Did you/will you have a ~20 week u/s?

[LittleBirdy]

Hi, I'm almost 16 weeks pregnant and trying to decide whether or not to have the standard 20 week ultrasound.

My circumstances: I am 27; DH is 31. No family history of any sort of genetic disorders - we are very blessed to be a healthy bunch! We have declined all genetic testing. So far it has been an uncomplicated pregnancy. I had some light spotting in the 1st trimester due to low progesterone and my midwives successfully treated this with an herb tincture. We heard the heartbeat loud and strong at 13 weeks. I am rock solid on my dates - I have regular cycles and we were using OPKs the cycle I got pregnant. Planning a homebirth with a team of CPM's.

The only thing that is a little off is my fundal height. It hit my navel at 15 weeks (first pregnancy).

What I'm mainly concerned about is a condition of the baby that could be picked up by u/s that is either a) treatable prior to birth or b) treatable, but really requires the baby to be born in a hospital so that there is access to a NICU, etc. right away.

I am having a hard time find information about what sorts of things are detectable, specfically, with the 20 week u/s in the absence of any other test results, how common they are, and what sort of treatment the baby would need at birth as a result. I am going to discuss this with my midwives at my next appointment but I would love the input of you knowledgeable ladies.

If you had an u/s, why? If not, why not?

[finnegansmom]

I will get a level II ultrasound (and have had them with my last 2). They can detect some anatomical issues which would affect where I birth. It's not invasive and only Amnio (or CVS) will confirm genetic issues. If the scan showed any issues with kidneys or heart or whatever, I would change my birth plan to include a hospital with a Level II nursery since where we are planning to birth does not have that.

[Pinoikoi]

Mine is tomorrow. Mainly I want to see that the baby is healthy. I know a woman irl that had her 20 week ultrasound and they found severe kidney problems with the baby.. no cure.. it prepared her somewhat to know that her baby would survive only a short time after birth.. personally if my child had a rare disorder like that, I would want to know because it can give so much info about the disorder to future parents that have to go through with it, kwim? It would be hard to deal with emotionally of course, but the research aspect I think is vital..

[MaerynPearl]

the #1 reason my midwife is making me get one at 20 weeks is to see where the placenta lies. If its possible to have it be previa, we will be keeping an eye on it.

I have a feeling I will be sent in for an early US as soon as I go to my first doctors appointment though, as I have been able to feel my fundus above my pubic bone since just before I hit the 6 week mark (last tuesday)

Of course, this is my third pregnancy so that probably has a lot to do with it.

I also, though, do want to be aware of any potential problems my baby may have so I can deal with them before I bring them into the world, and learn what may be necessary treatment for them (or even in severe cases, life span). I would never consider terminating my pregnancy but things like hydrocephalus... Id rather be prepared for that and not have it come as a complete shock so that I am dealing with the shock rather than spending that time with my baby in my arms (I have a cousin who was born with hydrocephalus and only lived to be 6... its painful but it helps if they know they are loved)

[IAMommy]

I had one, although it ended up being at 25 weeks. I do it because as a PP said, I want to know if there is anything that would preclude a home birth. That is the only reason I get it, to make sure there are no heart defects or what-have-you that would require immediate hospital attention.
Other than that, we don't do any other testing on the baby.

[Mandynee22]

I did every time. First off, if there's anything really obvious, it'll probably show or at least tip us off. I'd like to be prepared. Second, my maternal grandmother is a fraternal twin. She went on to have 3 sets of fraternal twins (2 sets didn't make it, the other set was my mother and aunt). I just needed to put that fear to rest LOL

[ivymae]

I listened to my gut - with #1, it told me to have one, with #2, it didn't, and with #3, it did. If it will help you relax and enjoy the rest of the pregnancy, consider having one. If you feel secure and like you do not need one, don't. Either way has risks/benefits, but for me, I felt like I needed to consider those for my family, at that time, with that pregnancy. What was true for #2 was not true for #3.

For what it's worth, i do not trust ultrasound results impeccably, so maybe that is where me "Eh" attitude towards them come from. I have had horrible experiences from having misread ultrasounds, so if they see something/don't see anything, i don't really put a lot of stock into it. Having a clear ultrasound does not guarantee a healthy baby, and vice versa. It is a tool, not a crystal ball, so don't give it more weight than it deserves.

[etsdtm99]

I have had them with my other pregnancies and will this time as well.. we have not done genetic testing with any pregnancy and would not terminate under any circumstances, but I just need to know everything looks good, esp. since we are planning a home birth this time..

[chai]

I planned on having two, and ended up with four (I'm 38 weeks). I planned on the nuchal measurement at 12 weeks, and the anatomical at 20. The one at 20 weeks showed my placenta was very near my cervix, so I had another at 29 weeks to confirm the placenta had moved out of the way (I'm planning a home birth and didn't want to have placenta issues at home). Then I had another one at 37 weeks because my fundal height hadn't changed in a month. Everything was fine.

So... I probably could have done without any ultrasounds (all my results ended up being good), but am glad I had them anyway. Each one was less than five minutes long, and the tech assured me that the sound waves delivered to the baby are much less than the doppler - since the u/s machine only sends signals every so often, whereas the doppler sends them constantly. I can't remember the details of the u/s, but I have declined the doppler throughout the pregnancy, so feel okay about having so many ultrasounds. I think it makes sense to do it that way... the info provided by the doppler is much less useful than that provided by an u/s, IMO, and the doppler is (presumably/potentially) more harmful.

[MamaMelis]

Originally Posted by finnegansmom

I will get a level II ultrasound (and have had them with my last 2). They can detect some anatomical issues which would affect where I birth. It's not invasive and only Amnio (or CVS) will confirm genetic issues. If the scan showed any issues with kidneys or heart or whatever, I would change my birth plan to include a hospital with a Level II nursery since where we are planning to birth does not have that.

This is exactly what we do We are having a home birth and as we decline all diagnostic tests like the quad screen or nuchal screen or the like, we wanted to rule out any large anatomical issues that would change our minds and have us choose a hospital birth.

[Plummeting]

I had one. I have a relative whose baby was born with very severe spina bifida. I'm not at increased risk, but after seeing all the things he needed immediately after birth, I was not comfortable risking birthing a child with that kind of issues at home. He was delivered by cesarean because the doctors were worried that he would not tolerate labor well due to the severity of his problems. One u/s seemed like a good risk to take to avoid something like that.

[klocke]

I did and I'm glad I did because we learned that baby #4 is actually babies # 4 & 5. Midwife never heard more than one heartbeat and due to me having two anterior placentas she never felt more than one. I wouldn't have known otherwise.

[MacKinnon]

We have with our last two and will with this, with DD I only had one at 21 weeks. With DS, I had an early scan due to previous loss and uncertain dates, one at 17 weeks that showed partial placenta previa, one around 32 weeks to show it cleared, and then I was in a car accident at 39 weeks and we had another to be sure everything was fine. With this one, we already had a viability scan and will have another to measure growth, etc. then the routine 20 week. If any issues come up from that, we would have more as needed.

I agree with all the other posters that we declined all other genetic testing, we won't terminate, but we do want to know of any potential issues that could rule out an out of hospital birth and/or cause the need for a c-section.

[GuavaGirl]

I had one because it's standard procedure to have an anatomy scan at 20 weeks, in my CNM's office, I wanted to make sure he was developing normally, didn't have a cleft lip (like dh), that their wasn't twins, wanted to find out the sex, and just wanted some cute pictures! It also helped everything to seem more real for us.

[Tizzy]

Just to be the odd one out...

I declined with this pregnancy.
With DS2 I had an earlier one for dating purposes, which seemed pointless afterwards, then I had a 2nd around 20 weeks and ended up with a third around 24 weeks due to some other non-pregnancy related health issues.
So much for avoiding too much U/S.

Then with DS2 we stuck to just the one at 18 weeks.

And now I've decided to forego any U/S unless I REALLY feel the need later in pregnancy.
As a planned homebirth, my main concern is the placenta placement. I am aware that it could be near my C/S scar (I'm positive it is not though) and also too close to my cervix. Regardless of what the U/S would find, I would need another closer to 35 weeks. So I figure we'll just skip the earlier one and wait until 35wks or so.

[BlackSheepPDX]

LIke others, I decline the genetic screening stuff and just do the 20 week ultrasound to look for big dangerous things that would be inappropriate for homebirthing.

[feminist~mama]

I didn't. My experience with US technology in general is that it is SO very very flawed and imperfect. It causes so much stress and worry that it's just not worth it on the off chance that something is indeed wrong and they do happen to catch it!

I've experienced this in my job for sure- "big" babies, babies with anomalies, babies with "low AFIs/ ie. almost no amniotic fluid", babies guaranteed NOT to have anomalies, etc.

I've also had experience in my own life with this- my sister was told repeatedly over a few weeks that she didn't have a viable fetus- her daughter is 5 years old now.

I could go on and on really- but basically it boiled down to not having a lot of faith that the US would relieve any worries, rather than add to them!

[Realrellim]

We did. I had pre-e with my first (undiagnosed until I was in labor, resulting in severe fetal distress, a c-sec, and a week-long NICU stay for DD). So, this time around they want to monitor things a little more closely. Specifically, they checked the usual stuff (that the major organs are present, that the heart has all four chambers and looks normal, for growth markers, etc), and I think they also checked my uterine blood flow at that one too. Also, it was nice to see that my placenta was up high, so it didn't attach to my scar and can't cause problems that way. We've had a few more since to continue monitoring growth and blood flow that way if pre-e does show up again, we have some advance notice if #2 appears to be struggling the way DD was.

With DD, we didn't have a 20-week u/s, but it wouldn't have prevented the issues we did have to deal with. For that matter, my doctors didn't even suggest having one.

OTOH, someone I know locally did get a u/s and discovered her little one had gastroschisis (basically, her abdomen wall didn't close, so her intestines were outside her body). She had to forgo her planned homebirth for obvious reasons, but everything at the hospital was set up with the necessary pediatric specialists during her labor so they were able to immediately do what needed to be done in those cases and her little one is doing really well now. Also, apparently the umbilical cord came unattached just after she pushed the baby out, before they could clamp it, but because that is apparently also common with that condition, the drs were prepared to deal with it.

I think u/s can be a mixed bag, but I'm glad we had the 20-week this time.

[chai]

Originally Posted by feminist~mama

I didn't. My experience with US technology in general is that it is SO very very flawed and imperfect. It causes so much stress and worry that it's just not worth it on the off chance that something is indeed wrong and they do happen to catch it!

I hear this a lot, and I have to wonder if there aren't different levels of ultrasound quality... maybe some places are still using old technology? Maybe some techs are more qualified than others?

My experience has been basically the opposite... (not saying your experience is invalid, just that it seems there can be a wide variety) I had my most recent ultrasound because of concerns/stress/worry that came up in a normal midwife visit (without technology) and the ultrasound confirmed everything was okay (baby was the right size, plenty of fluid, etc). That is how all of mine have been this pregnancy... reassuring rather than worrying.

Anyway, just thought I'd throw that out there... maybe it matters a lot WHERE you get your ultrasound...

[evjolin]

just had mine yesterday. i decide to for many of the above reasons--check placenta location, find out sex (boy!!), and make sure there wasn't anything majorly wrong with spine or heart the would require immediate care. oh--and also--the multiple thing. i know 2 people who have found out the were having triplets (no drugs).....so i reallllllly wanted to know it was just one!

we didn't do the earlier one, and aren't planning the later one, unless necessary to check amniotic fluid or something.

aside from the above reasons, it was GREAT for dh. i didn't get to see most of it because of how the room is set up, but he saw all of it and it definitely made an impression :-) made things very "real" for him.