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Transnuchal Lucency Ultrasound- Will you do it?

2805 Views 11 Replies 10 Participants Last post by  adorabelle
This is my first pregnancy so of course I'm freaking out. I went to my first OBGYN appt this morning and she wanted to do an ultrasound. I'm 8 weeks. I declined the ultrasound and she was totally fine with it. She said she recommends a transnuchal lucency ultrasound at 12 weeks to check for Down's Syndrome, etc.

Originally I was 100% against ultrasounds, but due to two previous LEEP and one laser ablation of my cervix, I decided it would be a good idea to do the ultrasound at 14 weeks to make sure my cervix is competent.

I'm so nervous about everything. I'm only 27, so I don't think anything would be wrong with the baby but it's just SO SCARY. I wish I could just relax and not worry. It's so hard because it's my first.

We're planning on going with a home birth midwife after I get the all clear at my 14 week ultrasound. I've got reservations about that because I'm a worrier but I like the idea of delivering at home a lot more than at the hospital.

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Breathe. :)

I have no idea why your doctor would suggest that unless you have some actual risk factors. As far as I'm aware, the ultrasound to check for down's syndrome is usually only done on women over 35.

I'm not really a worrier, so I'm afraid I can't help much with that. All I can say is that the odds are very good that your baby is perfectly fine.

Please don't let your fear keep you from a homebirth. I let my husband's fear keep me from one with my oldest son. I went to the hospital because of fear and I wound up with an unnecessary cesarean, which resulted in a year of pain. My other 2 babies were born at home, unassisted. I had moments/weeks during my pregnancy with ds2 where I was completely terrified, certain that the dr who cut me had been right. I knew what he said was completely illogical, though, so I ignored the fear because it wasn't based in reality.

There's a good saying that might help you..."Do it afraid". You don't have to get rid of the fear to do something, you just have to not let it control you. Try not to let the fear/worry influence your decisions.
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Thank you so much for your heartfelt comment. I think that's a normal ultrasound that the office does. I kind of wish I hadn't even gone, and truth be told, I wouldn't have if I wasn't concerned about my cervix. I am sure the 14 week cervical ultrasound will go fine. I think I should probably decline the 12 week u/s and just do the 14 week one. That would make me feel good about the home birth.

I am so glad you shared your story. One of my biggest fears is that I'd end up with a c-section, and I want to avoid that if at all possible. I have always wanted a home birth, and I think you're right- I need to not let the fear control me. I should do what I want to do and what I feel is right for myself, childbirth, and the baby. :) ((HUGS))
Do some research on the nuchal translucency sono. It does not diagnose Down's, or other chromosomal anomalies, but rather tells you whether you have an increased risk for them. Same idea with the Triple/Quad Screen blood test.

I do NOT do either test. Why? Because no matter what, I will love and want this child. Many times, these tests tell you have an "increased risk" and baby is fine. Increased risk just means a risk higher than your age-based risk. Everyone is at some risk for having a baby with a chromosomal anomaly. The standard is to recommend these tests to everyone, to protect providers from lawsuits, not because you in particular need it more than someone else.

Since it won't change the outcome for me, I'd rather not be told I have an increased risk, and then worry the rest of the pregnancy.

I DO do the 20 week anatomy scan sono, for the purpose of making sure baby has no obvious problems that would necessitate a hospital birth (spina bifida, heart defect, etc). My MW say you really need to wait til at least 18 weeks to see enough anatomy to make this scan worth it. So if that is your purpose, in addition to looking at cervical competence, I'd wait til 18-20 weeks.

I hope that helps. Try not to worry. Chances are baby is fine and healthy. =)
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I will not being doing it. With any prenatal testings I ask myself "are these results going to change the way I proceed with the pregnancy?" To nearly every test, the answer is no, so then I don't choose to do that test. For each person, those answers are going to be different. If it is a test you don't feel good about, you can decline and that is perfectly reasonable.
I'm doing it and we did it last time. I know I may be in the minority here, but I like the reassurance and I would want to be able to prepare (and to consider the possibility of amnio, although I think I would decline it) if there was a large risk of down syndrome or some other issue.

I'm pretty sure it has become standard to offer this screening to all women and not just those over 35. Keep in mind however that it is a screening and *not* a diagnostic test. It can only tell you if you have a high probability of a problem, but cannot tell you for sure. For some people the idea of a false positive as it were is way too stressful to be worth doing the test. I think you have to decide based on your own feelings about what you might do with the information and how much peace of mind vs. worry it might actually provide.

Apparently the u/s measurement that they do (this is the actual nuchal translucency part) is fairly accurate (especially if you are caucasian, apparently it is less accurate with some ethnicities) while the blood work they do is more prone to false positives. Just something to think about. If you are having a u/s anyway to check for cervical wellness, you could get the nuchal measurement done, but decline the blood work. Just a thought.

Good luck.
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Yes-- my OB told me that it's now the standard (at least in California) to recommend the NT ultrasound to everyone. I was surprised to hear that because it wasn't the standard when I was pregnant with my son just a few years ago.

I'm having it done, but for personal reasons... despite being wildly ill with m/s, this pregnancy still doesn't feel "real" to me yet and I am hoping that seeing something that wiggles and has arm buds, etc, will finally make it click for me. I could care less about getting a risk factor estimate for trisomy 23 or anything else.

If your gut's telling you no, I would go with that. It sounds like you have a good plan in place... have the 14 week cervical ultrasound and go from there.
My doctor informed me that this is something they now offer to all expectant mothers, which wasn't the case when I was pregnant with my son four years ago.

i think I am going to go ahead and have it. No result would make me think of terminating my baby. But I would like to know any and all possible problems that we may have to deal with in the future so I can be as prepared as possible and not caught completely by surprise. I will love my child no matter what and i want to be the best mommy I can be for them.
My midwife talked to me about this at the 11 week appointment I just had. She said that they are now doing a triple test with the blood screen, the ultrasound and I can't remember the third. I declined as I did when it was just the blood screening with my first 2. In my opinion if there is anything of concern that we need to know about it will come up in the 3D 20 week ultrasound.

The kind of ultrasound they are going to want to do will be looking for several things and will most likely be lengthy(more then just a quick peek). If you don't want them to look for genetic markers and just want them to check out the cervix then you can deny the screening and just ask for what you want.
Originally Posted by sarah_bella1050 View Post

My midwife talked to me about this at the 11 week appointment I just had. She said that they are now doing a triple test with the blood screen, the ultrasound and I can't remember the third.
There are basically three options for the screening if you start in the first trimester:

NT (nuchal translucency) ultrasound only

First trimester screen - the NT screen with additional bloodwork at the same time

Sequential screen - the first trimester screen plus the MSS/triple/quad screen blood test at 16ish weeks

I do the first trimester screen and I would pursue diagnostic testing if the risk came back very high. I got my results monday and they were very reassuring.
I thought I'd just add a few words since I've had bad experiences with these types of screening tests and am actually planning on having this done. The reason I'm having it, is that I'm 45! I'm surprised that they're offering this routinely for young moms to be. It's not particularly invasive, but it could cause a lot of unnecessary anxiety and stress. When I was 26 and pregnant with my oldest daughter, naive and not very assertive, my doctor convinced me that I should have what was then known as the triple check screening test. It came back indicating a strong possibility of downs syndrome. My husband and I discussed amniocentesis at that point, but decided that nothing we did would change the outcome of the pregnancy and I was just not into that invasive of a test. The doctor was not happy with our decision, but it was one of my first experiences of asserting myself during the pregnancy which I've now learned is imperative. I did worry throughout the pregnancy, but I was low risk for down syndrome because of my age and no history of genetic disorders on either side so I decided to enjoy the pregnancy and pray that everyone would be okay. My daughter was born full term, but the overmedicated, hospital labor experience was terrible for both of us and she ended up in the NICU with breathing issues. At that point, she was seen by a neonatalogist who looked at her and pronounced that she had down's syndrome. They ordered a full chromosomal profile before I even spoke with my wonderful, handpicked pediatrician who took one look at the baby and said that was the most ridiculous diagnosis she had ever heard. The baby showed no signs of down's syndrome and she would never have ordered more testing. To make a long story a little shorter, 7 weeks later the results were back and she did not have down's syndrome or any other chromosomal abnormality. She has just completed her 1st year of college and is a wonderful, bright, and wise young woman. I now have 3 other children and am pregnant with my 5th at the ripe old age of 45. I did have the NT with my youngest who is now 4 years old. It seems a little more sophisticated than the old triple check test and we received good odds that the baby did not have down's syndrome. Although the doctor performing it did try to convince us that we should have amniocentesis as well given my advanced maternal age (I was only 40 then!) Everything was fine and she is a healthy 4 year old. I'm going to go ahead and have it again, but I'm so much more experienced at asserting myself with the medical profession. I am very concerned with my risk at age 45, but the results wouldn't change the outcome of the pregnancy or convince me to have an amniocentesis. If we get odds that aren't as great, it will allow me to talk to friends that have raised children with down's syndrome and educate myself to prepare myself to be the best mother I can be for this particular child.

Sorry about the long rambling answer, but I just wanted to give some perspective on the test. If I were 26, I don't think I would do it. I'm hopeful that at 45, it will give me a little reassurance. I'll still refuse the quad screen though. I don't ever want to go through that again. That test has too many false positives.
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Thank you all for the great replies! I will have to see what feels right when the time gets closer. We went ahead and scheduled it like I will get it, but they said I could decline later if I wanted. It's awesome to hear what you ladies are doing!
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