Level 2/3D ultrasound?? What do you think?

[moxygirl]

My obgyn wants me to get a level 2 ultrasound, well, this week actually but I'm putting it off. I know level 2's expose the baby to much more ultrasound and I'm concerned. I've already had 3 level 1 (transvaginal) ultrasounds, one for dating and two to check my cervical length (I have cervical damage from my first delivery 7 months ago as well as a uterine prolapse) and want to expose the baby to as few additional scans as possible.

As to the reasons they want me to get a level 2, the superficial one is that I'm 35, advanced maternal age, blah blah blah. But I talked to the midwife at the practice the other day and told her my concerns. She recommended getting it because my blood test came back with a 1 in 270 risk of Downs and she thinks I should get the level 2 to make sure the baby's heart doesn't have a defect that would require immediate intervention at birth at a state-of-the-art hospital (better than we have in my area).

The thing is, I'm not the type to do things "just in case" that lightening-strike statistic comes true. I didn't even have an US with DS until 37 weeks, and that was only because my homebirth midwife was concerned about IUGR due to some issues I was having.

What do you guys think? Get one to be safe? Skip it and get a level 1 at my obgyn (and have them making decisions based on what they may feel to be incomplete/inferior info - that's one of my concerns).

What exactly ARE the risks of a level 2? Any research about additional risks above that of a level 1?

Don't worry about reassuring me. I want to hear people's honest concerns/opinions.

Thanks!!!

[MaerynPearl]

1 in 270 isn't exactly a lightning strike statistic.

Though I still wouldn't worry about it... that wouldn't be why I would get the ultrasound.

There has been no definitive proof that ultrasounds harm babies in any way, just like there is no proof that they do not. I have had to have several ultrasounds with each of my children due to various unrelated problems and have not seen any of the so-called negative effects some mothers attribute to the ultrasound. Especially since many of those same problems happen to babies whose mothers never have an ultrasound at all.

The reason why I would get the ultrasound has nothing to do with the Downs Syndrome risk or your advanced age and everything to do with problems that every woman is at some risk of (heart problems, spina bifida, complete previa) things that even if you have no family history, can show up... and if they do there are ways of giving baby (and possibly also mommy) more of a fighting chance to survive.

Yes, I understand that routine ultrasound is not recommended by such-and-such associations... but really, tell that to the moms whose ultrasounds did find that, despite no known increased risk... the moms whose children may not have survived without that early diagnosis.

That said, its your choice and it does NOT make you a bad mother if you decide not to do it. Its just my view on it that it is better to do than to avoid.

[finnegansmom]

From what I know the risk of someone who is 35 for Downs is 1:400 so your risk isn't really much higher, and since I'm assuming you didn't have the nuchal fold US at 12 weeks which assesses other factors with the blood screen, that 1:270 might be more of a guess?

I have no problem having the level II 20 week scan personally. Someone people chose not to do it and that's fine too. It won't change any condition the baby may or may not have, but on the off chance there is something that can be done in utero to help, or if I needed to be in a hospital with a level II nursery, then it would change my birth plan.

[HeatherB]

I might ask them how much of a difference it would make to do a standard u/s versus the level 2 u/s at 20wks. I had level 2s done with my first son because I have a history of spina bifida occulta (mild), and I had to have a second one done to get a better look at his heart. ("Had to" is relative... we complied with their suggestion and never thought otherwise.)

You might also see if you can do a standard u/s (if you want one) and if it works where you can change the resolution to Level 2 only if deemed necessary, but all in the same scan. It might provide less exposure than a full-on Level 2.

Anyway, if you're not comfortable with it, don't do it. It's definitely your choice. I do, personally, do one u/s mid-term with each of my pregnancies (we had more in that first one, but our choice now is just one), but AFAIK it's not even a level 2. I definitely do not do 3D.

[hollytheteacher]

Coming from the experience of a mom with a kid with a heart defect, i'd say DO IT. My son doesn't have DS but he was born with a congenital heart defect and i wish SO VERY BADLY that it had been caught before he was born so i could resarch and come to terms with it ahead of time. Yes I probably would have been more stressed out, but learning about it when he was 1 day old after a long tramatic birth was the least ideal situation i've ever dealt with.

I know everyone will have a different opinion on this but I just wanted to share mine. I know I will be getting a VERY in depth u/s this time at the 20 week mark so that they can REALLLLLY look at the heart. Maybe I'll even ask for a referral to a pediatric cardiologist to take a look. If this baby is going to need life saving heart surgery I want to know ASAP. There are so many arrangements to made...my life turned upside down with ds and his surgery.

Also, Heart defects are the number 1 birth defect and over 50% will need life saving surgery.

[CherryBomb]

Originally Posted by MaerynPearl

There has been no definitive proof that ultrasounds harm babies in any way, just like there is no proof that they do not. I have had to have several ultrasounds with each of my children due to various unrelated problems and have not seen any of the so-called negative effects some mothers attribute to the ultrasound. Especially since many of those same problems happen to babies whose mothers never have an ultrasound at all.

The reason why I would get the ultrasound has nothing to do with the Downs Syndrome risk or your advanced age and everything to do with problems that every woman is at some risk of (heart problems, spina bifida, complete previa) things that even if you have no family history, can show up... and if they do there are ways of giving baby (and possibly also mommy) more of a fighting chance to survive.

Unfortunately, I've fallen on the bad side of the statistics too many times to just assume I won't be the one who's baby had spina bifida, or a serious heart defect, etc. So for me, it's important to know what's going on, as much as I can.

But that's me, and I'm not you.

[lillymonster]

Originally Posted by moxygirl

As to the reasons they want me to get a level 2, the superficial one is that I'm 35, advanced maternal age, blah blah blah. But I talked to the midwife at the practice the other day and told her my concerns. She recommended getting it because my blood test came back with a 1 in 270 risk of Downs and she thinks I should get the level 2 to make sure the baby's heart doesn't have a defect that would require immediate intervention at birth at a state-of-the-art hospital (better than we have in my area).
Thanks!!!

Your risk for down's sound very close to normal. I am going to be almost 40 and my "risk" is 1 in 90. So I am getting blood testing and NT u/s testing for down's. The heart risk she is talking about I don't think has anything to do with down's.

But that being said if it was offered I would get it. Mainly because, I am 40 (I was 36 with my first, btw and I believe I got it then too) I am interested because this time, things are very different, I haven't been eating well, couldn't keep down my vitamins and I am worried about a slim chance of issues. I also had placenta previa that needed to be tracked last time.

I know people there are people that are less worried or are more able to be comfortable without having u/s, and that is okay for them, I am just not one of them, I need to be prepared and plan for the future.

[Just1More]

My understanding is that only about 15% of anomolies are detected by ultrasound. There can be a lot of false positives. We had one with our last baby (who was perfectly healthy, btw), and it caused a lot of unneeded stress. The level 1 tech couldn't see very well because I was a little further along than usual. She thought she saw some issue with the heart, so they sent us to have more testing. The level 2 tech/doc said everything looked great, no problems at all...but I was still high risk. Just because they thought they might have seen something once, they wouldn't ever change the possibility. They wanted to do u/s every week to every other week, and all this nonsense at the birth. I was doing dual care, and was actually planning a hb with another provider. The MW I was seeing for the hb was okay with continuing, so I stopped care with the hospital and just finished with her. It was a hard decision to make, because of all the unknowns. And I had to deal with repeated phone calls from the hospital and the level 2 doc...

So, we have opted to not have any more u/s unless we have some huge, unexpected reason. I'm just going to trust God that he'll give me what I need, and the strength to deal with it when it comes.

[moxygirl]

Thanks everyone. Does anyone have any links to stats on the risks of ultrasound vs the risks of not having one?

[JFTB1177]

Moxy, although I worry about a LOT of things in pg, risks of u/s is for some reason not one of them. Of course I wouldn't get one every week, but I will definitely get my NT scan and 20w anatomy scan (and will prob need more towards the end as my babies go pretty late). I am a "need to know" type person and although u/s's do not always find everything they can usually find the serious issues. I personally could never go through a pg not knowing what is going on with my baby, but I think that comes from having lost 4 pregancies. Like everyone else said, it's a very personal decision. If I was you I would just get the one u/s, and then if baby looks great you could refuse any others. But that's JMO.

[paintedfire]

I'm not getting an 3D ultrasound for one reason and one reason alone: I think they're kind of creepy.

[CherryBomb]

Funny, I think the standard 2D ones are creepy. Baby looks like a skeleton! I loved the 3D one because he actually looked like a baby!

[MaerynPearl]

Originally Posted by moxygirl

Thanks everyone. Does anyone have any links to stats on the risks of ultrasound vs the risks of not having one?

As I said, theres no real proof of any risks from the ultrasound (nor proof that they are actually safe)... so that sort of link wouldn't really be trustworthy.

[Katie T]

I have had to have a level 2 ultra sound with all of my babies as a just in case but I found it a important just in case. I have spina bifida occulta and so my babies have a increased risk of the same thing. If they were to have a opening I wouldn't do a vaginal birth as it can increase the risk to them.

I think if you need to be at a specific hospital that you wouldn't be at for a regular birth I would do it. I would hate to have anything happen because they aren't ready for it.

Now 3D just for fun ultra sounds I am against lol.

Good luck to you in making your decision and congrats on your new little one on the way!

[moxygirl]

Thanks everyone.

A couple people have mentioned just getting the one ultrasound and refusing others. As I mentioned in my original post, I've already had several transvaginal ultrasounds (12, 14, and 16 weeks, and I'll have another Wed, to check cervical length due to issues from my last delivery. So the level 2 would be the 5th ultrasound I've had in 8 weeks.

I'm going to ask at my Wed obgyn appt if they're set on a level 2 and why. If they don't give me a good reason, I'm going to refuse.

[lach]

Your title sort of has me confused. A Level II isn't a 3D ultrasound: it's just a very long Level I where they spend time looking at everything very carefully and taking measurements. I think the 3D ones are just vanity things, and require special equipment.

I have always got the level IIs, because I would want to know if there are any issues that I would need to prepare for. I probably won't get one every week for all 40 weeks, but there's no proof that ultrasounds are harmful. I don't really think that they're a big deal. I love seeing everything in the Level IIs, too. It's completely magical. It's so amazing to me that I can actually see the four individual heart chambers.

[lach]

Originally Posted by lillymonster

Your risk for down's sound very close to normal. I am going to be almost 40 and my "risk" is 1 in 90. So I am getting blood testing and NT u/s testing for down's. The heart risk she is talking about I don't think has anything to do with down's.

Half of babies with DS have heart defects of one sort of another. While some might not be a big deal, it's not uncommon for DS babies to be born with holes in their hearts and to need surgery right away. Before ultrasound technology allowed doctors to check out the hearts of DS babies before birth, death rates at birth for DS were significantly higher than they are now. In cases where there is an operable heart defect, a pediatric heart surgeon can be literally in the delivery room waiting to operate and save the baby's life.

I would not have known this either, but a friend of my family's went through this recently.

[moxygirl]

Originally Posted by lach

Your title sort of has me confused. A Level II isn't a 3D ultrasound: it's just a very long Level I where they spend time looking at everything very carefully and taking measurements. I think the 3D ones are just vanity things, and require special equipment.

I have always got the level IIs, because I would want to know if there are any issues that I would need to prepare for. I probably won't get one every week for all 40 weeks, but there's no proof that ultrasounds are harmful. I don't really think that they're a big deal. I love seeing everything in the Level IIs, too. It's completely magical. It's so amazing to me that I can actually see the four individual heart chambers.

Oops! Yes I realized that a level 2 and 3D aren't the same after I posted. It's strange because I thought I remembered asking either the obgyn or the nurse about it being 3D and I thought she said yes, but maybe I was wrong.

As far as there being no proof that ultrasounds are harmful, I agree completely. At the same time, there is no proof that they are SAFE either.

If the obgyn can give me a more compelling reason than "we want you to have one 'just in case'", then I'll consider it. But having one just because it's the thing you do when you're 35 (which was their original reason before the whole risk of Downs thing) doesn't fly with me.

I do appreciate everyone's responses. Apparently I'm one of the few who actually worries about this.

[Katie T]

At my level 2 ultrasound with my last pregnancy the tech flipped it into 3D and snapped a couple pictures of the face. It was very strange to see and kinda neat. But anyhow it was all done with the same machine. Yes my level 2's don't look any different than a level 1.

[moxygirl]

So... I've let my husband talk me into getting the level 2. The obgyn didn't say anything that would have convinced me but my husband reminded me that since I'm going with a medicalized birth this time (no choice due to complications during my homebirth), maybe I'd better let them do the tests that will allow them to make decisions they are comfortable with, instead of refusing things that are likely safe but will force them to have to make decisions outside their usual scope of practice. Blah. Okay whatever. He's not saying to do whatever they say no matter what, but he feels this isn't an intervention worth fighting over. I hope I won't regret it.

BTW, the level 2 ultrasound WILL include 3D.