[jraohc]

I'm facing some major indecision regarding ultrasounds. My midwife suggested that we consider the nuchal translucency test. I was all set to discount it, but DH is actually considering it. I don't mind the test part of it so much as my indecision on ultrasounds and whether or not it's really "necessary". I'm not sure what we would do if the test was abnormal either.

She also suggested in passing that for comfort of mind we should have a 20-week ultrasound in case there was a problem that would indicate the need for a fancy hospital. This is a midwife who works for a hospital with a level II nursery and I believe she made the suggestion because I told her we were considering a homebirth. I don't think she would have suggested it, or at least not worded it like that, if we weren't planning the homebirth. Does anyone know more about what a 20-week ultrasound can actually detect or not detect? How likely it is to detect a problem that would indicate the need for a high level nursery or other intervention during pregnancy?

I'm just looking for other opinions on ultrasound and what you plan on doing and why. Thanks for sharing in my indecision

 

[HypnoMama]

I was completely set against ultrasounds (and my midwife is totally supportive) until I started thinking more about the homebirth aspect. The thing Im most scared of is a low lying placenta/ hemmorage situation. So, we have decided to go ahead with the 20 week U/S because I know that will definately rule the placenta issues out and get a good look at it to make sure there are no interior abruption issues, etc.

Im curious to see what everyone else says.

 

[impromptukiss]

with our homebirth (#2), i had no u/s. i didn't feel the need & that the benefit outweighed the possible risks.

this time with be our second h/b, and i am still not sure if i will have an u/s or not. i had a m/c last pregnancy, so i'm still a little freaked out, adn it may give me that reassurance ... who knows.

 

[DoulaLMT]

I will have a 20 week ultrasound. But it wasn't really a decision for us - my FIL is an ultrasound tech and told us before we even conceived a child that he wanted to do an ultrasound on his grandkids at some point. He's 2 states away, or he'd probably be pushing us to have one now. So if I have to have one anyway, it might as well be at 20 weeks so we can find out the gender of our child!

I'd hate to deny him that privilege...so for us, it took me from "well.....should we??" to.."Ok fine I'll do ONE"

If it wasn't for that, I'm not sure what I would do. Those are some good arguments for them, in the case of homebirth....and of couse the potential risks.....

I guess I'm glad we have the situation we have.

 

[StrawHatBrat]

i honestly think it's responsible to have the 20 week US if you are planning a home birth. They can find things during the ultrasound that would warrant a hospital, or such. What if you had previa? What if the baby needed special care? what if.....

I don't believe the potential risks of ultrasound are worth skipping them all.

 

[To-Fu]

Could someone link me to some reputable sites talking about the potential risks of ultrasounds? I was planning to have two total performed during my pregnancy, and hadn't heard they could be harmful to my shrimp or me.

 

[NZmumof2]

As a family doc I counsel my patients to have an NT only if they want the infomation it gives. If they are going to continue the pregnancy no matter what why do the scan?

As for 20 week scans I don't have all the stats in my head but around 20% of heart defects alone are not picked up. It is true it may show a low lying placenta but a care provider should be able to identify this in late pregnancy usually because of malpresentation (if the placenta is down by the cervix the baby's head doesn't fit so they have an unstable lie).

I encourage my patients to have a 20 week scan because most major abnormalities can be seen and because I attend births at a rural primary care facility more than an hour from a NICU I prefer to have a bit of warning, I remain aware that a scan could well miss a significant abnormality and we do have the facilities to resuscitate and transfer babies if needed.

On a personal level, my partner had a 20 week scan that showed our baby had a "soft sign" of Down syndrome and CF (echogenic bowel). We spent the rest of the pregnancy worried about this, he was born perfect - we opted not to do an amnio since we would never terminate a pregnancy. So now I also know the unnecessary angst these scans can cause.

I'll be having regular growth scans from 24 weeks due to previous PET /HELLP so I'll just get them to look at the anatomy on the first one to limit the number of scans as much as possible. I do think the growth scans can help us check the baby is safe in my case, because I am at risk for IUGR and I would absolutely want to know that and avoid a stillbirth from not knowing the baby was starving.

Anna, partner to Leah for 10 years, mum to Bede 7, Emmett 3.5 and one due in Jan 08

 

[lilylove]

Here is an article that goes into the risks and also addresses the accuracy rate a little bit. We're not doing an U/S. I don't feel it's necessary for us.

 

[rootzdawta]

I'm unsure too. When I had the U/S with my first, I could clearly see it was bothering him and he would not position himself so the tech could take a good picture. One part of me wants to see my little pumpkin's hands and feet and show folks the picture and have it for the memory books. The other part of me doesn't want to do unneccessary "stuff". So I'm still thinking about it. The only problem I'm concerned about really is placenta previa but that is only because one of my good friends just dealt with that. I wonder if a skilled midwife would be able to detect this without an ultrasound?

 

[impromptukiss]

Quote:

Originally Posted by rootzdawta The only problem I'm concerned about really is placenta previa but that is only because one of my good friends just dealt with that. I wonder if a skilled midwife would be able to detect this without an ultrasound?

my midwife told me exactly where my placenta was without an u/s last time. we did still use the fetal doppler once a month (which i still wasn't thrilled about ...), and she was able to tell quite easily.

 

[LaurenB]

Quote:

Originally Posted by lilylove Here is an article that goes into the risks and also addresses the accuracy rate a little bit. We're not doing an U/S. I don't feel it's necessary for us.

Thank you!

 

[JunebugsMom]

If you are interested in any sort of genetic testing definitely do the nuchal scan--much less invasive and scary than an amnio!

With my son they found soft markers for down syndrome when they did the 20 week u/s. We ended up doing the amnio not because terminating was ever an option for us, but because we were just a nervous wreck and I couldn't imagine being that stressed for the remainder of my pregnancy. Everything turned out fine, but I will not get an amnio ever again. This time I will get the nuchal scan and well, I'm high risk for many reasons so I will end up getting several other ultrasoundsthroughout the pregnancy. It's my personal opinion that the risks of u/s is minimal.

 

[lilylove]

Quote:

Originally Posted by LaurenB Thank you!

Your very welcome

 

[KittyTheCat]

I'll have one at 20 weeks as well, mostly to appease my midwife. She suggested I have another at 35 weeks to check if the placenta has moved, but I doubt I'll do that. At least not unless the 20 weeks one shows the placenta to be low. In that case I'd check again later to see if it has moved.

 

[Free Thinker]

I will be doing one US at 20 weeks and another later at 30-32 weeks. I feel confident that the US is relatively safe,and I also feel more comfortable b/c I will be giving birth in a small rural hospital. If any major problems were to show up, I would want to be sent to a bigger hospital 3 hours away (versus my local one an hour away). The small hospital can do routine things, but they don't have a fancy nursery,and baby would be airflighted to the larger hospital of there were any major complications or problems. Some friends of ours had a baby w/ trisomy 13 a few years ago, and b/c of the US scan they knew something was wrong. They decided to deliver him at a special children's hospital several hours away b/c of this. He lived longer than most trisomy13 babies, and in all honesty he probably wouldn't have if he were born at our local hospital. I don't know what level our nursery is considered, but they typically will not deliver here before 34 weeks, nad prefer 36 weeks. If you go into labor before that you are stabilized (if possible) and airflighted to a larger hospital, same for baby. They just do not have the ability to fund the machinery needed for preemies here.

 

[MCKH]

Not quite in your DDC, but I really support the 20 week ultrasound. I always think it's better to be safe than sorry, and there is a lot of information (placental problems, cord problems, too low or too much amniotic fluid, heart defects, neural tube defects, genital/urinary tract defects, general atypical anatomy, etc.) that can be picked up on a level II or III U/S. I have absolutley NO concerns that ultrasounds are unsafe, particularly that late in a pregnancy when everything has already been formed. We are planning a homebirth, but personally I would want to be at a hospital with a world-class NICU at hand if there were a detectable problem. In the end, it's each mom's choice but that's my 2 cents

 

[LaurenB]

We will not be doing a routine U/S. If something came up and my midwives thought it was necessary, I would consider it. But otherwise, no.

 

[leewd]

Personally, I choose to do 2.

One early (9-12 weeks) to make sure it's really a baby and it's in the right place. I will not announce to the PIL that I'm PG without this.

Another at 20 to make sure the baby is anatomically correct. if there are any major issues that warrent a hospital birth, they can be found at this point.

I do NO other testing becuase we will not terminate unless (perhaps) the baby could not survive and this I'm not even sure about.

When we had a 30-32 week u/s with #1, they found a blip on one kidney that turned out to be a "multi-cystic kidney." Long story short, that kidney never developed. She has one perfect kidney that does the work of both. Had we not had the scan, we would not have known. HOWEVER, had we not had the scan, we would not have to go to a urologist every year and get a perfectly healthy child checked-out. She would not have been on anti-biotics for the first 6-7 weeks of her life which stripped her intestines and gave her diarahea for 2 months. The knowledge of this non-problem has caused more problems than it has solved and it has cost us a lot of money. (not to mention, my MIL sending out gossipy "prayer requests" for DD because she considers this an actual problem. "Oh, what if she needs a transplant!" Oh, please, look at the statistics. Unless she has major trauma to her good kidney, this is extraordinarily unlikey. And besides, at this point she has 1.5 siblings who most likely have 2 kidneys. We've got doners!)

This is why I choose not to have 30-weeks u/s anymore.

(Now, stepping down off soapbox. Thank you!)

--LEE

 

[kehliouise]

I am also with you on the indecision. The only thing is that my midwife doesn't even offer a 20 week or earlier ultrasound. I believe she will offer one at 32 weeks or something. I just have a lot of anxiety about this pregnancy and would feel a lot better if I could get that 20 week one and see that all the organs are there and everything. The first part of my first pregnancy we were being seen by a ob/gyn and not a midwife, so we had 2 ultrasounds. They both showed a perfect baby and I never had any worries. In november we had a miscarriage, and now I worry and having one this time. I also worry about birth defects and all sorts of other things, that I never considered worrying about the first time, but do now because of the past miscarriage. I am wondering if I do decide that an ultrasound would benefit me if I can insist on having one before 32 weeks.

 

[naturemama1]

My feeling (and my midwife's) is that the later you can hold off your u/s exposure, the better for the baby. In your shoes, I would choose to do a 20-week ultrasound rather than the earlier nuchal translucency test.

Personally, I try to avoid u/s exposure as much as possible, especially during the first trimester when so much formation is going on. I've declined the doppler so far, since learning a couple years ago that a doppler uses an even more intense stream of ultrasound waves than an u/s machine. I don't "need" to hear the heartbeat this early. I trust. And at 20 weeks we can start using a fetoscope, which will be a total thrill!

That being said, the reassurance factor is huge for a lot of women, especially women with negative history behind them. I have a dear friend, pregnant with #4 (third pregnancy), who needs a lot of reassurance and early scans, doppler checks, etc. At a certain point, if you're getting really worried about it, the stress is going to have a worse effect on your baby than the u/s exposure, IMHO, and at that point I think it's a valid compromise to make.

It's all good, basically.

Do the best you can within your circumstances -- isn't that what life's all about?