ultrasound question

[kdamnspot]

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[LisaG]

My former ob/gyn (retired) wanted to do one with my first pregnancy to check dates because my uterus was measuring large - turns out I just have a large uterus. Another doc I consulted with wanted to do one at 5 weeks just to see what my uterus looked like (I had a birth defect surgically corrected) - not sure what she would've done with the info at that point.

I think it's fairly common in mainstream ob/gyn to do an early ultrasound to cover their butts regarding dates. If your cycles are regular and/or you've been charting I don't see much use for them that early on other than reassurance.

Lisa

[sarahkjack]

Why do some people have earlier ultrasounds? Can you simply "request" one? I'm not looking to debate the merits/demerits of u/s, I'm just wondering what other women experienced as far as "when" they had their first u/s and "why" (request, spotting, concern, etc).

I have never been offered an early U/S and highly doubt it will happen this time. I'm not sure why some doctors give them earlier than others. I am happy with the usual 20 week U/S.

Sarah, mommy to Nathaniel, Ethan & Emily
Expecting a New Bundle of Joy 3/6/06!!

[Mariposa]

I saw a CNM with Abby and wasn't offered an early one. Had one at 20 weeks. I am seeing a CPM for homebirth this time and am going to request one at 20 weeks as well. I just need to see that things are looking okay in there and I also want to have video for this baby like I have for Abby.

I find myself trying to stay the same. Didn't do belly cast with Abby, so can't do one with his baby, etc...

[kdamnspot]

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[nubianamy]

My BF asked if I wouldn't mind having a video! I personally couldn't care less, but I was amused he wanted one. I once did photography at a birth and it was really beautiful (grainy black & whites).

I haven't had anyone offer to give an early u/s, but my dr's office said they would use a Doppler at 12 weeks. Not sure why, and I'm not sure if I should protest. I know Doppler uses weaker u/s. I'm also prepared for BF to ask for an early u/s as he is more worried about the pregnancy than I am. (Nothing to worry about, he's just a worrier.) =)

[MamaChel]

With my first I had an early u/s at 8-9ish weeks. This was to confirm the pregnancy since my uterus is posterior and they couldn't feel it. Then I had the 20 week u/s and one more at 36 weeks I think. One of the Drs in the practice was u/s happy.

Some Drs like to do early u/s and some don't.

[Mariposa]

Yeah, they just put the tape in the TV that the screen was on and recorded the whole thing. I really like it. Not sure how it will work this time though because my MW said she knows someone who will come to the house and do it and I really would like a video. We will see I guess.

[Mrs Dimples]

Holy cow, EVERYONE on my "other" due date board has already had one/is having one soon, I think it's mostly to "date" the pregnancy, although they have all been obsessing about pregnancy testing, etc, and I know most of them knew EXACTLY what day they conceived on. :scratch So I think it's just for fun, basically. That's what moms "want" and so they do it. I have no idea, can you tell? :LOL I will be having one US at 20-ish weeks barring some medical complication.

I think some people don't believe they're pg unless they "see" it, KWIM?

[Mrs Dimples]

I'm doing the same thing, Pepper, my MW said the guy's name was Denzel and he does it at your house and I'm sure you could make a tape if you wanted. I can't wait, I think it sounds lovely! :love

[Momalea]

My midwife said that if I choose to do one, the average range is between 18-22 weeks. If I remember correctly, around that range they can measure certain areas of the body to see if there is a greater chance of Downs, they can (mostly) tell if there is a problem with the spinal cord, things that might make you choose a c-section v. a home birth.

[amyrobynne]

When I was with a CNM practice, they highly recommended a 20 week u/s, but never talked about an earlier one.

The homebirth midwives I transferred to (and will see this entire pregnancy) don't recommend u/s at all unless there's a reason for concern.

[mexiguat]

Hi, so I called my Dr. to find out about the u/s and was told that it is a limited vaginal u/s which is routine. After that there is only one u/s at about 20 weeks. For me it's nice to have that 1st early one, especially since I'm super paranoid and want to see if all is well, also since for the last 3 - 4 months my cycle went from about 32 days to 40 - 43 days I am not sure really how far along I am so the early u/s can help give a better estimate of due date.

[Charles Baudelaire]

The reason OBs request early USs are these:

1. Dating
The earlier an US is performed, the more accurate the fetal dating will be. Out of the starting gate, embryos all develop at the same rate...for awhile. That is, a six-week embryo will look the same in pretty much everyone, therefore enabling a provider to predict with reasonable accuracy when the actual due date will be.

Later on, due to other factors, the fetuses don't develop at the same rate, so US for due dates are increasingly INaccurate as the pregnancy progresses.

2. Placement
Early US rules out ectopic or exuterine pregnancy.

3. Fetal heart rate
<85 BPM indicates a probable miscarriage or developmental problem.

In short, it's good for a bunch of things.

[Charles Baudelaire]

Oh, and as for the other poster who mentioned that the women on her preggo board are obsessing about dates and know exactly when they conceived, that is probably true.

BUT

As you probably know, an embryo can take up to six days or sometimes more to implant in the uterus and start making HCG and a placenta, which is really when pregnancy officially "begins." Therefore, you might have done the happy dance on the 1st, but your blast didn't implant until the 6th, so your due date estimate would be nearly a week off. Early US dating, though, can establish exactly how old it is, down to the day.

[zoe11]

I didn't have an ultrasound with my first at all (with a CNM in a hospital) and won't with this one either (DEM at home). The American College of Obstetricians and Gynecologists don't recommend the routine use of ultrasound AT ALL in pg, in other words they recommend that doctors don't do one unless there is a reason. Studies have shown US not to improve maternal or fetal outcomes. There have also been no studies proving the safety of ultrasound. So, I would have an ultrasound if there were a reason- no idea of my lmp, bleeding, risk factors for deformaties. Otherwise, no.

Mothering had a great article on ultrasound, risks and studies, etc, a few years ago.

Aly

[chiro_kristin]

So, I would have an ultrasound if there were a reason- no idea of my lmp, bleeding, risk factors for deformaties. Otherwise, no.

Sorry, not in your club but saw the thread and wanted to reply to this. Although I agree with zoe that there should be good reason, I have no idea of my LMP and I still chose no u/s!

(I don't mean to turn this into a why-not-to reply, but I have to say that most other invasive testing procedures are done only with reasonable cause, i.e. if there isn't reason to really suspect a problem, why do it? Okay, I'm done)

[Carliegirl]

I am totally with you on the risk of US. I have decided not to have one unless something goes wrong. I have read that there are a couple of safety concerns and I'd rather be careful.

[CaliMomof4]

In the past, I've had the standard 20 week u/s - mostly because I always measure big. This time, I'm not going to have one till late just to check placental placement. I had a c/s in '99 and want to know if the placenta is covering the old scar. I am having a homebirth with a DEM who can order hospital u/s but I think I will just pay the money and go to one of those 3D/4D places. The last u/s I had at a hospital was not a pleasant experience. The songrapher got mad at me for partially emptying my bladder (she was 15 minutes late) so she didn't really let me see much and the picture she printed out was terrible!

[momto3g3b]

With this pregnancy, I had an u/s at 4w,2d to assess whether I am carrying multiples since I've conceived either twins or triplets in 3 of my 5 prior pregnancies. My ob, my dh and I wanted to know early whether I was carrying more than one baby so we could take appropriate action (increase amount of supplements I take, reduce high-intensity exercise, etc) to hopefully prevent miscarrying one or more of the embryos, since it's happened twice before (lost a twin with pg #2 and lost 2 embryos with pg #5).

We saw 2 gestational sacs at the first u/s, and when I have my next ob appt (August 8th), I will have another u/s to check for heartbeats.

So....for me, that's why I had/have early u/s done.

ETA: Another reason I do u/s in pg is to assess for spinal cord/neural tube defects. I have twins who have both had neurosurgery for Chiari Malformation and tethered spinal cord, and one of my twins also has a significant form of spina bifida. As a result, I have a higher-than-average chance of having another child with a form of spina bifida, so u/s is important to me. If one or both of these babies has spina bifida (or Down syndrome or cleft lip/palate or any other problem), I'd want to know ahead of time so we can be prepared and not completely shell-shocked at the birth.

[honeybee]

Kate, wow! I'm so thankful u/s is available for situations like yours. Technology definitely has its place.

I refused the 20 week u/s with ds, against my doctor's recommendation. I decided to follow ACOG's guidelines. We did have a 41.5 week u/s to check amniotic fluid.

Unless my midwife sees a particular need for an u/s this time around, I will not be getting one.

Melissa

[Katwoman]

I have early u/s done around week 6 or 7 because I have a history of etopics and they always want to verify the baby is in the right place.

[a-sorta-fairytale]

Since i am having a vbac (hbac really) i have to have one u/s to check for placental placement. I know MOST insurence does NOT cover more than 1 u/s. So most docs put a "risk code" on it so it will get paid. The one most often seen by the ins adjusters is "pos ectopic" "spotting" and "unknown due date"

I was really wierded out to know that so many women have so many us duirng the pg. I still dont trust em.
MArgarita
Cali 4/30/04
edd 3/?/06

[MeganCatheline]

I'm not a big fan of u/s either, however I've already had 2.
I have a history of ectopic pregnancy and the first u/s at 5 weeks was inconclusive, so I had to have another this week. I'm glad the technology exists for situations like mine, and others where its use is warranted.
While I believe that u/s is probably ok, I wouldn't use it indiscriminantly (i.e. those mall u/s photo studios)

[Heart.Revolution]

I just came home from my US appt. I heard the heart beat!!! I was so nervous because all my previous US appts that I had in the past were to either determine if everything cleared out from the miscarriage. Not today though...I got to see my little 9mm bean baby and hear it pumping 150 bpm!

I wish everyone the best of luck with their little beans!

[Kam]

Momto3g3b, I'm so sorry to hear about your children's difficulties. It must have been so scary to be shell-shocked at birth. I hope you have a smooth pregnancy this time and get all the help and information you need.

I got pregnant and gave birth in Japan, and I had an ultrasound at every prenatal appointment (and there were so many at the beginning because I was bleeding and cramping and had just had a m/c). I'll bet I had more than 20 ultrasounds. I had no idea there was any controversy regarding their safety, but this time I am planning to be more proactive. Isn't it crazy how the availability of information creates the "need" for more information where there isn't really such? :irked:

warmly,
Kam, mamamama! to Meg

[zion]

early US are mostly used for date. But due date are estimates!!! If you know you lmp and are having no pain or bleeding, although reassuring, it's probably not necessary

[AnditheBee]

I know this is resurrecting a month-old thread, but I was looking for info on ultrasounds, and had to respond here:


As you probably know, an embryo can take up to six days or sometimes more to implant in the uterus and start making HCG and a placenta, which is really when pregnancy officially "begins." Therefore, you might have done the happy dance on the 1st, but your blast didn't implant until the 6th, so your due date estimate would be nearly a week off. Early US dating, though, can establish exactly how old it is, down to the day.

Actually, US dating would be measuring the growth of the embryo/fetus, which begins at the moment the fertilized egg starts to split; this happens prior to implantantation. However, it is possible for the sperm to live for a while before the egg is released, so it is conceivable (so to speak :wink ) to have sex on the 1st of the month and not actually have a fertilized egg in you until the 6th.

So yeah, your overall point about "knowing" the due date and the actual due date is well taken. :)

I have had an early US with both my pregnancies...neither time was totally "necessary" but at least this way they know the actual due date and won't start bugging me when they believe the baby to be overdue. However, one rationale which I haven't seen mentioned here, for routine and even multiple ultrasounds, is simply money.

The small-town OB practice I'm currently going to has a 3D/4D machine, and they seem reaaaaally happy to suggest an US, seemingly at the drop of a hat. I was commenting on this to someone, and they said, "Well, yeah, they have to pay for that multi-million dollar machine!" And even if a practice has an older, paid-for machine, the insurance companies are still going to give them money for each scan that they do.

I'm not saying there aren't legitimate reasons for early and routine US...just that some providers have motivations beyond the diagnosis of potential health problems. It's good to keep this in mind when making your own health care and pregnancy decisions. :thumb

[AppleCrisp]

I'm not saying there aren't legitimate reasons for early and routine US...just that some providers have motivations beyond the diagnosis of potential health problems. It's good to keep this in mind when making your own health care and pregnancy decisions. :thumb

I am always amazed at how the majority of people still actually think that their doctor and/or medical center is truly altruistic and out to help everyone...healthcare is a business and a lot of patients forget that. Not that aren't a lot of altruistic physicians out there, but there are also a lot who pay more attention to the bottom line, and order procedures or surgeries that may not be strictly necessary. I know where I am they count each and every procedure I do every month and question me if I fall below. Another thing I've seen is procedures being routinely done at teaching hospitals so that residents can get what they need. Anyone ever read "How To Raise A Healthy Child In Spite of Your Doctor"? GREAT book .

This came across kind of negative but I'm not....just some observations. I like drs. I like some hospitals.

[marchmommy]

I dunno why, although you guys are starting to make me wonder, but i have had an ultrasound at every single monthly appointment! And to find out the sex I was given a referral for a level 2 u/s at a digital imaging place in between my appointments. Nothing is wrong, I am completely healthy, and it's pretty nice to have 6 pictures to show off!

[AppleCrisp]

I dunno why, although you guys are starting to make me wonder, but i have had an ultrasound at every single monthly appointment! And to find out the sex I was given a referral for a level 2 u/s at a digital imaging place in between my appointments. Nothing is wrong, I am completely healthy, and it's pretty nice to have 6 pictures to show off!

If I knew it were 100% safe, I would LOVE to have multiple ultrasounds, but they don't do it at my office. I don't know if the insurance would cover it. They are so busy anyway, they barely spend any time with me as it is, so I doubt they would have time to scan on every appt. I am waiting for 22 weeks for my u/s but that will be it, if all goes well.

[marchmommy]

oh that is sad to hear, that your doctor's office doesn't get to spend much time with you! My OB is the only one in her office and she spends so much time talking to me and my boyfriend about anything and everything. Even called from her home when she was on maternity leave herself to discuss test results, and did research to find my boyfriend the cheapest blood testing place since he doesn't have insurance! Wish you were in VA, I'd give you her number!!!

[Mommyat16]

i am not sure why but i get an us every month to keep checking for the *possible* birth defect and my next one is tuesday. i will probably find out then what it is. at my 8 month us it will be the 3-d one. and every time i go i take a videotape and they record the us for me. it keeps my anxiety in check when ever im not feeling it move as much. i just sit down with the bf and a big bowl of popcorn and watch our little pumpkin swim around.

[AppleCrisp]

oh that is sad to hear, that your doctor's office doesn't get to spend much time with you! My OB is the only one in her office and she spends so much time talking to me and my boyfriend about anything and everything. Even called from her home when she was on maternity leave herself to discuss test results, and did research to find my boyfriend the cheapest blood testing place since he doesn't have insurance! Wish you were in VA, I'd give you her number!!!


Do you live in VA anywhere near Washington DC? I'm moving there before the baby is born and I will have to find a new practitioner.