Dr Howland started performing ultrasound examinations on pregnant patients in 1979. He has had a succession of ultrasound equipment culminating in the Pilips iU22 with colour Doppler and advanced 3D which he has now. This unit is "state of the art" and "top of the range". It is regularly upgraded as new developments take place.

OBSTETRIC SCANS
Scans are useful through a pregnancy to give information about the baby, the placenta and the mother. Scans at different times in the pregnancy give different information.

4.0-5.2 weeks
If the pregnancy is inside the uterus (not ectopic)

5.3-11 weeks
If the baby is alive, especially if there has been vaginal bleeding
Dates can be fairly accurately determined
The number of babies present
If twins are found, whether they are Identical (from one egg) or probably not Identical
The dates within a few days accuracy
If other problems such as ovarian cysts are present

11-14 weeks
Information about normal growth and structure of the baby
Possible abnormalities
The risk of Down syndrome can be refined using measurements on the baby

14-18 weeks
This is an intermediate period in the pregnancy when scanning may give less information
Amniocentesis is done at 15 weeks for checking chromosomal problems such as Down syndrome

18-24 weeks
Fetal morphology, which is looking at the baby to try to detect any abnormalities
Checking dates
Placental position
Cervix length, A short cervix increases the chance of a very premature delivery and recognition of this will assist in measures which help to delay delivery

28-32 weeks
Progress of some problems can be assessed, such as Rh incompatibility and parvovirus infections
Bleeding and placental position can be reassessed

32-35 weeks
Placental position
Growth rate of the baby
Placental function
Length of the cervix

35-39 weeks
Baby size
Placental function
Position of the baby

It may be difficult to detect abnormalities in the baby by ultrasound scans. For example, only about one third of heart defects are found on scans before the baby is born. When the scan is videotaped, it may be possible to review the tape later and see the defect with the knowledge of what is present. During scanning, evaluation of the scan images is often concentrated on a small portion of the image. Later review of these images may reveal problems that were not seen at the time of the scan. A "normal" scan never guarantees that no defects exist in the baby.

Dr Howland keeps selected images on CDs. Some problems not recognised at the time of the scan may be possible to be seen after the baby is born on review of the CD when the exact nature of the abnormality is known. You must be aware that abnormalities are missed by all doctors who perform scans due to concentration on small portions of the scan image during examinations and less than ideal scan image quality in some patients.

The Federal Government restricts payments by Medicare to specified conditions before 18 weeks and after 22 weeks. If one of these conditions is not present, the patient will have to pay for the entire scan themselves. Referring doctors should be able to warn patients who do not have a specified condition before the scan is done.