Ultrasound?

[Ottbabies]

So I UP'd until just yesterday, I am 26 weeks along now. My plan was to see my OB twice (once for bloodwork and the second visit to get the results) and have 1 U/S then just not go back. Well the U/S she ordered for me is a Detailed OB Complete Ultrasound that is 75 minutes long! I didn't find out until I called the medicine center where she is sending me to have it done. I think that is a bit excessive and not comfortable with it at all. Now I am really just questioning whether I should go back at all and why I want the blood work/ultrasound done in the first place. To be completely honest with myself I have a feeling I am carrying twins and wanted to see if the AFP test would give an abnormal result AND I wanted the U/S to check for an omphalocele. Although rare it would be a reason that I would birth in a hospital. Other then that whatever syndromes etc my baby would be born with I would accept and keep my baby anyway.

So I guess I am just torn. My OB is gone for the day when I called to discuss my concern for the lengthy U/S and what indicators I have that would warrant it. I am low risk by ACOG standards, young, healthy, no issues whatsoever. The worst I have experienced is nausea and heartburn. No bleeding, no cramping, no spotting etc etc. You get the picture.

Anyway wwyd? I mentioned my concern with U/S exposure at my visit yesterday but she completely brushed me off and moved on.

[lovestolearn]

I would definitely stop seeing that OB! If I were feeling fine and could tune in to my babies to see if they are fine, then I would continue to UP. If I still had concerns and felt that an ultrasound would help me relax, then I might find a midwife who is willing to order a brief ultrasound (but I rather doubt it, since I am not comfortable with ultrasounds!)

[yara1]

Originally Posted by Ottbabies

Other then that whatever syndromes etc my baby would be born with I would accept and keep my baby anyway.

exactly.

I am against ultrasound. It was a surprise (an unpleasant one), when my baby started kicking agressively during that procedure, other than that time - never happend during the whole 9 month...).

The only rational reason for ultrasound would be to see if there is no placenta previa. And it can be done in few minutes. (although a good professional can detect placental position without use of machinery...too bad they all "forgot" how to do it...)

[thankfulmomma]

Okay, coming out of hiding for this one...

I am also considering skipping my 20wk ultrasound (should be next week). I thought having them check for placenta previa would be a good reason to go along with it, until I read that there really is no placenta previa at 20 weeks! The placenta would still have plenty of time to move up and out of the way by the end of pregnancy. All they would do is schedule you for another ultrasound later on to be sure that it has moved.

So to tack on the the OP's question - can anyone give us one (or several!) good reason why we should have the US? Nothing they could find would change anything for me. And from what I've read, even a heart defect does not need to change my HB plans... it is detected early on after birth and then can be corrected. Anything else??

[Sarah Faith]

Other then that whatever syndromes etc my baby would be born with I would accept and keep my baby anyway.

Yes, but we are talking about unassisted birth here. Any syndromes that your baby may have might be much better treated in a hospital.

I am completely pro-life and would never abort a baby for any reason, but if I found out my child had spina bifida that could be fixed by in utero surgery I would want that. Or if I found out my child had downs and had a greater risk of being born with heart problems I would want to be in a hospital.

I am not saying this to say that every woman must have an ultrasound, though that was my personal decision, but to say that the decision to have one isn't as simple as just "well, I wouldn't abort so what is the point".

ETA: I should reveal my bias I suppose, I had standard prenatal care with a CNM though I did have an unassisted childbirth, my personal "requirements" for having a safe UC at home included getting regular prenatal care to make sure I remained low risk.
I mean regular low risk midwife prenatal care too, so only one US and some standard bloodwork (no amnio) and no cervical checks.

[GoBecGo]

WRT heart problems (with Downs syndrome or not) - only 25% or detected at the 20week ultrasound. So a clean bill of health for the foetal heart is FAR from useful.

[MeepyCat]

Originally Posted by thankfulmomma

I thought having them check for placenta previa would be a good reason to go along with it, until I read that there really is no placenta previa at 20 weeks! The placenta would still have plenty of time to move up and out of the way by the end of pregnancy. All they would do is schedule you for another ultrasound later on to be sure that it has moved.

I had placenta previa at 20 weeks, and I assure you that it is a real condition at that time. I'd had two episodes of bleeding by the time the original date for my 32 week follow-up ultrasound came around, had to reschedule that u/s because I was on hospital bed rest, and then started hemorrhaging the night before the rescheduled scan. Knowing that I had previa made it much easier for me to deal with bleeds calmly and much easier for me to communicate effectively with the doctors I needed to see for the problem. It does make some difference in later pregnancy too - if you're having preterm contractions, the standard investigative procedure is a cervical exam and maybe a fetal fibronectin test, and if you have previa, these things are totally contraindicated.

I had hoped to get through my most recent pregnancy with just one ultrasound (because I mostly don't find them useful, assuming everything is normal), but I found the second trimester ultrasound and the subsequent follow-ups to be helpful in my case. My feeling is, if you're going to just look once, look thoroughly. Look at everything. Have the MFM specialist in to double check, don't just rely on the u/s tech. Be as thorough as you can, and move on with the maximum amount of information.

[GoBecGo]

I don't think she meant praevia doesn't exist at 20 weeks, only that for the vast majority of those who have it dx at 20 weeks it will no longer be present at birth, so the dx of it then is not always very useful.

[Ottbabies]

Originally Posted by MeepyCat

I had placenta previa at 20 weeks, and I assure you that it is a real condition at that time. I'd had two episodes of bleeding by the time the original date for my 32 week follow-up ultrasound came around, had to reschedule that u/s because I was on hospital bed rest, and then started hemorrhaging the night before the rescheduled scan. Knowing that I had previa made it much easier for me to deal with bleeds calmly and much easier for me to communicate effectively with the doctors I needed to see for the problem. It does make some difference in later pregnancy too - if you're having preterm contractions, the standard investigative procedure is a cervical exam and maybe a fetal fibronectin test, and if you have previa, these things are totally contraindicated.

I had hoped to get through my most recent pregnancy with just one ultrasound (because I mostly don't find them useful, assuming everything is normal), but I found the second trimester ultrasound and the subsequent follow-ups to be helpful in my case. My feeling is, if you're going to just look once, look thoroughly. Look at everything. Have the MFM specialist in to double check, don't just rely on the u/s tech. Be as thorough as you can, and move on with the maximum amount of information.

I can certainly understand this but in my current situation I have had no issues whatsoever. No bleeding, no cramping, no preterm contractions, my cervix is tightly closed, etc basically no indication physically that anything is wrong.

I did end up canceling my care with the OB and found a midwife who will see me for a general visit and give me a referral for an U/S. Thank you for you input ladies, I appreciate it!

[CorasMama]

Originally Posted by yara1

The only rational reason for ultrasound would be to see if there is no placenta previa. And it can be done in few minutes. (although a good professional can detect placental position without use of machinery...too bad they all "forgot" how to do it...)

Originally Posted by thankfulmomma

Nothing they could find would change anything for me. And from what I've read, even a heart defect does not need to change my HB plans... it is detected early on after birth and then can be corrected. Anything else??

Actually, there are other rational reasons for ultrasound diagnosis, and there are defects that ought to change HB plans. For instance, the OP mentioned being concerned about omphalocele. I spent some time today seeing some pictures of omphaloceles that ruptured during natural birth. I won't get into the scary stuff by telling the difference in outcomes for those babies, but it's not a risk I'd take.

And that's but one condition that really is affected by how or where the baby is born.

[GoBecGo]

Prevalence of gastroschisis is 1 in 10,000, prevalence of omphalocele is around 4 in 10,000. Just in case anyone wanted to weigh risk.

[CorasMama]

While those numbers are not accurate (gastroschisis is more common, omphalocele less), prevalence of death by ultrasound is approximately 0 in 10,000. And as I said, ventral wall defects aren't the only issues that can change one's birth plans, I was just addressing the specific concern the OP had expressed.

[chel]

i was dx with a cervical issue (IC) by u/s at 22w. it was so severe i was put on bedrest. dd made it to full term. staff didn't think i had much of a chance to make it to viability even with bedrest.

my level 3 u/s was nowhere close to 75min, maybe the entire appt, but not the scanning, maybe 15mins tops, my trans vag u/s was at most a minute.

i too was thinking of skipping the u/s and only went due to my age and two recent m/c of unknown causes. i wouldn't suggest everyone needs an u/s, but it can be helpful.

[MJB]

I didn't have an U/S with my last pregnancy (100% UP and he was fine) but I chose to this time.
Personally, we would have terminated if there was a severe defect-- we have two kids and busy careers and that is just not something we would want to take on. But for a more minor issue it would be good to be prepared before the birth so we could make whatever different choices were necessary. I also wanted to know how long my cervix was since it seems very soft and has been about 1cm this pregnancy (it was normal length, yay). We also wanted to know the sex since this is our last child and we all had our hearts set on a girl.
My U/S seemed very thorough and lasted about 25 minutes. I don't see why you'd need one 75 minutes long!

[CorasMama]

I think it may have been a 75 minute appointment? I've had a bajillion ultrasounds this pregnancy, for very legitimate reasons, and we have to look at a LOT of stuff, and the only one that lasted that long included a 20 minute fetal echocardiogram, and a 10 minute break for me to move around and try to get her in a better position. Also, mine are longer because seeing her heart is really tough because it's positioned weird. And I still haven't had a level 2 u/s that was 75 minutes.

[Ottbabies]

Originally Posted by CorasMama

I think it may have been a 75 minute appointment? I've had a bajillion ultrasounds this pregnancy, for very legitimate reasons, and we have to look at a LOT of stuff, and the only one that lasted that long included a 20 minute fetal echocardiogram, and a 10 minute break for me to move around and try to get her in a better position. Also, mine are longer because seeing her heart is really tough because it's positioned weird. And I still haven't had a level 2 u/s that was 75 minutes.

At first I was surprised to hear this too so I asked the women I was speaking with at the medicine center and she said the 75 minutes is broken up as 60 min for the U/S and 15 minutes to fill out any paperwork/wait time. To be sure I fully understood I asked if it would be 60 of scanning as in 60 minutes of exposure and she said yes. So I have no idea what kind of U/S my ob ordered but that was excessive! Especially since looking at my records of this pregnancy from her office show that everything is fine (bloodwork/urine wise) as well as the PAP and vaginal exam (she checked my cervix) was all normal.

[CorasMama]

well, 60 minutes in the u/s room is NOT 60 minutes of exposure! There's the arranging you and your clothes, the waiting for the medical assistant to leave and the u/s tech to come in, then the getting settled, then the u/s itself, then the waiting for the radiologist or peri to evaluate what they've seen and come in and talk to you. There's a whole lot of lying there with/without gel on your belly and NOTHING ELSE HAPPENING.

[stellamia]

I would have an U\S but NOT a 75 minute one! My 20 week U\S with my last baby lasted 20 minutes or less (and that was more than long enough for me) and they checked EVERYTHING! They looked at his brain, organs, heart, lungs, body parts....everything. I agree that 75 minutes is excessive and unecessary.

[Pirogi]

Originally Posted by CorasMama

While those numbers are not accurate (gastroschisis is more common, omphalocele less), prevalence of death by ultrasound is approximately 0 in 10,000. And as I said, ventral wall defects aren't the only issues that can change one's birth plans, I was just addressing the specific concern the OP had expressed.

I am not interested in a huge debate. I just wanted to mention that here have been no studies that show that ultrasound is safe in pregnancy.

[bsymomof10]

I don't have ultrasounds routinely with my babies. I think that if you trust your feelings you will know if you need an ultrasound. With my last baby I heard an arrythmia that bothered me. I knew that most of the time they resolve themselves and are nothing serious. I couldn't shake the feeling that I needed to know before birth if everything was ok.

It wasn't. My baby had a serious, rare heart defect that we needed to have intubation equipment ready at birth in case she couldn't breathe. This allowed me to make decisions about who her doctors would be and which hospital was the best. If I'd waited and had an emergency at birth I would not have had the choices I did.

I don't believe in routine ultrasound. I am expecting my tenth baby and only four of them have had ultrasound. One because I had excrutiating pain at 6 months, one because I needed to be reassured that "my number" wasn't up after 6 babies, my heart baby, and this one because I was measuring 20 cm at 12 weeks. All of them were quick scans except my heart baby.

I think you need to listen to what your gut is telling you, if you need one just to feel safe that is ok too.