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U/S at 29 weeks question

post #1 of 5
Thread Starter 

So far every single test I've had has come back normal, MaterniT21, amnio, no GD...

Because of advanced maternal age, I had an u/s to check for growth at 29 weeks.  While the tech was doing the test she was telling me everything looked normal, but she had problems seeing one of the feet.  Then the Dr. came in and told me that one of the feet may be slightly clubbed.  Or it could be the position of the baby.  I'm just transferring to a midwife practice from an OB group - thinking they'd be more relaxed, but I'm wondering if I'm making a big mistake.  The OB group sent me to a specialist to do ultrasounds and not only did the u/s tech do the scan, but the perinatologist too.  That was at 20 weeks.  Could a club foot develop after my 20 week u/s, or that the specialist didn't notice anything at the 20 week u/s or the 16 week u/s (during the amnio scan)?

Now I'm looking at my complete 29 week u/s result and they have put "suboptimal" for Upper extremities, Lower extremities, etc...really just about everything.  The conclusion was: All visualized anatomy was normal, however the upper and lower extremities, face, spine, and cord insertion were significantly limited by gestational age and fetal position. Recommend return in 2 weeks to reevaluate right fetal foot, which may be clubbed

 

What does that mean, that they couldn't see anything because the baby is too old already?  Why the heck are they doing u/s at that age then?  Seriously, is the u/s tech maybe not very good?  They also have a recommendation to induce by 40 weeks on the u/s...I'm seriously thinking to go back to my OB group - I'm upset that the u/s tech was telling me everything looked good when there's a suspected club foot and then the report is full of "suboptimals".  I'm afraid they're going to "medically" convince me to get an induction (the midwife had already mentioned that they offer it at 39 weeks due to my old age) based on their lack of abilities to do a proper u/s.  

 

Ideas?  

post #2 of 5

They say around 20 weeks is the best time to check the anatomy. Before then, some things are still undeveloped or too small. After then, the baby starts getting more crowded in the womb and its harder to see what things actually look like. I think if the foot was normal looking enough at 16 and 20 weeks that there's probably nothing wrong (although I'm no expert). I'm also thinking that "suboptimal" means their view may have been less than perfect, not that there is anything wrong with your child in that aspect.

post #3 of 5

Was there a change in care between the previous US? I'm thinking that an issue with a clubbed foot should have been easily detected at the 16 or 20 week scans. It sounds to me like baby's just larger and they had difficulty seeing what they needed to see - I wouldn't be overly concerned.

 

Also, if it's ONLY an issue of a possible clubbed foot, it shouldn't really shouldn't affect birthing plans, since that's not an issue that should either complicate labor or result in an immediate risk to baby, and nothing would be done about it until after the birth, anyway.

post #4 of 5
Thread Starter 

Thanks for replying.  I did switch practices about 3 or 4 weeks ago.  I have a follow up u/s to check up on the club foot next week.  I guess I'm just concerned that they're over scrutinizing - I know they need to look at every part of the baby to get a composite of how the baby is growing, but I feel like they did an anatomy scan that went beyond that for no good reason.  Perhaps that is just how they do the growth scans...but why check the insertion of the umbilical cord when that was done at 20 weeks and was fine?  And surely that has nothing to do with getting measurements.  I was mostly venting that they did a full anatomy scan when at 28 weeks it's so much harder to see the anatomy well, and you're more likely to see issues that aren't really there...(of course, that's what I'm hoping too...that there is no club foot!).  I did meet with another midwife today and she told me that I can just decline a lot of the stuff they offer (like induction at 39 weeks) - but my concern was that if you scrutinize too closely (even when it's not called for), you'll more likely find issues and some may affect birthing plans - like amnio fluid checks, which aren't an exact science.  

Hopefully my fears are unfounded.  

post #5 of 5
They may have been giving the scan extra scrutiny since you were a new patient to their practice. That in itself is commendable, but in my opinion they should not have mentioned anything about a possible club foot at this point, since they couldn't get a good angle and it was fine on the anatomy scan. Seems like chances are good that they're freaking you out for no reason, since they'll need to do another scan to re-check anyhow.
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