Benefits of routine 20wk ultrasound - Page 3

[Meli65]

My midwife's advice re: tests is always, "What are you going to do with the results?" Since no test is 100% perfect and accurate, if the results are not what you want to hear, what will you do about it?

That being said, the only prenatal test I had done with my second child (at age 39) was the 20-week ultrasound -- I decided to do so to rule out (more or less, of course) any major birth defects or problems that might make a planned home birth not such a good idea. Going to the hospital to have the ultrasound completely solidified my reasons for not wanting a hospital birth -- I hated every minute of it! How I was kept waiting, how the hospital staff would walk through the room completely avoiding eye contact with me, how I was charged megabucks for the procedure because of the hospital's mistake with my insurance ... ugh.

[Patchfire]

Originally Posted by Rico'sAlice

I don't mean this in a mean/snarky way, but I totally don't understand feeling that everything is "ok" after having an US. I'm not trying to criticize, I just totally don't relate. I just can't imagine relying on something like that for my peace of mind. Maybe it's just an individual personality thing?

I'm with you there. While I did have an u/s with dd, I did not with ds. Around 27 weeks or so, I had this fear of anencephaly. Serious fear. Dh and I discussed it, and he asked me if I wanted an u/s, would it make me feel better. And I had to answer honestly, no. In this case, it was a weird, irrational fear (brought about by some reading, as it happens), but either way, I told him that there's no reason an u/s would 'catch' it or anything else that happened to be wrong. I didn't truly think anything was wrong, despite the weird fear I have.

I think to an extent it's approaching things from a different paradigm/mindset.

[alegna]

Originally Posted by aileen

i have decided not to do one, however, i did find a few instances where in utero treatment was quite successful. the one i remember off the top of my head was block bladder, where 2% of infants survived a few decades ago and now with u/s guided prenatal sugery as many as 80% survive. the idea of prenatal surgery fills me with dread, and i know there are surgeries that were preformed prenatally that are no longer performed for ethical reasons, but i think that saying there are no defects being treated is misleading (and incorrect). there are defects being treated;

I'd be interested if you have any links that show that there are currently in-utero surgeries being done routinely (not as part of a study) as when I tried to research it I didn't find any. (I'm sure I could have missed them though!)

thanks,

-Angela

[kettunainen]

I would have one IF the diagnostic results were extremely accurate. As it stands, they are not. I know that getting a false positive would ruin the rest of my pregnancy, just as not catching something that would have been detectable by u/s would make me extremely resentful of technology on top of having to deal with whatever that something was that wasn't caught.

For me, it's peace of mind the other way around. Not getting one is better than getting one, just because I'm protecting myself from whatever the results might be, good or bad.

I don't want to hold on to a good, perfect u/s result, only to find that there WAS something wrong. I would feel incredibly betrayed. Ditto goes for false positives.

Because I don't trust the technology, I don't trust my peace of mind to it.

[Full Heart]

I was watching Babies: Special Delivery last night and saw 2 cases of babies being diagnosed with something at u/s and how it was handled at the birth. First was a baby with Gastroschisis. Baby was born vaginally. The only thing different between that birth and one that would happen at home would be the shock factor for the parents and the lack of sterile bag for the baby to be in. Second was a diaphramatic hernia. Even knowing ahead of time the baby was transported to another hospital, then airlifted to another! (anyone see this episode? I didn't get to watch the end and wanted to know what happened). I found it very interesting.

So just cause you know ahead of time doesn't mean you can actually birth somewhere that has the specialized care you need. You may have to travel out of state. For instance one of the hospitals in my area does many higher order multiple births because they have such a good outcome. Women come from all over the world to have their multiples here. And traveling is not something everyone is capable of doing even for such a rare circumstance.

And like Angela said I don't know of inutero surgery being done routinely. I only know of ones in studies. Just cause a baby has a problem fixable inutero doesn't mean you can actually have it fixed.

I'm not saying this to be pessimistic I just want people to realize that even if they detect something on u/s and you think something can be done something might not be able to be done. I'm sure it does work out the other way though but just so you are aware.

During my 3rd pg I had 2 u/s. 1 at about 20 weeks and the other at 41 weeks. Neither caught my battledore placenta, which is something you should be able to catch on u/s. Not that its a real problem, can be but rarely is. As it was ds was 9 lbs so certainly not lbw! There is a lady I know of, she had her routine u/s at 20 weeks. Baby was fine. Had a hb. Baby wasn't fine. Baby never took a breath because there was a problem with the lungs because u/s can't tell if the lungs are gonna function properly.

Again its totally a personal decision. Its what you can live with. Then even if you make every decision you think is right that doesn't mean in the end you won't regret something. Hind sight is 20/20. (And there is something to be said for having too much information)

I actually enjoy these thread and people sharing their opinions cause it makes me question myself. What would I do? I always have plenty to contemplate! Like the peace of mind thing. I am still struggling with that one.

[aileen]

Originally Posted by alegna

I'd be interested if you have any links that show that there are currently in-utero surgeries being done routinely (not as part of a study) as when I tried to research it I didn't find any. (I'm sure I could have missed them though!)

thanks,

-Angela

no, you're right; i can't find anything that "proves" that surgery or even other medical interventions are being done routinely. that's true. however, i don't even know what would constitute routine treatment of a birth defect that occurs in only 1 out of every 40,000 live births. and not every baby born with eagle-barret syndrome is a canidate for surgery. so, sadly, i personally have no idea how to determine what is routine treatment once a couple decides not to terminate pregnancy (which, it seems based on my very limited reading, may be the norm.) i'd be interested (i like this thread and it's many layered issues, too, Full Heart...hopefully the op doesn't mind my digressions.) to know what does constitute routine care versus experimental care. (and how extensive your research was, too, angela.) i'm sure there are those who consider ultrasound itself to be still in the experimental stage and yet it seems to be clearly used routinely. due to the fact that, at least in the u.s., there is no national system to track birth defects or to note various trends on how and when they occur, and that in the states that do report birth defects the reporting is only done passively and are not random samples, i'm not sure there is a way to determine even prevalence, let alone what routine treatment entails. (pretty convinent for a county that pumps out 85,000 different synthetic chemicals every year not to have a national birth defects monitoring program, huh?)

and while i admit you fully got me on the routine thing , i still contend it's misleading to say there are currently no birth defects being treated in-utero. in my opinion, or maybe more specifically, for me to make a decision, informed consent requires that i accept and digest the full range of possibilities. mothers are currently taking medications to treat rare disorders before birth, routine or not. knowing of an incredibly rare defect that is possibly treatable if detected and acknowleding and accepting that, is part of my decision to forego the u/s. maybe i'm a bit on the dark side or too much of a pessimist, but if i can't find one counterexample, i don't feel like i have the whole story. i know statistically outcomes are not improved with use of routine ultrasound; but i can't seem to base my decision solely on that info. i need stories and lives and slow, s-n-a-i-l slow mulling it over.

and i happen to know at least 20 healthy babies and children who i am close to whose mothers chose not to have a routine 20 week ultrasound, if my personal experience were more like sophiecat's i would allow myself the room and time to make a careful and deliberate choice all over again.

and i think Meli65 has the beat advise of all: what will you do with the information? i think that question can help you decide not only what to do, but help you determine ahead of time where you may fall on the whole peace of mind spectrum. i've surprised myself over and over again with this prenancy that i just get more "hands-off" and while i have great concern for the babies who are struggling with these rare syndromes, somehow, unlike with my daughter's pregnancy that concern doesn't migrate over to my own belly. weird.

and if anybody wants links to eagle-barret stuff randomly out of curiosity or is wondering where i pulled the 2%/80% stuff from:
http://www.cumc.columbia.edu/news/jo...17n2_0021.html
http://rdu.news14.com/content/health...2404&SecID=376
http://www.emedicine.com/med/topic3055.htm
again, just stuff i stumbled across trying to make a decision, not scientific research by any means.
i promise i'll be quiet now.

[Twinklefae]

Originally Posted by Rico'sAlice

I don't mean this in a mean/snarky way, but I totally don't understand feeling that everything is "ok" after having an US. I'm not trying to criticize, I just totally don't relate. I just can't imagine relying on something like that for my peace of mind. Maybe it's just an individual personality thing?

I kind of agree with this. I've been talking to my doctor about it (she's also my family doctor and I'm really liking being pregnant with her so far as she considers my point of view) and she has pointed out a few benefits (like the risk of heart defects) that I am seriously considering, but mostly, the whole idea makes me so nervous that I just don't think it will help!

I have a close friend who was told that her first baby had a serious brain problem and that she should terminate immeidiatly. Like right then. She wouldn't, insisted on having the weekend to think and discuss with her husband, and on Monday - nope, sorry, nothing wrong. The child turns 2 shortly, and is 100% fine.

So I think for me, I would worry more if I had one, that they would tell me something mistakenly. Plus, there are so many birth defects that don't show up on u/s.

For me, I'm pretty sure I will not be going. But, as my doctor said "It's your body and it's your choice"

[Brisen]

Originally Posted by Rico'sAlice

I don't mean this in a mean/snarky way, but I totally don't understand feeling that everything is "ok" after having an US. I'm not trying to criticize, I just totally don't relate. I just can't imagine relying on something like that for my peace of mind. Maybe it's just an individual personality thing?

I'm the same. I think in part, because an US or heartbeat on the doppler don't seem "real" to me, like how TV is not "real." I've had US with 2 of my 3 kids, and it never felt like the pic on the screen was part of me. My nausea and heartburn and fatigue and cramps and growing belly and kicks and hunger were all very real. I also worry about false positives putting stress on me, and when I compare the benefit of knowing about a (remote) problem beforehand to the dangers of US waves, the dangers outweigh the benefits, for me. Though if I we were in a situation where everything pointed to an US being very beneficial, I wouldn't flat-out refuse. And I've had my share of losses, so I know where worried mamas are coming from, to an extent. I just worry more about the harm being done to my baby by the US than I worry about my peace of mind -- or maybe more accurately, because I worry about the harm from the US, it wouldn't serve to give me peace of mind.

I'm also not allowing doppler; I'll wait until the heartbeat can be heard with a fetoscope, assuming this pregnancy lasts that long. Again, hearing a heartbeat isn't going to ensure that I don't miscarry again, and I worry about the harm it is doing to my baby.

[4daughters]

From what I've seen no test is accurate and yes peace of mind is nice, but US can also cause unecessary scares. My sisters baby supposedly had some lung defect, when born he was fine. My neighbor who had ultrasounds, her baby was born with a defect, muscle missing in her chest and had to get surgery. Another friend told her baby was DS and was perfectly fine when born. Although I have had ultrasounds and it is nice to see the baby, this time around I am not. My last pregnancy was twins so I had to get tons of US unwillingly, even tried to talk my doc to give me less and she threatened to no treat me anymore, the nerve. I swear that my babies had some adverse effects to all those ultrasounds. The irony is that they were supposed to detect TTS and in the end they did have it slightly. I told my OB aren't you happy you made me get all those ultrasounds and they missed anyway!! So this time I feel more peace of mind not get any US.

[bamakathy]

20 Week Ultrasound Can Save Lives!

My daughter had her twenty week sonogram, and they found the baby had CDH (congenital diaphragmatic hernia), which means the baby has a hole in her diaphragm that didn't close over right, and her stomach and intestines have moved up and taken up valuable room in the chest cavity where the heart and lungs are. She has been referred to a high risk OB, is consulting with a pediatric surgeon to be there at the birth to take care of the baby, and will be at a facility with a neonatal intensive care unit when she delivers. This type of defect happens in 1 out of 2500 births, and is not uncommon. However, if you don't prepare for it, your baby's chance of survival would be greatly diminished. Get the sonogram. There is definitely a reason for it. To NOT have it could endanger your baby's life.

[alegna]

Originally Posted by bamakathy

There is definitely a reason for it. To NOT have it could endanger your baby's life.

Medical groups and statistics disagree. Studies have shown no statistical improvement in outcomes with routine u/s.

I'm sorry about your grandbaby, but chances are that everything could be taken care of just fine if they found out at birth.

-Angela

[Lady Lilya]

I'm uncomfortable about them. I agreed to do just the 20wk one since they said it is the most informative. I am not expecting anything to be wrong. I will insist that they don't dilly dally while doing it, to minimize the baby's exposure.

[angelcat]

Well, I absolutely wanted at least one. For me, yeah, for sure for peace of mind. I still didn't relaxt after, totoally, but it helped. If anthing major that would show up was wrong,. I'd rather find out ahead of time.
So, here's the story of my ultrasounds:

#1. At about 8 or 9 weeks , I think. I had this irratiopnal fear that after tleling all my family & most firends, that it was jsut the stomach flu, and those pregnancy tests were worng. So, I conveniently forgot the date of my last period and the dr. ordered an utrasound.

#2. I had some spotting at about 15 weeks. It was just so scary. It happened xmas day, too, so I had to go to the ER and of course couldn't get an ultrasound right away. I finally did a little over a week later, around 16 weeks. It was the best ultrasound. The tech showed me the screen the whole time, explained what I was looking at, and told me everything looked good.

#3. Routine 20 week one. They hadn't been able to do all the stuff they usually do at 16 weeks as it was too early. They saw a shadow on Rachel's heart. I was SOOOO scared. It was awful. They told me it was fine at that stage, and that I needed another ultrasound in the 3rd trimester, as it woldn't be nirmal then. Sao just to make sure it was gone, as it likely would be. (This was not the regualr doc, but the less expereienced on who vceovered for her)

#4. This was maybe around 30 weeks. I waited very anxiously for results. The dr. started out telling me all about how big baby was, & head size, altho she said that measurement might not be accurate, so no need to worry. I finally had to ask her about the heart. She said the shadow was still there. I started to freak out. Whatever that meant I figured must have been really bad casue the other doc wouldn't even tell me. All the regualr doc said was, odds are it was nothing. I asked ehr what precaustions they were going to take. She shrugged & said "L:isten to baby's heart really well after birth."

That was the last mention of that. I still sometimes worry she has some heart defect that has yet to show up.

So, if I had to do it over, I'd stop after the 2nd ultrasound. I didn't feel I needed more, or want more. And as it turned out, the 4th one was a complete waste of time.

The upside was that when everyone, (and I do mean everyone) asked if it was twins I could say "no, and I've had 4 ultrasounds, so no surprises!"

So , next time, I
d want the ealry one, and just one part way thru. Any others, I'll be asking a lot of questions before I agree to it.

[Lady Lilya]

My husband was born with a hole in his heart. It filled in over time and was nothing. He is extremely healthy now. They told his mother it was common and that babies DO continue to develop after the birth.

[jarynsmom06]

Originally Posted by WaturMama

I think there are cases where the baby would have a condition and we wouldn't terminate, but it would be very useful to know ahead.

I have a couple friends who have had babies with some surprises--one with Down's Syndrome and one with a cleft palette. They both spent the beginning of their babies lives dealing with the shock, a bit depressed, and, in the case of the one with cleft palette, needing to do research about how to make nursing work.

I would rather know ahead so I could be mentally and emotionally prepared to welcome the baby for who s/he is, be as present as possible, and have any information necessary to give him or her the most healthy start possible.

My sister had 3 US when she was pregnant with my nephew as well as a blood test for Downs and it came back negative....he was born with Downs, but he is such a blessing.

[jarynsmom06]

Originally Posted by baybemama

I may be in the minority here but I would say the biggest reason I absolutely wanted my 20 week ultrasound and will get them in future pregnancies is peace of mind. I can't belief how much relief I experienced when I was told and could see that baby was perfectly fine, had a healthy spine and heart and that my placenta location was fine. Not to mention being able to see the little guy kept me smiling for weeks.

Right there with you hon. I will have one with my next as well.

[Lyrelle]

All I have to offer is my own experience, and how it has made me decide in favor of the 20-week ultrasound.

With my first pregnancy I was unsure whether I wanted the 20-week ultrasound at all, and certainly no more than that. Then the midwife says "I think something is wrong and you need to have an ultrasound today - we'll find a place that will work you in." and all thoughts went out of my head, I was so terrified. As it turned out, the bleeding that had the midwife worried meant nothing, but the ultrasound showed that my baby had developed Pentalogy of Cantrell. The doctor said that it was a lethal defect, there was no chance the baby would survive, and did we want to terminate. As it turns out, the only reasons we would terminate would be if either my life was in severe danger or if the baby was in pain (an experience like this tends to clarify really quickly where you stand on such an issue). So here we had this knowledge that the baby could die at any time - this was at 13 weeks. I began researching everything I could find about ectopia cordis, giant omphalocele, etc. Also, I started singing my favorite songs to her, talking to her, telling her everything I'd thought to tell her after birth, now that I knew I might never have that chance. We had just made arrangements with a prominent children's hospital for some preliminary tests - in my research I'd found that if I could carry my baby to term, she had a small chance as long as interventions were begun immediately - when we found out in one of the follow-up ultrasounds (we'd been having them biweekly, after I talked them out of doing it weekly) that Roo had died. I was induced, and my husband and I got to hold her before they took her away.

I believe that the month and a half we had between diagnosis and birth were invaluable. They allowed us to bond with the baby in a way that we wouldn't've thought to, and they allowed us to begin to grieve, so that we were better able to deal with her death when it came. True, if we hadn't known, we would've had six more weeks (or more, since I hadn't started to miscarry naturally when I was induced) of blissful ignorance. But we wouldn't have had the chance to get ready to say goodbye.

This time around, I am going to have the 20 week ultrasound. There are several scenarios in which immediate intervention after birth could be helpful, and so I feel that outweighs the negatives.

Anyway, that is just my story. Hope it helps someone trying to make up their mind.

[k9sarchik]

I, too, have done a lot of reading on this subject. I am opting out on the 10 week u/s but I will do the 20 week u/s. After reading several studies on it, I am very comfortable with the 20 week.
Even though my DH and I have both agreed that we will not terminate a pg, we would like some peace of mind on issues and know whatever we can in advance.

[Sandstress]

Originally Posted by alegna

I'd be interested if you have any links that show that there are currently in-utero surgeries being done routinely (not as part of a study) as when I tried to research it I didn't find any. (I'm sure I could have missed them though!)

thanks,

-Angela

I believe they're being done on "routine" basis at Texas Childrens Hospital. Routine is in quotes because they're not that common; it has to be in certain situations, as the following link describes.

http://www.texaschildrenshospital.or...y/Default.aspx

[alegna]

Originally Posted by Sandstress

I believe they're being done on "routine" basis at Texas Childrens Hospital. Routine is in quotes because they're not that common; it has to be in certain situations, as the following link describes.

http://www.texaschildrenshospital.or...y/Default.aspx

I don't think I'd call that routine. It's not like they're doing them for all babies with a given condition. They are just one of the only places to *do* them for the very rare case. Notice they don't list anything like- we do surgeries A, B and C here.

-Angela