Minimizing ultrasound exposure in the 20 week scan

[azohri]

I'm going in for my 20 week scan next week. I didn't have any ultrasounds with DS who was a planned homebirth turned c-section.  This time I'm doing the 20 week scan to make sure that my placenta is not implanted over my scar.  I'm basically planning to tell the technician that I only really care about where my placenta is and that if they want to spend a few minutes looking at major organs that's fine. 

I haven't been able to find any compelling reason to do all the measurements that they usually do (anyone?).  They don't seem very accurate and I doubt they would change anything for me at this point, especially since I'm already planning a hospital birth.  I know that the technician may be reluctant to keep it short (like less than 10 minutes max), but I figure once I know where my placenta is I can always just stand up and say sorry but I'm done. 

Does anyone have any experience with keeping the 20 week scan short?  Or any insight into reasons to get things checked besides placenta and major organs?

[dogmom327]

While I think you desire is perfectly reasonable and prudent, the only thing I can think is that it might be a liability issue for the clinic to not complete the scan "properly" (by their definition anyway). I would get your plan cleared with the clinic manager and your doctor first if only to avoid issues with your insurance paying for the scan. If you don't have a complete scan, it's possible the insurance company will deny the claim. Probably not likely but if the clinic pitches a fit that's one possible outcome.

I think the measurements are to determine conception/due date and then if anything is developing abnormally. For example, one of my nephew's kidney's was much smaller than the other during his 20 week scan (it resolved itself by 40 weeks though).

[wissa19]

If you are only worried about the placenta over the scar, you might be disappointed.  They were only able to tell me mine was away from my cervix, but couldn't tell me if it was near my C-section scar.

When they do the scan they are looking for things that might make it safer for the baby to be delivered by c-section or if there needs to be a specialist present for the birth.  For example, they look are the spine for neural tube defects/spina bifida, that the intestines are in the abdominal sack/wall, that the heart is o.k., they measure the different parts of the brain.  they also look at blood flow from the placenta & cord to the baby.  (and of course, as you mentioned they check the location of the placenta)   I don't think the main point of the scan is to necessarily check for size, but to make sure the baby has all the right parts in all the right places.  

I don't think they will be able to keep the scan to less that 10 minutes and still check off everything on their list.  I think a lot of how long the scan lasts has a lot to do with the position of the baby and how much the baby is moving around.

Hope that helps you some with your decision.  I know you don't want any thing done that isn't necessary, but I will say I felt so happy after my scan just knowing that everything about the baby was looking good.  

[snugglebug14]

I want to second the pp's comment that they may not be able to tell you if the placenta is over your scar. I had two scans done this pregnancy...the anatomy scan at 20 weeks and a scan to check growth at 35 (because I was measuring significantly behind at that point). The two scans were at two different hospitals and both times I asked about the position of the placenta in relation to my scar. Both techs told me that they couldn't determine that. I know that I have heard of other women commenting on being able to find that info out during a scan so I was a bit disappointed since that was one of my concerns with having a home VBAC. But I think it is only during a level 2 scan that they can determine whether the placenta is over the scar. But who knows....maybe your hospital will have the technology/skill to be able to determine it. I hope for you that they can and that it can put your mind at ease! Often times the placenta will be located high enough in the uterus that it isnt even a concern which they would be able to tell. Mine is on the lower side, no concern over placenta previa, but my neurotic mind worries a bit about whether its low enough to be over the scar. But i figure since two techs and one doc all looked at the scans and no-one seemed concerned (besides me) then I shouldn't worry too much about it. Best of luck with your VBAC mama <3

[Chrisa]

Originally Posted by dogmom327 

While I think you desire is perfectly reasonable and prudent, the only thing I can think is that it might be a liability issue for the clinic to not complete the scan "properly" (by their definition anyway). I would get your plan cleared with the clinic manager and your doctor first if only to avoid issues with your insurance paying for the scan. If you don't have a complete scan, it's possible the insurance company will deny the claim. Probably not likely but if the clinic pitches a fit that's one possible outcome.

I think the measurements are to determine conception/due date and then if anything is developing abnormally. For example, one of my nephew's kidney's was much smaller than the other during his 20 week scan (it resolved itself by 40 weeks though).

I agree with the first paragraph. I also wanted the abridged version, and was told they have to measure everything. I don't know what would have happened if I kept pushing, but I didn't want to antagonize them (the only MFM practice close enough to my home, and I'm high risk). it might be worth discussing it beforehand.

They measured everything, though, which annoyed me: I had had the Maternit21 test, and felt that some measurements were unnecessary. 

[azohri]

Thanks for all the good responses.  I'm disappointed to hear that they may not be able to determine if my placenta is over my scar - but since I'm feeling tons of kicks right at my scar, I figure it can't really be there, right?

Unfortunately the midwife at my last appointment wasn't super helpful when I tried to discuss minimizing the ultrasound with her.  She basically said that she was fine with me just having a basic scan to determine placenta placement, but that in terms of the specifics I'd have to discuss it with the tech.  Super frustrating.  Maybe I'll try to call on Monday and see if I can speak to a different midwife about it.

[JudiAU]

Visually viewing the organs is one part of the scan but the measurements are important too because they tell you the size in relationship to the fetus say for an enlarged or undeveloped heart or one kidney is undersized or the femur is especially short in relationship to normal development. All of these might be key that further examination, say, by a heart specialist might be in order or a different birth plan.

The ultrasound tech can probably not be reimbursed fully if they "don't do their job" fully so they might not be willing to shorten it.

This is of special concern to me because we had friends with a homebirth and no ultrasounds whose baby had brain damage at birth as a result of unknown heart defect. Damage could have been avoided if she had birthed at a hospital with heart specialist in place.

[wissa19]

I just wanted to add my 20 week ultra-sound was only 15 minutes and they were able to look at everything (Even with me asking them to check twice on the gender).

[azohri]

I just wanted to report back that the ultrasound technician was great about keeping the ultrasound short.  She obviously didn't agree with our decision/concerns, but she was very willing to respect it.  She checked the placenta placement and major organs in less than 10 minutes and said everything looked great.  Whew!
 

[dogmom327]

Nice!