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Questions about Level II Ultrasound

post #1 of 19
Thread Starter 
Hi! I'm scheduled to have a Level II ultrasound in November and I wonder if it really is all that informative with regard to the possibility of baby being born with down syndrome or any other health concerns...

Has anyone had this type of ultrasound recently? I really want to avoid an amnio, so I'm hoping this ultrasound will help us avoid that...

I'd prefer to hear from parents who have actually had this test or plan to have it -- I realize there are lots of moms out there that are against any kind of testing and I respect your decisions. I just don't want anyone to think I'm trying to start a debate, because I'm not.

Thank you!
post #2 of 19
Some information can be gained that way. The only way to identify ds for SURE though would be an amnio.

I don't do any testing at all without medical reason, so I do no u/s and can't imagine considering an amnio. But I wouldn't terminate if a child had DS so it wouldn't be worth the risk for me to identify that anyway.

post #3 of 19
I agree with the PP. If there is no medical reason, I'd just skip both.
post #4 of 19
I had a level 2 done with my twins. I think the accuracy of the test comes down to the u/s tech doing the test. They do measure everything carefully, and all they're looking for is markers for certain things. There are no guarantees (as there aren't with any test). I don't know the percentages, unfortunately. I think as far as invasiveness, the u/s is the least invasive measure. If they see markers they'll likely tell you to get an amnio. Obviously, that decision is yours to make. It helped me going in, to know what I would do in that situation (that I wouldn't get the amnio, no matter what the test said) but you could also wait and think it over. It's not like there's a huge rush after the u/s.
post #5 of 19
I just had one last month to look at the subchorionic hemorrhage and I'll have another this week. Until it resolves I could have a few. From my understanding, it's a regular u/s machine (maybe alittle nicer) and it has more to do with the techs and the fetal/maternal specialists interpreting the results than anything else. I'm not sure how accurate it would be for Downs. But I'd probably go with a level 2 before diving into an amnio.
post #6 of 19
Just wanted to add from your ETA. I have had this test done with my DD. As another poster said, there are many variables as to determining who accurate the test info is. Tech, position of uterus, position of baby, doctor reading results, etc. That's why unless there was a reason to prompt me getting it, I'd rather just forgo all that worry and stress.
post #7 of 19
I forgo all genetic testing like the quad screen or ultra screen but I do like having the 20 - 22 week ultrasound. To me although I would not change anything I would like to be prepared for any big antatomical problems or signs of a genetic problem. It can indeed provide you with info it is not a totally worthless test and specially if they are trying to send you for a more invasive test it is worth having in my opinion.
post #8 of 19
I made the mistake of getting the Quad Screen that showed I had an increased chance of a baby with Down's Syndrome. They were talking me into amnio, but I opted for a Level II u/s instead.

The test showed there were no abnormalities-however there are no guarantees. I think that if they had seen markers for Downs I would have had amnio-to be better prepared. However my baby could still be born with Down's so who knows......
post #9 of 19
When I was PG with DD I was cautious about getting an U/S. I asked my MW what information she would get from the U/S that would be useful during labor and delivery, and she listed about 10 things, like the number of babies, basic anatomical measurements, information about the organs (esp. the heart), location of the placenta, the length of the cervix, the bloodflow through the umbilical cord, and others I can't remember.

I had a Level II U/S with both pregnancies and am glad I did. I would not have an amnio, no matter what they told me, but having the U/S answers a lot of questions and provides good information IMO. Esp. if you are trying to avoid interventions in a hospital setting, it's good to be able to have U/S results in your chart to show them everything is fine and progressing normally.
post #10 of 19
A Level 2 Ultasound is better than a regular old ultrasound, but it cannot pick up everything. As a PP said, only Amnio can tell you for sure whether your child will have an extra chromosome. I happen to know quite a few moms who had Level 2 ultrasounds that 'ruled out' Down Syndrome, and they went on to have a baby with Down Syndrome anyway.

That said, I have a child with Down Syndrome and am currently pregnant with #2. We will be having a Level 2 ultrasound to check out this baby, something we did not do with our son. We are doing a Level 2 because it is our best bet at this point in the pregnancy to see if there is anything going on with this baby that may need medical attention at birth. We do not want to risk harming the baby doing an Amnio, so we will leave it up to the Level 2. The best way, short of doing and Amnio, to determine whether a baby has Down Syndrome is to do the Nuchal Fold Translucency screening between weeks 11 and 14. It is more accurate than a regular old Level 2 ultrasound later in pregnancy. Again, it is still just a screening and does not tell you anything for sure.
Good Luck.
post #11 of 19
I had a Level II with my twins also, actually a couple. I liked the peace of mind and the specialist who was a dr doing the US as opposed to just some ultrasound tech. We learned a lot.

We did pass on the DS testing.

Good Luck. In my opinion it was worth it.
post #12 of 19
After our AFP/quad screen came back suggesting we were at higher risk for Down Syndrome, we opted to have a level-II ultrasound done. Although it's true that we'll not know *for sure* if the baby doesn't have Down Syndrome until he/she is born, having the level-II u/s done honestly made us feel much better.

In our case, the specialist (who has specialized in detecting high-risk u/s for more than 20 years ... I'd recommend investigating your doc/technician to learn more about their detection rates) did a VERY thorough search and did not detect any soft markers for DS. The level-II u/s is essentially another screening test. Whereas our quad screen results gave us a 1 in 173 chance of having a child with DS, the u/s screening adjusted our odds to 1 in more than 1,000 (don't recall the exact number), but that put us back in a "low-risk" group. For us, after being scared to death that something was seriously wrong, it was an incredible relief to see that our child was growing and thriving and doing really well. Even if the baby does have DS, he/she is extremely healthy with no detectable cardiac issues, growth restriction, etc.

While we understand that the u/s couldn't tell us definitively if everything is fine, we felt like it was worth it. We've since had another level-II u/s because I have pre-existing hypertension (controlled with pregnancy-safe meds), and we needed to check for any intrauterine growth restriction. Everything still looks great.

For the record, I will never have a quad screen done again. I believe it put us through a great deal of unnecessary stress and anxiety. The quad screen has an extremely high false positive rate. I really regret having it done.

I am sorry you are dealing with this stress. I know all too well how you must be feeling. All I can say is to have some very open and honest conversations with your partner about this and proceed based on your own comfort level.

I'll be thinking about you and hoping eveything goes smoothly!
post #13 of 19
As far as the actual test, to me, it's up in the air about invasiveness. There is concern about the actual u/s waves and their effect on fetuses since nothing has really been proved or disproved.

BUT... I did have a levelII with DS to determine if he had a cleft palate. It was the case, like several others here, that I wanted to be prepared for his needs after birth such as surgeons, speech therapists, hospital grade breast pumps etc.

Unless there was a very severe problem, I don't think I'd ever have an amnio.
post #14 of 19
I did the original screening for downs and it came back a bit of a red flag (the levels were too low? or too high? I cant remember which) They reccomended we get a level 2 u/s and then consider an amnio. We went to the big hospital 4 hrs away to a specialist to get our level 2 u/s and I feel that it was definitely worth it. While its true that it doesnt rule out downs, it does check EVERYTHING. The test took us over an hour and they checked so many parts of her heart/lungs/nervous system/brain/face/bone structure/fingers/toes/etc etc. It was incredibly thorough and not at all invasive. Some people say that they would not abort regardless of the test and therefor it has no bearing, but IMO the test shows so many more things that can help you prepare for your birth. If it shows a possible heart defect (there is an increased likelyhood of that w/ downs) then you may want to plan accordingly. If the test shows more severe issues then you may want to give birth at a hospital with a better/higher end NICU. For us, we were planning an unassisted birth, and any sign of remotely possible heart/brain/lung defects would have had us changing our plans. Since ours came back completely normal, we felt that the risks were lessened enough that we were comfortable going on with our unassisted birth. I dont think that a baby with downs, in itself, would rule out a very natural/out of hospital birth, but some of the complications that come with it, if known for certain before hand, would, for us.

I'm rambling. Newborn on my lap (who was born 100% fine even w/ the test coming back positive) so hard to write and lacking sleep.
post #15 of 19
Thread Starter 
Thank you so much for sharing your experiences and knowledge! I really appreciate it.

I learned something new... I didn't really think about how the tech/doctor's experience/competence is an issue to consider, but clearly it is! I also didn't know it can take up to an hour! This info is helpful because now I have a better idea what to expect.

Thank you! Thank you!
post #16 of 19
I had one with this pg at 17 weeks- no risk factors but my dr doesn't do us in her office so she sends everyone somewhere else and they just always do level 2. It didn't seem any diff to me exam wise than the level 1 I had with dd except for the atmosphere. they were all business- my dr said it's because they're job is to look for and find problems (which they didn't thank god). That was really the only thing diff. I guess they did a lot more measuring than a level 1- she knew length of every bone, size of everything- she even measured his aorta (the artery that comes directly out of his heart). I am thankful that we had it, but I never would have consented to an amnio and we don't to the blood tests (quad or triple screen) I figure if they can see it great, if there's something wrong they can't see- it won't change how I feel, kwim? As far as safety- it's exactly the same as a level one- just longer. It wasn't 3-d or anything.
post #17 of 19
yes, it's very useful to pick up all sorts of birth defects.

Not so much trisomy 21 (down's but he was racist so I don't call it that) - that's what the integrated screen in the first/second trimester is for.

But other serious birth defects, yes - heart issues, limb issues, brain and spinal cord issues, kidney issues, lung issues, cleft palate. And some of those things lead to diagnoses of chromosomal problems - for example one of the lethal trisomies has clenched hands as one of the symptoms, so if they saw these sorts of symptoms you might want to have an amnio to see if it is a c'somal problem.

Among me and my immediate family/friends we've had one baby with transposition of the grand arteries (lethal, but surgery at one week of age totally corrects it - she had to give birth next to a NICU). Another who was born with this before we had good U/S had to be helicoptered out when he was two hours old, leaving his mother behind, and she met all the doctors for the first time the day she gave birth.

One baby has a mild kidney issue that would otherwise have shown up with recurrent UTIs, and potential kidney damage. There's a lot you can do prophylactically for UTIs.

One baby had a hernia in the diaphragm which meant her guts kept her lungs from growing - immediate NICU treatment on birth and she survived, with no brain damage.

A friend had a baby with a lethal chromosomal problem. They found out at 20 weeks, and could choose their plan of action accordingly. I know if I knew my baby would die I'd have a homebirth.

A blogger I read had a baby with a severe growth problem with his whole body which would have meant searing unending pain until he died (in the first year). They chose to terminate.

All of these women were young, helthy, fit and active with no family history of trouble, ie "no medical reason". brith defects aren't susually anyone's fault, they just happen to healthy normal people.

Other things like for example, cleft palate you need to read up on how to feed them.

Yes, they're not foolproof and they can miss things, but not having it means they'll miss EVERYTHING.
post #18 of 19
My daughter has spina bifida. Her regular u/s detected a "soft" sign for it and it was diagnosed with a level II u/s. I then had multiple u/s to monitor her until delivery. I don't know what type of u/s they would officially have been called. I skipped the quad screen with her. I know it was incredibly helpful to us to know her condition before she was born so we could plan accordingly and be big advocates her her. Also because we knew she was born in the same hospital where she was treated so I was able to be with her most of the time.

This time around we again skipped the quad screen as I think it's a useless test. We went straight to a level II u/s. We got great views of everything so we felt no need to do an amnio. It was never even suggested by the doctor.

As others have mentioned the level II isn't great for picking up Down Syndrome. It can pick up "soft" signs, but it's unlikely to give a definitive answer. The only 99% sure answer is from genetic testing through an amnio. The level II can detect a wide range of other problems though.

And again as I've stated over and over on these boards - just because someone gets testing does not mean they plan to terminate is there is a problem. There are other reasons and making that assumption is really insulting.
post #19 of 19
I'm skipping 95% of testing, but I did have a Level 2 at 19 weeks. In our area, Level 2s are done/read by perinatologists, so they are very thorough. You can also ask many questions about the scan and they will be able to answer them, whereas many "regular" ultrasound techs cannot.
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