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would you do an US in my situation? - Page 2

post #21 of 32
You need to do what you have to do to be comfortable and trust in your ability to birth this baby. If having an US will do that for you, then do it.

Some questions you might want to consider:

If you have an US and they find a defect that could be cured by surgery while baby is still in the womb, would you? Would having to make that choice add to your stress level?

Do you have reasons why you are concerned about the possiblity of a defect?

If the US if vague, then what? Another one? More exams?

I wish you luck and peace!
post #22 of 32
Quote:
Originally Posted by georgia View Post
I've heard of many false positives for various issues and then U/S missing heart issues that were actually present. ITA with Ruthla. But, if your deepest instincts are saying get the U/S...I'd listen.
:

I've known mamas who had u/s only to have them miss major heart defects, requiring immediate open heart surgery, which were only detected by the mom's intuition w/in two weeks of birth (this happened twice in the last 3 months). And also other defects that are missed...like someone who's baby was missing an arm and it wasn't detected.

Add that to all the false positives...and nope! An u/s wouldn't give me any reassurance. But if it would for you, then do what gives you peace of mind. HTH!
post #23 of 32
You have to do what makes *YOU* comfortable, if that means an U/S, you should do it.
The beauty of UC is that we decide what interventions, what risks etc we take or don't take, and only we live with our decisions, so it is important that we make decisions that ultimately make us happier in the long run, and not that of a doc, MW, spouse or friend.
post #24 of 32
Quote:
Originally Posted by Sourire_Smile View Post
Some questions you might want to consider:

If you have an US and they find a defect that could be cured by surgery while baby is still in the womb, would you? Would having to make that choice add to your stress level?


I'm confused. Are you asking this because the answer would change when she should get an US if she decides she would feel more comfortable having one (because, in the very rare cases where fetal surgery is indicated and offered, you usually need to know about the defect before 28 weeks)?

I'm asking because fetal surgery (surgery done while the baby is still in the womb), in almost all instances, is still very much in it's infancy, if you don't mind the pun. The only possible exception, although it's still being researched, is fetal treatment in the case of Twin to Twin Transfusion Syndrome (TTTS). There are very few hospitals that do fetal surgery (I happen to work in the NICU at one that does), there are only select conditions (Congenital Diaphragmatic Hernia- CDH, Myelomeningocele, TTTS, etc.) that may be eligible for fetal treatment-- and it may vary by hospital which condition they offer fetal treatment for, probably based on which conditions they have grants to do research on because most of what is going on in fetal surgery currently is experimental. Which also means that those offered fetal surgery, at this point, are generally on the severely affected end of the spectrum for their defect. For example a baby with a small CDH, who will still require surgery and intensive care after birth would not be offered fetal treatment because the risk of doing fetal surgery is greater than the risk of allowing them to continue to develop without intervention, whereas a baby with a very large CDH who has a very small chance of surviving without intervention may be offered fetal treatment-- with the understanding that it may or may not increase the chance of survival.

The only reason I explained all of that is that in the vast VAST majority of cases, fetal surgery doesn't enter into the equation.

Sorry to be so .

I agree with moonfirefaery, there are risks either way (US or no US), each mother has to figure out for themselves which set of risks they are comfortable with.
post #25 of 32
For the OP : they will catch massive heart defects, like three chambered heart, transposition of the great arteries, etc, etc. They won't catch minor valve issues, pumping irregularities and that sort of thing on a normal ultrasound (they need a more in depth ultrasound for it). As I phrased the question - is anything you miss going to require immediate NICU care? And the answer was no, they'll see anything that bad. They can see the heart well at 22 weeks. As the baby gets bigger, visualisation of some things gets harder, but I'm not sure what. I'm sure 18-20 weeks is timed so if you'd terminate it's as early as possible.

The main question I would ask is how educated and determined are you? If the doc freaks out over say the baby's size (as opposed to something real and worrisome), are you immediately going to cave and get ultrasounds every couple of weeks and get induced at 38 weeks? Or will you be able to still make a good rational decision. Do you have a friendly care provider you could discuss things with and you can trust not to over-react either?

Quote:
Originally Posted by Jster View Post
And also other defects that are missed...like someone who's baby was missing an arm and it wasn't detected.
Cripes! How did that get missed! They count arms, fingers, toes, look for opening hands (clenched is a sign of awfully bad trisomies), legs that bend and straighten (again, can be a sign of a terrible problem), etc. it's like saying "oops, we didnt notice there was no brain!"
post #26 of 32
My girlfriend had not one, but two ultrasounds---one in the second trimester and one in the third trimester. She was told she was having a healthy perfectly formed little boy. When he was born he was missing an arm. So, ultrasounds do miss serious defects!
post #27 of 32
Quote:
Originally Posted by mischievium View Post


I'm confused. Are you asking this because the answer would change when she should get an US if she decides she would feel more comfortable having one (because, in the very rare cases where fetal surgery is indicated and offered, you usually need to know about the defect before 28 weeks)?
I only asked to raise a very slight possibility. No more, no less. I have no medical background, it was just one thought that occured to me.

I also totally agree with moonfirefaery

"there are risks either way (US or no US), each mother has to figure out for themselves which set of risks they are comfortable with."


Good luck Mama.
post #28 of 32
I wanted one, and I got one, and I dont regret it at all.
If you want one, get one.
post #29 of 32
Quote:
Originally Posted by annabanana View Post
but... our hospital is not equiped to deal with neonatal emergencies. if my baby were to require an emergency surgery soon afterbirth (what comes to mind is a heart defect), we'd need to be medevac-ed to ottawa, which is at least 3 hours away. if a treatable heart defect is detected on the ultrasound, i'd rather give birth in ottawa.

on the other hand, i'd like to find out how common are false positives? i guess i could always do another scan, ask for a second opinion, and so on. i guess they'd insist on it, if there were problems with the heart.

so i'm leaning towards having an ultrasound at 18 weeks, but oh, i don't want to...if i were in toronto, with the hospitals close-by. hm, on the other hand, from our location in toronto, in rush hour, a trip to sick kids would be at least an hour, if not more...

thoughts? please.
Hi, I have some personal experience to share with you on this. My older sister passed away at Sick Kids at 8 days old dt a major heart defect (this was 1976 btw). When I mentioned this to my OB during my 1st pgcy, she suggested a fetal echocardiogram at McMaster, and I agreed...wanting to rule out any problems. WELL, they thought they saw a minor problem and got me to go back for another one (although no second opinion!)...which showed the problem "might need minor surgery" (i.e. at Sick Kid's in Toronto) and we were then told we had to have the baby there at McMaster (we lived 45 min from Hamilton at the time). I ended up with a scheduled c/s (for breech at 38 weeks 5 days) and my perfectly healthy and fine baby kept in the level 2 nursery for 2 days under observation. It was a nightmare. The weeks preceeding her birth were some of the most frightening of my life. As it turned out though, the scan was wrong and her heart was totally normal. Everyone acted like it was a miracle and that we did the right thing by going for all the bells and whistles at McMaster (for non Canadians, this is one of the country's leading hospitals). But I was extremely upset and angry about what had happened and it took me a long time to get over the bitterness of being given a false diagnosis, which had a huge part in me consenting to an unnecessary c/s.

My advice? With heart defects you have time...3 hours is tons of time. My sisters heart was so bad, the doctor later said it was a miracle she was born alive...but she seemed normal at birth and was sent home (a huge error, obviously) and lived 7 very normal days before signs of illness showed. The newborn heart has a valve that is open for the first 5-6 days, bypassing the aorta, so it buys you some time in certain circumstances. Even with my family history, I am comfortable having UCs and getting baby checked afterwards. I WISH I had done this with my first child. I wish I had never mentioned my fears or sought out the scan to "rule out" a heart defect. I went through so much needless pain, as did she. I didn't dream that the country's best technology at McMaster would result in a false postive ...and yet it did.

Well, that's just my personal experience. I hope it is helpful.
post #30 of 32
Quote:
Originally Posted by Ruthe View Post
If you need to do this, I agree you should wait until later in the pregnancy... if you want them to "catch" a minor defect, it would be more detectable on a bigger baby; and if there is a situation that could change in later pregnancy (such as a low lying placenta) might as well do the ultrasound later, after it's had time to resolve.
I just wanted to add here that my fetal echocardiogram for my dd wasn't done until about 32 weeks, and at that point the ribs were hardening and they had to look through them at the heart (like looking through venitian blinds, they said). Also, bigger babies are not easier to see on u/s...they are harder to see and things are more distorted. I'd do the scan in the early 20s, if I felt it was really necessary.
post #31 of 32
go with your gut, it you have a feeling, follow it through.
post #32 of 32
Thread Starter 
thank you for your thoughtful responses. my gut feeling right now is not to do it. i also have a friend who US showed a minor heart problem, which turned out not to exist.

i will see how i'm feeling at about 20 weeks. i know that US on an older babies are not as clear as at 18-20 weeks--this is the best age to diagnose most problems.

i just don't want to go to that hospital for no reason, and i won't set my foot in there unless my gut feeling tells me to. DH is with me on this, so that's easy.
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