Two anatomy scans = too many, right?

[janevar]

My intervention-happy OB practice (which I am in the process of leaving for a HB Midwife, thank goodness!) strongly recommended that I get TWO anatomy ultrasounds-- one at 17/18 weeks and one at 20 weeks.

I asked an OB WHY, and, a typical M.D., she patronizingly reassured me that "it just is better, and more accurate" or something, without actually giving me a real scientific answer.

I've been reading scary books that suggest that too many U/S are a bad thing, that they haven't been properly proven to either reduce perinatal death or be totally safe for the fetus. So i canceled tomorrow's 17-week u/s and rescheduled it for 20 weeks.

I did the right thing, right? I'm 30, have no high risk factors, my NT scan was totally normal and healthy. But now I'm second guessing myself (it is so hard, isn't it, to say "NO" to a doctor's advice!). Help!

(oh, and hi. I'm a long time lurker, first time poster. Soooo happy and excited to be 17 weeks pregnant today! Whee!)

[louis]

If this Ultrasound is just to check baby's anatomy, then you really don't need two. I am glad you are standing up for yourself (and your body & baby) and doing what feels right for you. The OB couldn't even give you a good reason to have two. It's unnecessary and a few more dollars in the doc's pocket.

Hope you find a HB midwife that helps provide you with the birthing experience you want.

[JayJay]

It does seem odd to have two at that time! I think you'll be just fine with one.

I had a bunch this last pregnancy - to check for placental problems. Gosh I think I had...phew...let me see...8 or 9! I gave birth on the 12th and she is just peachy - clever, alert, beautiful child, so I'm not convinced they do harm, personally. Irritate the baby's ears, yes, probably though! I suppose my case is a bit different though because we needed to make sure her lifeline was attached. For that reason we had three biophysicals done at the end of the pregnancy as well. It was very reassuring for me!

For you - well, gosh, one ought to be enough unless they detect evidence of anything weird happening. I would have canceled and rescheduled too! Xxx

[MeepyCat]

Originally Posted by louis

It's unnecessary and a few more dollars in the doc's pocket.

First let me say that I'm in favor of a certain amount of routine use of ultrasound, and of scans in response to indications of problems. I do think they're safe and helpful.

But two anatomy scans? Within three weeks of each other? Come on! It would be one thing to schedule a subsequent scan to check out an anomolous finding, but that's not what's happening here. I'm sure that many of their patients love the extra scan. I'm equally sure that they have a population of patients that has trouble getting time off work for it and would prefer to just do one.

I vote that they want to bill your insurance.

[umsami]

I've had to have lots of biophysical profiles u/s with all of my pregnancies due to gestational diabetes. All of the kids were fine. Still, if I were you, I wouldn't do two scans three weeks apart. Even my scans are at least a month apart--and I'm high risk. Doesn't make any sense to do two so close. I think you did the right thing.

[BarnMomma]

My old OB practice was ultrasound happy too. Toward the end of my pregnancy they sent me in DAILY for ultrasounds becaseu I had refused the 2nd blood glucose test and to their horror this meant that my baby was growing huge and out of control and I needed to be checked daily since I went past my due date. (DS was 7.7 by the way)

But here's the thing, my midwife said that ultrasounds might be very uncomfortable for the babies especially the older they get and it can make them turn and try to get away from it. Well, my baby was sunny side up and I had the miserabl2 72 hours of back labor to prove it. But all those ultrasounds could have been the reason why.

This time I'm allowing 2. After the 20 wk I'm DONE unless my midwife can offer me a very valid reason for more, not just curiosity.

Good for you for standing up for yourself.

[TSomm]

Yes, that seems a bit excessive. My new approach to something I question is not to simply ask "why", but use the BRAINED method...

B - What are the benefits?
R - What are the risks?
A - What are the alternatives?
I - What does your intuition tell you (this is yours to answer).
N - What if we did nothing?
E - Then, give yourself time to evaluate your options
D - Decide.

http://www.mybirthbydesign.com/BRAINED.pdf

I'm just about to have my first child and I'm going to use this method when battling vaxes and other issues at well child visits, etc. I'm going to make that doctor work for it rather than just go with the flow of what he/she has done with every other client.

[WaitingForKiddos]

I think that they are so close together it's a toss up if there's a benifit. Your gut says not to, so trust your gut.

That said. I really don't think that ultrasounds are harmful. I've yet to see a study that actually demonstrates harm.

[gcgirl]

Originally Posted by WaitingForKiddos

I think that they are so close together it's a toss up if there's a benifit. Your gut says not to, so trust your gut.

That said. I really don't think that ultrasounds are harmful. I've yet to see a study that actually demonstrates harm.

I agree here. The only reason to do TWO, IMO, is if scan one suggests an anomaly and you need a Level 2 scan to look closer. Otherwise, why? I would need more specific information on why it's "more accurate".

[MaerynPearl]

I needed two anatomy scans but ONLY because the first time the tech didnt get a clear shot of my daughters kidneys. (if she had, I would not have found out DD is a girl until she was born! she wasn't showing us her gender either)

[staceychev]

I'll end up having three scans, but that's because I'm being monitored by a maternal fetal medicine MD due to my thyroid condition (along with being 37). If I wasn't high risk, I'd say that one was more than adequate...

[prone_to_wander]

I'm 5 months now and I skipped my 12 weeks scan and only had my 20 week one. I agree with the previous posters who said that it seems unnecessary ($$ for the doctor). If they found something at 20 weeks, then you could decide if you wanted any other scans. But really, all these interventions don't really make us all that healthy. They just make us paranoid. Follow your instinct.

[Plummeting]

Originally Posted by MeepyCat

I vote that they want to bill your insurance.

Me too. I saw a midwife for DD's birth, but she worked in an OB practice where they routinely did as many ultrasounds as a woman's insurance would pay for, apparently. I was given one at 14 weeks, having been told it was to check for any problems. When I got the notice from Tricare (military insurance) stating what had been ordered, why and that they had paid, it said that the u/s was ordered because I had been on antidepressants prior to pregnancy and they wanted to check fetal age to determine that it was safe for me to go back on antidepressants. The only true part of that was that I was on Zoloft until I found out I was pregnant. I quit as soon as I found out and had no intention of going back on it, nor had I ever discussed going back on it with the m/w or OB. Additionally, I'd had a very early u/s at 7 weeks because I was having some problems, so they already knew how far along I was. They just made all of that up so insurance would pay for the u/s, since we were planning on the regular 20 week scan as well, and Tricare won't pay for multiple ultrasounds unless there's a medical reason for them.

Past 20 to maybe 22ish weeks it starts getting more difficult for them to see certain things, just because it gets more crowded in there, but if you don't want both of those ultrasounds, you are absolutely right that you don't need them both. And I bet if you got a statement from your ins showing why the doc had ordered them, it wouldn't say "standard anatomy scan" (or whatever) on both of them. They'd make up some phony reason for ordering one or the other of them.

[starkyld]

I had my second anatomy scan today. I had just planned to have one, at 20 weeks, but the first tech did not get a good image of the heart and hands, so they asked me to come back in 3 weeks. We saw both hands and the heart (four chambered and pumping) today, but the image of the heart was still frustratingly less clear than they wanted it to be. I spoke with the perinatologist for confirmation that none of the images showed cause for alarm, but I'll be going for a fetal echocardiogram in a week and a half just to make sure that the heart is properly developing. I feel a little conflicted about having THREE ultrasounds in less than 5 weeks when I'd only wanted one, but I also want to be sure that we don't have any indication that this kid would need immediate treatment after birth beyond what my midwife can provide in my living room.

If I were you, I would've cancelled that 17 week appointment as well. Excessive routine ultrasounds aren't the best practice for low-risk pregnancy. The 17 week ultrasound would only be of additional use to you if you wanted to schedule an amniocentesis afterwards if you get problematic findings and would consider termination--you'll be able to get more information from the 20 week ultrasound as it is. However, if you do go in for your 20 week scan and they aren't able to get clear images, I don't think it would be a bad idea for you to do a follow-up scan or two to get all of the information that you and your care provider seek.

[mymary]

When you guys are talking about scans do you mean the half hour long anatomy scan or are you talking about a quick peek from ultrasound-like 5 min or less.

I have had a lot of u/s just recently for position verification(baby keeps turning and turning around).

Is it the length of time under ultrasound or just the fact that its being done period? Does anyone know?

Had one at 17 weeks and then one at 20 weeks. Nothing more until recently (I am 40.5 weeks now). Maybe 4-5 for position checks over the last 2 weeks or so.

[katelove]

Originally Posted by mymary

When you guys are talking about scans do you mean the half hour long anatomy scan or are you talking about a quick peek from ultrasound-like 5 min or less.

I have had a lot of u/s just recently for position verification(baby keeps turning and turning around).

Is it the length of time under ultrasound or just the fact that its being done period? Does anyone know?

Had one at 17 weeks and then one at 20 weeks. Nothing more until recently (I am 40.5 weeks now). Maybe 4-5 for position checks over the last 2 weeks or so.

If ultrasound is harmful (and we do not know either way yet) then, I would think that the longer the exposure the more chance of harm or the more damage done. However, this is my opinion as we don't know for sure. It may be that even the 20-30min anatomy scan is not enough exposure to cause damage or it may be that the damage is done in the first 2-3mins. So, to answer your question, no-one knows the answer to your question

I personally think, in the absence of clear evidence either way, that it is wise to avoid any ultrasound unless necesary. As other's have said, it is a valuable tool when used correctly but, IMO I hear too many stories of it not being used correctly. And, I define correctly as to provide information which will make a difference to the outcome for mother and/or baby *or* will provide reassurance which cannot be achieved by other means.

OP, I you did the right thing cancelling the 17 week USS.

[Bokonon]

Originally Posted by janevar

My intervention-happy OB practice (which I am in the process of leaving for a HB Midwife, thank goodness!) strongly recommended that I get TWO anatomy ultrasounds-- one at 17/18 weeks and one at 20 weeks.

I asked an OB WHY, and, a typical M.D., she patronizingly reassured me that "it just is better, and more accurate" or something, without actually giving me a real scientific answer.

I've been reading scary books that suggest that too many U/S are a bad thing, that they haven't been properly proven to either reduce perinatal death or be totally safe for the fetus. So i canceled tomorrow's 17-week u/s and rescheduled it for 20 weeks.

I did the right thing, right? I'm 30, have no high risk factors, my NT scan was totally normal and healthy. But now I'm second guessing myself (it is so hard, isn't it, to say "NO" to a doctor's advice!). Help!

(oh, and hi. I'm a long time lurker, first time poster. Soooo happy and excited to be 17 weeks pregnant today! Whee!)

Did you have a triple- or quad-screen that indicated possible problems?

[nia82]

My insurance doesn't cover those 20 week scans at all. Only a dating scan at 8 weeks and if medically necessary (very strict guideline, e.g. when bleeding, cramping strongly only)....

The 20 week scan (and just ONE of them ) is the only one I want... I want to make sure the organs are doing fine....

[akat]

mymary, I wouldn't worry about your quick checks. Especially b/c you have a pretty good reason for them!

There is no evidence that they are harmful, I've just heard that 'we don't really know if they are'.

Only once have I seen mention of why they might be, and I don't remember where it was - it was that the waves may heat up the baby's brain, and then there is no way to dissipate the heat.

[katelove]

http://sarahjbuckley.com/articles/ultrasound-scans.htm

This article by Sarah Buckley discusses the available evidence and the gaps which remain.