular ultrasound scans just to check on how the foetuses are fairing.

"When carrying twins, a mother is expected to deliver earlier than expected, thus an ultrasound scan can help the doctors to inform the woman when they are likely to give birth. Several studies have suggested that a mother carrying twins is likely to have complications during delivery or before, thus close monitoring is needed for such cases,” he says.

Kazungu adds that scanning can also help rule out if one has fibroids, saying that most of the time a mother having fibroids tend to have signs and symptoms similar to those of pregnancy.

"A scan will give you a clear confirmation if it’s a pregnancy or fibroids. In cases where one has been diagnosed with fibroids, they are immediately put on medication to prevent cases of infertility,” he says.

Kazungu explains that severe fibroids can block the fallopian tubes thus leading to one not conceiving, because of the blockage of the passage of sperm and eggs.

Muganda, however says that an ultrasound scan can also be used to scan the abdomen to determine the uterus structure or adnexa on ovaries or pelvic mass.

"A mother should go for it depending on their obstetrician’s advice and schedule to know the uterine size, content, rule out uterine mass or ovarian mass, as well as to observe the uterine cavity (the endometrium). Depending on the mother’s complaints, the experts can call for an emergency abdominal scan,” he says.

Experts share tips

Dr Marie Aimee Muhimpundu, head of non-communicable diseases at Rwanda Biomedical Centre

Mothers should make sure they get the antenatal care as advised by their gynecologists just to be on safe side throughout their pregnancy. Getting all the recommended vaccinations and eating healthy foods, especially vegetables and fruits it also vital. Besides, they should avoid stress, tobacco and alcohol, as well as ensure they get enough rest.

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Erick Musengimana, works with Rwanda Diabetic Association

Mothers should attend prenatal consultations. Secondly, they should be on a balanced diet every time and take folic acid as well as iron supplements. Heavy activities should be avoided because they can interfere with the pregnancy. Besides, reaching out for a doctor anytime they don’t feel well is recommended as it helps the medics to rule out the problem before it affects their pregnancy.

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John Muganda, a gynacologist

Exercises can help mothers avoid some complications at birth and ease the process of delivering. But they should not be strenuous or heavy exercises but simple such as yoga. Also, being in touch with their gynecologists is important as it helps them report any unusual sign and symptoms for immediate attention.

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Bandora Iragura, medical student at University of Rwanda

Mothers should always stick to a balanced diet which contains all the nutritional ingredients required for their babies to grow well. This prevents the cases where children are born malnourished. On the other hand, staying away from bad vices such as drinking alcohol and smoking will ensure a safe pregnancy.