Early fetal ultrasound service detects potential prenatal problems earlier

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Recently, Ayelet Lahat visited the new Toronto Centre for Early Fetal Ultrasound at the Perinatal and Gynaecology Department of Sunnybrook Health Sciences Centre for her second pregnancy’s ultrasound – she was only 14 weeks pregnant.

The Toronto Centre for Early Fetal Ultrasound is the first of its kind in Canada performing early stage fetal targeted ultrasound examination in order to detect potential fetal conditions such as structural anomalies – which are complications that may occur with the development of the fetal skull, brain, spine, abdominal wall, limbs, stomach and bladder – and to also detect chromosomal disorders, such as Down’s syndrome.

Ayelet, who was referred to the Centre at Sunnybrook by a fetal assessment specialist in Israel who examined her during her first pregnancy, says that since the early fetal ultrasound involves very minimal risk, if any, the benefits have a huge impact for pregnant women. “I didn’t have any specific concerns but I know that even healthy women often have babies with various abnormalities and it was very important for me to know at this early stage that everything is okay,” says Ayelet. “In addition, I believe the early ultrasound is more detailed and that it can detect more fetal conditions than the ultrasound that is typically done later.”  

Congenital anomalies, which are defects present in a baby since birth, are relatively common, occurring in two to three per cent of low-risk pregnancies. In Canada, the first targeted ultrasound for detection of anomalies is traditionally performed at 18-20 weeks. The Toronto Centre for Early Fetal Ultrasound performs targeted ultrasound for detection of possible fetal problems six to eight weeks earlier, at 12-15 weeks.

“Our aim is to get ultrasounds for pregnant women done sooner, so that women have more possibilities and testing options,” says Dr. Ori Nevo, a Maternal Fetal Medicine specialist and lead physician at Sunnybrook’s Toronto Centre for Early Fetal Ultrasound. “We have the same equipment as everyone else, but the performance and interpretation of the scan requires a different level of expertise that we can offer at an earlier stage in a woman’s pregnancy.”

Using conventional ultrasound equipment and using transvaginal ultrasound, the Centre provides pregnant women with greater information about their fetus early in their pregnancy. At a stage when most possible anomalies are already present, with only a few anomalies developing later, the benefits of early scanning include greater testing options and earlier treatment for those fetal problems that are amenable to therapeutic interventions, such as the treatment of twin-twin transfusion syndrome and treatment of certain urologic problems.

While most of the scientific articles and case reports relating to early fetal ultrasound examination have been submitted by researchers in Israel, Italy, the Netherlands, Germany, and other countries, the service remains relatively unknown and unavailable across North America. Sunnybrook Health Sciences Centre is the first professionally accredited facility to offer this service to women in Canada.

“The women we are seeing are either at risk for fetal anomalies or are obese, and in that case, the later ultrasound may be of limited resolution,” says Dr. Nevo, who is also an assistant professor in Obstetrics and Gynaecology at the University of Toronto. “However, ideally, any pregnant woman would benefit from early fetal ultrasound examination.”

Relieved and happy with the results of her early fetal ultrasound examination, Ayelet admits that she is now less stressed regarding the outcome of her pregnancy. “We found out that we are going to have a healthy, baby girl,” she says. “This is very exciting because we have a boy, and I think it’s nice to have at least one of each.”

Until construction of Sunnybrook’s new Perinatal & Gynaecology unit is completed in 2010, The Toronto Centre for Early Fetal Ultrasound is located at 76 Grenville Street, Toronto, Ontario.