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Medical Equipment News

Thursday, November 29, 2007

Q&A with a sonographer

10:17am Thu 29th November

Our very own mum-to-be Kelly Young sat down with Sonographer Celia Goldsmith from Maidenhead and asked the questions every pregnant woman wants to ask:
Q&A: Celia Goldsmith, sonographer

Do you have any children?
Yes I have 2 girls and 2 boys aged 17, 16, 14, and 10, so the pain of childbirth is a distant memory - now I’m experiencing the pain of adolescence.

And have you had a 4D scan? If so what did you think of it?
Sadly I haven’t had a 4D scan as they weren’t available when I was pregnant! How I wish they were. I think they’re amazing; it must be such an emotional experience for new mothers these days to see their unborn baby’s face! We’ve had many couples become quite emotional when they see their baby’s face pop up on the screen for the first time.

How long have you been a sonographer?
I have been a sonographer for over 20 years and still love my job.

What training should a sonographer hold and how long do you train?
A qualified sonographer should hold a D.M.U (Diploma of Medical Ultrasound) certificate. I first trained for 2 years as a radiographer to gain my D.C.R. (Diploma of College of Radiographers) and then as an ultrasonographer for a year. Nowadays it’s a 3 year degree course for Radiographers and a post graduate certificate in obstetric ultrasound for 1 year.

Have you worked in an NHS hospital doing scans?
My radiography scan training was at Guys Hospital and then I moved on to Queen Mary’s in Roehampton. I also trained at Kings College for ultrasound and scanned at Queen Charlotte’s Hospital.
After starting a family I moved nearer to home and scanned at Heatherwood and St Marks’s Hospital. I have also worked in the private sector at Princess Margaret Hospital and The Bridge Clinic in Maidenhead.

How does it compare to what you’re doing now?
The London Ultrasound Centre is a much calmer, more relaxing place to work. I am privileged to work beside Mr. Maxwell the Medical Director, and to have access to state of the art equipment in a really modern facility. I have more time to spend with our patients and it’s very satisfying when they enjoy the experience.

What do you like most about your job?
The thing I most I like about my job is that I am always learning and updating my knowledge. With 4D ultrasound being relatively new there are new advancements and developments to pick up almost every day. Before I started at the London Ultrasound Centre I’d never even performed a 4D scan.

What is the mark of a good sonographer?
The mark of a good sonographer is someone who is versatile, friendly and makes a mother’s experience special every time. Never forget what it was like when you were a first time mum to be. Keeping up good practice is essential and a regular audit of one’s own work also keeps you fresh and ahead of the game.

Do you have any particular funny/interesting story about a scan you’ve carried out?
We had one couple who came in for a 4D scan who couldn’t stop laughing when they saw their baby. The mother was making comments to the father like; “Look at his big fat tummy, he’s just like you!” And he said that the baby’s lips were just like hers. They were so funny together it was making me giggle and I struggled to hold the ultrasound probe steady. I’m sure their DVD has moments of wiggling pictures when I’m laughing out loud. I especially remember that scan as they were enjoying it so much.

I’ve had two very different experiences of scans, one bad and one good, and it was all down to the attitude of the sonographer. How do you strike a balance between doing your job and the needs of the parents-to-be?
Striking the balance between a performing your job to the highest standard and the needs of parents can be tricky, but giving full, honest explanations of what we are doing and why seems to strike the happy medium.

4D Ultrasound scans are becoming more and more popular, why is this?
4D scans are more widely available because the technology is better and more available. With modern parents being so time pressured they are seeking earlier opportunities to bond with their unborn child and 4D scans are a great way to do this. And with digital technology making image capture and display so easy who wouldn’t want to take home a DVD or prints of their unborn baby to proudly show friends and family?

How does a 4D scan work, how is the picture put together?
The clever part of the 4D scan is the computer inside the ultrasound machine. It arranges lots of 2D pictures together several times per second and adds colour to produce a realistic 3D image. The 4th dimension is time and because the computer is so fast you can actually watch your baby moving, yawning, scratching its nose, stretching in real time. Sometimes with twins they often prod each other!

When can you have a 4D scan?
4D scans can be integrated into any scan that we do at The London Ultrasound Centre however the most attractive pictures are obtained between 24 and 34 weeks when the baby has put on some puppy fat and filled out a bit. At The London Ultrasound Centre we are pioneering new techniques with 4D scanning where a mother to be can take home a professionally edited DVD of 4D images of her baby from the very first scan at around 9 weeks (when baby is the size of a bean) all the way up to her last scan when her baby is fully formed at 38 weeks.

Is there anything a M2B could do beforehand to improve the image?
The main things that influence the quality of the pictures are the stage of the pregnancy, the position of the baby and to some extent the size of the mum. Ultrasound doesn’t travel well through body fat and if mum has been piling on the pounds then it’s more difficult to obtain good 4D images.
The biggest factor however is the position of the baby, and we can’t determine that until we actually start the scan. That’s why with our Cocoon4D service have a range of options that the parents can add on once they have had their 4D scan.
On the odd occasion when baby is in an impossible position for 4D images we strongly advise parents not to waste the opportunity and let the sonographer perform a Growth Scan to check the health and well being of their baby. After all it may be the last scan a mother has before birth.
Ironically when a baby is in a difficult position eating chocolate and drinking sweet fizzy drinks sometime stimulate the baby to pose for pictures!

Although a 4D scan isn’t a medical scan, if a sonographer picked up a possible abnormality would you tell the parents?
Yes, absolutely. We are fortunate at the London Ultrasound Centre to have a team of Fetal Medicine Specialists available and so if any abnormality were spotted we would be able to discuss the findings with the parents and offer a complete management plan. Generally a 4D scan is only performed after the 20 week anomaly scan has confirmed all the structures of the baby, so any abnormality should have already been detected.

Are there any risks involved in a 4D scan?
The scan process is the same as for an ordinary 2D scan. In this regard a 4D scan is really no different from a 2D scan but the images are displayed in a more attractive way. It is important to remember that the majority of women who are pregnant these days will have been scanned themselves while they were still inside their mother’s womb.

Is it possible not to find out the sex of your baby with a 4D scan, or will parents-to-be have to find out because they are so detailed?
Babies are not always that willing to show their genitals off to us in a 4D scan so we don’t have to divulge the sex of the baby to the parents. An experienced sonographer can determine gender clearly on a 2D scans if the baby is obliging.
We had one well known celebrity and his partner who didn’t want to know the sex but their baby revealed all while I was lining up the scan image in 2D. Of course I kept that information to myself but one always has to be careful not to give the game away accidentally!


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