The whole "viability scan" thing...

[justKate]

So I just found out that I'm pg and contacted my care provider (ob/midwife group).  They don't see me until I'm 10-12 weeks along.  During my last pg, I had a "viability scan" around 8 weeks--we saw the heartbeat and that the baby was where s/he should be.  I didn't know any better, that's just what we did.

This time around, I gather they don't care to see me until they can hear the heartbeat on a doppler, which is fine, except that my best friend just had twins and I'm terrified of ending up in the same boat.  Is there any reason to do any sort of appointment sooner than 10-12 weeks?  They do want me to have lab work about a week prior.  The only thing I can see is that if, God forbid, there are twins in there, I would need to be even more mindful of my nutrition.

Thanks for any thoughts!

[cat13]

Congrats on your pregnancy!!!   IMO, I think it just depends on what you are most comfortable with. Would having an earlier us significantly change how you eat or significantly lower your stress levels? If so, then you might want to get it, although one could argue that you could just eat what feels right for your body regardless of whether or not you have multiples. 

Another reason to get it is to confirm your due date, since early us can be more accurate for dating purposes than us in the 2nd & 3rd trimester... I think some women like this so their doc doesn't bump up their due later on when they are "measuring big," which can lead to being bullied into early induction. But there's also a lot of info out there suggesting that LMP is still the best way to gauge EDDs.

There's also a lot of good information out there to suggest that it's best not to do any us, unless there is a problem that you need to look into. I found this article to be very informative about us. In the end, I think that you just need to use your intuition to see what is the best decision for yourself.

Congrats again on your LO!

[obdoc]

I agree with cat13.

Many women I see have very irregular periods and LMP is not reliable, or they can't give an accurate LMP.

If there is any history of infertility, or surgery--like appendectomy or history of STD, I am always worried about possibility of ectopic.  We were always taught that every pregnancy is an ectopic until PROVEN otherwise--and this lesson has served me well.  None of my patients have come in with an undiagnosed ectopic--which can be life-threatening.

So--I find virtually all women look forward to that early ultrasound--it picks up twins early (although finding twins at the 2nd trimester fetal anatomy scan is an OK time to find out too), and dating is a lot more accurate.  I can't stand it when I see women change their due date (NOT ME!), based on later ultrasounds--especially if the date is moved up.  I make it very clear that we will be using the first ultrasound--keep the baby in the womb as long as we can----and tell my patients that elective inductions--even at 39 weeks per current guidelines is not happening.  I will OFFER at 41 weeks (which means most will deliver on their own), and if the women decides she wants to proceed with induction, she is told that if the induction does not intiate labor (cervical dilation), she may be sent home to wait a few more days.  Doing a C. Section because we couldn't force a baby out to suit her schedule is not an option I offer at the end of a "failed induction"

[nia82]

It really depends on what you want, most practices offer an early ultrasound, my birthing center writes referrals upon patient request as well. I had one with DS and it's an internal one (yikes!) but I had irregular cycles and did not chart. With DD I opted against it, I knew my ovulation date so I knew my due date, I was ok with finding out if it was twins or not by 20 weeks (I opted for an anatomy scan) and I know the signs of ectopic pregnancy (I have no prior history that would put me at elevated risk though). It's odd though an obgyn practice doesn't offer this, they usually get quite pushy about it (i first saw an ob with DD and quickly switched after all the pestering to do an u/s and doppler checks which I not wanted until labor).

[justKate]

I think that's why I was sort of surprised--when pg with DD, I had an OB/midwife practice, and I wasn't charting at the time, so I did need help with my dates.  This time, I was charting, and I'm using military medical--which I think will be fine for the birth, because they have midwives on staff, but as far as prenatal care goes, meh.  I should be happy that they're sort of low-intervention, but I was just surprised.  I don't have any reason to think there's anything wrong with this LO, so I'm going to chill out for a while!  Or try, at least....

[Jaimee]

When you're sure of your conception day, aren't experiencing any issues, and you have a care provider that is willing to listen to you about your conception date then there really is zero reason to get an early u/s.... IMO.  I had an early u/s with my second and with this one b/c both times I was breastfeeding and had strange cycles and crazy high hCG levels.  I was happy to confirm dates so that there wouldn't be an issue later on with measuring big or small, worries about induction, etc. which I personaly feel can lead to worse interventions than the risk of an early u/s.  As other posters have said, I'm sure you would be conscious of your nutrition either way.  Do you plan on getting a 20 week u/s?

[WifeofAnt]

I would wait.  What is it going to change if you can find out if there are twins in the 2-4 weeks you'd wait?  You'd still know months ahead of the birth.  This sounds incredibly cold hearted but I'd rather not find out early because of the risk of a vanishing twin.  Ignorance would probably be bliss.  A lot of the nutrition you need in the very beginning is to make changes in your body.  Changes you don't have to make twice.  Its not like you literally need double the nutrition.  An ultrasound at 10-12 weeks will still be mostly accurate.