geburts abc

Fine ultrasound optional service instead of 2nd basic ultrasound


Fine ultrasound - organ ultrasound - organ screening - malformation diagnostics (DEGUM II)

Ultrasound is a medical service that is not part of prevention, but prenatal diagnostics. Up to three basic ultrasound examinations around the 10th, 20th and 30th week can be taken up by the pregnant woman as a health insurance benefit. The so-called fine ultrasound can be performed instead of the 2nd ultrasound examination from the 19th week of pregnancy onwards. It usually takes place between the 20th and 22nd week of pregnancy. The examination is routinely recommended for high-risk pregnancies. Parents are under no obligation to have any examination carried out.
For the fine ultrasound examination, a high-resolution device is used, i.e. the ultrasound device used is more advanced than the ones normally used. The unborn child is exposed to high intensity ultrasound waves for about 50 to 60 minutes. The child's body and organs are examined for abnormalities.
The considered indications are as follows:
- previous pregnancies with chromosomal defects,
- hereditary diseases of the parents or diseases of the mother which can have a negative effect
  on the development of a child (e.g. diabetes mellitus),
- Taking medication in early pregnancy, an intensive X-ray examination or radiation treatment,
- a family genetic predisposition,
- problems during a previous pregnancy,
- any abnormalities in the screenings,
- multiple pregnancies.
If one of these factors is present, the fine ultrasound is covered by the statutory health insurance, otherwise the pregnant woman must pay for the examination herself if she wants it. If there is no medical indication, this examination is an IGe - benefit[IGe stands for “Individuelle Gesundheitsleistung”. This means services which are not covered by the health insurance but need to be paid for privately.]. The examination can be carried out by gynaecologists or centres specialising in malformation diagnostics.

The following aspects can be examined:
- all the organs of the child that can be easily depicted, such as the brain, stomach, kidneys,
  bladder and heart,
- whether the age-appropriate development of the child corresponds to the norm,
- the amount of amniotic fluid,
- the blood flow in the umbilical cord,
- location and appearance of the placenta,
- blood circulation in the uterine vessels to check placental supply and maturity
Tested is: Are all limbs present? Are the abdominal wall, spine and cranial calotte healthy? Can a cleft palate be ruled out? If organ ultrasound leads to uncertainty or a suspected diagnosis, parents are advised to have further examinations carried out, such as an amniocentesis or umbilical cord puncture. The pregnant woman and her partner should be aware that an ultrasound examination can never reveal all physical or chromosomal defects and not all diseases of a person.
Conclusion
Fine or organ ultrasound should be used to find or diagnose deviations from the norm. Parents should be aware of the fact that they can be faced with difficult decisions. If you are sure that a late abortion is out of the question for you, there is no need for fine ultrasound, which is a burden for the child simply because of its length. Tests cannot heal. Suspicious diagnoses often lead to further examination or are regarded as a medical indication for an abortion. Any suspected diagnosis will influence the further course of pregnancy, even if it is not confirmed.
We refer to the publication of Otwin Linderkamp on the benefits and dangers of ultrasound. In 2017, Otwin Linderkamp searched through all the ultrasound studies available in databases. He made the results available to GreenBirth e.V..