would you do an US in my situation? - Mothering Forums
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#1 of 32 Old 08-27-2007, 10:25 PM - Thread Starter
 
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i had one with DD, and opted not to have one with DS, but after an accident at 38 weeks the hospital insisted on a scan, and i consented. i was fully confident i dind't want any this pregnancy.

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.
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#2 of 32 Old 08-27-2007, 10:31 PM
 
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i never had one w/ dd. it was a risk i took (or didn't take, however you look at it). just do what feels right for you

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#3 of 32 Old 08-27-2007, 10:40 PM
 
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I wouldn't.

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#4 of 32 Old 08-27-2007, 10:50 PM
 
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I find that for myself personally, getting an u/s during pregnancy buys me peace of mind so that I can approach my birth without lingering fears hanging around my paranoid brain about whether the baby might come out with some terrible defect (as my first baby did). It allows me to breath a sigh of relief & move on. It's quite a personal decision, choose what feels best for you!

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#5 of 32 Old 08-27-2007, 11:29 PM
 
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I wouldn't. I'm a UPer and don't do birth planning based on hospital emergency response time, since odds are I won't need any of that stuff (well, change all that to past tense since my UC baby is a year old almost and my DH is snipped now).

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#6 of 32 Old 08-28-2007, 01:09 AM
 
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If I had one--which I personally wouldn't--I'd wait until after 20 weeks. Why would you want one at 18? Also, do you have any reason to think something's wrong? If not, then why bother with the U/S? I agree with sublime birth girl here. But hey, if you have reason to worry, or it just makes you feel better, have one. But still, wait until after 20 weeks.
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#7 of 32 Old 08-28-2007, 01:18 AM
 
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I think if you feel the need for one, trust yourself.
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#8 of 32 Old 08-28-2007, 01:56 AM
 
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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.
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#9 of 32 Old 08-28-2007, 02:13 AM
 
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I wouldn't either

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#10 of 32 Old 08-28-2007, 02:38 AM
 
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I agree with other mamas that if it seems to you a necessary intervention, then do it, but I would definitely wait until the very end of the pg. If they are looking for heart or spinal or other organ anomolies, there's no reason that I know of that they couldn't detect them then.

With our first, we ended up having a series of unecessary ultrasounds simply because the technology has improved so much recently that they are seeing things they don't understand although clearly have always taken place during development. In our case, they were concerned about the development of ds1's brain. It was fine, but we endured four ultrasounds, neessarily spaced three and four weeks apart, to determine that and obviously a lot of stress.

Another couple we know had their baby induced to birth after their u/s and dr thought their baby was too big and possibly would have breathing problems they didn't want to be any worse if they waited to birth spontaneously, because of something he thought was in the child's lungs. Their HUGE 5 1/2lb baby was born without breathing problems (which is miraculous given the child's obvious prematurity). I'm sure that the more you ask women about their experiences with u/s from this perspective, the more stories you'll hear about how innaccurate the technology, the reporting technologist and then finally the diagnosing dr can be and in combination, cause quite a hefty margin for error.

You do know that routine u/s is no longer supported by the societies of ob/gyns in both the US and Canada? I'm still amazed at how routine it remains though. Anyway, for you, I think it would be more beneficial for both you and your baby to wait, and if in the end you still want one, then do it; if not, you'll have nothing to regret.

I do appreciate that for you being so far north, the idea of traveling to do an u/s so late in pg is less than appealing (or would you do that in your local hospital?). That may have contributed to my desicion not to do one as well when I wasn't sure how things were going for babe during that time when movement slows temporarily around six-ish months.

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#11 of 32 Old 08-28-2007, 03:49 AM
 
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I wouldn't!

I wish I hadn't had mine this pregnancy. Mine was for purposes of "dating" the pregnancy... and it's been nothing but stressing me out since I swear the "date" they gave me is totally bogus...

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#12 of 32 Old 08-28-2007, 03:50 AM
 
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I would not have an U/S either.
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#13 of 32 Old 08-28-2007, 04:10 AM
 
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If it were me, I would not have the u/s. I'm concerned about health effects of the u/s itself.

Besides, nothing is conclusive. You could get a scan and freak out over the results, just to have everything turn out fine. Or you could have the scan, think everything's OK, and then get blindsided by a health problem in the newborn. No technology can ever assure you of a healthy baby.

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#14 of 32 Old 08-28-2007, 04:50 AM
 
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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.

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#15 of 32 Old 08-28-2007, 09:59 AM
 
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nope unless you are losing sleep over it.

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#16 of 32 Old 08-28-2007, 11:31 AM
 
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i would never get an ultrasound.

i'm not a religious person, but i say that there's a reason that there's no window on the front of our bellies.

growing people deserve peace. soon enough, everyone will be trying to critique and analyze your little person, deciding what is and isn't 'wrong' with her. what standards she does and doesn't meet.

i say NO to analysis of my fetus-babies. i vote for finding other ways of making peace. like meditating on health and joy, and doing whatever it takes to symbolically and physically release fear. writing bad things and burning them, crying, going to a mountain and feeling small, climbing a mountain and feeling big, getting a massage, going skinny dipping...

best to you!
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#17 of 32 Old 08-28-2007, 11:50 AM
 
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i wasnt going to get one last time (UP/UC) but changed my mind. an old friedn was going through a pregnancy where she was planning a homebirth with midwives. she wasnt going to get an u/s either but suddenly felt strongly compelled. turned out her baby had a heart problem. her entire pregnancy changed, her birth, everything, it was not a 'good' heart problem. this is why i got my u/s, which came back normal and all was well.

there is more to the story! after i got my scan, my friend gave birth. baby was fine! they whisked him away from her all the same, but all her fear and worry and all those tears... they couldnt whisk that away. i wont get another u/s.

p.s. unless dh just insists. which is possible.

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#18 of 32 Old 08-28-2007, 11:53 AM
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does a heart defect run in your family? do you have a strong reason to believe that you are likely to have a child with a heart defect? what sorts of heart defects in particular? and are their diagnosable by ultrasound?

and then, of course, the question of "what are the incidents of false positives, etc?" should also come to bear.

as others have said, you should do what you think and feel is right. if that means having an U/S, then that's what it means. if it means nto having one, then that's what it means.
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#19 of 32 Old 08-28-2007, 12:46 PM
 
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Originally Posted by Unoppressed MAMA Q View Post
i would never get an ultrasound.

i'm not a religious person, but i say that there's a reason that there's no window on the front of our bellies...
I don't say never like I used to. I'm on my eighth pregnancy, never had an U/S, haven't had a doppler in the past six pregnancies, and don't intend to get either again. That being said if I had heavy bleeding late second or into the third trimester with no known cause, I'd consider U/S to determine how far the placenta was from the cervix as that *could* make a difference in my birthing plans.

That being said I did pass a golf ball size clot at 13 weeks with my first and declined U/Ss. At 13 weeks I figured the medicos couldn't learn anything that would change the outcome. Later we figured the placenta was low lying (bled profusely a few hours after sex.) I didn't get a late pregnancy U/S to measure placental distance from cervix as I figured if it were an issue I'd have had more bleeding in the six months following the original bleed.

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#20 of 32 Old 08-28-2007, 12:50 PM
 
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US is not 100% accurate on guessing weight, gestational age, or whether everything is a-ok, and I do not know the rate of false positives. You do need to consider what you will do if something does show up wrong; think long and hard about that before having the ultrasound. What if you are told everything is fine only to deliver a baby with a life-threatening issue 3 hours from the hospital? What if you are told something is wrong only to deliver a healthy baby, but you've had to have a very interventionist pregnancy and birth? What are you more comfortable with? A US cannot offer certainty. In fact, if something shows up wrong it can affect the whole way your pregnancy and birth are handled, as well as causing a lot of anxiety. However, it can also offer reassurance. But both of these senses can be false.

It sounds to me like the real issue here is that you are worried something will go wrong and that you will be too far from the hospital. I think that is a very real concern. I don't think it has anything to do with a lack of faith in life, birth, or yourself; I think it is very natural for us to fear the worst and to prepare for it. I have been preparing for the worst but hoping and expecting for the best, minus the ultrasound. I think that is a good approach for anyone, ultrasound or not. My advice to you would be to do the same: prepare for the worst, expect the best. Do what makes you feel most comfortable. It sounds like you truly aren't 100% comfortable with birthing so far from the hospital...and while US may ease your mind if everything looks fine, I think it will be an artificial sense of reassurement. Your comfort with this decision needs to come from many sources, not just a US. I think a better thing to do would be to plan to give birth nearer to a hospital.

I have a great deal of faith in birth, but even so, one of the reasons I feel comfortable with my choice to UC is that there is a hospital ten minutes from my home. I also know from experience that the paramedics can be here in 5 minutes. A hospital with an awesome NICU is about 20 minutes off. (Tricare only covers a birth in the Army hospital, so even if I weren't UCing, I'd still have to transfer if there was a neonatal emergency.) I have the number of a midwife who is accepting of my UP/UC choice and who would be willing to see me if I had any concerns. I believe that this will turn out wonderfully and be best for my whole family...but I also know there is always that slim chance. Having access to prenatal care from such a wonderful woman as well as quick access to emergency care puts me even more at ease. I have gained a lot of knowledge since I began this journey, and my confidence has raised a little everyday. I have also taken precautions in case my plans do not go, well, to plan. I know that it's unlikely for any complications or defects to occur. I trust medical professionals' skills at handling these rare situations (just not normal births). All of this is what gives me the peace of mind I need to proceed.

I think one of the most important factors upon birth outcome is the stress level of the mother. If you feel like an ultrasound would put your mind at ease, then have one. But I think you also need to find other sources of reassurance..and as time goes by, you probably will. I would recommend waiting until a bit after 18 weeks if you do have an ultrasound, maybe 20 or 22 weeks. And again, have a good plan in case of an emergency.

I am booking an ultrasound for later this week because I'm not sure of the exact location of the placenta. I can hear it best low in my uterus, but I also hear it up a little higher but more faintly. To make sure it is not in a position that will hinder a safe birth, I'm going to have an ultrasound. While we're there we're going to confirm how many babies there are (probably just one!), gender, and position...as well as see if we can get a weight estimate. We may as well if we're paying for it. I feel like that will put my mind at ease...and I trust this midwife, so if she says the placenta is somewhere that would make birth risky, I can take her advice whatever it may be--have a midwife there, be in the hospital, C-section.

In the end...it's up to you. Just think long and hard about it, because once you have the US and the results, there is no going back. Just like once you're 39 weeks along and in labor without having had any testing, there's really no going back from there either.

Good luck mama.

ETA - Woo, I sure wrote you a novel. Sorry!!

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#21 of 32 Old 08-28-2007, 04:49 PM
 
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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!
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#22 of 32 Old 08-28-2007, 10:29 PM
 
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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!
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#23 of 32 Old 08-29-2007, 05:26 PM
 
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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.
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#24 of 32 Old 08-30-2007, 04:23 PM
 
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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.
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#25 of 32 Old 08-31-2007, 06:38 PM
 
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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?

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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!"
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#26 of 32 Old 09-02-2007, 07:03 PM
 
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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!
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#27 of 32 Old 09-02-2007, 09:16 PM
 
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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.
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#28 of 32 Old 09-02-2007, 09:23 PM
 
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I wanted one, and I got one, and I dont regret it at all.
If you want one, get one.
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#29 of 32 Old 09-02-2007, 10:33 PM
 
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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.
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#30 of 32 Old 09-02-2007, 10:41 PM
 
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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.
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