London Ultrasound Clinic News

 


 

  • 0 What is an Ultrasound Scan

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    Ultrasound Scans Ultrasound scans are one of the most common diagnostic procedures and it is being used to evaluate the health of organs and tissue as well as monitor an unborn baby.      What is an Ultrasound Scan?   The ultrasound scan or ultrasonography as otherwise known is a painless diagnostic imaging technique utilising sound waves to produce internal images of the body. It is called ultrasound as the sound frequency being used is at the region of 1 to 20MHz. A sound frequency that the human ear can’t hear. These are the frequencies used by the navy sonar and by animal echolocation such as dolphins and bats. The ultrasound waves are produced by the transducer or the probe as most commonly known. As these sound waves travel through the body bounce back because of differences in the tissues. The bounced back sound waves are called echoes. These echoes are picked up by the probe and a powerful computer analyses them and creates the 2d ultrasound image on the scanner screen.   What is it used for? There are various kinds of sonograms that can be performed and each looks at different organs of the body to confirm or exclude possible pathology. In our ultrasound practice it is commonly used to diagnose problems in the: Abdomen Female pelvis amd ovaries(Gynaecological)  Testes and Prostate Urinary tract, kidneys, ureter and bladder In the veins of the legs The joints and tendons of the body Major blood vessels Soft Tissue to examine lumps and bumps. Unlike CT and MRI, ultrasound does not use radiation and therefore is pregnancy-friendly and therefore, is being used in all stages of pregnancy starting from as early as 5 weeks gestation. Ultrasound scanning is live and is ideal for musculoskeletal exams to evaluate moving joints. Specialist Ultrasound Techniques In some situations, a clearer picture can be obtained when an ultrasound probe is inside the body. Specially shaped and designed probes can be placed inside the vagina (transvaginal) or the rectum (transrectal). If you need to have this type of the scan you will be informed beforehand and the radiologist or sonographer will explain what they are doing all the time. What does it involve? Ultrasound is carried out by a Consultant Radiologist or specialist trained Radiographer called Ultrasonographer or Sonographer, skilled in the technique and interpretation. You will usually lie on a couch in a darkened room and the doctor will place a handheld probe the size of a small camera, on the skin over the area to be examined. Warm lubricating jelly is used so that the probe can be moved easily and to allow good contact with the skin. Gentle pressure is applied and you may be asked to turn or move to obtain optimum pictures. Often you will be able to watch the monitor where the picture is constantly updated during the scan. Why would you need an Ultrasound? The most common reasons your doctor will request an ultrasound scan  are: Pelvic scans: This scan can be performed both transabdominal and transvaginally. Transabdominal scans require a full bladder. You will need to consume a litre of water 30 to 60 minutes prior to your scan taking place. The ultrasound probe is pushed against the lower abdominal wall to look down into the pelvis. A transvaginal (TV) Scan is performed with an empty bladder, using a thin probe inserted into the vagina. This allows detailed information to be obtained by having the probe closer to the pelvic organs. Abdominal scans: Performed transabdominal, these scans usually involve fasting for four hours before the examination to allow for improved imaging of the liver and gall bladder. Renal scans: Performed transabdominal with a full bladder, this requires the patient to drink a litre of water 30 to 60 minutes prior to the scan taking place. This scan then helps to assess the kidneys and bladder. Doppler Venous/arterial scans:  Doppler imaging analyses the flow of blood within vessels. Musculoskeletal scans: These are carried out by a musculoskeletal speciali What are the benefits and risks of sonography? Benefits  Ultrasound scans are noninvasive. An ultrasound scan exam may be occasionally, temporarily uncomfortable, but it should not be painful. Ultrasound is widely available, easy-to-use and less expensive than other imaging modalities. Ultrasound scans are extremely safe and do not use any ionizing radiation. Ultrasound scanning gives a clear picture of soft tissues such as liver that does not show up well on x-rays. Risks  There are no known harmful effects on adults or babies related to an ultrasound scan. Unlike some other scans, such as CT, ultrasound scans don’t involve exposure to radiation. What are the limitations of Ultrasound Imaging Sound waves do not travel well in bowel or gas so abdominal organs such as stomach and bowel or organs obscured by bowel cannot be fully evaluated with ultrasound. It can also be hard to fully visualise the internal anatomy of large patients as the sound waves have further to travel and therefore the returning echoes are weaker. Are there any special preparations needed for a scan? This will depend on the kind of imaging test you are having. You should have received information about preparation with your appointment confirmation. It is therefore very important to read your confirmation letter/e-mail carefully. Certain types of ultrasound scan may need you to follow specific instructions to improve the image quality of the scan. Examples include: Drink plenty of water and do not empty your bladder until after your scan – this may be necessary before an antenatal scan or gynaecological pelvic scan. Avoid eating for 8 hours before your scan, but drink plenty of clear fluids and do not empty your bladder until after the scan – this may be necessary before an abdominal scan checking your liver and gallbladder. External Ultrasound scan An external ultrasound scan is used to examine the liver, kidneys and other organs in your abdomen. It can also be used to assess your muscles and joints and many other organs through your skin. A lubricating gel is put on your skin and a small handheld probe is moved over your skin to assess the underlying structures. You should not feel anything other than the sensor and gel on your skin. Internal or Transvaginal Ultrasound scan An internal ultrasound allows our ultrasonographer to look through the vagina. During the procedure, you will be asked to lie on your back and a small probe will be gently passed into the vagina and the images are transmitted to a monitor. Internal examinations are ideal for looking at your ovaries and womb and may cause some discomfort, but should not be painful. Who will I see? Our Sonographer, a Health Care Professional specifically trained to perform and understand the ultrasound scan images, will do your ultrasound scan exam and provide you with a written ultrasound scan report that you can take it your doctor.  Our sonographers will also discuss the ultrasound scan results with you during and after your scan. How long does a scan usually take? The actual examination takes 10 to 15mins depending on the scan you having. Please allow some extra time for your ultrasound report.     Preparing for an Ultrasound scan Certain types of ultrasound scan may need you to follow specific instructions to improve the image quality of the scan. Examples include: Drink plenty of water and do not empty your bladder until after your scan – this may be necessary before an antenatal scan or gynaecological pelvic scan. Avoid eating for 8 hours before your scan, but drink plenty of clear fluids and do not empty your bladder until after the scan – this may be necessary before an abdominal scan checking your liver and gallbladder. External Ultrasound scan An external ultrasound scan is used to examine the liver, kidneys and other organs in your abdomen. It can also be used to assess your muscles and joints and many other organs through your skin. A lubricating gel is put on your skin and a small handheld probe is moved over your skin to assess the underlying structures. You should not feel anything other than the sensor and gel on your skin. Internal or Transvaginal Ultrasound scan An internal ultrasound allows our ultrasonographer to look through the vagina. During the procedure, you will be asked to lie on your back and a small probe will be gently passed into the vagina and the images are transmitted to a monitor. Internal examinations are ideal for looking at your ovaries and womb and may cause some discomfort, but should not be painful.   Where can I get an ultrasound in London? If you live London your doctor can refer you for an ultrasound scan to your nearest NHS hospital. As the NHS scanning waiting time in most London hospitals are around 6 weeks, you can, opt to have a private ultrasound instead in one of local ultrasound clinics. What is a Private Ultrasound Scan? A private scan is an ultrasound scan undertaken by a private healthcare provider where the cost of the examination is undertaken solely by the patient or through a private health insurance provider. The alternative to a private ultrasound scan is an ultrasound provided by the NHS. We offer baby scans and scans for men and women. Why have a private ultrasound in London? The main reason patients choose to go private is to: Reduce NHS waiting times, Get faster results and treatment Choose a flexible and more suitable time Reduce anxiety associated with not knowing Convenience Can I get an ultrasound without referral? Yes you can self-refer.Unlikely the other Imaging Modalities a doctor’s referral is not necessary for an ultrasound examination. You do however need a referral if you plan to have your scan through NHS instead of a private clinic. How much does a private ultrasound scan cost? The price of a private ultrasound scan in London shouldn’t be prohibited when it comes to someone’s wellbeing. The cost of scans in London however range from as little as £99 to more than £400. Our ultrasound scan prices are competitive and affordable with no compromise to the level of care. The price you see for the ultrasound scan is the price you pay with no hidden extras and no booking fees Private Ultrasound  If you are looking for reassurance early in your pregnancy (not 4D ultrasound) or a general medical private ultrasound in London to visualise the internal organs and body structures to get quick answers about your health, you can rest assured that our sonographers have the skills and the knowledge to provide you with the instant answers you need.      Author- Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Medical Ultrasound Practitioner  Specialities:   Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare.     Reviewed: 28/06/2020 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons)  and Tareq Ismail  Pg (Dip) Medical Ultrasound, BSc(Hons)    

  • 0 Why you should book a private ultrasound scan instead waiting for the NHS during the Covid-19 era.

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    International Ultrasound Services offers private ultrasound scans in a convenient central London location. This private scan service is offered to patients who: Require quick diagnosis and treatment of their symptoms Are anxious and the NHS waiting increases their anxiety Require a private baby scan not offered by the NHS. Avoid overcrowded Emergency departments that most often than not are not able to offer an ultrasound scan.     Disease Diagnosis during the novel Covid-19 era It is now even more important to not ignore any symptoms of a potential disease. Pain, discomfort or 'strange feelings' are your body's way to say that something is wrong. During the current coronavirus pandemic, the NHS has cancelled most routine investigations including ultrasound scans.   The reasons for this are: Medical resources should be spared and prioritized.  Avoid unnecessary exposure of medical personnel to (potentially) infected patients and vice versa. The risk of infection is particularly high during ultrasound investigation due to the proximity of the sonographer and the patient The number of visits should be reduced to the essential minimum    Importance of Early Diagnosis It is a grave time for the NHS throughout the UK but mainly in overpopulated London. While every effort is directed towards the COVID-19, lives will undoubtedly be lost due to delay in the diagnosis of disease. The chances of survival can significantly increase when a disease is caught in the early stages. People will underlying known or unknown disease have higher mortality than healthy people who caught the coronavirus.   Cancer Diagnosis According to Science Blog diagnosis of cancer has been heavily impacted. Fewer people booking GP appointments resulting in an up to 25%t drop-in urgent and 2-week referrals. This very concerning as it means that more than 2000 cases of cancer are not diagnosed every week. This will, in turn, create a massive backlog for when NHS re-opens. At our London Ultrasound Clinic, we offer same-day private scans to diagnose any potential disease and any signs of cancer.   Pregnancy Ultrasound scans Pregnancy ultrasound scans are still offered by the NHS although guidelines by ISUOG  recommend the dating scan should be performed at 13+6 weeks gestation. The anomaly scan should be performed at 23 weeks and the growth scan should not be performed (as always has been in the UK) unless there are clinical indications.  If you need a private baby scan you can rest assured knowing that we are here to offer you the help and support you need in a comfortable setting with a personalised approach.   Heart Disease The novel coronavirus not only causes viral pneumonia but also has major implications for the cardiovascular system.   What is coronavirus? The coronavirus is a flu-like virus that can affect the lungs and airways. People with underlying conditions have a higher risk of complications.   What is an Ultrasound scan? Ultrasound is probably the easiest and faster medical examination to diagnose bodily disease. It is a non-evasive medical test using high-frequency soundwaves to obtain images of the inside of your body.  Ultrasound is mainly used to diagnose issues with: The upper abdomen including the liver The urinary tract Issues with the female anatomy such as the uterus and the ovaries Problems with the thyroid gland Testicular problems in men Musculoskeletal Issues Investigate superficial lumps   In conclusion, it is now more important than ever to make sure that these niggles you feeling are nothing significant to concern and that you have no underlying causes that can impact your fight with coronavirus.  As the NHS has diverted resources in fighting the COVID-19 it is anticipated that future mortality rates of diseases unrelated to coronavirus will increase due to collateral damage caused by delayed diagnosis. It is time to take responsibility for your own health and your loved ones and book a private ultrasound in London today. Don't wait for tr NHS to reopen as this can take a long time.  

  • 0 Understanding 2D and 3D pregnancy ultrasounds

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    If you’re expecting a baby, you can most certainly expect an ultrasound. Sure, the word “ultrasound” sounds complicated, but it’s not. In fact, it is simply making use of sound waves to produce pictures of the baby on a screen or monitor. Because this involves bouncing the sound waves off of internal objects to produce an image, it is considered safe for mother-to-be and baby and can help ensure baby is healthy and mom side-steps common pregnancy complications, by aiding in diagnosis and treatment of a variety of medical conditions, making pregnancy ultrasound a true must-have. NHS offers at least two ultrasound scans during pregnancy but you can also opt for a private ultrasound in London.  The pregnancy ultrasound scan generally takes less than 20 minutes and is performed at different times during the pregnancy. It is expected that a fetal ultrasound will be performed in the first trimester of pregnancy called early pregnancy scan, in the second trimester and the third. A healthcare provider may perform the foetal ultrasound at different times, but many perform ultrasounds at eight to 12 weeks of pregnancy to determine the actual due date by viewing the fetus and its size; at 10-13 weeks to check the development of the brain and spinal cord; at 16-20 weeks to check baby’s size, growth and likelihood of birth defects; and in the last trimester to check the amount of amniotic fluid and the baby’s overall well-being and development.  A general baby ultrasound produces a 2D (a two-dimensional still view) image of the fetus. Oftentimes, a healthcare provider will perform a 3D (a 3-dimensional still view) ultrasound, which is considered a level II exam, to take a more detailed look at the fetus. A moving view of the 3D technology is called a 4D ultrasound. Ultrasounds are performed by a healthcare specialist called sonographer who applies a handheld device called a transducer across the pregnant woman’s abdomen. This scan is called transabdominal ultrasound. It may also be performed as transvaginal ultrasound, or by inserting the hand-held transducer into the pregnant woman’s vagina. This is not painful, but the pregnant woman will experience slight pressure. In short, ultrasonography is an important tool for any pregnant woman and her baby, so make sure you discuss this with your healthcare provider.

  • 0 Sonographer

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    Medical Sonographer  A sonographer is a healthcare professional who specialises in the use of ultrasound imaging devices to produce diagnostic images, scans, videos or three-dimensional volumes of anatomy and diagnostic data, frequently a radiographer, but may be any healthcare professional with the appropriate training. Most people associate medical sonography with ultrasound scans during pregnancy, as sonogram pictures are the most common way to view a foetus. There are many things that sonography, also called ultrasound technology, is used for in the medical field. Sonograms are used for looking inside the body painlessly, and as such can be used to track blood in the circulatory system, view tendons and ligaments, ensure the proper functioning of digestive organs, and much more. At International Ultrasound Services our two sonographers and founders provide a wide range of private ultrasound direct to our community in London., including early pregnancy scans as well as Wellman and well-woman scans.   Job Description A medical sonographer uses a sonography machine which bounces sound waves off of structures within the body to get a picture of what's going on inside. Ultrasound examinations require that the medical sonographer have up-close contact with patients, and that the sonographer know how to interpret the results.   Education and Training Medical sonographers have a lot of different choices for how they want to go about their training. They can study an undergraduate course or obtain postgraduate qualifications after they have finished a relevant undergraduate course such as radiography or midwifery.   Ultrasound Scans A sonographer is required to operate and maintain complex ultrasound equipment in order to perform sonographic procedures. Operating sonography equipment and producing high-quality images takes a significant amount of training and practice. The ultrasound process involves applying a gel to the skin in the area that needs to be examined which helps with the transmission of sound waves. Then the sonographer places an acoustic transducer on the patient’s skin. The transducer produces high-frequency sound waves that are transmitted into the body. These sound waves bounce around the parts inside the patient’s body and then come back to the transducer which detects these wave echos and how they bounce around inside the body. Structures in the body will reflect these sound waves differently. Mapping these waves together produces an image of the body’s internal structures. The sonographer’s goal is to move and manipulate the transducer over the body in order to obtain the best view of the situation inside the patient. These acoustic signals are then converted into electronic signals to create a digital image of internal organs, blood vessels and other structures. These images can be viewed on a monitor and can be recorded on video for use by other medical professionals, such as doctors, surgeons and radiologists. The sonographer will issue a medical report that will be used by the clinicians to identify the best way of treatment associated with the patient's symptoms and ultrasonic findings.   A sonographer spends more time with their patients than many other health care professionals. The ultrasound process is very “hands-on”, and many technicians appreciate the amount of patient contact they get to be involved with. While some sonographers specialize in a certain area, others perform on a variety of patients and conditions. Many sonographers work in tracking fetal health and development. Other specialities include abdominal, adult and pediatric heart and vascular procedures. A cardiac sonographer (also known as an echocardiographer) works on researching the heart and supporting vein system.      

  • 0 The Thyroid - Function and Pathologies

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    What is the Thyroid? The thyroid gland is the biggest gland in the neck. It is situated in the anterior (front) neck below the skin and muscle layers. The thyroid gland takes the shape of a butterfly with the two wings being represented by the left and right thyroid lobes which wrap around the trachea. The sole function of the thyroid is to make thyroid hormone. This hormone has an effect on nearly all tissues of the body where it increases cellular activity.  The thyroid produces hormones that help your body to function properly. The thyroid gland absorbs iodine from the diet, which is found in fish, seafood and dairy products. It also produces two hormones; thyroxine (T4) and triiodothyronine (T3) which help keep the body functioning normally. Ultrasounds is the first imaging modality being used to identify any thyroid abnormalities. The thyroid scan is one of our most popular investigations amongst the private ultrasounds we offer in our clinic in London. Common Thyroid Problems The thyroid gland is prone to several very distinct problems, some of which are extremely common. These problems can be broken down into [1] those concerning the production of a hormone (too much, or too little), [2] those due to increased growth of the thyroid causing compression of important neck structures or simply appearing as a mass in the neck, [3] the formation of nodules or lumps within the thyroid which are worrisome for the presence of thyroid cancer, and [4] those which are cancerous.  The information in this article is arranged to give you more detailed and complex information as you read further. —      Goiters ~ A thyroid goitre is a dramatic enlargement of the thyroid gland. Goitres are often removed because of cosmetic reasons or, more commonly because they compress other vital structures of the neck including the trachea and the oesophagus making breathing and swallowing difficult. Sometimes goitres will actually grow into the chest where they can cause trouble as well. Several nice x-rays will help explain all types of thyroid goitre problems. —      Thyroid Cancer ~ Thyroid cancer is a fairly common malignancy, however, the vast majority have excellent long term survival.  —      Solitary Thyroid Nodules ~ There are several characteristics of solitary nodules of the thyroid which make them suspicious for malignancy. Although as many as 50% of the population will have a nodule somewhere in their thyroid, the overwhelming majority of these are benign. Occasionally, thyroid nodules can take on characteristics of malignancy and require either a needle biopsy or surgical excision.  —      Hyperthyroidism ~ Hyperthyroidism means too much thyroid hormone. Current methods used for treating a hyperthyroid patient are radioactive iodine, anti-thyroid drugs, or surgery. Each method has advantages and disadvantages and is selected for individual patients. Many times the situation will suggest that all three methods are appropriate, while other circumstances will dictate a single best therapeutic option. Surgery is the least common treatment selected for hyperthyroidism. The different causes of hyperthyroidism are covered in detail. —      Hypothyroidism ~ Hypothyroidism means too little thyroid hormone and is a common problem. In fact, hypothyroidism is often present for a number of years before it is recognized and treated. There are several common causes, each of which are covered in detail. Hypothyroidism can even be associated with pregnancy. Treatment for all types of hypothyroidism is usually straightforward. —      Thyroiditis ~ Thyroiditis is an inflammatory process ongoing within the thyroid gland. Thyroiditis can present with a number of symptoms such as fever and pain, but it can also present as subtle findings of hypo or hyperthyroidism. There are a number of causes, some more common than others. Each is covered on this site.   Thyroid Cancer In the UK, approximately 3000 people are diagnosed with thyroid cancer each year according to Cancer Research. It is a fairly rare type of cancer that develops slowly and is usually more common in middle-aged and older people. However, there is one type, known as papillary thyroid cancer, which often affects younger people. Overall, more women get thyroid cancer than men. It rarely affects children. The four main types of thyroid cancer are: Papillary Thyroid Cancer - Papillary cancer develops in the follicular cells and grows slowly. It is usually found in one lobe; only 10% to 20% of papillary cancers appear in both lobes. Follicular Thyroid Cancer - Follicular cancer also develops in the follicular cells and grows slowly, yet is less common. When detected early, it can be treated successfully. Papillary and follicular cancers makeup 80% to 90% of thyroid cancers, and are grouped under the term differentiated thyroid cancer. When detected early, especially in people below the age of 45-50 years, it can be treated successfully. Medullary Thyroid Cancer - Medullary cancer develops in the C cells. It can be controlled if it is found and treated before it spreads to other parts of the body. Medullary cancer accounts for 5% to 10% of thyroid cancers. Anaplastic Thyroid Cancer - This is a very rare and aggressive form of thyroid cancer that takes its origin from differentiated thyroid cancer or other benign tumours of the gland, and in its giant cell variety is often rapidly fatal. The outlook for most types of thyroid cancer is usually very good, and many people are completely cured of the disease, even if it has spread beyond the thyroid. As we well know, there are many kinds of cancer; unfortunately, they all come about because of the out-of-control growth of abnormal cells. Healthy Cells vs. Cancer Cells Healthy cells are like a cat.  They need structure to determine the size of bones and shape of the body, tail and whiskers. The DNA in genes and chromosomes determine this. They need the energy to play and prowl and sustain life. This is derived from chemicals in food. Cats need a system to deliver chemicals (food nutrients like amino acids, carbohydrates, fats, vitamins and minerals) to all parts of their body. These are the blood vessels. Growth factors take a kitten into a lazy old cat, all the while helping it to function normally. The body and its cells are mostly made up of protein. The building blocks of proteins are substances called amino acids that in the form of enzymes and hormones literally control every chemical reaction within the cells. When these are modified, different messages are sent to a complex control system that can alter their function. There are twenty different kinds of amino acids that are essential to life. Twelve of these can be synthesized within the body however; eight must be supplied by the daily diet.   Signs and Symptoms of  Thyroid Cancer   The most common symptom of thyroid cancer is a lump or nodule, that can be felt in the thyroid gland or neck. Other symptoms are rare. Pain is seldom an early warning sign of thyroid cancer. You may have a tight or full feeling in the neck, difficulty breathing or swallowing, hoarseness or swollen lymph nodes.   Thyroid Ultrasound The thyroid ultrasound scan will identify any lumps on the thyroid and will also check the overall appearance of the thyroid for evidence of thyroiditis.  International ultrasound services offer ultrasound scanning services in a central London location.     Author- Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Medical Ultrasound Practitioner  Specialities:   Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare.     Reviewed: 07/04/2020 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons)  and Tareq Ismail  Pg (Dip) Medical Ultrasound, BSc(Hons)  

  • 0 Symptoms of Thyroid Cancer

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        The thyroid ultrasound scan is one of the most common private ultrasound scans in London.  It is very common to identify thyroid nodules during a thyroid ultrasound in our private ultrasound clinic. Some of these nodules have benign appearances but some others have been proven by FNA to be malignant. You should, therefore, be aware of the thyroid cancer signs and seek medical advice when necessary.    Thyroid Cancer Symptoms, Signs   What are the symptoms of thyroid cancer? Lump in the neck (or lump in throat): painless, enlarged nodule; But not always, sometimes there is pain. Thyroid cancer involves the adjacent tissues (e.g. throat), causing a difficulty swallowing, hoarseness. One or multiple firms or hard, fixed thyroid nodules. Swollen lymph nodes in the neck. Thyroid cancer symptoms are often not accompanied by high thyroid symptoms and low thyroid symptoms. Early symptoms of thyroid cancer At the beginning of the disease, thyroid cancer symptoms almost do not emerge. Therefore, the patients do not notice it. Only with an increase in the size of the thyroid cancer, the patient will feel discomfort and have thyroid cancer symptoms. Most of the thyroid cancers do not lead to changes in thyroid function, so the patients have "thyroid cancer symptoms" but no high thyroid (hyperthyroidism symptoms), as well as no low thyroid (hypothyroidism symptoms). Advanced thyroid cancer symptoms In the early stage, the thyroid cancer symptoms often can not be perceived by victims. However, with further growth of the tumour, the thyroid cancer increases in size and therefore causes thyroid cancer symptoms: Sufferers palpate a lump in the thyroid, that is larger with time and characterized by one or multiple firm, hard and fixed thyroid nodules. The large thyroid cancer has the ability to invade and squeeze the adjacent organs and tissues. For this reason, the patients may experience some "thyroid cancer symptoms", such as difficulty in breathing and swallowing by pressure on the trachea or throat. ①When the growing thyroid cancer involves nerves, other "thyroid cancer symptoms" may occur. If the so-called "recurrent laryngeal nerve" affected, the voice may sound hoarse due to a paralysis of the vocal folds. The hoarseness is very common and can occur in the throat cancer, oesophagal cancer, other benign or malignant tumours of the neck.   Thyroid cancer symptoms may also occur due to an invasion to the so-called "cervical sympathetic plexus". If the thyroid cancer involves the nerves in the neck, it will develop a "Horner's syndrome": It is characterized that the pupil is constricted, the eyeball is sunk back into the orbit (eye socket) and the upper eyelid droops on the affected side. Horner's syndrome can also be caused by "Pancoast tumour", that is lung cancer in the apex of the lung.  If the "cervical plexus nerves" of the neck are affected, the patients may feel pain in ear, shoulder or the back part of the skull.The above three types of thyroid cancer symptoms are all caused by thyroid cancer, that invades and compresses the nerves of the neck. In end-stage, the above thyroid cancer symptoms get worse, and the weight loss looks very prominent. Thyroid cancer metastasis Can thyroid cancer spread? There are large differences in the degree of malignancy among the different types of thyroid cancer. In some cases, the thyroid cancer spread to lymph nodes starts in the stage 1 thyroid cancer; Some thyroid cancers begin with stage 2; Some thyroid cancer does not spread via the lymphatic circulation, until stage 3 or 4. Lymph node metastasis to the neck is not always proportional to the prognosis for recovery. For lymph node metastasis, the thyroid cancer symptoms are manifested with some rough and swollen lymph nodes in the neck, poorly moved in the neck's tissue. Does thyroid cancer spread to distant organs? Thyroid cancer cells can spread to the lungs, liver, bone, brain, and that patients thus lose the chance of surgery, but not always. Thyroid function In general, thyroid cancer does not affect the thyroid function, and therefore, thyroid cancer symptoms do not include abnormal thyroid function. One of the exceptions is that the follicular thyroid cancer (20% of thyroid cancer) will cause high thyroid symptoms: such as tremor, loss of weight, sweating, heat intolerance, heart palpitations, restlessness, irritability. The other is low thyroid, which can be caused due to the normal thyroid tissue and cells damage by thyroid cancer. Therefore, thyroid hormone production is not enough. The low thyroid symptoms: inactivity, cold intolerance, muscle pain, increased need to sleep, constipation, dizziness, tingling sensations in hands, hair loss, and rougher voice. Weight gain? It seems unlikely because the end-stage thyroid cancer symptoms are cachexia and emaciation. When to seek medical advice for thyroid cancer? If you have the above-mentioned symptoms, you'd better make an appointment with your doctor. Lump in the neck, enlarged thyroid, thyroid nodules is all the words used to describe the diseases associated with the thyroid. They are very common, and the vast majority of lump and nodules are benign, due to goitre, hyperthyroidism, as well as thyroiditis and thyroid adenoma. Less than 5 per cent are thyroid cancer. In recent years, there are about 50,000 people a year who are diagnosed with thyroid cancer in the United States. Thyroid cancer typically presents as a thyroid lump or one or more thyroid nodules. Compared with benign, they all look almost the same. How to clarify the causes and diagnose thyroid cancer, is the doctor's responsibility and expertise. It is recommended if you have an enlarged thyroid, thyroid nodules or lump in the front of your neck/throat, you should see your GP and request an ultrasound scan in London asap.     Author- Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Medical Ultrasound Practitioner  Specialities:   Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare.     Reviewed: 07/04/2020 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons)  and Tareq Ismail  Pg (Dip) Medical Ultrasound, BSc(Hons)

  • 0 Vascular Diseases

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    One of the most dangerous medical conditions existing in the world today is that of vascular disease. While it can take many forms, they all associated with high cholesterol and high blood pressure. Unfortunately, the majority of patients with some form of this disease do not seek treatment until their symptoms force them to, very often when they become life-threatening. Perhaps a little more education is in order so that people become more aware of the dangers of leaving these conditions to go untreated. The Dangers of High Cholesterol When a person’s cholesterol is not in check through medical treatment, there is a risk that cholesterol and fat deposits can find their way into the bloodstream and adhere to the walls of arteries and veins. Over time, these deposits build-up, causing the diameter of the artery or vein to decrease, restricting the flow of blood through them. Blood is needed for healing and when it cannot effectively reach an area that needs it, there is a chance that problems can develop that will lead to even more complications like losing a limb or worse. Restricted movement of blood through veins and arteries also causes the heart to work harder to get the blood throughout the body. This results in spikes of high blood pressure weakened arteries and veins and even damage to the heart itself, over time. Out of control conditions that are easily treated can have a domino effect on the body, causing more harm than help, so no matter how minor a condition may be thought of as being, it should be taken as seriously as possible, including high cholesterol. The Most Dangerous Forms of Vascular Disease The most common form of vascular disease that affects a lot of patients today is that of Peripheral Artery Disease or PAD. Peripheral means that it will affect the limbs of the body, primarily, most often the legs rather than the arms. It begins with feeling a sluggishness or fatigue in those limbs while moving about like they are weighted down. This is the first sign that blood is not flowing as it should throughout those areas. Patients will also experience occasional numbness or tingling in the region, not often enough to be considered chronic but often enough to be noticeable. The condition occurs when the flow of blood through the arteries to the heart becomes so bad that the lack of oxygen resident in the blood begins to damage the heart itself. Blood flows from the heart to the lungs, where oxygen is released into the bloodstream. If the arteries that serve that route have become blocked due to plaque buildup, the less oxygen-rich blood is released to flow back into the heart, causing the heart itself to become damaged. Symptoms of this condition can include progressive shortness of breath, chest pain and fainting following exertion. Over time, the restricted blood flow will cause ulcers or sores to develop in the skin, and infection of those ulcers can grow quickly, due to a lack of healing blood flow to the area. This can lead to a loss of a limb due to gangrene, further restricting the patient’s ability to move around on their own. While serious, this is not the most dangerous form of this disease; that title is reserved for Pulmonary Vascular Disease. Other types of vascular diseases include Post-Thrombotic Syndrome, Vasculitis, Aortic Dissection, Carotid Artery Disease, Buerger’s Disease, Varicose VeinsFibromuscular Dysplasia, Critical Limb Ischemia (CLI), Renovascular Hypertension (RAS), Lymphedema, Stroke, Chronic Venous Insufficiency (CVI), Pulmonary Embolism, Mesenteric Artery Disease, Thoracic Aortic Aneurysm and, Thrombophilia all of which can be fatal.   Diagnosis of Vascular Disease The occurrence of vascular disease increases with age and the prevalence varies considerably. Diagnosis is of the utmost importance as people with this disease have four to five times more incidence of stroke or heart attack. It is, therefore, a good habit to go for checkups every now and then just to be on the safe side and also eat healthy foods which are low on or better yet free of calories. Vascular ultrasound can detect early signs of vascular disease. International Ultrasound Services offers private ultrasound to check the health of your veins and arteries. This will give a quick diagnosis and will allow you to act on any findings. In our private ultrasound clinic we offer: Carotid ultrasound scans to evaluate the health of your carotid arteries for any signs of atheroma. DVT ultrasound scans to check for any signs of deep vein thrombosis.   Effective Treatments Treatments for the vascular disease can include blood thinners to alleviate some of the pressure involved in getting blood to circulate, medications to control cholesterol and high blood pressure, and finally, surgery to remove any clots or blockage to a specific area. All of these conditions can eventually become life-threatening, so treatment must be acquired as soon as possible.       Author- Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Medical Ultrasound Practitioner  Specialities:   Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare.     Reviewed: 07/04/2020 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons)  and Tareq Ismail  Pg (Dip) Medical Ultrasound, BSc(Hons)

  • 0 Testicular Cancer

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    Testicular Cancer  Testicular ultrasound is one of our most common private ultrasound tests for men to exclude testicular cancer which is a disease in which malignant (cancer) cells form in the tissues of one or both testicles.   The Testicles The testicles are 2 egg-shaped glands located inside the scrotum (a sac of loose skin that lies directly below the penis). The testicles are held within the scrotum by the spermatic cord, which also contains the vas deferens and vessels and nerves of the testicles. The testicles are the male sex glands and produce testosterone and sperm. Germ cells within the testicles produce immature sperm that travel through a network of tubules (tiny tubes) and larger tubes into the epididymis (a long coiled tube next to the testicles) where the sperm mature and are stored. Almost all testicular cancers start in the germ cells. The two main types of testicular germ cell tumours are seminomas and nonseminomas. These 2 types grow and spread differently and are treated differently. Nonseminomas tend to grow and spread more quickly than seminomas. Seminomas are more sensitive to radiation. A testicular tumour that contains both seminoma and nonseminoma cells is treated as a nonseminoma. Testicular cancer is the most common cancer in men 30 to 34 years old. There are 2400 testicular cases every year which is almost 6 every day.   Risk Factors of Testicular cancer   Anything that increases the chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor. Risk factors for testicular cancer include: Having had an undescended testicle. Having had abnormal development of the testicles. Having a personal or family history of testicular cancer. Being white.   Signs of testicular cancer. Signs of testicular cancer include swelling or discomfort in the scrotum. These and other symptoms may be caused by testicular cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur: A painless lump or swelling in either testicle. A change in how the testicle feels. A dull ache in the lower abdomen or the groin. A sudden build-up of fluid in the scrotum. Pain or discomfort in a testicle or in the scrotum.   Diagnostic Tests   Tests that examine the testicles and blood are used to detect and diagnose testicular cancer. The following tests and procedures may be used: Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. The testicles will be examined to check for lumps, swelling, or pain. A history of the patient’s health habits and past illnesses and treatments will also be taken. Testicular Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. International Ultrasound Services provides testicular ultrasound scans and other private ultrasound tests helping to obtain a quick diagnosis and speed up any treatment. You can also combine your private scan with other ultrasound scans for men to evaluate your overall health. Serum tumour marker test: A procedure in which a sample of blood is examined to measure the amounts of certain substances released into the blood by organs, tissues, or tumour cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumour markers. The following 3 tumour markers are used to detect testicular cancer: Alpha-fetoprotein (AFP). Beta-human chorionic gonadotropin (β-hCG). Lactate dehydrogenase (LDH). Tumour marker levels are measured before radical inguinal orchiectomy and biopsy, to help diagnose testicular cancer. Radical inguinal orchiectomy and biopsy: A procedure to remove the entire testicle through an incision in the groin. A tissue sample from the testicle is then viewed under a microscope to check for cancer cells. (The surgeon does not cut through the scrotum into the testicle to remove a sample of tissue for biopsy, because if cancer is present, this procedure could cause it to spread into the scrotum and lymph nodes.) If cancer is found, the cell type (seminoma or nonseminoma) is determined in order to help plan treatment. Prognosis The prognosis (chance of recovery) and treatment options depend on the following: Stage of cancer (whether it is in or near the testicle or has spread to other places in the body, and blood levels of AFP, β-hCG, and LDH). Type of cancer. Size of the tumour. Number and size of retroperitoneal lymph nodes. Testicular cancer is often curable. Treatment for testicular cancer can cause infertility. Certain treatments for testicular cancer can cause infertility that may be permanent. Patients who may wish to have children should consider sperm banking before having treatment. Sperm banking is the process of freezing sperm and storing it for later use.   Stages of Testicular Cancer   After testicular cancer has been diagnosed, tests are done to find out if cancer cells have spread within the testicles or to other parts of the body. The process used to find out if cancer has spread within the testicles or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:•Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.•CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.•Lymphangiography: A procedure used to x-ray the lymph system. A dye is injected into the lymph vessels in the feet. The dye travels upward through the lymph nodes and lymph vessels, and x-rays are taken to see if there are any blockages. This test helps find out whether cancer has spread to the lymph nodes.•Abdominal lymph node dissection: A procedure to examine lymph nodes in the abdomen. Lymph nodes are removed and a pathologist checks them for cancer cells. For patients with nonseminoma, removing the lymph nodes may help stop the spread of disease. Cancer cells in the lymph nodes of seminoma patients can be treated with radiation therapy.•Radical inguinal orchiectomy and biopsy: A procedure to remove the entire testicle through an incision in the groin. A tissue sample from the testicle is then viewed under a microscope to check for cancer cells. (The surgeon does not cut through the scrotum into the testicle to remove a sample of tissue for biopsy, because if cancer is present, this procedure could cause it to spread into the scrotum and lymph nodes.)•Serum tumour marker test: A procedure in which a sample of blood is examined to measure the amounts of certain substances released into the blood by organs, tissues, or tumour cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumour markers. The following 3 tumour markers are used in staging testicular cancer:◦Alpha-fetoprotein (AFP)◦Beta-human chorionic gonadotropin (β-hCG).◦Lactate dehydrogenase (LDH). Tumour marker levels are measured again, after radical inguinal orchiectomy and biopsy, in order to determine the stage of cancer. This helps to show if all of the cancer has been removed or if more treatment is needed. Tumour marker levels are also measured during follow-up as a way of checking if cancer has come back. There are three ways that cancer spreads in the body. The three ways that cancer spreads in the body are:•Through tissue. Cancer invades the surrounding normal tissue.•Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.•Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body. When cancer cells break away from the primary (original) tumour and travel through the lymph or blood to other places in the body, another (secondary) tumour may form. This process is called metastasis. The secondary (metastatic) tumour is the same type of cancer as the primary tumour. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer. The following stages are used for testicular cancer: Stage 0 (Carcinoma in Situ) In stage 0, abnormal cells are found in the tiny tubules where the sperm cells begin to develop. These abnormal cells may become cancer and spread into nearby normal tissue. All tumour marker levels are normal. Stage 0 is also called carcinoma in situ. Stage I In stage I, cancer has formed. Stage I is divided into stage IA, stage IB, and stage IS and is determined after a radical inguinal orchiectomy is done.•In stage IA, cancer is in the testicle and epididymis and may have spread to the inner layer of the membrane surrounding the testicle. All tumour marker levels are normal.•In stage IB, cancer:◦is in the testicle and the epididymis and has spread to the blood or lymph vessels in the testicle; or◦has spread to the outer layer of the membrane surrounding the testicle, or◦is in the spermatic cord or the scrotum and maybe in the blood or lymph vessels of the testicle. All tumour marker levels are normal. •In stage IS, cancer is found anywhere within the testicle, spermatic cord, or the scrotum and either:◦all tumour marker levels are slightly above normal; or◦one or more tumour marker levels are moderately above normal or high.   Stage II Stage II is divided into stage IIA, stage IIB, and stage IIC and is determined after a radical inguinal orchiectomy is done.•In stage IIA, cancer:◦is anywhere within the testicle, spermatic cord, or scrotum; and◦has spread to up to 5 lymph nodes in the abdomen, none larger than 2 centimetres. All tumour marker levels are normal or slightly above normal. •In stage IIB, cancer is anywhere within the testicle, spermatic cord, or scrotum; and either:◦has spread to up to 5 lymph nodes in the abdomen; at least one of the lymph nodes is larger than 2 centimetres, but none are larger than 5 centimetres; or◦has spread to more than 5 lymph nodes; the lymph nodes are not larger than 5 centimetres. All tumour markers levels are normal or slightly above normal. •In stage IIC, cancer:◦is anywhere within the testicle, spermatic cord, or scrotum; and◦has spread to a lymph node in the abdomen that is larger than 5 centimetres. All tumour marker levels are normal or slightly above normal. Stage III Stage III is divided into stage IIIA, stage IIIB, and stage IIIC and is determined after a radical inguinal orchiectomy is done.•In stage IIIA, cancer:◦is anywhere within the testicle, spermatic cord, or scrotum; and◦may have spread to one or more lymph nodes in the abdomen; and◦has spread to distant lymph nodes or to the lungs. The level of one or more tumour markers may range from normal to slightly above normal. •In stage IIIB, cancer:◦is anywhere within the testicle, spermatic cord, or scrotum; and◦may have spread to one or more nearby or distant lymph nodes or to the lungs. The level of one or more tumour markers may range from normal to high. •In stage IIIC, cancer:◦is anywhere within the testicle, spermatic cord, or scrotum; and◦may have spread to one or more nearby or distant lymph nodes or to the lungs or anywhere else in the body. The level of one or more tumour markers may range from normal to very high.   Testicular Cancer Prognosis   For nonseminoma, all of the following must be true:•The tumour is found only in the testicle or in the retroperitoneum (area outside or behind the abdominal wall); and•The tumour has not spread to organs other than the lungs; and•The levels of all the tumour markers are slightly above normal. For seminoma, all of the following must be true:•The tumour has not spread to organs other than the lungs; and•The level of alpha-fetoprotein (AFP) is normal. Beta-human chorionic gonadotropin (β-hCG) and lactate dehydrogenase (LDH) may be at any level. Intermediate Prognosis For nonseminoma, all of the following must be true:•The tumour is found in one testicle only or in the retroperitoneum (area outside or behind the abdominal wall); and•The tumour has not spread to organs other than the lungs; and•The level of any one of the tumour markers is more than slightly above normal. For seminoma, all of the following must be true:•The tumour has spread to organs other than the lungs; and•The level of AFP is normal. β-hCG and LDH may be at any level. Poor Prognosis For nonseminoma, at least one of the following must be true:•The tumour is in the centre of the chest between the lungs; or•The tumour has spread to organs other than the lungs; or•The level of any one of the tumour markers is high. There is no poor prognosis grouping for seminoma testicular tumours.   Testicular Cancer Questions and Answers  •Nearly all testicular cancers are one of two general types: seminoma or nonseminoma. Other types are rare (see Question 1).•This disease occurs most often in men between the ages of 20 and 39. It accounts for only 1 per cent of all cancers in men (see Question 1).•Risk factors include having an undescended testicle, previous testicular cancer, and a family history of testicular cancer (see Question 2).•Symptoms include a lump, swelling, or enlargement in the testicle; pain or discomfort in a testicle or in the scrotum; and/or an ache in the lower abdomen, back, or groin (see Question 3).•Diagnosis generally involves blood tests, ultrasound, and biopsy (see Question 4).•Treatment can often cure testicular cancer (see Question 5), but regular follow-up exams are extremely important (see Question 6).  1. What is testicular cancer? Testicular cancer is a disease in which cells become malignant (cancerous) in one or both testicles. The testicles (also called testes or gonads) are a pair of male sex glands. They produce and store sperm and are the main source of testosterone (male hormones) in men. These hormones control the development of the reproductive organs and other male physical characteristics. The testicles are located under the penis in a sac-like pouch called the scrotum. Based on the characteristics of the cells in the tumour, testicular cancers are classified as seminomas or nonseminomas. Other types of cancer that arise in the testicles are rare and are not described here. Seminomas may be one of three types: classic, anaplastic, or spermatocytic. Types of nonseminomas include choriocarcinoma, embryonal carcinoma, teratoma, and yolk sac tumors. Testicular tumours may contain both seminoma and nonseminoma cells. Testicular cancer accounts for only 1 per cent of all cancers in men in the United States. About 8,000 men are diagnosed with testicular cancer, and about 390 men die of this disease each year (1). Testicular cancer occurs most often in men between the ages of 20 and 39, and is the most common form of cancer in men between the ages of 15 and 34. It is most common in white men, especially those of Scandinavian descent. The testicular cancer rate has more than doubled among white men in the past 40 years but has only recently begun to increase among black men. The reason for the racial differences in incidence is not known.  1. What are the risk factors for testicular cancer?•Undescended testicle (cryptorchidism): Normally, the testicles descend from inside the abdomen into the scrotum before birth. The risk of testicular cancer is increased in males with a testicle that does not move down into the scrotum. This risk does not change even after surgery to move the testicle into the scrotum. The increased risk applies to both testicles.•Congenital abnormalities: Men born with abnormalities of the testicles, penis, or kidneys, as well as those with inguinal hernia (hernia in the groin area, where the thigh meets the abdomen), may be at increased risk.•History of testicular cancer: Men who have had testicular cancer are at increased risk of developing cancer in the other testicle.•Family history of testicular cancer: The risk for testicular cancer is greater in men whose brother or father has had the disease. The exact causes of testicular cancer are not known. However, studies have shown that several factors increase a man’s chance of developing this disease.  1. How is testicular cancer detected? What are the symptoms of testicular cancer?•a painless lump or swelling in a testicle•pain or discomfort in a testicle or in the scrotum•any enlargement of a testicle or change in the way it feels•a feeling of heaviness in the scrotum•a dull ache in the lower abdomen, back, or groin•a sudden collection of fluid in the scrotum Most testicular cancers are found by men themselves. Also, doctors generally examine the testicles during routine physical exams. Between regular checkups, if a man notices anything unusual about his testicles, he should talk with his doctor. Men should see a doctor if they notice any of the following symptoms: These symptoms can be caused by cancer or by other conditions. It is important to see a doctor to determine the cause of any of these symptoms.  1. How is testicular cancer diagnosed? •Blood tests that measure the levels of tumour markers. Tumour markers are substances often found in higher-than-normal amounts when cancer is present. Tumour markers such as alpha-fetoprotein (AFP), Beta-human chorionic gonadotropin (ßHCG), and lactate dehydrogenase (LDH) may suggest the presence of a testicular tumour, even if it is too small to be detected by physical exams or imaging tests.•Ultrasound, a test in which high-frequency sound waves are bounced off internal organs and tissues. Their echoes produce a picture called a sonogram. Ultrasound of the scrotum can show the presence and size of a mass in the testicle. It is also helpful in ruling out other conditions, such as swelling due to infection or a collection of fluid unrelated to cancer.•Biopsy (microscopic examination of testicular tissue by a pathologist) to determine whether cancer is present. In nearly all cases of suspected cancer, the entire affected testicle is removed through an incision in the groin. This procedure is called radical inguinal orchiectomy. In rare cases (for example, when a man has only one testicle), the surgeon performs an inguinal biopsy, removing a sample of tissue from the testicle through an incision in the groin and proceeding with orchiectomy only if the pathologist finds cancer cells. (The surgeon does not cut through the scrotum to remove tissue. If the problem is cancer, this procedure could cause the disease to spread.) To help find the cause of symptoms, the doctor evaluates a man’s general health. The doctor also performs a physical exam and may order laboratory and diagnostic tests. These tests include: If testicular cancer is found, more tests are needed to find out if cancer has spread from the testicle to other parts of the body. Determining the stage (extent) of the disease helps the doctor to plan appropriate treatment.  1. How is testicular cancer treated? What are the side effects of treatment?•Surgery to remove the testicle through an incision in the groin is called a radical inguinal orchiectomy. Men may be concerned that losing a testicle will affect their ability to have sexual intercourse or make them sterile (unable to produce children). However, a man with one healthy testicle can still have a normal erection and produce sperm. Therefore, an operation to remove one testicle does not make a man impotent (unable to have an erection) and seldom interferes with fertility (the ability to produce children). For cosmetic purposes, men can have a prosthesis (an artificial testicle) placed in the scrotum at the time of their orchiectomy or at any time afterwards. Some of the lymph nodes located deep in the abdomen may also be removed (lymph node dissection). This type of surgery does not usually change a man’s ability to have an erection or an orgasm, but it can cause problems with fertility if it interferes with ejaculation.     Author- Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Medical Ultrasound Practitioner  Specialities:   Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare.     Reviewed: 07/04/202 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons)  and Tareq Ismail  Pg (Dip) Medical Ultrasound, BSc(Hons)

  • 0 Ultrasound for Common Urologic Conditions in Both Men and Women

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    The urinary tract ultrasound or US Urinary tract is the primary imaging modality in the investigation of the urinary tact symptoms in men and women. Below we discuss the most common urinary tract symptoms that patients seek medical advice.   Common Urologic Conditions in Both Men and Women   Incontinence Total Incontinence Total incontinence is defined as a constant or intermittent loss of urine without normal urination. Stress Incontinence Stress incontinence is defined as an involuntary loss of urine not caused by bladder contraction and is associated with activities such as coughing, sneezing, laughing, lifting, or exercise. Stress incontinence usually occurs in females and may be associated with multiple vaginal deliveries. Urge Incontinence Urge incontinence is the involuntary loss of urine associated with an overwhelming desire or need to urinate. Overflow Incontinence Overflow incontinence results from urine loss as a result of a failure of the bladder to empty rather than an inability to properly store urine. The hallmark of overflow incontinence is a high urine volume after urination. Enuresis Enuresis refers to involuntary wetting in children. It is generally a problem at night but also occurs during the daytime. Urinary Tract Infections (UTIs) Upper urinary tract infections involve the kidneys. An infection of the kidney associated with fever chills, and flank pain is known as acute pyelonephritis. Acute pyelonephritis usually represents a serious infection and requires treatment with intravenous antibiotics and subsequent long-term oral antibiotic therapy. Lower urinary tract infections may involve the bladder (known as cystitis) or the urethra (known as urethritis). Symptoms typically include frequency, urgency, nighttime urination (nocturia), and painful urination (dysuria). Females have a higher incidence of cystitis, which increases throughout their lifetime. Treatment is usually with oral antibiotic therapy. Kidney Stones The patient with a kidney stone typically complains of pain in the flank, back, or side along with blood in the urine. Patients generally toss about and cannot find a comfortable condition. Sometimes there may be associated with nausea and vomiting. If there is associated infection (i.e., high fever, chills), immediate intervention is usually necessary. Approximately 12 to 24 million Americans will develop a kidney stone during their lifetime. Kidney stones are more common in men and occur frequently in people in their thirties or forties. Care of the patient with a kidney stone is based on: Size and location of the stone and likelihood of its spontaneous passage Any complicating medical problems (i.e., diabetes) Complications related to the stone (i.e., obstruction or infection) The large majority of stones pass spontaneously, and the patient requires only pain medication. However, stones that do not pass spontaneously or cause persistent symptoms are treated using lasers, ultrasound, or shock waves. Cancers Related to the Urinary Tract Bladder Cancer Bladder cancer is the second most common urologic cancer with close to 50,000 new cases and 12,000 deaths reported each year. It is 3 times more common in men than women, and it is 4 times more common in Caucasians than African-Americans. Although no cause of bladder cancer is known, it is felt that environmental exposure to carcinogens plays a major role. Cigarette smoking is a major risk factor for bladder cancer. When diagnosed early, most bladder cancers can be treated and effectively cured. Kidney Cancer Renal cell carcinoma is the most common solid renal tumour and occurs in 90% of cases. It primarily occurs in adults, and males are twice as likely to be affected. Thirty thousand new diagnoses are made each year in the United States, and 12,000 deaths from it are recorded. Presenting symptoms such as pain, blood in the urine (hematuria), and flank mass occur only rarely today and generally indicate advanced disease. Greater than 50% of tumours present as asymptomatic, incidental findings on radiographic imaging studies such as ultrasound or CT scans. Surgery is the most effective treatment for primary renal cell carcinoma as most tumours do not respond well to radiation therapy or chemotherapy.   Author- Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Medical Ultrasound Practitioner  Specialities:   Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare.     Reviewed: 07/04/2020 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons)  and Tareq Ismail  Pg (Dip) Medical Ultrasound, BSc(Hons)

  • 0 What is a Private Scan

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     What is a Private Scan?  A private scan is a medical imaging examination undertaken by a private healthcare provider where the cost of the examination is undertaken solely by the patient or through a private health insurance provider. There is a large number of private diagnostic imaging providers that offer various scans including private ultrasound, CT and MRI scans.   What is a Scan? A medical scan is a medical imaging investigation employed to diagnose any internal abnormality of the human body that can explain any health symptoms someone might be experiencing.   Different types of scans There are various kinds of diagnostic scans but the most common are:   Ultrasound Scan The ultrasound scan, mostly associated with pregnancy ultrasounds, is using sound waves to obtain internal images of your organs. Uses no radiation and it is not known to be harmful to adults and most important to unborn babies. You can find more information about ultrasound scans.   CT Scan   Unlike the ultrasound scan, the CT scan uses radiation to obtain images of the internal organs and can be used in cases where ultrasound offer suboptimal imaging information. Due to radiation risk, CT scans are limited to patients where the diagnosis outweighs the radiation risks from the scan.   MRI Scan   The MRI scanner uses magnetic fields to obtain the required diagnostic information.   Can I pay for a scan? Yes, you can pay to have a private scan but CT and MRI investigations will require a doctor's request. The majority of the ultrasound scan clinics do not require a doctors referral.   How much an ultrasound Scan cost? Ultrasound scan prices vary quite significantly throughout the UK and mostly in London.  The average price is however roughly between £100 and £200. Private hospitals will charge significantly more than a private ultrasound clinic run by NHS sonographers. This can sometimes be more than 3 times. You also need to be aware of any hidden costs. A few ultrasound clinics offer significantly discounted examinations, raising concerns not only about the quality of the service but also the diagnostic accuracy of the results.     Why should I have a private ultrasound scan? The main reason patients choose to have a private ultrasound scan in London instead of one provided for free by the NHS is that the waiting times can be very long. Most NHS providers aim to offer an ultrasound examination within 6 weeks. It is unfortunately very common these days to hear stories of patients waiting for more than 6 weeks. This wait can have a significant impact on the patients' health management. Another reason the patient chose to go private is convenience. Although the NHS is slowly changing, most imaging departments operate between 9 to 5 which is not always suitable for our fast-paced and busy lifestyles.      How to choose a private ultrasound clinic?   There are so many ultrasound clinics in London offering scans and mainly private ultrasounds that makes it very difficult to choose the best.   What should you look for when you choosing an ultrasound clinic? Care Quality Commission registration  Independent reviews to find out what users think about the service they received. If the sonographers or radiologists are experienced and knowledgable.  How long they have been offering ultrasound services?     Author- Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Medical Ultrasound Practitioner  Specialities:   Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare.     Reviewed: 07/04/2020 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons)  and Tareq Ismail  Pg (Dip) Medical Ultrasound, BSc(Hons)

  • 0 Assessment Cycle or Tracking Cycle

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    What is a Tracking Cycle? We use a ‘Tracking Cycle or Assessment cycle’ to check that the orderly process of egg maturation through follicles’ size development, hormonal changes, and endometrial (the lining of the uterus) thickness build-up is occurring. This cycle is used to assess whether there is an ovulation cause for the couples infertility, assess the ovarian reserve and diagnose luteal phase insufficiency (low progesterone levels in the second half of the cycle). The follicle tracking scan is the most accurate method to time ovulation and aid couple achieving pregnancy naturally.   Why tracking cycle? Follicle-stimulating hormone (FSH) and luteinising hormone (LH) are released from the pituitary gland (found at the base of the brain) under control of higher brain centres and feedback from ovarian hormones. These hormones stimulate the immature eggs in the ovary to undergo growth and maturation (follicles). This process releases estrogens and progesterone from the maturing follicles, which then stimulates the endometrium (lining of the uterus) so that it is ready to accept a fertilized egg (embryo), to undergo implantation, and hence achieve a pregnancy. As the egg matures a cyst called a follicle develops on the ovary, which produces estrogens. This follicle, which can be seen and measured on an ultrasound picture of the ovaries, may grow to about 2cm in diameter just before ovulation. The estrogens’ effects on the body are usually obvious, particularly by the amount and consistency of mucus discharged from the vagina. Ovulation is triggered by a surge of Luteinising Hormone (LH) from the pituitary gland. LH also stimulates the ovary to begin producing the hormone progesterone. Progesterone causes a slight increase in body temperature and prepares the endometrium for implantation of the fertilized egg.   What is involved in the tracking cycle? Tracking cycle is a combination of ultrasounds scans and blood tests carried out at certain days of the menstrual cycle. Day 2 blood tests for FSH, LH, Prolactin, Oestradiol and progesterone Day 5 Ultrasounds scan to assess the ovarian reserve according to the Antral Follicular Count (AFC) Ultrasounds scan and blood test every 2-3 days from day 9 till ovulation. Blood tests to measure progesterone 7 days after ovulation (day 21) with or without ultrasounds scan to check the corpus luteum.       Author- Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Medical Ultrasound Practitioner  Specialities:   Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare.     Reviewed: 07/04/2020 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons)  and Tareq Ismail  Pg (Dip) Medical Ultrasound, BSc(Hons)

  • 0 Private Scan for Ectopic Pregnancy

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    Private Scan for Ectopic Pregnancy Ultrasound imaging is the first line of tests performed when ectopic pregnancy is suspected. An ectopic pregnancy happens when the products of fertilization implants and develops beyond the confines of the uterus and it is one of the more serious complications of pregnancy. It is one of the most common reasons for an early pregnancy scan as the incidence of ectopic pregnancies is 1-2% and is still the most common cause of pregnancy-related death in the first trimester, accounting for about 10% of all pregnancy-related deaths. Ectopic pregnancy is almost always not viable, except for very few instances. This condition can bring bleeding within the abdominal cavity which can be fatal for the mother. The most common form of ectopic pregnancy is one that takes places within the fallopian tubes, which is also called a tubal pregnancy. Other locations of implantation are the ovaries, cervix, and the abdomen. As has been mentioned, this condition can bring bleeding and death, and as such should be treated as an emergency. The course of a normal uterine pregnancy starts when the uterus receives the newly fertilized egg. The egg implants itself in the nutrient-rich uterine lining where it will eventually develop. On the other hand, in ectopic pregnancy, this process does not take place in the uterus: 98% of the time it happens in the Fallopian tubes.   Diagnosis  With the current advances in diagnostic tools and procedures such as the early pregnancy scan, ectopic pregnancy can be detected and addressed earlier. However, in spite of the diagnostic advances, this condition is still the main cause of morbidity and mortality among mothers all over the world. An increase in the incidence of ectopic pregnancy can be found in countries with substandard prenatal imaging and care. International Ultrasound Services offers same-day early pregnancy scans as well as other private pregnancy scans in an effort to speed up diagnosis and treatment.   If you suspect that you might have an ectopic pregnancy you should seek medical assistance immediately. Ectopic pregnancy takes place when the fertilized egg implants into the lining of the Fallopian tube. The egg eventually erodes into the surrounding blood vessels, bringing about bleeding. The bleeding that takes places within the Fallopian tube will push the egg out of the tube, ending up in what is called a tubal abortion. The Fallopian tube does not undergo inflammation in this case, and the pain is brought about by the prostaglandins present at the actual area of implantation and the irritation due to the presence of blood in the peritoneum. When bleeding becomes more profuse, it can bring about the threat to the mother. While the common cause of the increase in bleeding is the delay in the diagnosis of ectopic pregnancy, some bleeding takes place a little faster. This is especially true when the implantation takes place in the proximal area of the Fallopian tube. In this case, the egg may eventually erode into the Sampson artery located in close proximity to the tube. In 50% of cases, ectopic pregnancies resolve by itself, without intervention. This is especially true with tubal abortions. Currently, the need to perform the surgery has been drastically reduced with the introduction of methotrexate in the treatment of ectopic pregnancy. It should be remembered, though, that surgery will still have to be performed when the Fallopian tubes is near rupture or have already ruptured. Surgery may entail a limited incision via a laparoscopic method, or a larger incision may be used, in which case it is called a laparotomy.   Ectopic Pregnancy Signs and Symptoms The early signs and symptoms of ectopic pregnancy are usually so subtle, if they are even present, which is why it is quite difficult to make an early diagnosis. The average time for the signs and symptoms of ectopic pregnancy to present themselves is about 7.2 weeks following the last menstruation, and the range is from 5 to 8 weeks. Diagnosis may come in even later for areas where facilities are insufficient.   The following are the early presentations of ectopic pregnancy: Hypogastric pain accompanied by a sensation of swelling. The pain may be perceived as intense stomach pain, but the pain may also occur in the form of a strong cramping sensation.Dysuria, or pain when urinatingA vague abdominal discomfort which is similar to symptoms brought about by the presence of corpus luteum in the ovaryMild vaginal bleeding. This is a form of withdrawal bleeding, a phenomenon that occurs when progesterone levels go down. This symptom may also be noted during the early stage of pregnancy (also called “ implantation bleed”) or during a miscarriage.Abdominal pain during a bowel movement.Later on, ectopic pregnancy presents itself as pain and bleeding, which may be vaginal or abdominal, or both. The causes of bleeding are as follows: Hormonal trigger, i.e., a drop in the level of progesterone•  Peritoneal bleeding secondary to rupture of the Fallopian tube Some of the differential diagnoses are miscarriage and normal pregnancy in its early stage. Pelvic inflammatory disease, or PID, is the most common faulty diagnosis for ectopic pregnancy. To rule out the presence of PID, a pregnancy test can be performed. A positive pregnancy test essentially rules out PID because a pregnancy that is concurrent with an active pelvic infection is very rare. When bleeding becomes more profuse, the following symptoms may occur: •  Pain which may be located at the lower back, abdomen, and pelvis •  Shoulder pain. This is regarded as a dangerous sign because it indicates irritation of the diaphragm secondary to the blood that is filling up the abdomen. •  Unilateral pelvic tenderness and cramping sensation •  The pain is comparatively acute as opposed to other more chronic pelvic pain, which worsens with time. Ectopic pregnancy should also be differentiated from other conditions like pelvic inflammatory disease, appendicitis, and other gynaecological, gastrointestinal, and urinary problems.   Ectopic Pregnancy Causes While a number of risk factors for ectopic pregnancy have been identified in previous studies, no particular risk factor can be singled out in 30 to 50 per cent of cases. Infertility, smoking, endometriosis, a previous history of pelvic inflammatory disease, prior use of DES, a history of D & C or other uterine surgeries, tubal surgery, use of an IUD or intrauterine device, tubal ligation, and a history of ectopic pregnancy are just some of the risk factors enumerated.   Ectopic Pregnancy Treatment Medical Methotrexate has been used for the non-surgical treatment of ectopic pregnancy since 1993. Methotrexate can halt the growth of the embryo, inducing either an abortion or resorption of the embryologic tissue or the passage of the products of conception during the woman's regular menstrual period. If administered early enough, methotrexate is effective in terminating ectopic pregnancy.   Surgical   Surgical treatment may have to be initiated once bleeding has set in. In a patient with only little bleeding seen on ultrasound, however, the decision to perform surgery turns into a dilemma. Studies to back this up will have to be identified. Two surgical procedures, laparoscopy and laparotomy, can be used by the surgeons. Both approaches can provide a visualization of the pelvis and the affected Fallopian tube. The tube can then be incised either by taking out only the portion where the embryo has implanted (salpingostomy) or by taking out the entire tube (salpingectomy). Robert Lawson Tait is credited for doing the first successful surgery for an ectopic pregnancy, which took place in 1883.   Author- Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Medical Ultrasound Practitioner  Specialities:   Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare.     Reviewed: 07/04/2020 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons)  and Tareq Ismail  Pg (Dip) Medical Ultrasound, BSc(Hons)

  • 0 URINARY TRACT INFECTION IN WOMEN – CAUSES, SYMPTOMS, TREATMENT & PREVENTION

    • by Administrator
    • 06-11-2019
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    Urinary  Tract  Infection  ( UTI ) is  defined  as  the  infection  of  any  part  of  the  Urinary  system  i.e  the  Urethra, Urinary  bladder, Ureters  or  the  Kidneys. These  infections  are  quite  common  in  women  because  of  the  short  length of  the  urethra  &  the  proximity  of  the  urethral  opening  to  vagina &  anal  opening.   How does Urinary Tract Infection develop?   Causes of UTI : UTI  develops when infective organisms invade the various parts  of the  Urinary tract . To  begin  with, they  may  affect  the  urethra, and  if  the  infection  remains  uncontrolled,  they  may  ascend  upwards  to  invade  the  Urinary  bladder,  ureters  or  even  the  Kidneys.  The  factors  which  aggravate  the  risk  of  UTI’s  in  women  include: Female anatomy–  As discussed above,  the close  association between  the  female  urethra,  vagina  &  anal  region  increases  the  likelihood  of  spread  of  bacteria from  vaginal  or  gastro-intestinal  tract  to  the  urinary  Moreover, the  short  urethra in  women  decreases  the  distance  that  the  bacteria  need  to  travel  in  order  to  reach  the  urinary  bladder . Thus,  the  incidence  of  UTI’s  is  more  in  women  as  compared  to  men. Sexual activity –  Sexual  activity  increases  the  chances  of  UTI  especially,  if  there  are  multiple  sexual  Women  are  more  prone  to  sexually  transmitted  infections  &  the  organisms  may  be  transmitted  from  the  genital  region  to  the  urethra  by  the  contact  with  fingers/genitals/other  devices. Certain contraceptive measures –   Certain  birth  control  measures  such  as  using  the  Diaphragm  or  spermicidal  agents  can  increase  the  chances  of Pregnancy- UTI’s  are  common  in  pregnancy,  the  risk  begins  at  6  weeks   &  peaks  at  about  22-24  weeks  of    The  reason  is  the  relaxation  of  smooth  muscles  in  response  to  pregnancy  hormones  and  the  resultant  increase  in  volume of urinary  bladder,  accompanied  by  urinary stasis (  decreased  urinary  flow rate ).  This  also  leads  to  increased  episodes  of  urinary  reflux  i.e  backward  flow  of  urine  from  the  bladder   into  the  ureters  or  even  kidneys  occasionally. All  these  factors  increase  the  chances  of  development  of  UTI  in  pregnancy. Menopause- After  menopause,  the  circulating  levels  of  Oestrogen  in  the  body  decrease  and  this  leads  to  changes  in  the  mucosal  lining  of  the  urinary  &  genital  tract  that  increases  the  chances  of infections. Obstruction to  urinary  flow –  This  maybe  due  to  certain  abnormalities  of  the  urinary  tract  or  presence  of  stones  ( calculus) in  urinary  tract,  which  may  prevent  smooth  forward  flow  of  urine  and  may  predispose  to Low Immunity  –  A decreased  immunity,  for  eg  in  women  with  Diabetes  or  HIV  infection,  increases  the  chances  of Recent Urinary  / Genital  procedure-  Any  surgical or  interventional  procedure  involving  the  urinary  tract  or  sometimes  the  genital  tract  also  may  increase  the  possibility  of  UTI Others- Other  causes  like  a neurological  condition  ,  history  of  previous  urinary  infections    may  also  increase  a  woman’s  chances  of  developing  UTI.     How do I know if I have UTI ?   Symptoms of Urinary Tract Infections : Urinary  tract  infections  may  sometimes  cause  no  symptoms   but  mostly,  a  woman  gets  one  or  more  of  the  following  signs/symptoms : Urgency- There  may  be  a  strong  urge  to  urinate,  which  may  sometimes  be uncontrollable Frequency- You  may  soon feel  the  need  to  urinate  again  even  though  you  have  passed  urine Dysuria- There  may  be a pain  in  urethral  region  or  pelvis  while  urinating Odour- The  urine  may  be  foul-smelling Colour- Sometimes,  the urine may appear cloudy or maybe blood    Consult your doctor  if the urine appears  bloodstained. Pelvic pain-  When  the  infection  reaches  the  bladder,  it  may  lead  to  pelvic  pain  or  pain  felt  in  the  lower  part  of  the Flank pain-  Pain  in  the  upper  back  &  sides  may  be  a  sign  of  infection  in  the  kidneys  and  it  maybe  accompanied  by  fever,  chills,    Consult  your  doctor  immediately  if  you  develop  any  of  these. The  gold  standard  for  diagnosing  a  Urinary  Tract  Infection  is  a Urine  test  for  routine  microscopy  and  a  Culture/Sensitivity test  to  check  for  the  presence  of  specific  infective  organisms  and  their  sensitivity  to  various  antibiotics.  A  culture/sensitivity  test  guides your  doctor  to  prescribe  the  most  effective  antibiotic  for  the  organism  causing  your  UTI.     How can UTI be treated ?   Urinary Tract Infection Treatment : The  best  cure  for  a  urinary  tract  infection  is  to  take  relevant  antibiotics  for  the  prescribed  period  of  time  as  advised  by  your  doctor. However,  there  are  other  supportive  measures  that  need  to  be  followed  in  order  to  facilitate  relief  of  symptoms  &  complete  cure . Antibiotics  usually  lead  to  a  quick  relief  of  symptoms,  however,  you  must  continue  the  medications  for  the  complete  prescribed  duration  or  else  it  may  lead  to  incomplete  cure  of  UTI  which  may  then  flare  up  again  after  a  few  days  and  thus  may  lead  to  recurrent , resistant infections . You  can  also  take  certain  supportive  measures  to  ease  your  discomfort  when you  have  UTI  : Drink plenty  of  water :  Drink  at  least  8-10  glasses  of  water  in  a    Water  helps  to  dilute  the  urine  and  hence  decreases  the  irritation  &  pain  in  the  urinart  tract.  It  also  helps  to  flush  out  the  toxins &  organisms  causing  the  UTI. Avoid coffee/  tea  or  other  liquids  that  may  irritate  your Urinary alkalinises may  sometimes  be  prescribed  by  your  doctor  &  help  decrease  the Avoid sexual  activity when  you  have  active Cranberry juice,  Barley  water,  etc  help  ease  the  discomfort  but  the exact  benefit  afforded  by  these  is  still Use warm heating pads on lower abdomen  &  back to relieve the discomfort.    However,  make sure that the pads are not excessively hot.     What are the complications of UTI ?   Usually,  if treated properly,  UTI  does not cause any long term complications.  However, if  treated  incompletely,  or  in  a  person with  compromised  immunity,  it  may  lead  to  the  following  complications: Recurrent infections-  Recurrent  UTI  is defined as the occurrence of  UTI  3 times or more in a  year.  Partially  treated  infections  or  in  cases  where  the  cause  for  the  primary  infection  persists  &  is  not  eradicated may  lead  to  recurrent Kidney damage- Persistent  infection  or  a  very  acute  &  severe episode  of  UTI  may  sometimes  lead  to  permanent  kidney  damage  which  may  necessitate  a  prolonged  course  of Preterm birth  –  Untreated  UTI  may  lead  to the onset  of  preterm  labour  &  delivery  leading  to  low  birth  weight  & a compromised  baby  who  may  need  Nursery  care  or  admission  to Sepsis- Spread of infection all over the body may lead to serious complications  &  sepsis which may require hospital/ICU  admission.     How  can  UTI  be  prevented  ?   Prevention of Urinary Tract Infection :   UTI  can  be  prevented  by the following  measures  : Drink plenty  of  liquids –  at  least  8-10  glasses  a  day After urinating  or  passing  stools,  wipe  from  front  to  back,  to  prevent the spread  of  organisms  from the anal  region  towards Avoid the use  of  spermicidal  jellies  or  diaphragms  for Avoid multiple  sexual  partners Ensure that  you  take complete  treatment  for  the first  episode  of    UTI  as  prescribed  by  your    What is the role of ultrasound in the management of urinary tract infections?   Urinary tract ultrasound imaging is being used in cases of confirming UTI to evaluate the urinary tract anatomy and exclude any underlying pathology such as kidney stones, tumours and bladder problems. In cases of chronic complications, ultrasound will evaluate any damaged caused to the kidneys from recurrent infections such as renal scarring or hydronephrosis. Your doctor will probably refer you to your local hospital to have a kidney ultrasound scan but as the ultrasound NHS waiting times are along you can opt to have a private ultrasound instead. You can find more about the private urinary tract scans we offer at the exam page information.  

  • 0 PELVIC INFECTIONS: CAUSES AND PREVENTION

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    Pelvic Infections or Pelvic Inflammatory Disease (PID), is a term used for infection of Pelvic organs i.e the Uterus, Fallopian tubes & Ovaries in a woman. These are commonly transmitted sexually but may, sometimes, be attributed to other causes. According to WHO, about 448 million new cases of Sexually Transmitted Infections (STI) are diagnosed annually and it is among the top 5 disease categories for which an individual seeks medical care. Signs and Symptoms – Many women having PID may not have any obvious symptoms, but usually an episode of PID or Pelvic infections may present with the following symptoms:   Lower abdominal pain Pain during intercourse Bleeding after intercourse Irregular/ abnormal periods or spotting in between two periods. Excessive or foul-smelling vaginal discharge Vaginal or Perineal itching Frequent or painful/burning urination Occasionally, in advanced cases, there may be fever, vomiting, severe pain or even fainting episodes. Pelvic ultrasound is the first line of investigation for suspected pelvic inflammatory disease. You can find more about the investigation at our pelvic ultrasound page.   Complications – Pelvic infections and PID can be a cause of significant morbidity and may have long-lasting outcomes including: It is the leading cause of infertility, about 1 in 8 women having a history of PID can have difficulty in getting pregnant. It may lead to chronic pelvic pain in about 25% of women. They may have pain related to menstrual cycles or may have persistent lower abdominal pain. PID leads to the formation of adhesions i.e scar tissue in or around fallopian tubes which significantly increases the chances of Ectopic pregnancy ( pregnancy implanted outside the cavity of the uterus that can lead to serious life-threatening complications) In the long-term, recurrent pelvic infection, especially with HPV, can be a precursor of cervical cancer. Causes and Risk factors – PID is generally considered to be a polymicrobial infection, i.e it is caused by multiple micro-organisms. These generally include bacterial pathogens like Chlamydia and Neisseria along with a number of other pathogens like Gardnerella, Mycoplasma, Trichomonas, Herpes Simplex Virus-2 and various anaerobic bacteria that may be transmitted by sexual contact and are found in the vagina. Hence, it comes as no surprise that PID results primarily from unprotected sexual intercourse in most cases. However, there may be other causes for the development of the infection and the following factors may increase the risk of a woman suffering from PID: Unprotected sexual activity i.e intercourse without using a condom. Having multiple sexual partners or having intercourse with a person who has multiple sexual partners. The onset of sexual activity before the age of 25 years. A history of the prior sexually transmitted disease which has been incompletely treated in the woman or the sexual partner. A history of sexual abuse Any history of Gynaecological interventional procedure for eg. Endometrial biopsy, IUCD insertion, Hysteroscopy etc. Vaginal douching has been paradoxically associated with the development of a vaginal infection as it alters the normal vaginal balance of useful versus harmful bacteria. However, some studies have failed to demonstrate a clear association between the two. Apart from these, certain genetic factors have been studied which are found to predispose to pelvic infection. Any decrease in generalized body immunity may also cause a flare-up of an underlying infection for eg – in prolonged illness, HIV infection or any immune-compromised state such as pregnancy. Pelvic Infection Treatment and Prevention – PID or Pelvic Infection treatment is usually by an antibiotic course along with other medications lasting for about 2 weeks. Depending upon your symptoms, this may be either an oral medication or sometimes, in severe cases, a woman may need to be hospitalised for injectable medications or surgical intervention as required. It is important for the sexual partner to be treated simultaneously to prevent re-infection. However, PID and sexually transmitted infections are better prevented than treated. Hence, anyone who is at risk of pelvic infections should take the following precautions: Practice safe sex i.e always use a condom at the time of intercourse ( unless of course, you are actually trying for pregnancy) Avoid indulging in indiscriminate sexual activity with multiple partners or with a partner who is in a sexual relationship with multiple persons. Avoid indulging in sexual activity at a very young age. Consult a doctor at the first sign of infection & take proper treatment. Practice good perineal hygiene and avoid vaginal douching. It helps to wipe from the front backwards after passing urine/stools rather than wiping from back to front. Consume a variety of fruits, probiotics and a healthy, well-balanced diet to boost your immunity.    

  • 0 Uterine Fibroids

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    What are fibroids Fibroids are benign (Non-cancerous) growths that develop from the muscle tissue of the uterus. Although their cause is unknown, they are known to be hormone-dependent tumours & estrogen stimulates their growth. They may be present inside the cavity of the uterus, within its wall, on its outer surface or attached to it by a stem-like structure.   Who is most likely to have fibroids? They are more common in women aged between 30-40 yrs but may actually occur at any age.  Commonly associated with familial predisposition & early onset of periods, these tumours are found more frequently in African- American women & Caucasians.   How does a woman suspect she may have fibroids? Most of the fibroids may not cause any symptoms at all and diagnose on a routine pelvic ultrasound scan during a gynaecological check-up.  When symptomatic, the Fibroids may cause the following symptoms : Changes in menstruation- Longer, more frequent or heavy menstrual periods.   Painful periods or vaginal bleeding at times other than menstruation. Pain- Often dull, heavy & aching pain in the lower back or abdomen Pressure symptoms-  Difficulty in urination or frequent urination; constipation/ rectal pain or difficult bowel movements A large lump in the abdomen Infertility or miscarriages and commonly diagnosed during early pregnancy scans and follicular tracking scans   How are fibroids diagnosed? The fibroids may present with the above symptoms or be detected on routine pelvic ultrasound examination. Once clinically suspected, the diagnosis may be confirmed by: Ultrasonography- Uses sound waves to create a picture of uterus & other pelvic organs Hysteroscopy- Uses a camera mounted on slender long device to see the inside of the uterus Hysterosalpingography-  Special X-ray test used to detect changes in the shape & size of Uterine cavity and fallopian tubes. Laparoscopy- Uses a camera on a slender long device to see the inside of the abdominal cavity MRI- Uses magnetic waves to produce exact images of body tissues   Do all fibroids need to be treated? No, fibroids that do not cause symptoms, are small or occur in a woman nearing menopause often may not require treatment. However, certain signs & symptoms  may signal the need for treatment: Heavy or painful periods Bleeding in-between periods A rapid increase in size Infertility Pressure symptoms, Difficulty in urination or defaecation Pelvic pain or lump abdomen   Can medications be used to treat fibroids? Medications can be used to decrease the heavy bleeding or pelvic pain caused due to fibroids, but they do not prevent the growth of the fibroids nor do they make the fibroids disappear. Some medications that can be used are the painkillers eg. Paracetamol &  Brufen, Oral contraceptive pills,  Progesterone pills or IUCD  & Gn RH agonists.   What surgeries may be used to treat fibroids? Myomectomy is the surgical removal of fibroids while leaving the uterus intact. It may be done by laparoscopy/ hysteroscopy or by giving a cut on the abdomen in a conventional manner. Hysterectomy is the surgical removal of the uterus with the fibroids. The ovaries may or may not be removed. This also may be done by Laparoscopy or abdominally or vaginally. Hysterectomy is done when other treatments have failed or the fibroids are too large & childbearing function of the uterus has been completed. Other treatments modalities include Uterine artery embolisation or HIFU (High intensity focused Ultrasound ).   Pelvic ultrasound Scan   The pelvic ultrasound scan is the first line of investigation when fibroids or other gynaecological problems are suspected.  Your doctor will probably refer you to your local hospital to have a transvaginal ultrasound scan but as the ultrasound NHS waiting times are along you can opt to have a private ultrasound instead. You can find more about the transabdominal and transvaginal scans we offer at the exam page information.  

  • 0 Pregnancy & Ultrasound

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    Ultrasound in Pregnancy Ultrasound is a ubiquitous technology in all areas of medicine but many people are confusing it with other diagnostic imaging modalities. It is not unusual to find people putting it in the same bracket as an x-ray. This misguided impression can quite understandably evoke significant anxiety, especially where pregnancy is concerned. Let’s start by stating a simple but important fact. Ultrasound does not involve ionising radiation.Ultrasound is a form of sound waves generated at very high frequency. This will be in the range of 3.5 to 7 million cycles per second (Megahertz). Normal sound waves audible to the ear are at a much lower frequency of fewer than 20 thousand cycles per second.  How Ultrasound Works The sound waves are produced by a crystal built in the probe used for the test. The waves are then reflected from the various structures they encounter as they travel through the body. The data produced by the reflected waves is then processed by the computer in the scanning machine to produce an image on the screen representative of the reflecting structures. That is how the detailed image of the pregnant uterus and baby within, complete with movements, is produced and seen in real-time. The conventional position for an obstetric ultrasound is on your back, usually propped up comfortably to allow you a clear view of the monitor screen. A clear, water-based conducting gel is applied to the abdomen. The gel helps transmit the sound waves. A hand-held probe is then moved over the area in a systematic way. Alternatively, the ultrasound scan is performed with the probe placed in the vagina (transvaginal ultrasound scanning). This technique often complements conventional transabdominal ultrasound techniques by providing better detail especially in the very early phase of pregnancy such as in the early pregnancy scan. A woman will normally be advised accordingly if this is deemed to be the more appropriate route or sometimes as an additional measure if the abdominal route has not provided all the required information.   Preparation A full bladder is necessary to get a good picture. Therefore, the person due to being scanned will be asked to drink a few glasses of water (or similar) an hour or so before the test and to refrain from urinating before the procedure. A full bladder is, however, not necessary for the transvaginal Ultrasound. There may be some slight discomfort from pressure on the full bladder otherwise the procedure is perfectly painless. The conducting gel may feel slightly cold and wet. There is no perception of the sound waves and of-course you cannot hear them. When to have a Scan Scans may be performed in the First Trimester to: Confirm a normal pregnancy Confirm viability Assess the baby's age (gestation) Assess potential problems such as threatened miscarriage, ectopic pregnancy etc. Assess the baby's heartbeat Confirm the number of embryos/fetuses Identify any abnormalities of the placenta, uterus, and other pelvic structures The main early trimester scans are the early pregnancy scan and the dating scan. In the Second Trimester (after 13 weeks) Assess the baby's age, growth, position, and sometimes gender. A detailed look at the baby’s vital organs and limbs to identify or rule out any possible congenital problems. Identify any developmental (growth) problems Rule out multiple pregnancies Evaluate the placenta, amniotic fluid, and other pelvic organs. In the Third Trimester (after 26 weeks):Scans not normally required at this stage except when monitoring pregnancy development and fetal wellbeing in special situations: these may include: Multiple pregnancies Suspected fetal growth problems Chronic medical conditions such as diabetes, hypertension, epilepsy etc. Pre-eclampsiaOther situations where a scan may be called for are when there is a need to: Detect cervical changes that might predict preterm labour. Verify breech presentation or other uncommon fetal or cord position before delivery. Get valuable information leading to treatment of any conditions arising in the course of a pregnancy in a bid to improve a woman’s chances of having a healthy baby.  Scan Aided Tests and Procedures Pregnancy ultrasound plays a crucial role in antenatal care. Some tests which are routinely done for diagnostic purposes are directly ultrasound-guided. Such tests include: Amniocentesis: This is the most well-known and commonest invasive test used to make a diagnosis of any condition that may be affecting the fetus. It is commonly performed in the early second trimester (15 – 16 weeks) and is now routinely ultrasound-guided. An amniocentesis is a test in which the cells that are floating in the fluid surrounding the fetus are examined for the chromosomal pattern of the fetus. The operator will have the ultrasound probe on the abdomen and will guide the fine needle used under direct ultrasound guidance into the womb. Once the tip is seen to be inside a pool of amniotic fluid, a sample will be drawn for the test. Normally this takes a few short minutes and in the vast majority, only one attempt is sufficient.Amniocentesis results are usually available two to three weeks after the test. Amniocentesis carries a risk of losing the pregnancy of about 0.5 - 1% (1 in 100-200). Age is probably the commonest indication for requesting amniocentesis usually for the diagnosis of Down’s Syndrome. This is because, all other factors being normal, the older the mother, the higher the risk of Down’s and other chromosomal disorders. A 21-year-old mother has a 1:1700 risk of having a baby with Down’s Syndrome, a 30 year old 1:950, at 40 the risk is almost 1:100 and by 45 years of age, it is 1:30.As mentioned earlier while these statistics refer to the most recognized chromosomal anomaly, there are other anomalies, some of them incompatible with life. It is therefore important for any prospective mother to be aware that the overall risk of all chromosomal anomalies is significantly higher than that of Down’s alone at any stage of life. A 201-year-old will, therefore, have an overall chromosomal abnormalities risk (for her baby) of about 1:500 and at 40 the risk would have risen to 1:66.CVS: This stands for Chorionic Villus Sampling which simply means taking a biopsy from the developing placenta. It is also ultrasound-guided. The procedure is also performed under direct ultrasound guidance. It differs from amniocentesis in three major aspects: It can and is usually performed earlier in the pregnancy. This is towards the end of the first trimester. Results are available much more rapidly with a normal turnaround of 48 – 72 hours. It has a significantly higher procedure associated miscarriage rate which could be as much as twice that of amniocentesis. Fetal Echocardiography: Congenital heart defects occur in about 1% of live births. Causes are multiple and sometimes cannot be identified. Whilst a routine detailed ultrasound scan performed at 18-20 weeks will focus on the heart among other major organs, not all defects will be detected. It is also sometimes necessary to perform a much more detailed study of the baby’s heart. This specialised structural study using ultrasound is called echocardiography or popularly just shortened as ‘echo’. Situations, where this may be recommended, include: A family history of congenital heart disease An abnormal fetal heart rhythm detected during a routine examination. Fetal heart abnormalities detected during a routine pregnancy ultrasound scan Abnormality of another major organ system such as the gut or lungs. Insulin-dependent (type 1) diabetes Exposure to some drugs in very early pregnancy. For example, some anticonvulsants used to treat epilepsy can damage the developing heart. If the mother has abused alcohol or drugs during pregnancy If a mother has diabetes, phenylketonuria, or a connective tissue disease such as lupus If the mother has had rubella during pregnancy Diagnosis of some chromosomal abnormalities   Cordocentesis Sometimes it becomes necessary to obtain a sample of blood from the umbilical cord of the unborn baby, usually for diagnostic purposes. This requires direct ultrasound visualization. This would simply not be feasible without the aid of ultrasound. In some condition, transfusion of blood into the unborn baby is performed. Again, this is directly dependent on ultrasound.There are many other areas where ultrasound in pregnancy is not only useful but indispensable. These include localization of the placenta which could help determine the safest mode and timing of delivery, checking pattern of blood flow in the cord, a useful feature in monitoring fetal well-being in at-risk fetuses, estimating fetal weight which could be useful in making important decisions and many more.   Biophysical ProfileSometimes there is concern about the unborn baby’s wellbeing. This may be because the baby is not moving well, growth is unsatisfactory or the pregnant mother is suffering from such conditions as pre-eclampsia, diabetes etc. It may, in such circumstances, be deemed necessary to monitor the baby closely and one of the strategies sometimes adopted is to perform what is known as a biophysical profile > With this one checks the baby’s movements, general muscle tone, breathing movements and fetal heart pattern. Apart from the latter, the rest is all done by using ultrasound.   Transvaginal Ultrasound scanning   The idea of having the scan performed vaginally can and does provoke anxiety for some women. It is important to say that this is a safe procedure and does not in any way pose a risk to either mother or baby.In very early pregnancy, this may be the preferable method of scanning as it produces sharper details and may give crucial information otherwise unobtainable (using trans-abdominal scanning). It is also the case that a transvaginal scan does not require a full bladder, not the most comfortable of requirement especially for an expectant mother struggling with perpetual nausea. A vaginal scan also circumvents the difficulties with obtaining a good view of the embryo/fetus in early pregnancy for women who are overweight or obese.   Amniotic FluidUltrasound scanning is quite useful in estimating the amniotic fluid volume. This is easy to do and in most cases, this will be normal. However, where the volume is found to be reduced or increased, it could be a very important gauge of the baby’s wellbeing. It may also be the first warning that something is not quite right with the baby and could trigger further, more specific, tests. Serial ultrasound scan monitoring of fluid volume is sometimes used to monitor the progress of a pregnancy and together with other tests could be used to make a decision on the timing and/or mode of delivery. Placental locationIt is not possible through a physical examination to tell the exact location of a placenta in the womb. For the majority of pregnant women, this is really of no importance. However, about 1 in 50 mothers (2%) will have placenta praevia (low-lying placenta) at term. This is a potentially dangerous condition for both mother and baby and most of those affected will need close antenatal observation and delivery by caesarean section. Ultrasound scanning does accurately locate the placenta and aid in making these crucial decisions.It is important to stress that almost one in five women will be found to have a ‘low-lying’ placenta at their 20 weeks pregnancy scan. This is no cause for panic as for the vast majority of them, the placenta will be normally located by the time they get to the third trimester. Many units offer a repeat ultrasound scan at around 32-34 weeks as a form of reassurance. Placental abruptionPlacenta praevia (above) is not to be confused with Placental abruption (abruption placenta). The two conditions are not related even though for both the main concern is severe haemorrhage that is associated with them. In placental abruption, the placenta gets partly or wholly detached from the womb. That will cause bleeding and in most cases, pain. The extent of the bleeding and therefore its effect on the baby will depend on the degree of placental detachment. Ultrasound scanning has a limited role in placental abruption. The diagnosis is mainly secured on a clinical presentation rather than ultrasound findings. Twins and ultrasound scanningIn days gone by, it was not unusual for twins and rarely other forms of multiple pregnancies not to be discovered until the time of delivery. Ultrasound changed all that. It is exceedingly unusual for that to happen in modern times in most developed countries. Over 95% of mothers in the United Kingdom have antenatal ultrasound scans and the figure is just over 70% in the USA. Even in those countries where ultrasound scans are not offered as a matter of course, the obstetrician or midwife looking after the pregnant woman will suspect the presence of multiple pregnancies in the course of examining her abdomen. This will usually trigger a recommendation for an ultrasound scan. Confirming the number of fetuses is then, in most cases, a straightforward affair. Identical or not?Many prospective mothers carrying twins are anxious to know whether the babies are identical or not. In many (but not all) cases it is possible to tell whether they are or not using ultrasound scanning.If the twins are sharing the same gestation sac or even if they are in different sacs but sharing the same placenta, they are then definitely identical. This is, however, not that common (and a good thing too).Most twins have separate placentas and sacs. These could be identical or non-identical. It is sometimes possible to tell with a fair degree of confidence whether such twins are identical or not depending on the timing of the ultrasound scan. Of-course if the twins are of different sex, that is confirmatory that they are non-identical. However, it is only possible to tell the gender of a fetus after about 16-17 weeks. The babies have also got to be in a favourable position to be able to do this.Sharing a sac or placenta not good?This is not the best form for twins as there are significant potential complications unique to this type of twins. Some of these complications can be life-threatening for the one or both babies. The subject is discussed further in the section on multiple pregnancies. Doppler UltrasoundWhen there are problems or suspected complications, this special type of ultrasound may be employed to try to get important information which may aid in decision making. It takes its name from the 19th-century Austrian physicist Christian Doppler who was the first to describe the phenomenon. So, what is it?Doppler ultrasound is a form of ultrasound that can detect and measure blood flow. Doppler ultrasound depends on the Doppler effect, a change in the frequency of a wave resulting here from the motion of a reflector, in this case, the red blood cells.If you are keen to know what the various types of Doppler Ultrasound are, here we will attempt to explain. It is not a walk in the park. Don’t say you haven’t been warned. Colour Doppler -- This technique estimates the average velocity of flow within a vessel by colour coding the information. The direction of blood flow is assigned the colour red or blue, indicating flow toward or away from the ultrasound probe (transducer). Pulsed Doppler -- This method allows a sampling volume or "gate" to be positioned in a vessel visualized on the grey-scale image, and displays a graph of the full range of blood velocities within the gate versus time. The amplitude of the signal is approximately proportional to the number of red blood cells and is indicated, not in colour, but simply as a shade of grey. Power Doppler -- This device depicts the amplitude, or power, of Doppler signals rather than the frequency shift. This allows detection of a larger range of Doppler shifts and thus better visualisation of small vessels, but at the expense of directional and velocity information.  Color Doppler depicts blood flow in a region and is used as a guide for the placement of the pulsed Doppler gate for more detailed analysis at a particular site.Doppler ultrasound has many applications including, for example, the detection and measurement of decreased or obstructed blood flow to the legs as in suspected DVT. Colour Doppler ultrasound is done first to evaluate vessels rapidly for abnormalities and to guide placement of the pulsed Doppler to gain sample volume for detailed analysis of velocities. The bottom line:It is very difficult to imagine modern obstetrics without ultrasound. It is an integral part of the care of the pregnant mother and her unborn baby and there is no doubt at all that millions of people across the globe arguably owe their lives to this technology which is now taken as a matter of course. Twins and other forms of multiple pregnancies FrequencyAbout 1% of spontaneous conceptions among the Caucasian population will be twins or other less common forms of multiple pregnancies. The rate is slightly higher for those of black African ancestry and somewhat lower for Japanese and others of oriental ancestry. The rate of multiple pregnancies in assisted conception such as IVF is significantly higher. For any individual woman, family history is a significant factor. If a woman is a twin herself, she has a much higher chance than average of having twins herself. The same applies to a woman who has first-degree twin relatives i.e. siblings or parents. The rate of identical twins is however constant and is not influenced by age, race, family history or any other factors. Monozygotic twins is another term to describe identical twins. The rate is roughly 4 per 1,000 births. Twin IssuesTwins may be exciting but these pregnancies also have their own specific challenges. It is important to stress up-front that the majority of twin pregnancies, upwards of 85%, have a completely successful outcome and dispel the impression that twin pregnancy is automatically bad news.That done, let's turn to the common saying, which happens to be largely true, that doctors and midwives like repeating when speaking about twin pregnancies. The saying goes “all pregnancy complications are commoner in twins apart from prolonged pregnancy”. That is an important and honest starting point. So, when you talk of prematurity, pre-eclampsia, placental abruption, growth restriction, antepartum haemorrhage, postpartum haemorrhage, it is a true general statement that the risk of any of these is higher, the bigger the number of babies a woman is carrying. Unique Twin Issues: Increased risk of pregnancy complications is not the only issue that needs to be dealt with. There are problems that are unique to twin pregnancy. The most important one of these is a twin-to-twin transfusion. This condition occurs only in identical (monozygotic twins) and specifically those who share a placenta. The medical term for a common placenta in twins is monochorionic. It is true that twins that share a placenta have got multiple blood vessel communications within that placenta. These communications are not always a problem and in many if not most cases there is no problem as there is physiological equilibration of the blood flow in both. However, for some, these communications are a problem which is sometimes lethal for one or both. This is brought about by an imbalance in the blood flow whereby one ends up as a ‘donor’ and the other a ‘recipient’. It means there is a net flow of blood to the recipient and this is the one at greatest risk as he/she gets overloaded. Can anything be done? When twin-to-twin transfusion is suspected or diagnosed, the care becomes a specialist issue. There will be serial ultrasound scanning to track the progress of the condition of the twins. Other tests will also be done to keep a close eye on the babies. Sometimes intervention is required to try to reduce the severity of the condition. In most cases, delivery is early to try to prevent further deterioration. Not all cases of twin-to-twin transfusion are that severe. Some are mild enough not to require any intervention. Vanishing twin It is true but probably not widely recognised that twin pregnancies in the second and third trimester represent at most two-third of pregnancies that start as such. What does this mean? Basically, it means, a lot more pregnancies start as twins. For a variety of reasons some embryos in twin pregnancies do not make it beyond the first few weeks and these pregnancies continue as singleton pregnancies. Some of these women would have had early ultrasound scans say at 6 or 7 weeks. Presence of twins would have been identified then and a repeat scan a few weeks down the line a repeat scan shows, not two, but one fetus. The other twin has ‘vanished’.As mentioned earlier, this phenomenon is estimated to affect up to a third of all twins that start as such. Mercifully, this vanishing occurs fairly early before the first scan for most affected mothers and therefore these will be oblivious of the fact that they started off with twins. The loss of the one twin is usually accompanied by very mild or no noticeable symptoms.     - Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Ultrasound Practitioner   Specialities:   Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare.     Reviewed: 07/04/202 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons)  and Tareq Ismail  Pg (Dip) Medical Ultrasound, BSc(Hons)    

  • 0 Abdominal Ultrasound Scan. Gallstones: Risk Factors and Causes

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        The private abdominal scan is one of our most popular examinations. Upper abdominal pains that can be caused by calculi within the gallbladder are very common. Cholelithiasis is the medical term for Gallstone disease. Cholelithiasis is one of the most common and costly of all digestive system diseases. This post outlines some of the associated risk factors and the more common causes of gallstone formation with some additional details about their classification. According to the NHS, gallstones are thought to be caused by an imbalance in the chemical makeup of the bile within the gallbladder. These chemical imbalances cause tiny crystals to form within the bile that can gradually increase in size from tiny grains of sand to the size of a pebble over a period of time.   Risk Factors The risk factors identified by Wang and Afdhal (2016) for gallstones in the gallbladder (cholelithiasis) include:- diet, age, gender, oestrogen therapy, obesity, fasting, diabetes, family history, rapid weight loss, some medications including those that reduce cholesterol or Lipids or an antibiotic called Cerfriaxone, disease of the ilium or it’s resection and spinal cord injuries. Stockley (2001) states that gallstones are not exclusive to fair, fat, flatulent, fertile over 40 years old females as was previously thought but are also found in young and old alike and have even been detected on fetal ultrasound scanning in the womb. According to Nathanson (2014) it has been estimated from autopsy studies that 12% of men and 24% of women of all ages have gallstone disease present and that 10-30% of them become symptomatic. There are over 40,000 operations to remove the gallbladder and its gallstones (cholecystectomy) performed annually in the UK. Stockley (2001) states that gallstones are formed in several ways: Cholesterol stones which are hard are formed due to an increase in the concentration of cholesterol in the blood (hypercholesterolaemia). An increase in bilirubin in the blood (hyperbilirubinaemia) found in patients with haemolytic anaemia which form irregularly shaped soft, small brown pigment gallstones. Biliary stasis caused by a faulty, malformed, non-emptying gallbladder or obstructed cystic duct leading to stagnant bile. This creates high concentrations of cholesterol and bile pigments following excessive water absorption. This leads to the formation of mixed cholesterol and bile pigment stones, the most common type of gallstone.    Gallstone Classification There are different methods used for gallstone classification, namely their chemical composition location Wang and Afdhal (2016) classify gallstones into 3 types based on their chemical composition and macroscopic appearance: cholesterol, pigment and rare stones. 75% of gallstones in the Western world are cholesterol stones consisting mainly of cholesterol monohydrate crystals and precipitates of amorphous calcium bilirubinate. These stones are further sub-classified as either pure cholesterol or mixed stones that contain at least 50% of cholesterol by weight. The remainder of gallstones are classified as pigmented stones that contain mostly calcium hydrogen bilirubinate and they can be further sub-classified into two groups: black pigment (20%) and brown pigment stones (4.5%). Rare gallstones account for 0.5% and include calcium carbonate stones and fatty acid-calcium stones.   Wang and Afdhal (2016) classify gallstones by their location as Intrahepatic stones which are predominantly brown pigment stones Gallbladder stones which are mainly cholesterol stones with a small group of black pigment stones. Bile duct stones (choledocholithiasis) which are composed mostly of mixed cholesterol stones.   Gallstone Diagnosis The abdominal ultrasound scan is the first line of investigation in the diagnosis of gallstones. This ultrasound scan is performed on a fasted patient.  The reason for fasting is that the gallbladder is like a balloon. When we eat something fatty, the gallbladder will excrete the bile into the gut to break down the fat and therefore the gallbladder collapses and it is not possible therefore to see if there are any stones within the lumen.  International Ultrasound Services offers private ultrasound scans to evaluate your gallbladder for any signs of gallstones, thickening of the gallbladder wall and the existence of any pericholecystic fluid. We will also check your liver, your pancreas, your kidneys and the spleen at the same time. You can book an ultrasound scan in London by visiting our ultrasound scan appointments booking page. You can find more information about the upper abdominal scan here.     References: NHS Choices (2016) Gallstones causes. Available at: http://www.nhs.uk/Conditions/gallstones/Pages/causes.aspx [Accessed 17/10/2016] Wang, D., Afdhal, N. (2016). Gallstone Disease In: Feldman, M., Friedman, L., Brandt,L.(eds) Sleisanger and Fordtran’s Gastrointestinal and Liver Disease Pathophysiology / Diagnosis / Management. Volume 1. 10th Edition. Philadelphia, Saunders Elsevier. pp -1100 - 1108 Stockley, M (2001) Abdominal Ultrasound. 1st edition. Greenwich Medical Media Nathanson, L. (2014) Gallstones, In: Garden, O., Parks, R. (eds.) Hepatobilary and Pancreatic Surgery. A Companion to Specialist Surgical Practice. 5th edition. Edinburgh. Saunders Elsevier. p 174. Bibiliograph: http://www.webmd.com/digestive-disorders/gallstones#1What Are Gallstones? [Accessed 17/10/2016] http://www.livescience.com/34726-gallstones-symptoms-treatment.html. [Accessed 18/10/2016] Mayo Clinic (2013) Gallstones causes. Available at: http://www.mayoclinic.org/diseases-conditions/gallstones/basics/causes/con-20020461. [Accessed 18/10/2016]      

  • 0 Private scans

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    Welcome to our new private scan blog. Our private scan clinic in Notting Hill Gate offers a wide range of private scans for men and women as well as pregnancy private scans. We are conveniently located a few minutes walk from Notting Hill Gate tube station and we offer a range of out of hour private scan appointments, including emergency/on-call private scans to suit your lifestyle. You can find the whole range of our private scans and costs here.         Who interprets the results of the private scan and how do I get them? Our Sonographer, a Health Care Professional specifically trained to perform and understand the ultrasound scan images, will do your private scan and provide you with a written report that you can take it your doctor.  Our sonographers will also discuss the results with you during and after your ultrasound scan examination. It is very common that sometimes when you leave you to remember of a question that you forgot to ask, so please don't hesitate to contact us either via phone or e-mail and we will do our best to answer your question.   What are the benefits and risks of the ultrasound scan examination? Benefits Ultrasound scanning is noninvasive. An ultrasound scan exam may be occasionally, temporarily uncomfortable, but it should not be painful. Ultrasound is widely available, easy-to-use and less expensive than other imaging modalities. Ultrasound imaging is extremely safe and does not use any ionizing radiation. Ultrasound scanning gives a clear picture of soft tissues such as liver that do not show up well on x-rays. Risks There are no known harmful effects on humans related to ultrasound scan examinations.   What are the limitations of Ultrasound Scan Imaging?  Ultrasound waves do not travel well in bowel or gas so you can not fully evaluate abdominal organs such as stomach and bowel or organs obscured by the bowel. It can also be hard to fully visualise the internal anatomy of large patients as the sound has further to travel and therefore the returning echoes are weaker.   Why choose us for your private scan? We are conveniently located in the heart of London, just a few minutes’ walks from Notting Hill Gate station, in a cobbled cul-de-sac off Kensington Mall in the Royal Borough of Kensington and Chelsea. We offer same day and emergency after hours and weekend appointments in a clean and caring environment, to suit your needs. Unlike some of our competitors, we provide you with a private scan report at the same day to fast track any potential treatment.  We have years of experience in medical ultrasound scanning. Experience gained working for flagship NHS trusts alongside leaders in the field of diagnostic medical imaging including general ultrasound, urology, musculoskeletal, gynaecology, pelvis, testicular and vascular scan examinations. You can, therefore be assured that your health is in good hands. Our range of private scan examinations includes the abdomen, pelvis, kidneys, bladder, prostate, ovary, testicle, scrotal, knee, shoulder, groin, ankle, wrist to name a few. We are also experts in pregnancy ultrasound and we regularly rotate through our hospital EPU that mainly deals with recurrent miscarriage. Our full range of private scans can be viewed via the site menu. Our competitively priced private scan services and personalised service is second to none and this is the reason our clients recommend us to friends and family.    About Ultrasound Scans Diagnostic Medical ultrasound scan or medical sonography as otherwise known is a painless imaging technique utilising sound waves to produce internal images of the body.It is called ultrasound as the sound frequency being used is at the region of 1 to 20MHz. The human ear can't hear these frequencies.The sound waves are produced by the transducer or the probe as most commonly known. As they travel through the body they bounce back to the transducer due to various sound transmissions differences in tissues. The returning echoes are picked up by the probe and a powerful computer analyses the echoes and creates the 2d image on the screen.There are various kinds of ultrasound scans that can be performed and each looks at different organs of the body such as tendons, muscles, joints, blood vessels, liver, kidneys, uterus and ovaries to confirm or exclude possible pathology.Unlike Ct and MRI, ultrasound does not use radiation and therefore is pregnancy friendly. It is also live and is ideal for musculoskeletal exams to evaluate moving joints.   Looking for a private scan in London? IUS London specialises in diagnostic private ultrasound scans to provide you with quick diagnosis and the much-needed reassurance about your health, within a convenient location. The cost of a private ultrasound scan shouldn’t be prohibited when it comes to someone’s wellbeing. This is why our prices are competitive and affordable with no compromise to the level of care. The price you see is the price you pay with no hidden extras. We have hundreds of happy clients including GP’s, consultants, radiologists and midwives to name a few. Some of our clients choose us when large, well-established ultrasound scanning companies failed them in diagnostic accuracy and especially aftercare. We offer ultrasound scan appointments via our online booking system or on the phone. We do not charge a deposit or a cancellation fee as we care more about our clients and we respect their decision to decide what is best for them without concern about the ultrasound scan deposit they already paid.     

  • 0 Private Pregnancy scans and Scanxiety

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    Scan Anxiety- Scanxiety and the truth   There have been lots of talks lately on the newspapers and online about scanxiety - someone created a fancy word to describe anxiety before diagnostic scans such as CT and MRI. The term quickly included private ultrasound scans mainly private pregnancy scans in a newspaper attempt to grab the reader’s attention.  The Guardian headline reads:"Scanxiety: why private baby scans are on the riseMany pregnant women are paying for extra ultrasounds, for reassurance or for ‘souvenir scans’. But does multiple scanning pose a risk to the unborn child?" The MailOnline article reads:Pregnant women with 'scanxiety' are told to avoid private ultrasounds as firms offer multiple scans to assuage their fears The study found almost a third of mothers-to-be pay for extra scans while pregnant Many do so due to anxiety, despite NHS offering scans at 12 weeks and 20 weeks Parent site ChannelMum.com says ‘pop-up’ firms target women with 'scanxiety' Another article on MailOnline reads:The rise of 'scanxiety': Pregnant women are risking their babies' health by paying for unnecessary scans UK and US guidelines advise getting two scans: one at 12 weeks, one at 20 weeks A new study shows a third of mothers-to-be pay for extra private ultrasounds Too many high-intensity scans may cause harm to the foetus, experts warn  Anxiety over the baby's health may be doing more harm than good, they say     Going through these articles as a qualified sonographer with more than 15 years experience, i found out that they were full of inaccuracies, misinformation and scaremongering. Ultrasound is used in pregnancy since the late 70s. There were a few research publications suggesting that ultrasound might affect the growth of the unborn baby but with no conclusive evidence and consequent studies failed to duplicate the results. The medical community, therefore, is suggesting that ultrasound should be used where clinically indicated. NICE recommends 2 scans at 12 and 20 weeks as sufficient during the pregnancy. A new study in England, however, shows that almost a third of expectant mothers are paying for additional private scans.  So NICE knows better than the pregnant mothers or is it because NICE has to take into account the lack of NHS sonographers and midwives and try to alleviate the stress on the NHS? If two ultrasound scans are enough in the UK, why they are not enough in the USA, Australia and most other European countries? So would you say to an expectant mother and her partner who had a miscarriage and sometimes, unfortunately, multiple ones, who are in the waiting room shaking waiting to find out if their baby has a heartbeat that is overreacting and suffering from scanxiety? Do you think that the ultrasound scan is clinically indicated? I would say yes as the ultrasound scan will either reassure them, that their baby is alive or at the worst-case scenario will confirm their fear but at least they will know and they will be able to deal with it. In very anxious patients, sometimes a quick scan is the best option for alleviating stress which is helpful in so many other ways. In our London ultrasound clinic, we do not just do pregnancy scans such as the early pregnancy scan but we do a variety of other ultrasonic examinations such as abdominal, pelvic and musculoskeletal examinations. We have clients from all walks of life including health care professionals who are not willing to wait 6+ weeks to have a scan on the NHS as they want to find out if there is something wrong with them and treat it ASAP. We assume that these clients are suffering from scanxiety too but all these articles concentrated on expecting mothers as a soft target. Never the less anxiety associated with the results of a scan either ultrasound, CT or MRI between cancer patients is well documented. Some concerns on these articles arise from the intensity of the ultrasound beam and the length of ultrasound scanning. The intensity of the ultrasound beam is significantly higher on 4D scans than 2D scans as is the scanning time. In our London ultrasound clinic we do not offer 4D ultrasound scans but most of the ultrasound clinics that do offer them, they offer them later in pregnancy at 20+ weeks, when the baby is well developed and the effects of ultrasound intensity are minimal.  The most valid point of these articles is the use of untrained/unqualified sonographers. I am not aware of any ultrasound clinics in the UK that uses unqualified sonographers and as far as I know, most of the ultrasound clinics are registered with CQC. Never the less the DailyMail has compiled a list with tips on finding a reputable scanning clinic:   TIPS ON FINDING A REPUTABLE SCANNING CLINIC  ·  Check that your ultrasound clinic is registered with the Care Quality Commission, to ensure it meets professional standards.·  Look online for clinic reviews and check how long the company has been established.·  Ask the clinic about staff qualifications and experience. Any reputable firm will be happy to help. Your sonographer should be HCPC qualified.·  Some clinics do offer discounts to make the treatment affordable for everyone. However if you are being pressured to buy more packages than you need or can afford, consider going elsewhere. It's your body, your baby and your choice.·  If you feel overly anxious, speak with your midwife. Your ultrasound clinic will work with him or her. If you have any questions please feel free to contact us.     - Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Ultrasound Practitioner   Specialities:   Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare.     Reviewed: 07/04/202 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons)  and Tareq Ismail  Pg (Dip) Medical Ultrasound, BSc(Hons)

  • 0 Our Most Frequent Pregnancy Scans

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    The pregnancy scans offered by the NHS might not always be enough to offer the reassurance that the pregnancy is progressing properly. You can find below the most popular private pregnancy scans in our ultrasound clinic in London. These scans offer peace of mind that every couple seeks. Early pregnancy scan. We offer this scan from the 6th to 11th-week gestation. This scan will confirm your pregnancy, calculate your estimated due date, detect whether it is a single or multiple pregnancy scan. Dating scan.  We offer this scan from the 11th to 14th week. This scan will date your pregnancy by measuring the crown to rump length (CRL), confirm if it is single or multiple pregnancies and most importantly will confirming foetal viability by checking the baby’s heartbeat. Gender scan. From 16 weeks onwards we can identify the gender of your baby with very high accuracy. Using our ultrasound scanner, loaded with the latest ultrasound technology the sonographer will be able to tell you if you having a boy or a girl. Growth scan. If you had previous birth complications or have any concerns or worries this scan will check your baby’s growth. We offer the growth scan, between the 24th and 38th week of your pregnancy.       What are the benefits and risks of the pregnancy ultrasound scans? Benefits The pregnancy scan is non-invasive. If a transvaginal scan is required the ultrasound exam might be a little uncomfortable but not painful. Ultrasound examinations are significantly cheaper than other diagnostic imaging modalities. Ultrasound imaging is safe for the baby and the mother as there is no ionizing radiation involved. You can not see the baby using conventional x-ray imaging. Ultrasound is the preferred imaging investigation for the diagnosis and monitoring of pregnancies. Ultrasound allows the sonographer to see inside the uterus in real-time and provides necessary information about the pregnancy. Risks There are no known harmful effects on humans related to pregnancy ultrasound examinations. Although ultrasound has been used in pregnancy for more than 40  years with no evidence suggesting it is harmful to the patient, embryo or fetus, ultrasound should be performed only when clinically indicated and by qualified practitioners.   Who interprets the results of the private scan and how do I get them? Our Sonographer, a Health Care Professional specifically trained to perform and understand the ultrasound scan images, will do your exam and provide you with a written report that you can take it your doctor.  Our sonographers will also discuss the results with you during and after your examination. Our sonographers are advanced practitioners with years of ultrasound scanning experience; fully qualified, registered with the HCPC and work full/part-time for flagship London NHS hospitals. On an average month, they perform more than 500 examinations a month and regularly train junior radiologists in the art of ultrasound scanning. During the working day in the NHS, they deal with all kinds of routine and emergency scans. They rotate through the hospitals' recurrent miscarriage unit where they gain valuable experience in pregnancy and its various complications. It is very common that sometimes when you leave you remember of a question that you forgot to ask, so please don't hesitate to contact us either via phone or e-mail and we will do our best to answer your question.     About  Pregnancy Scans A pregnancy ultrasound scan is the same as a ‘normal’ scans but is being used to evaluate the overall health of your baby instead of looking at other organs such as gallbladder for gallstones or kidney for kidney stones. So in pregnancy ultrasound scans are being used to visualise the baby, the placenta, the uterus and cervix and your ovaries.Pregnancy ultrasound scans or prenatal ultrasounds are very common and being carried in any stage of the pregnancy.   When Is an Ultrasound Performed During Pregnancy? You will normally offer two ultrasound scans during your pregnancy from the NHS. The first pregnancy scan is at 12 weeks and called a dating scan. The second pregnancy scan is at 20 weeks and called an anomaly scan.Most of the expectant mothers, especially the ones with previous complications such as miscarriage they do not believe that 2 ultrasound scans during pregnancy are enough and this is the reason they choose to have a private pregnancy scan in London with us.   What are ultrasound scans used for in pregnancy? Depending on your stage of pregnancy, ultrasounds will be used to give you and your doctor or midwife answers about your pregnancy. First Trimester Ultrasounds Check that you are pregnant and that your baby has a heartbeat. Check if you have a singleton or twins Make sure that the pregnancy is not an ectopic located within the endometrial cavity and is not outside the womb such as in the fallopian tube. Look for the cause of any bleeding you might have. Date the pregnancy by measuring the crown-rump length of the foetal pole. Second Trimester Ultrasounds   Verify dates and growth Estimate the  baby's risk of Down's syndrome by measuring the fluid at the back of your baby’s neck between about 10 weeks and 14 weeks Help with diagnostic tests by showing the position of the baby and placenta. Check your baby to see if all his organs are normal. Diagnose abnormalities Assess the amount of amniotic fluid and the location of the placenta. Evaluation of fetal well-being Third-trimester Ultrasounds Make sure your baby is growing at the expected rate. Confirm if your baby is a boy or a girl. Some mothers to be will, unfortunately, get various complications during pregnancy such as high blood pressure, kidney infections and abnormal liver function tests. As ultrasound scans are pregnancy-friendly your doctor wight refer you for an abdominal/liver scan or a kidney scan to check for anything that might explain your symptoms.Although these ultrasound scans are not pregnancy scans, they are related to pregnancy and in most cases, all the complications resolve after delivery. But like everything else related to your health and your baby’s health: better safe than sorry. What can be seen during the early scan: At 5 weeks gestation (i.e 3 weeks after conception) a small gestation sac might be visible. At 6 weeks, the yolk sac, the embryo (foetal pole) and the heartbeat might be visible. At 7 weeks the embryo will be around 10mm with a fast heartbeat. At 8 weeks, the embryo will be around 16mm and the body and the head might be distinguishable. The embryonic movement might also be seen. At 9 weeks, the embryo is now a foetus and head, body and limbs start to form.   Why choose us for your private pregnancy ultrasound scan in London? We are conveniently located in the heart of London, just a few minutes’ walks from Notting Hill Gate station, in a cobbled cul-de-sac off Kensington Mall in the Royal Borough of Kensington and Chelsea. We offer same day and emergency after hours and weekend appointments in a clean and caring environment, to suit your needs. We have years of experience in medical ultrasound. Experience gained working for flagship NHS trusts alongside leaders in the field of diagnostic medical imaging including general ultrasound, urology, musculoskeletal, gynaecology, pelvis, testicular and vascular examinations. You can, therefore, be assured that your health is in good hands. Our range of ultrasound examinations includes, other than pregnancy, the abdomen, pelvis, kidneys, bladder, prostate, ovary, testicle, scrotal, knee, shoulder, groin, ankle, wrist to name a few. We regularly rotate through our hospital EPU that mainly deals with recurrent miscarriage. Our full range of scans can be viewed via the site menu. Our competitively-priced pregnancy scan examinations and personalised service is second to none and this is the reason our clients recommend us to friends and family.    About Ultrasound Scans Diagnostic Medical ultrasound scan or medical sonography as otherwise known is a painless imaging technique utilising sound waves to produce internal images of the body.It is called ultrasound as the sound frequency being used is at the region of 1 to 20MHz. The human ear cant can’t hear these frequencies.The sound waves are produced by the transducer or the probe as most commonly known. As they travel through the body they bounce back to the transducer due to various sound transmissions differences in tissues. The returning echoes are picked up by the probe and a powerful computer analyses the echoes and creates the 2d image on the screen.There are various kinds of ultrasound scans that can be performed and each looks at different organs of the body such as tendons, muscles, joints, blood vessels, liver, kidneys, uterus and ovaries to confirm or exclude possible pathology.Unlike Ct and MRI, ultrasound does not use radiation and therefore is pregnancy-friendly. It is also live and is ideal for musculoskeletal exams to evaluate moving joints.   Looking for a private pregnancy ultrasound scan in London? IUS London specialises in diagnostic private ultrasound scans to provide you with quick diagnosis and the much-needed reassurance about your health, within a convenient location. The cost of a private ultrasound scan shouldn’t be prohibited when it comes to someone’s wellbeing. This is why our prices are competitive and affordable with no compromise to the level of care. The price you see is the price you pay with no hidden extras. We have hundreds of happy clients including GP’s, consultants, radiologists and midwives to name a few. Some of our clients choose us when large, well-established ultrasound scanning companies failed them in diagnostic accuracy and especially aftercare. We offer ultrasound scan appointments via our online booking system or on the phone. We do not charge a deposit or a cancellation fee as we care more about our clients and we respect their decision to decide what is best for them without concern about the ultrasound scan deposit they already paid.      - Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Ultrasound Practitioner Specialities: Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare.   Reviewed: 07/04/202 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) and Tareq Ismail Pg (Dip) Medical Ultrasound, BSc(Hons)

  • 0 Pregnancy Ultrasound Scan

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    Pregnancy Ultrasound Scan An ultrasound scan is frequently offered to women that are pregnant at about 12-14 weeks. In certain conditions, for example, if there aren't any particular risks or issues, you may be able in have earlier or later scans if needed.   How they work An Ultrasound works by transmits silent sound waves through the body tissues to create an image of your baby in your womb, which you and your partner will be able to see on a TV/computer screen. Before having your transabdominal scan, you'll be asked to drink lots of fluid rather than to empty your urinary bladder! If your urinary bladder is complete, it then pushes up from your uterus to provide a better perspective of your infant. This is really important in the very first 50% of pregnancy. When you are lying down,  a gel is going to be put on your lower abdomen and a handheld probe/scanner/transducer will be moved in various directions on the skin to allow you to visualise your infant in your womb. Ultrasound scans may also be carried out utilizing a vaginal probe. If this is true, you'll not typically need to have a full urinary bladder since these sorts of ultrasound scans provide a clearer image, particularly in an early pregnancy ultrasound.  While the scan is been carried out, the sonographer will usually explain what she/he is looking at, and you may be given a black and white print of the image to take home with you, as well as a written ultrasound report. Some units even give you the option to get your bay scan recorded on a videotape, which you can buy.   Do ultrasound scans hurt? Ultrasound scans are completely painless, and also to date, there is no medical evidence to prove that they can harm either a pregnant woman or her unborn baby.   What the scan can tell you about your pregnancy? Seeing your baby moving around throughout the scan can be extremely enjoyable and reassuring to see your baby is developing normally and also to monitor its growth along with well being. The scan will show the exact position of your baby and the placenta. Will evaluate for any causes of bleeding in early pregnancy, along with excluding an ectopic pregnancy. Identify fetal abnormalities, especially of the head or spine, such as the structural/developmental defects spina bifida and hydrocephalus, or to specify this risk of this chromosomal disorder Down's syndrome. Show your baby moving and allow you to hear his/her heartbeat and see fetal movements. The scan will also evaluate the amniotic fluid volume and blood flow to the womb along the umbilical cord. Where possible will allow you to find out the sex of your baby at the 20-week scan.     - Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Ultrasound Practitioner Specialities: Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare.   Reviewed: 07/04/202 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) and Tareq Ismail Pg (Dip) Medical Ultrasound, BSc(Hons)

  • 0 6 Week Pregnancy Scan

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    Congratulations on your pregnancy and welcome to the world of baby scans. The 6 weeks early pregnancy or the early pregnancy scan as more commonly known will possibly be the first time the parents will meet their baby. Unless there are complications such as suspicions or ectopic pregnancy or miscarriage,  6-week ultrasound scans are not routinely offered by the NHS. You might, however, want to have a private 6-week ultrasound scan if you suspect that your pregnancy is not progressing well or if you would like a definite pregnancy confirmation. Most common reasons for a 6 Week Ultrasound Scan The most common for the 6 weeks and generally for early gestation baby scans are: Previous miscarriage. You had fertility treatment. Pelvic pain on one side Vaginal spotting or bleeding. you are unsure how far along you are in your pregnancy. You want a visual confirmation that you are pregnant after a positive pregnancy scan. What should you see on a 6-week scan? At 6 weeks gestation, you might be able to see:  a black circle (black is fluid on ultrasound) which is the gestation sac A little white ring which is the yolk sac where the baby feeds from in the early weeks of pregnancy, the embryo (foetal pole)and possibly the heartbeat might be visible. Depending on the individual pregnancy all the above however might not be visible during the scan. At 6 weeks, you won’t, in general, be able to see much detail of your baby. The ultrasound scan, however, should be able to confirm the gestation age by measuring either the gestation sac or the foetal pole if visible. Sometimes but not always you will be able to see the baby’s heartbeat. Most importantly the sonographer will be able to check that your baby is within the right place i.e in the endometrial cavity and that you do not have an ectopic pregnancy. Ectopic pregnancy is when the fertilized egg attaches itself outside of the uterus with the most common location being the fallopian tube on the side where you ovulated from. Everyone obviously is different and sometimes a follow-up ultrasound in a week to 10 days later might be necessary to give you more information. Your baby at 6 weeks How many mm is a 6-week old foetus? At 6 weeks, your baby should measure approximately 5-9mms in length. Can you see the baby at 6 weeks? 6 weeks into your pregnancy is also the earliest time that you might be able to see the foetal pole and the foetal heartbeat. Can you see the baby heartbeat at the 6-week scan? The foetal heartbeat looks like two parallel lines flickering and it is not always visible at the 6-week scan. The literature suggests that the foetal heartbeat should be around 90-110 beats per minute but we have seen slower heartbeats with positive pregnancy outcomes. What else can you see? The yolk sac, a ring shape bright circle might also be visible. The yolk sac is where your baby is feeding on at this early stage in pregnancy. Sometimes only the gestation sac is visible with no foetal pole or yolk sac and you might be asked to come back in a week to 10 days. In most cases, this is because you might be earlier in your pregnancy than you think. What is the earliest You can have a pregnancy scan? The 6-week scan is the most common gestation age that an ultrasound is performed. We do not recommend a scan before the 6 weeks gestation unless you are worried about a miscarriage or an ectopic pregnancy, as at 5 weeks gestation you will possibly see the endometrium being thickened and echo bright and possibly a gestation sac. A 5-week baby scan might help to find the cause for any early pregnancy pain or bleeding. If you are more than 6 weeks you may also want to read more about the 7-week scan and the 8+ week scan. What happens at a 6-week scan? It is more likely that at 6 weeks gestation age you will need to have a transvaginal or internal ultrasound scan instead of a transabdominal scan (through the abdomen). This is because it is a very early stage and everything is still small. The transvaginal scan will be able to get closer to the endometrium and produce a better clearer image of the pregnancy insitu. Feeling nervous about having an ultrasound scan so early in your pregnancy is normal. Try to stay calm and prepare yourself for what may happen. Bringing with you your partner or a close family member for extra support might be a good idea.  We do allow another family member present in the scanning room during the private ultrasound even during Covid-19. How many scans will I have during pregnancy through the NHS? You will have at least two baby scans during your pregnancy provided by the NHS: a 12-week dating scan and a 20-week anomaly scan. The 12-week scan will provide confirmation and dating for your pregnancy. The 20-week scan will provide information about your baby’s growth and development. About  Pregnancy Scans A pregnancy ultrasound scan is the same as a ‘normal’ scan but it is being used to evaluate the overall health of your baby instead of looking at other organs such as gallbladder for gallstones or kidney for kidney stones. So in pregnancy, ultrasound scans are being used to visualise the baby, the placenta, the uterus and cervix and your ovaries.Pregnancy ultrasound scans or prenatal ultrasounds are very common and being carried in any stage of the pregnancy. If you have any questions or you want to know more about our private ultrasound in London please leave a comment and we will do our best to answer. At our private ultrasound clinic, we offer pregnancy scans from as early as 5-6 weeks gestation in times to suit you. Who interprets the results of the early pregnancy scan and how do I get them? A Sonographer, a Health Care Professional specifically trained to perform and understand the ultrasound images, will most likely do your exam and provide you with a written report that you can take it your doctor. About Ultrasound Diagnostic Medical ultrasound scan or medical sonography as otherwise known is a painless imaging technique utilising sound waves to produce internal images of the body.It is called ultrasound as the sound frequency being used is at the region of 1 to 20MHz. The human ear cant can’t hear these frequencies.The sound waves are produced by the transducer or the probe as most commonly known. As they travel through the body they bounce back to the transducer due to various sound transmissions differences in tissues. The returning echoes are picked up by the probe and a powerful computer analyses the echoes and creates the 2d image on the screen.There are various kinds of ultrasound scans that can be performed and each looks at different organs of the body such as tendons, muscles, joints, blood vessels, liver, kidneys, uterus and ovaries to confirm or exclude possible pathology.Unlike CT and MRI, ultrasound does not use radiation and therefore is pregnancy-friendly. It is also live and is ideal for musculoskeletal exams to evaluate moving joints. Other ultrasound scans related to pregnancy? Some mothers to be will unfortunately get various complications during pregnancy such as high blood pressure, kidney infections and abnormal liver function tests. As ultrasound scans are pregnancy-friendly your doctor might refer you for an abdominal/liver scan or a kidney scan to check for anything that might explain your symptoms. Although these ultrasound scans are not pregnancy scans, they are related to pregnancy. In most cases, all the complications resolve after delivery, but like everything else related to your health and your baby’s health better safe than sorry. What are ultrasound scans used for in pregnancy? Depending on your stage of pregnancy, ultrasounds will be used to give you and your doctor or midwife answers about the health of your pregnancy. First Trimester Ultrasounds Check that you are pregnant and that your baby has a heartbeat. Check if you have a singleton or twins Make sure that the pregnancy is not an ectopic located within the endometrial cavity and is not outside the womb such as in the fallopian tube. Look for the cause of any bleeding you might have. Date the pregnancy by measuring the crown-rump length of the foetal pole. Second Trimester Ultrasounds Verify dates and growth Estimate the  baby’s risk of Down’s syndrome by measuring fluid at the back of your baby’s neck between about 10 weeks and 14 weeks Help with diagnostic tests by showing the position of the baby and placenta. Check your baby to see if all his organs are normal. Diagnose abnormalities Assess the amount of amniotic fluid and the location of the placenta. Evaluation of fetal well-being Third-trimester Ultrasounds Make sure your baby is growing at the expected rate. Confirm if your baby is a boy or a girl. Do you want to book your early pregnancy scan?   - Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Ultrasound Practitioner Specialities: Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare.   Reviewed: 26/07/2020 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) and Tareq Ismail Pg (Dip) Medical Ultrasound, BSc(Hons)

  • 0 Pregnancy Scans

    • by Administrator
    • 21-01-2019
    0.00 of 0 votes

    Pregnancy Scans A pregnancy ultrasound scan is the same as a ‘normal’ ultrasound scan but is being used to evaluate the overall health of your baby instead of looking at other organs such as gallbladder for gallstones or kidney for kidney stones. So in pregnancy ultrasound scans are being used to visualise the baby, the placenta, the uterus and cervix and your ovaries.Pregnancy ultrasound scans or prenatal ultrasounds are very common and being carried in any stage of the pregnancy.   When Is an Ultrasound Performed During Pregnancy? You will normally be offered two ultrasound scans during your pregnancy from the NHS. The first scan is at 12 weeks and called a dating scan. The second pregnancy scan is at 20 weeks and called an anomaly scan.Most of the expectant mothers, especially the ones with previous complications such as miscarriage do not believe that 2 scans during pregnancy are enough and this is the reason they choose to have a private pregnancy scan in London with us.   What are ultrasound scans used for in pregnancy? Depending on your stage of pregnancy, ultrasounds will be used to give you and your doctor or midwife answers about your pregnancy. First Trimester Ultrasounds Check that you are pregnant and that your baby has a heartbeat. Check if you have a singleton or twins Make sure that the pregnancy is not an ectopic located within the endometrial cavity and is not outside the womb such as in the fallopian tube. Look for the cause of any bleeding you might have. Date the pregnancy by measuring the crown-rump length of the foetal pole.   Second Trimester Ultrasounds   Verify dates and growth Estimate the  baby's risk of Down's syndrome by measuring fluid at the back of your baby’s neck between about 10 weeks and 14 weeks Help with diagnostic tests by showing the position of the baby and placenta. Check your baby to see if all his organs are normal. Diagnose abnormalities Assess the amount of amniotic fluid and the location of the placenta. Evaluation of fetal well-being   Third-trimester Ultrasounds Make sure your baby is growing at the expected rate. Confirm if your baby is a boy or a girl. Some mothers to be, will, unfortunately, get various complications during pregnancy such as high blood pressure, kidney infections and abnormal liver function tests. As ultrasound scans are pregnancy-friendly your doctor might refer you for an abdominal/liver scan or a kidney scan to check for anything that might explain your symptoms.Although these scans are not pregnancy scans, they are related to pregnancy and in most cases, all the complications resolve after delivery. But like everything else related to your health and your baby’s health: better safe than sorry.     - Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Ultrasound Practitioner Specialities: Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare.   Reviewed: 07/04/202 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) and Tareq Ismail Pg (Dip) Medical Ultrasound, BSc(Hons)

  • 0 8- 12 Week Pregnancy Ultrasound Scan

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    Your eight-week private ultrasound scan can be an exciting and apprehensive moment. If this is your first pregnancy ultrasound you will be understandably anxious as getting a glimpse of your baby for the first time is a big deal.   Why have an 8-week baby ultrasound scan? From anywhere between 8 and 12 weeks pregnant, your healthcare professional might suggest that you schedule your first ultrasound appointment. This is also called your “dating” scan. The main reason for this scan is to confirm the gestational age of your baby. This date is based on your baby’s size and will be a very close estimation. Some eight-week ultrasounds might be performed for other reasons, including: If you are experiencing bleeding If multiple pregnancies are suspected To check the size of your embryo To confirm that your baby has a heartbeat To check the health of your ovaries and fallopian tubes To rule out an ectopic pregnancy or other problems If you have just discovered you are pregnant but you aren’t sure when you became pregnant your chosen healthcare professional might also recommend an early pregnancy ultrasound scan. Eight weeks pregnant is an early stage to perform an ultrasound and you wouldn’t ordinarily need one so early. What to expect during your 8-week ultrasound Depending on your healthcare professional and your personal preferences, your eight-week ultrasound can be performed using a wand across your abdomen or another type of wand inside your vagina. A vaginal ultrasound is helpful if your bladder isn’t full enough or your uterus is still too small to see. At this point in your pregnancy, an ultrasound can confirm that your baby is healthy and progressing as it should be. If you are having twins (or more), you might be able to see multiple yolk sacs and multiple heartbeats. However, as it is still early days one baby may be missed at this stage. Don’t be afraid to ask your sonographer questions. If this is your first ultrasound it’s very normal that you would be curious about what you see on screen. Your baby at 8 weeks At eight weeks pregnant, your baby will measure about 1.6 centimetres and it will be losing its little tadpole tail. Keep in mind that your baby’s big forehead and tiny body will still make him or her look rather disproportionate at this stage. Your little one will also start to make involuntary movements, similar to a slight flicker or a jump. These movements are extremely tiny so you won’t be able to feel them. Inside and out, a number of your baby’s body parts will start to become more defined as well, including their: Nose Lips Eyelids Arms Legs Bones The valves and air passages in their heart   Every pregnant woman is offered ultrasound scans during pregnancy. However, the number and timeline will be different for each woman. Your ultrasound schedule will depend on a few key factors, including: The progression and health of your pregnancy Your personal preferences Your chosen healthcare professional Whether you will be giving birth in a public or private hospital Your medical history Your health insurance policy If you didn’t have an ultrasound last week, your nine-week ultrasound will likely be scheduled to assess the gestational age of your baby. If you’re not sure when your last menstrual period (LMP) was, a scan at nine weeks will be able to confirm your approximate date of conception. Your first ultrasound can be a very emotional experience so it’s a good idea to take along your partner or close family member for support.   The purpose of a 9-week ultrasound Depending on your unique pregnancy, your chosen healthcare professional may schedule an ultrasound scan at nine weeks for a few different reasons. If this is your first ultrasound, it will give you the opportunity to accurately determine your due date. Especially if you haven’t tracked when your LMP was. Knowing how far along you are in your pregnancy is important. At some point between 11 and 13 weeks, your healthcare professional will suggest conducting a Nuchal Translucency (NT) scan. This scan tests for Down syndrome and for accurate results, you need to know how far along you are. If you have miscarried a previous pregnancy or you have experienced some level of vaginal bleeding over the last nine weeks, you may also be offered an ultrasound. This scan can confirm whether your pregnancy is progressing healthily.   What to expect during your 9-week ultrasound This ultrasound may be conducted vaginally or externally on your abdomen. Know that if your healthcare professional has officially referred you for an early scan Medicare will cover it. At nine weeks, you will be able to see your baby’s head, body and limbs. You will also be able to hear your little one’s heartbeat for the first time with a Doppler monitor. Bring some tissues with you; this can be a very emotional moment. It’s also important to understand that miscarrying during the first three months of pregnancy is quite common. If your ultrasound shows that your baby is growing slowly, or has a lower than average heartbeat your chances of miscarrying are high. If you have been experiencing pain or vaginal bleeding, you might be somewhat prepared for this news. However, no matter how prepared you think you may be, hearing your miscarriage suspicions confirmed is likely to be a distressing experience.   Your baby at 9 weeks  At nine weeks, your baby will measure approximately 2.5 centimetres. The foetus will resemble a green olive and weigh less than 2 grams. Your little one’s eyes will have grown larger and even have some colour, but their eyelids will still be fused shut. Your ultrasound may be able to show you the beginnings of what will be your little one’s fingers and toes too.   If you have not yet had any type of pregnancy ultrasound and you are around 12 weeks pregnant, your maternity care provider may suggest you have one. There are many reasons for having an ultrasound at this stage, but one of the most common is to screen for one of the congenital chromosomal abnormalities – Trisomy 21, otherwise known as Down Syndrome. This means that there is an extra chromosome – 21 contained in every cell of the body. People with Down Syndrome have physical and intellectual disabilities. Older women are more at risk of having a baby with Down Syndrome. When a woman is 12 weeks pregnant her risk of having a baby with Down Syndrome can be fairly accurately assessed. When a foetus has Down syndrome they tend to have more fluid at the base of their neck, in the region known as the nuchal fold area. This fluid can be measured in a test called nuchal translucency. A foetus with Down Syndrome has a measurement which is thicker than in those who do not. It is worth remembering though, that a larger than average nuchal fold measurement is not a guarantee that the baby will have chromosomal problems. Other tests for Down Syndrome need to be done if in doubt. In addition, blood tests such as a Chorion Villus Sampling test or an amniocentesis help to clarify any suspicions. I can see my baby! The 12 week ultrasound may be the first time parents have seen their little baby. So this is exciting if a little nerve-wracking time. It’s completely normal for parents to consider the possibility that their baby may not be developing as it needs to and perhaps build apprehension before the procedure. After all, this is one of the reasons why a 12-week ultrasound is recommended. One of the benefits of having an ultrasound so early in pregnancy is that if complications are found, then parents may be given a choice of continuing with the pregnancy or not. Medical recommendations on this issue are very important. Ethical, religious and personal belief systems also need to be carefully balanced and weighed up. Parents need to feel as if they are fully informed and comfortable with the explanations provided by the sonographer doing the 12-week ultrasound. Follow up care by the healthcare team are equally as important.   What is a first-trimester screening test? Maternity care providers will often suggest a pregnant mother has a blood test taken when she is 10 weeks pregnant. This is specifically to conduct a measurement of pregnancy hormones. If chromosomal abnormalities are present, these results can be out of the normal range. These blood tests, in combination with the 12-week ultrasound, provide what is known as “A First Trimester Screening Test”. A mother’s age, including the results from the blood test, and the findings of the ultrasound all provide an individualised picture of her risk of having a baby with Down Syndrome. This screening test is not a definite diagnosis of chromosomal problems, but rather provides a risk assessment. If there are concerns, then further testing can be done.   How will they do the 12-week ultrasound? The 12-week ultrasound is generally done via the mother’s abdomen. It’s not always necessary to have a full bladder, however, the individual sonographer may recommend that you have a partially full bladder. This will help to lift your uterus up out of your pelvis so it is easier to see the foetus. Sometimes it is necessary to do a vaginal ultrasound. This will lead to even clearer images.   Reasons to have a 12-week ultrasound To check that the foetus is developing as it should be. The measurements of the foetus’s skull – the Biparietal distance is calculated and compared against standard lengths for foetuses at similar gestational ages. To see if the foetus has a heartbeat. This should be clearly detectable at the 12-week ultrasound. To confirm pregnancy dates and estimate the date of delivery. To check for multiple foetuses and confirm if one or more is present. To check the size of the foetus and developing placenta. To measure the amount of fluid at the base of the foetus’s neck and make an individualised risk assessment of them having Down Syndrome. The sound waves from the ultrasound return echo-free measurements. This is because of space which is translucent due to its fluid content. To check for other physical abnormalities in the foetus. To check the uterus, fallopian tubes and pelvic region for other complications.   What else is measured during a 12-week ultrasound? The foetus’s length, specifically from its head to its bottom. This is known as a Crown Rump length. A general check of the mother and foetus’s internal organs and structures. Many parents are amazed by the amount of detail they can see at the 12-week ultrasound. They are also surprised by their foetus’s movements and agility. Of course, at 12 weeks gestation, it is too early for a pregnant mother to be aware of her baby moving. And it can be a strange sensation when looking at the monitor and seeing movement but not being able to physically detect it. Many parents feel an instant emotional connection with their baby when they see it for the first time. It’s not uncommon for fathers to say that the whole pregnancy idea was a little foreign and somehow not real. But being able to see their baby rather than talking about it and having to use their imagination, makes all the difference.   When will I know if everything’s alright with my 12-week ultrasound? You should be told straightaway if everything is going well. If you have had your biochemistry blood tests taken before the ultrasound and these results are back, then you should be able to have these results as well straight after your ultrasound is finished. Many maternity healthcare providers recommend mothers have the blood test at 10 weeks gestation. The sonographer will be able to talk their way through the procedure and turn the screen so that you can see what they are looking at during the ultrasound. There may also be a separate monitor for you and your partner to look at. If you want an explanation, then just ask the sonographer to tell you what they are checking. If they are unsure or want clarification they will often request a colleague come into the room and have a look at the ultrasound. Obviously, this can be a pretty unnerving process especially if you’ve not had any reason to believe that there are any complications.   How accurate is the first-trimester screening test? At the current time, the combined First Trimester Screening is thought to be the most accurate test for Down Syndrome. For those women whose results return a high risk of carrying an embryo with Down Syndrome, the next stage is generally Chorionic Villus Sampling or an Amniocentesis. Having a low-risk result for the First Trimester Screening Test does not give a 100% guarantee that there will not be a chromosomal abnormality. What it does is categorise a pregnancy into an increased or decreased risk.   How long will my 12-week ultrasound take? Generally, bookings of 30 minutes are made. This allows the sonographer enough time to do a thorough and comprehensive check and assessment. Try not to squeeze your appointment time between a lot of other tasks you need to achieve in the same day. Put aside some time before and after your ultrasound so you can make it to the appointment in plenty of time, and have the chance to reflect on it afterwards. Ask your partner to be with you on the day, and aim to enjoy this as an event you can both share. Some couples choose to bring their parents along as well and view this as an opportunity to meet their grandchild for the first time. How you manage this is your choice, just be mindful that ultrasound rooms can be quite small, so accommodating more than a couple of people can present a practical challenge.   Are 12-week ultrasounds part of my routine pregnancy care? Ultrasounds during pregnancy are routinely offered because they provide such an excellent means of diagnosing problems if they are present. They are also low risk, non –invasive and relatively low cost considering the amount of information they give. But you are entirely free to make your own choices regarding whether you want to have pregnancy ultrasounds or not. Some parents feel very strongly that having an ultrasound is not right for them. Part of their reasoning is that if abnormalities are found, then they may be put into a position of having to make decisions based around these findings. Some parents choose to wait until the screening ultrasound at 18-20 weeks and feel that at 12 weeks it is still too early to be able to see much of their baby’s development. If you are in any doubt, then speak with your maternity care provider about your own individual needs.  

  • 0 7 Week Baby Ultrasound Scan

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    It is quite common for our London pregnant couples to have their first pregnancy scan at around 7 weeks of pregnancy. The most common reasons for this private ultrasound scan is to confirm the pregnancy, to check viability and that everything is ok in general.     Other reasons to have a 7-week baby ultrasound are to: Confirm whether it is a singleton or multiple pregnancies. Confirm gestational age Spotting or bleeding Confirm the presence of a heartbeat. Measure the foetal pole and ensure the size of the baby is the right size for gestational age. Make sure the uterus, fallopian tubes and ovaries are ok. Confirm the foetal pole is within the endometrial cavity and it is not an ectopic pregnancy When a mother has irregular periods and is therefore unsure about her gestational age.   When is a dating scan necessary? This is a scan or ultrasound which determines your expected date of delivery (EDD) based on the development of the embryo. A dating scan is generally done for women who: Are unsure about their last menstrual period. Have irregular cycles Recently had a miscarriage and have soon conceived again. Stopped using hormonal contraception. Have conceived while they are breastfeeding. In any other situation such as multiple partners, where confirming gestational age is considered important.   How big will my baby be at the 7-week ultrasound?   The average crown to rump length (CRL) of the embryo at 7 weeks gestation is between 5mm-12mm. Crown/rump length and gestational age are closely compared with each other during pregnancy ultrasound until around the end of the first trimester.     When should I have my earliest scan? The ideal time to assess the gestation age with ultrasound is between 7-10 weeks of pregnancy. The crown-rump length measurements obtained at this gestational age can vary between 3-5 days.    How will my 7-week ultrasound be done? This early baby scan is normally performed trans-abdominally. In some instances, however, an internal scan (Transvaginal) may be required to see all the necessary detail or if your womb tilts backwards.   We will always try to scan trans-abdominally first but if we need to do a transvaginal ultrasound scan then we will discuss this with you. To perform this early baby scan, you will be asked to lie down on the examination couch and expose your lower abdomen. A small amount of water-based gel will be applied to your skin. The gel will help the transducer to make good contact with the skin. The ultrasound transducer will be placed on the body and will be moved in different directions over the area of interest to obtain the required information/ultrasound images. There is usually no discomfort from pressure as the transducer or probe as otherwise known,  is pressed against the area being examined. However, if scanning is performed over an area of tenderness, you may feel pressure or minor discomfort from the transducer. Once the ultrasound scan is completed, the clear ultrasound gel will be wiped off your skin. Any portions that are not wiped off will dry quickly. The ultrasound gel does not usually stain or discolour clothing. This ultrasound examination is usually completed within 10-15 minutes. After an ultrasound examination, you should be able to resume your normal activities immediately.   Can I see my baby’s heartbeat at the seven-week ultrasound? Heartbeat should be visible at 6+ weeks gestation and you should be able to see a tubular flickering structure. The baby's heart rate at this early stage of pregnancy is fast and it is between 90-110 beats per minute.   Will my seven-week ultrasound be really clear? The image quality of your pregnancy ultrasound scan will depend in the quality of the ultrasound equipment and also the experience and skills of the sonographer. At International Ultrasound Services we have years of ultrasound scanning experience and therefore you can rest assured that we will achieve the best image quality possible without compromising the safety of the baby or mother.  If you have any questions please leave a comment and we will do our best to answer. At our private ultrasound clinic, we offer pregnancy scans from as early as 5-6 weeks in times to suit you.   Who interprets the results of the early pregnancy scan and how do I get them? Our Sonographer, a Health Care Professional specifically trained to perform and understand the ultrasound images, will do your exam and provide you with a written report that you can take it to your doctor.  Our sonographers will also discuss the results with you during and after your examination. It is very common that sometimes when you leave you remember of a question that you forgot to ask, so please don't hesitate to contact us either via phone or e-mail and we will do our best to answer your question.   What are the benefits and risks of the early pregnancy ultrasound examination? Benefits The early pregnancy, reassurance scan is non-invasive. If a transvaginal scan is required the ultrasound exam might be a little uncomfortable but not painful. Ultrasound examinations are significantly cheaper than other diagnostic imaging modalities. Ultrasound imaging is safe for the baby and the mother as there is no ionizing radiation involved. You can not see the baby using conventional x-ray imaging. Ultrasound is the preferred imaging investigation for the diagnosis and monitoring of pregnancies. Ultrasound allows the sonographer to see inside the uterus in real-time and provides necessary information about the pregnancy. Risks There are no harmful effects on humans or babies related to pregnancy ultrasound examinations. Although ultrasound has been used in pregnancy for more than 40  years with no evidence suggesting it is harmful to the patient, embryo or fetus, ultrasound should be performed only when clinically indicated and by qualified practitioners.       About  Pregnancy Scans A pregnancy ultrasound scan is the same as a ‘normal’ scans but is being used to evaluate the overall health of your baby instead of looking at other organs such as gallbladder for gallstones or kidney for kidney stones. So in pregnancy ultrasound scans are being used to visualise the baby, the placenta, the uterus and cervix and your ovaries.Pregnancy ultrasound scans or prenatal ultrasounds are very common and being carried in any stage of the pregnancy.   When Is an Ultrasound Performed During Pregnancy in the NHS? You will normally be offered two ultrasound scans during your pregnancy from the NHS. The first pregnancy scan is at 12 weeks and called a dating scan. The second pregnancy scan is at 20 weeks and called an anomaly scan.Most of the expectant mothers, especially the ones with previous complications such as miscarriage they do not believe that 2 ultrasound scans during pregnancy are enough and this is the reason they choose to have a private pregnancy scan in London with us.   What are ultrasound scans used for in pregnancy? Depending on your stage of pregnancy, ultrasounds will be used to give you and your doctor or midwife answers about your pregnancy. First Trimester Ultrasounds Check that you are pregnant and that your baby has a heartbeat. Check if you have a singleton or twins Make sure that the pregnancy is not an ectopic located within the endometrial cavity and is not outside the womb such as in the fallopian tube. Look for the cause of any bleeding you might have. Date the pregnancy by measuring the crown-rump length of the foetal pole. Second Trimester Ultrasounds Verify dates and growth Estimate the  baby's risk of Down's syndrome by measuring the fluid at the back of your baby’s neck between about 10 weeks and 14 weeks Help with diagnostic tests by showing the position of the baby and placenta. Check your baby to see if all his organs are normal. Diagnose abnormalities Assess the amount of amniotic fluid and the location of the placenta. Evaluation of fetal well-being Third-trimester Ultrasounds Make sure your baby is growing at the expected rate. Confirm if your baby is a boy or a girl. Some mothers to be will, unfortunately, get various complications during pregnancy such as high blood pressure, kidney infections and abnormal liver function tests. As ultrasound scans are pregnancy-friendly your doctor wight refer you for an abdominal/liver scan or a kidney scan to check for anything that might explain your symptoms.Although these ultrasound scans are not pregnancy scans, they are related to pregnancy and in most cases, all the complications resolve after delivery. But like everything else related to your health and your baby’s health: better safe than sorry. What can be seen during the early pregnancy scan: At 5 weeks gestation (i.e 3 weeks after conception) a small gestation sac might be visible. At 6 weeks, the yolk sac, the embryo (foetal pole) and the heartbeat might be visible. At 7 weeks the embryo will be around 10mm with a fast heartbeat. At 8 weeks, the embryo will be around 16mm and the body and the head might be distinguishable. The embryonic movement might also be seen. At 9 weeks, the embryo is now a foetus and head, body and limbs start to form.     Why choose us for your early pregnancy ultrasound scan in London? We are conveniently located in the heart of London, just a few minutes’ walk from Notting Hill Gate station, in a cobbled cul-de-sac off Kensington Mall in the Royal Borough of Kensington and Chelsea. We offer same day and emergency after hours and weekend appointments in a clean and caring environment, to suit your needs. We have years of experience in medical ultrasound scanning. Experience gained working for flagship NHS trusts alongside leaders in the field of diagnostic medical imaging including general ultrasound, pregnancy, urology, musculoskeletal, gynaecology, pelvis, testicular and vascular examinations. You can, therefore, be assured that your health is in good hands. Our range of ultrasound examinations includes the abdomen, pelvis, kidneys, bladder, prostate, ovary, testicle, scrotal, knee, shoulder, groin, ankle, wrist to name a few. We are also experts in pregnancy ultrasound and we regularly rotate through our hospital EPU that mainly deals with recurrent miscarriage. Our full range of scans can be viewed via the site menu. Our competitively-priced private ultrasound scan services and personalised service is second to none and this is the reason our clients recommend us to friends and family.    About Ultrasound Diagnostic Medical ultrasound scan or medical sonography as otherwise known is a painless imaging technique utilising sound waves to produce internal images of the body.It is called ultrasound as the sound frequency being used is at the region of 1 to 20MHz. The human ear cant can’t hear these frequencies.The sound waves are produced by the transducer or the probe as most commonly known. As they travel through the body they bounce back to the transducer due to various sound transmissions differences in tissues. The returning echoes are picked up by the probe and a powerful computer analyses the echoes and creates the 2d image on the screen.There are various kinds of ultrasound scans that can be performed and each looks at different organs of the body such as tendons, muscles, joints, blood vessels, liver, kidneys, uterus and ovaries to confirm or exclude possible pathology.Unlike Ct and MRI, ultrasound does not use radiation and therefore is pregnancy-friendly. It is also live and is ideal for musculoskeletal exams to evaluate moving joints.   Author- Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons) - Medical Ultrasound Practitioner  Specialities:   Abdomen, Small Parts, Gynaecology/Obstetrics and Vascular...Yianni Kiromitis is a London based NHS and Private Medical Sonographer, with more than 20 years’ experience in Healthcare.     Reviewed: 10/04/2020 by Yianni Kiromitis PgC Medical Ultrasound, BSc(Hons)  and Tareq Ismail  Pg (Dip) Medical Ultrasound, BSc(Hons)

 

 

 

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