Question for those against routine use of ultrasound...

[annakiss]

If you had had a baby with a defect and were pregnant again, would you have an ultrasound to look for it in the new baby?

DS was born with a cleft lip & palate, and I've been taking 8 mgs of folic acid daily while ttc. I wasn't planning on using any sonic devices in the next pregnancy, but part of me also worries that it could happen again. Clefts usually result from a combination of environmental and genetic factors, and our genetic risk factor is quite low as this was an isolated incident (meaning that no one in either my or DH's families has had a cleft). Our chance of having another baby with a cleft is 3 to 5%, which is NOT above the general population. The percentage tells me no, it should be fine. But I think that until I deliver and find out, I will wonder. What would you do?

[USAmma]

That's a personal decision. I'm not against u/s and I do believe that it can be a useful tool to dx certain birth defects. My dd's both have Spina Bifida Occulta and I have clefting in my family. I wanted to get those things checked out on the u/s so I could be mentally prepared for them.

Darshani

[Patchfire]

haha, I think I just clicked on the wrong answer. I would say no.

We have a genetic risk of cleft palate running through my family, and my dad and I both have other palate issues. Nothing so extreme as a cleft, but enough that I am aware of the risk.

That said, we had a routine u/s with dd, and no one looked for it specifically. We're going to be avoiding u/s exposure this time, so I'm going to do the same thing I did with dd - mentally prepare that yes, it is a possiblity, that yes, I might have to pump instead of nurse. Remote possibility, but a possibility - and knowing wouldn't change that, for me personally.

[Malama]

I'm very against routine ultrasound use.... but....

I'd say that it depends on what you'd do with the knowledge.... If your baby had some kind of cleft, would you choose to terminate? do your birth somewhere else? etc....

OR, if it's something that you will be spending your pregnancy stressing about, you might wanna just check and have peace of mind.

[annakiss]

Oh, yes, to address that issue - if there was a cleft I don't think I'd terminate. It doesn't seem like enough of an issue to do that. I also would not choose to go to a hospital or the like instead. I mean, maybe if there were a neural tube defect or something, but not for a cleft. Gee, even thinking about termination makes it all feel a little more real. Which is why I took such great care to plan the next pregnancy. I'll need to address this some more within my own thoughts and feelings.

Honestly, I don't know if it would give me peace of mind or not, or if I'll even need that. Just looking for thoughts on this.

[yoga]

If it wouldn't change your course of action, I say, don't bother.

Good luck!

[mollyeilis]

I would not have us done for that. The only thing I'd have one done for in a future pregnancy would be to check on the position of the placenta, since I've now had a c/s and want to know if the placenta is over the uterine scar.

Of course, the placenta can and does move until very late in pregnancy so any us would be done very late, by which time I'd likely know anyway if there were placental problems, so...maybe I won't have one done.

I just don't know of any condition that can be made better by knowing ahead of time. I read a study that showed that even major conditions, like heart problems, don't have better outcomes when diagnosed in utero, but they are treated more aggressively and with more interventions. They end up the same, though. So really, I feel, what's the point?

[jecaly]

a friend of mine had an ultrasound late in her pregnancy, during with it was determined that her son had a cleft lip as well as low amniotic fluid. she was devastated about the cleft, and it made the experience of the emergency section that followed (because of the low fluid) much more traumatic. i watched them pull that perfect baby out of her, not even a hint of a cleft, and have always been a little angry that the ultrasound upset her so much (she was giving the child up for adoption, so it was already a tough time).

i guess what i'm saying is..even if you do use ultrasound to try to tell whether the baby has a cleft, it might not be accurate.

and on a completely different note: i know a couple of grown people who had clefts as babies, and i find that scar kind of sexy. joaquin phoenix, anyone?

good luck, anna!

*jennifer

[girlndocs]

I voted no, because even if we assume the u/s & the person reading it are infallible, and the fetus is cooperative enough to let us get a peek, if cleft was discovered it wouldn't change anything. We'd just deal with it after the birth.

[Houdini]

I have two boys with clefts and it was great to know that our youngest was going to have a cleft (through the u/s). It gave us a general idea of the level of the cleft and we were able to show the older kids what the baby may look like when he was born. We don't have a family history of cleft either and so I wasn't really expecting another cleft baby. They didn't see Zachary's on u/s because it was not very involved, but Nicholas' was more involved so they were able to see his with no problem. I think the biggest thing for us was being able to prepare the older kids, so they weren't surprised when they saw him.

[StacyL]

What would be the point of getting an u/s to find out if the baby had a cleft palate? It's not something you can do anything about until the baby is born, so why bother?

[annakiss]

Originally Posted by StacyL

What would be the point of getting an u/s to find out if the baby had a cleft palate? It's not something you can do anything about until the baby is born, so why bother?

A lot of people like to know in advance in order to mentally prepare for it. In my case, it would be to eliminate nine months of wondering and worrying (it's not really a fun surprise like the sex of a child).

[annakiss]

Originally Posted by jecaly

even if you do use ultrasound to try to tell whether the baby has a cleft, it might not be accurate.

I would be eligible for a 3d ultrasound because of our first child's defect.

Originally Posted by jecaly

and on a completely different note: i know a couple of grown people who had clefts as babies, and i find that scar kind of sexy. joaquin phoenix, anyone?

He says that he was born with that scar and that it is not from a cleft, which is actually totally plausible. On my son, I wouldn't say with the way the scar has healed so far that it will really look sexy one day.

[Houdini]

As a a parent of two cleft kids, I agree with the preparation part of knowing before hand. I was able to prepare my other three kids for what the baby may look like. I was able to prepare myself for how to feed him when he was born (he was unable to nurse). I was a lot calmer knowing ahead of time.

[applejuice]

I voted no.

I have had four pregnancies with no ultrasound scans.

The birthing population was never told the dangers of routine X-ray pelvimetry until routine diagnostic ultrasound became available.

Doctors will let us know the dangers of diagnostic ultrasound (non-ionizing radiation) when they have another, more dangerous technology waiting in the wings.

[tinyshoes]

What about an occult cleft, wherein there is no visible clefting, but the bones in the hard palate are not fused? That could happen to anybody's baby, and even an u/s would not provide any clues as to what to expect.

Just addin' grist to the mill--to help you explore your options & outcomes, annakiss.

[wtchyhlr]

I don't know... this is my first pregnancy, and so far I've managed to stay away from frequent ultrasounds (we did have one at about 12wks because midwife couldn't find the heartbeat,. and we wanted to make sure it was beating), i generally want a low tech pregnancy. Something like a cleft isn't going to change how i feel about the baby

[2tadpoles]

I didn't vote because I'm not against ultrasound.

But my thinking is that if there is a history of defects in the family, then the ultrasound is no longer "routine."

No, you can't do anything about a cleft until the baby is born, but a stressed, anxious, worried mother isn't good for the baby, either. If it'll give you peace of mind, then do it.

[annakiss]

Originally Posted by tinyshoes

What about an occult cleft, wherein there is no visible clefting, but the bones in the hard palate are not fused? That could happen to anybody's baby, and even an u/s would not provide any clues as to what to expect.

There's also sub-mucousal clefts, where the muscle is not fused in the soft palate, but the tissue covers it. But what we had before was a complete cleft lip & palate, so the potential damage is a lot more than that.

For the record, I'm not even pregnant yet and I don't know how I will feel once I am. I'm pretty confident that I've taken all the necessary precautions and that the likelihood of this happening is slim. I think my husband is interested in finding out, however.

Thank you 2tadpoles for that post. It was quite thoughtful.

[milk4two]

If knowing will set your mind at ease, or help you prepare mentally and emotionally I vote yes.

I'm not in favor of routine ultrasound and prefer to skip them altogether. My midwife suggested one for me (to rule out twins) and I decided to wait. After thinking it over for awhile I decided I really wanted to know one way or the other, although I knew if the u/s said no I would feel bad for giving in. Go with your heart.