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Discussion Starter · #1 ·
I need some advice whether to have a 20-week u/s or not. This is my second pregnancy. With my first, I had agreed to every test because I started out at an OB/Gyn practice and was made to feel that they were all necessary. Then I switched to a free-standing birthing center, where I realized that most of the tests were unnecessary. The even said that they don't routinely send their patients for ultrasounds unless there are specifici indications.

Now we live in a different area, and I am being seen at another free-standing birthing center. While they don't require most of prenatal testing (except for the glucose test, which I'm not too thrilled about), they do offer them somewhat suggestingly. In the beginning, I was set on completely avoiding u/s during this pregnancy. And now I've already had two, both intra-vaginal. The first one was done b/c I had some discharge, and the second one to confirm the due date. In both cases I felt that the ultrasounds weren't really all that useful. If the bleeding continued and ended in a miscarriage, then there was nothing an u/s could do anyway, and the dates I don't terribly care about, as long as the midwives don't get too nervous if I go over the due date.

I know that this 20-week ultrasound is supposedly important, so the baby's anatomy and placenta position can checked, but I'm still not convinced of its importance. On the one hand, an u/s is fairly benign and unintrusive, on the other hand, is it really necessary? I mean how many tests do we need to do to have a piece of mind during pregnancy? From my experience so far, the tests themselves frequently introduce unnecessary anxiety. I am now 19 weeks pregnant and need to make a decision within the next two weeks. If you have any advice to share with me, I'd greatly appreciate it.
 

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I don't do u/s at all without medical reason. And having a look-see and finding out gender isn't medical reason.

-Angela
 

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I have mixed feeling about the 20-week ultrasound. After the AFP triple screen blood test which I was more worried gave us beautiful results I decided to do the 20-week ultrasound. At that appointment, I found out DD had a two-vessel umbilical cord. Essentially, she was missing an artery in the cord. She had one artery and one vein whereas most babies have two arteries in the umbilical cord and one vein. In and of itself the anomaly isn't something to worry about and the majority of babies who have such an umbilical cord are normal but some babies who have a two-vessel cord have heart and/or kidney problems. There's nothing to be done for the baby until she's born. Needless to say I spent rest of the pregnancy worried about whether DD would be ok or not. I think my ultrasound gave me too much info. The doctors would have known DD had a two-vessel cord even w/o the ultrasound because when they cut the cord at birth they can tell if it's a typical three-vessel cord or not. I recall my OB cutting the cord during my eventual c-section and proclaiming, "Oh..Look! She has a two-vessel cord!" Um..yeah, thanks. I already know THAT!


DD is totally normal btw.
 

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Discussion Starter · #4 ·
Quote:

Originally Posted by alegna
I don't do u/s at all without medical reason. And having a look-see and finding out gender isn't medical reason.

-Angela
I don't know where you found any mention of the baby's sex in my post, but I'm NOT at all interested in finding out this information. In fact, if I do elect to have the u/s, I will specifically request that they DON'T tell me the baby's sex, just like we did with our first.

The intent of my question was to find out if there is a medical indication warranting the use of the 20-week u/s, i.e. how important it is to have the information about the baby's anatomy, placenta placement, etc. If you have any comments about that, I'd be more interested to hear them.
 

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Quote:

Originally Posted by natural mommy
I don't know where you found any mention of the baby's sex in my post, but I'm NOT at all interested in finding out this information. In fact, if I do elect to have the u/s, I will specifically request that they DON'T tell me the baby's sex, just like we did with our first.

The intent of my question was to find out if there is a medical indication warranting the use of the 20-week u/s, i.e. how important it is to have the information about the baby's anatomy, placenta placement, etc. If you have any comments about that, I'd be more interested to hear them.
I wasn't meaning you specifically, just in general


The OB/Gyn organizations say they shouldn't be used without reason. A normal pregnancy has no reason.

-Angela
 

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Well from my own experience I will always have one u/s to have a look at the placenta, make sure baby's organs seem ok, etc.

With ds I was very mainstream so I was very excited about my 20 wk u/s cause I wanted to see the baby and know the gender (I'm totally the opposite now!). The doc was really quiet and then kept asking me if I'd had any bleeding which I hadn't. Turns out I had a complete placenta previa. That's one of those things that is always means for a c-section. Now lucky for me the previa cleared up in my last few weeks of pregnancy and I was able to have a vaginal birth. However I now have a personal fear of having an undiagnosed previa and losing the baby and possibly even myself. Also I wouldn't want to give birth in a birth center or at home if it can be determined that there is something wrong with my baby that would need immediate medical attention upon birth.

I know these things are all very rare. So I guess in the end you need to weigh the risks of the ultrasound with the risks of not "knowing" about certain things. I know there is a thread on MDC somewhere about the risks of ultrasounds and links/studies to back it up so you may want to start there.
 

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Hi there,

My birth center does not do u/s unless there is a specific reason either. I didn't have one with DS (Jan '05) and I have not had one with this pregnancy either (I'm 36 weeks). The difficult thing for me is that when I was pregnant with DS it really didn't even cross my mind. I knew that u/s don't improve outcomes, how there is debate about their safety, and how they often create worry about problems which ultimately don't exist - so I was perfectly content to not get one.

This pregnancy has been a bit different, and I've felt like I wanted a u/s from early on. All along I've had this "nagging feeling" that I should "just check" on the baby, BUT along with that has been a very strong urge to find out the gender. So, I've come to the conclusion that my nagging feeling was more a result of wanting to find out gender then a true worry about the baby. Rationally, I do believe that there are other indicators of serious problems, and other problems can be identified at birth just as easily as by u/s.

Yeah, I'm kind of rambling lol......but I guess we will see when this baby comes if I was worrying for nothing, and for now I am working on trusting that everything is fine!

Suzanne.
 

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I would have the 20 week u/s no matter what....

I had a stillborn son who died at 26 weeks due to no fluid and it compressed his cord. If I had stayed at the doctors I had first attended, I would have had an u/s the week he died. If I had gotten the u/s and it showed his low fluid, I could have been admitted and gotten the fluid levels up, preventing his death.

I did not know this until I was pregnant with my daughter in which it happened again, I had low fluids which had caused her to have decels whenever she compressed her cord. It wouldn't have been figured out without the u/s since I was measuring fine, and her heartbeat was good at every appt. And even with NST's 2X a week, the u/s that they did in the clinic was off. One day I measured 10 and the next I had only 3, since the nurse couldn't see the cord in the lower quality u/s. I ended up delivering her at 36 weeks due to no fluid and decels. Luckily, they caught my low fluid before it was too late and I lost another child.
 

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Mary. Having a 20w ultrasound definitely sounds like the right decision for you.

Most midwives (who spend much more time palpatating than OBs) can detect low fluid levels, or at least a suggestion of it, in which case there IS a medical indication for u/s. It is not recommended even by ACOG (American College of Obstetricians and Gynecologists) for routine use, only for medical indication. Although there are unknown risks, and known changes that occur with ultrasound, it's also not as dangerous as, say, prenatal X-rays, or murcury-laden shots.

I don't think there's a "wrong" decision, but if it makes you feel less trusting in your body or birth, then there's reason not to do it, y'know?
 

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This is one of those things about which I am quite ambivalent. In my past 3 pregnancies, I always had ultrasounds. When we lost pg #2, we had had a regular abdominal scan (the 20 week one) just 3 days before. So I know first hand that it doesn't prevent tragedies. Because of that loss, we had lots of scans with pg #3. But the good thing about that high-tech monitoring was that it made the same process unnecessary this time around during pg #4.

But, I'm in the 'window' of vulnerability for cervical failure (roughly 18-21 weeks and I'm now 19w, 3d), so a quick u/s to check the cervix and the baby's overall well-being was logical.

My dh lives in constant fear of having his heart ripped out of his chest again, as it was when we lost little Nathaniel (pg #2). So this u/s was also something that I think he desparately NEEDED to relax and let himself love this little creature growing inside me.

So, I think sometimes medical necessity is not the only consideration. Sometimes our peace of mind is just as important.

FWIW, I'm overjoyed that I finally made the decision to have the scan. Now I feel better able to go through the rest of this pregnancy without the constant fear nagging at me.

Good luck with your decision making process. This is a very personal decision that everyone should feel able to make for themselves and with regard to their own situation and history.
 

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I was concerned about u/s exposure and all and after reading about it, I eventually had the 20 week u/s for the following *personal* reasons (i.e. I don't mean these to apply to anyone else but myself. Just a disclaimer, heh
: ) :

* Yes, there are some possible ill effects, but honestly one or two ultrasounds don't worry me too much. Many ultrasounds? No, I personally wouldn't do them without serious reason. It's like this: I drink tea and soda while pg even though large amounts have been shown to cause issues. Many mamas drink some alcohol while pg (even daily) even though large amounts of it causes issues (do a search on MDC for wine during pregnancy). Where does one draw the line? Everyone has to do their own personal risk assessment on an issue that is so inconclusive (which ultrasound is, IMO...a big grey area).

* I wanted to check all the major organs and check for placenta previa, amniotic fluid levels, etc. I had a concern that perhaps the over eager sonagrapher would "diagnose" something that wasn't there. What reassured me was finding out that my birth center uses a doctor who has a long track record of accuracy in reading ultrasounds. I felt much more comfortable that I wasn't having some amateur doc/tech who wanted to "see things" that were not there. Had this not been the case I don't know if I would have chosen to go forth with the u/s or would have specifically requested not to know about anything on which they were unsure or waffling.

* It is definitely reassuring to hear "four chamber heart", "lungs and kidneys there" etc. etc, even though you never know what will happen in the future. My dh has some relatives and their ds was born with major organs missing/out of place so immediate surgery was imperative to save his life. Does this mean I think all people should get the u/s? No, but for many people getting that info is important for them.

* I know this would be a controversial statement, but my midwife's personal opinion (even though she constantly stressed that it was MY decision) was that seeing the 20 wk ultrasound and knowing everything was "in order" is a big factor for her in knowing that the pg is really "low risk." Of course other issues could come up and change the risk factor but it is a big reassurance for the mom too (in my case) to see that as far as anatomy goes, so far we're all good.

Ok sorry for the
but I hope this helps. Good luck with your decision!
 

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I willingly agreed with my first, and was glad I did because it led to the diagnosis of my incompetent cervix. This time around, I'm of even higher risk, so I have even more frequent (more frequent than my liking, too...every 4 weeks) ultrasounds to monitor my various problems. While I'm not thrilled by the idea of so many ultrasounds, thus far they've been quite helpful in identifying problems that we've been able to "fix" before they became harmful to me or baby.
I do not know the gender of my baby, even though I have ample opportunity to find out. I'd much rather have ultrasound out of medical necessity than out of curiousity. I never understand the Dr's who allow their patients to make follow up ultrasound appointments so they can learn the gender if it wasn't apparent at the 20 week anatomical scan.
 

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we have decided to avoid all medically unnecessary tests. In that I mean if there is not a medical indication for a test we don't want it. The risk of false positives and the worry and stress they cause is the main reason. The other is that we wouldn't terminate based on a maybe.

If something were to arise, unexplained bleeding, lack of movement for days and days etc... then we'd think about it.
 

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my only reason for doing the 20wk u/s was to ensure the placenta wasn't anywhere near my cervix. We are home birthing, and don't need a 'bleeding surprise' if I had placenta previa!
I still didnt' find out the sex, and I made the u/s tech talk me thru each step, so it was a learning experience for me as well. In these cases, it was worth it to me.
 

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I had one with DD, and will have one again. I am 36, and I turned down all the genetic screens, etc, but I acknowledge that I am old enough for my baby to have higher risk of some things that would change how I would approach birthing. I'm currently planning a home waterbirth, but the u/s can identify several situations which would cause a change in plans. That said, I think it is really important to find an u/s tech with a lot of experience...

Also, I absolutely loved the impact that "seeing" DD had for my DH, and I think DD will really like seeing "her baby". Perhaps not a reason to have an u/s, but it was a wonderful side benefit for us.
 

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I had bloody discharge early in my pregnancy (followed by an intravaginal scan..ugh) and the 20 week u/s confirmed for us that I did not have a partial placenta previa or other placental anomaly.

Since you did have some issues early on it may be worth checking to see if the placenta is in the right spot. A partial previa may not cause problems during a vaginal delivery, but it can add complications so it's good to know ahead of time if that's something to be prepared for.
 

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I've been on both sides of this fence, and it doesn't make it any easier to decide. With my second baby, we were going to skip the US, but had one when we still couldn't hear a heartbeat around 18 weeks. Heart was fine, just bad positioning, but the US showed a kidney abnormality that ultimately required surgery when she was 6 mos old. Knowing about that didn't change anything about my pregnancy, labor, or birth, but it did change the way we managed things after she was born. There's always the chance that she would have been fine, but there's also the chance that she would have contracted a serious infection and lost the kidney, or worse. So I was glad we had that information.

With our third baby (due any day now, we're all ready for you, come on out!) we had the US because the kidney condition is genetic. Kidneys looked fine, but we had a scare about ventricle size and were completely and totally stressed out for two weeks. DH had a grand mal seizure the same day, as a result I believe, and couldn't drive for months. And of course everything is fine, all the stress was totally unwarranted and our lives were changed dramatically and irreversibly as a result.

Soooooo... no help from me
: I have one baby who could have had serious trouble if we hadn't done it, and I have one baby who looks to be just fine but scared the daylights out of us unnecessarily.

In general, you have to do what's within your comfort zone. If you don't see a reason, skip it! I honestly don't know what I'd do if we get pregnant again.
 

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Quote:

Originally Posted by mamafish9
I am 36, and I turned down all the genetic screens, etc, but I acknowledge that I am old enough for my baby to have higher risk of some things that would change how I would approach birthing.

I'm in a similar situation; I had a level II u/s because I just turned 40 but turned down all other tests (blood, cvs, and amnio). Waiting for the test made me extremely nervous, but everything checked out fine.

I know this is a very difficult decision. My biggest concern was being told something was wrong where everything is fine and the tremendous stress a false positive would cause me. I struggled with this but decided in the end that I'd rather know about all the "what-ifs", even if they are false positives, rather than be in the dark and worry anyway. And the test itself is harmless (after all, it's based on sound, and we are all bombarded by sound waves every day).
 

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juliansmom - by that reasoning, sonic blasts (which can burst eardrums) are harmless also. I'm not someone who thinks that ultrasound is "SO dangerous!", but it's not benign/neutral, either. Therapeutic ultrasound is used because it DOES have an effect on the cellular level (I used to get therapeutic ultrasound when I went in for medical massage). Fetal cells in rodents have shown changes based on reactions to exposure to the level of ultrasonic radiation found in standard diagnostic sonography. Fetuses react to the noise of ultrasound - they can hear it (it's not "ultrasonic" to them) and they seem to not like it (they tend to pull away from the source of the noise).

High levels of background noise is stressful to the human psyche and physiology, and has been shown to increase stress and lower immune function. Not to mention the headaches things like unwanted rock music causes.

I don't think all of this is enough to reject an indicated or desired ultrasound, but it would be false to say it's an entirely passive, neutral test. It DOES have physiologic effects on the fetus, even being "just sound".
 
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