Not having a 20week scan? What can be done for child at that stage?(36 Posts)
OK, so this seems to be mostly about choices after tests... if it isn't the right places for choices about tests please let me know!
I'm considering not having the 20week scan for the following reasons
1) I personally wouldn't abort (except in case of likely maternal death) after 20weeks
2) I will (anyway) be giving birth within minimal transferring distance of Great Ormond Street which seems to be the alternative suggested outcome in case of most abnormalities that could be found.
3) There is only a /tiny/ chance of them finding anything that can be fixed in utero (some types of diaphragmatic hernia only as far as I can make out from reading up/talking to the screening dept.)
4) Long term effects of scans are unknown (not been done for a generation yet) and there is some evidence that they can alter the handedness of babies, i.e. mess with their brains. Nothing wrong with being a leftie, but definitely not happy about changing the brain of an unborn child for limited potential benefit.
So, what would help me decide for the scan? Some more information on number 3 I think. If there was anything that could/should be done pre-birth it would alter the balance.
Does anyone know of any stats or even anecdotal evidence on this? My MW has never come across anything being done in utero although I do have one friend who had surgery on her/the baby.
Thank you for getting to the bottom of this!
I would say it is about being prepared for any eventuality.
If they find that your baby has a specific illness they can have specialist doctors ready to help without waiting around.
Sorry posted to quickly.
Even if they cant help in utero they can be prepared to do anything needed after the birth.
I know of people who have found out about heart/kidney problems during the scan which needed immediate attention post-birth, so they had to give birth in a particular hospital and have a specialist team standing by.
Also isn't it a good idea to know the position of the placenta?
If you only had to have one scan in pregnancy this is the one I would choose . It picks up any abnormalities that may need special treatment at delivery . And more importantly position of the placenta .
But I do agree with you on the little known effects of scans and the issues it may have on the brain ( how do we know that it is not that that causes the amount of children whom seem to have some kind of behavioural issues nowadays days )
So I would be cautious in that respect .
If your earlier scan was ok then it's likely to be fine but you could also find some serious conditions that will require immediate intervention to prevent suffering. That's what happened with my fourth. I can't imagine why anyone would take that chance.
I think some conditions would need treatment immediately with paeds on hand.
Also if you have a low lying placenta you NEED to know.
I think they can also check growth, and if the baby is not growing properly maybe book you fir further checks and possible early delivery/intervention if the womb environment isn't optimum?
Though I don't think there is much they can actually do at 20 weeks, just prepare for future situations?
My friend had a kidney problem picked up at the 20 week scan. The baby was monitored after birth and put on antibiotics to prevent urinary infections. The issue was cured by a simple op aged 1. If it hadn't been picked up at scan their baby would have suffered painful urinary infections and much more invasive interventions until the same diagnosis would have been reached and the first year of his life would have been awful and full of pain. For me that alone would be a good enough reason to have the 20 week scan even without the other stuff they can find out.
The left-handedness study was inconclusive, and never repeated because it was ruled unethical as scanning mid-pregnancy had such huge and overwhelming benefits. Given that scanning in 1st world is nigh on universal, and there is no increase in left-handers in the population, it does suggest that the Swedish study is not sufficiently accurate.
If they discover conditions incompatible with life at do not show up at 12ish weeks (eg certain kidney problems), then you might want to know about this in advance. Also, if there are some types of heart problems, your baby's survivability might be affected by labour choices and availability of cardiac paeds team. In London, this might mean delivery in a hospital which does both labour and top notch paeds - would you like to be stuck, even if only briefly, in hospital A whilst your baby was in hospital B, when you could have arranged it so no separation was needed? And there are a few conditions in which a treatment plan can be begun before birth, with better outcome than if they have to take the time diagnosing after.
Fortunately, most babies do not need immediate, specialist intervention and it is totally your choice.
Hmm... interesting responses. Seriously, all your replies are genuinely helpful in making the decision. Thank you!
I'll be giving birth with care from UCH because it is closest to me and seems good. It is also where I'd be referred from elsewhere if any complication was found as far as I can make out. So, given that as far as I can tell most ops (e.g. for bowels having grown outside baby/heart/kidney issues) that we could be prepared for need to be done/started within days rather than hours at the soonest I'm not sure how much difference the being ready makes for a UCH birth? (If I was far from a large teaching hospital/specialist children's hospital that would obviously be different).
In terms of placenta position I was rather hoping for a 34+ week scan (which is offered at UCH) as I think that is what they do anyway if they see it is low during the 20week one? (Apparently they can move a bit during pregnancy?!?) Plus that would give a better idea of likely presentation which could make a difference to VB/CS choice (as far as I can tell VB is now still recommended for most things they can find at 20weeks, even the bowel-out-side-of-baby one which surprised me).
Has anyone had any experience of a positive intervention for the baby?
So you are planning to have another scan, but you just want it at 34 weeks rather than 20?
Ah, more replies - thank you noblegiraffe and scaevola, I hadn't seen your responses when I typed the above.
With regards to the kidney thing I'd be really interested to find out why they couldn't just scan the baby's kidneys once born to diagnose, although I have been told it is not usually done I'm not sure why?
With regard to transfers scaevola I totally agree - if I wasn't where I'd almost certainly end up being transferred to to start with that would be a major factor for me.
SamSmalaidh - the original MV I spoke to didn't particularly encourage the 34+ one unless there was a cause for concern discovered later but I think baby & placenta position would make a difference to my birth plan (e.g. MLU in hospital vs consultant lead ward) so, to an untrained eye it seemed like a good plan.
Plus, baby much more developed (I know lot is done by 20wks but they also pick that date as it is easy to get a pic of whole baby in one go beofre it gets too big) by then so I'd be less concerned about the brain.
So, I guess not 'planning' a 34 week one yet (will speak to MW nearer the time) but I can certainly see good reasons for one for me more easily if that makes sense!
The scan for ds at 20 weeks did pick up on a minor kidney abnormality. This meant he needed an ultrasound at birth, and if it had been bad enough, would have been further treated (treatement is fairly conservative eg. antibiotics). It's exactly the sort of thing that is picked up on earlier rather then later and if necessary can be treated immediately.
As it happens, he is probably left handed, but then so are two of his aunties and grandparent.
I know another mother who's 20 week scan picked up on a serious heart defect. The mother was given medication and the baby was delivered safely and went on to have further treatment. That problem would have been fatal if the scan had not picked it up.
My nephew had kidney problems, picked up at 20 weeks scan. Wasn't much they could do before birth, but meant he was started on antibiotics a few hours after, to prevent kidney infections. Wouldn't have been picked up otherwise until he became very ill.
And my friend's baby was picked up as failing to grow properly at 20 week scan - they had no idea previously. She was monitored closely, given steroids and delivered early as he had more chance that way - he was very small for dates though so clearly hadn't been growing properly. He's fine now, but most likely wouldn't have been if they'd not picked up the problem when they did.
I don't think it's just about picking up severe abnormalities and offering abortion choice at all.
Like others have said the main benefits are to identify any issues with baby that might need specialist help at birth and to check the position of the placenta. I had understood that it can actually be harder to see things in a much later scan as the baby is so squashed?
We didn't have the tests for Down's syndrome as we knew we wouldn't take any action based on that but wanted the 20 week scan for the baby's sake - in case it needs help when born.
If there's something seriously wrong would they not sometimes schedule a section so they can be sure the right people are available when baby is born rather than if you have birth in the middle if the night or at the weekend?
The example you mentioned of diaphragmatic hernia really struck a cord with me as that is precisely what my son was diagnosed with. Like you, we did not consider termination. But having the diagnosis meant that we were given extra and specialist care in pregnancy and labour and because his condition was known, there was a team of about 10 various doctors/nurses waiting to 'catch' him and he immediately got the life-saving attention he needed.
Without the antenatal diagnosis, he could have died before we ever knew what was wrong with him. As it was, we still knew he could die but had had weeks to prepare and read up on the condition. So, for me, the opportunity to prepare myself was what made the scan/diagnosis worth it. And chances are your 20 week scan will be totally fine. Please don't worry!
GingerJulep - it would be a logistical nightmare to scan all new born babies's kidneys on the off chnace that a small percentage of them will have this kidney problem.
It would mean new mothers queing up in the waiting room witing for the scan when they should be at home resting and bonding. So it is only done when there is cause for concern following in utero scans.
It is far more convenient - faster, more economical - to check the kidneys along with all the organs and limbs and placenta checks, amniotoc fluid checks and all the other things they do at the 20 week scan. Can you imagine individually scanning all the organs after birth?
Personally I don't believe there's anything wrong with scans or we would know by now. And if there was, it would be at the 12wk scan or earlier as its the first three months of a baby's development that are most crucial and vulnerable. So a scan later in pg is less likely to be damaging. On your other points, having TFMR-ed at 20wks and 29wks, don't have a scan until after 24wks as after that they'll only put TFMR to you as an option if any condition is fatal/seriously serious. It's not something undertaken lightly. I don't think you'd be risking much with your baby by having a scan post 24wks than 20wks if that would make you feel better. Anyway, the vast majority of scans never identify any problems; just in an unfortunate minority. I'm sure you'll be just fine.
Actually there are illnessess that can be found at 20 weeks and treated saving the babies life. Hydrops, pleural effusion, acsites, etc. This alone is reason to have one. Also for severe birth defects (missing skull/brains etc) finding out in advance and preparing could make a lot of difference. In addition although people say they would never do soemthing they never actually can say for sure until faced with it, trust me I was one of them!
As for the safety of scans, I had one every 1-2 weeks all the way through as had massive complications, previous stilbirths and losses. DS is very healthy and very very bright. My DT's I also had loads of scans and they too are fine. One of the 3 are left handed but that is no problem they are bright. In addition scans can help bonding with the baby for mum and dad/siblings.
Yes, you can scan a baby; once you have some idea of what you're looking for, and after the baby has had the full gamut of crash interventions when they haven't a clue what's wrong and have to throw everything at it to maintain life before investigations start.
I suppose it's a case of whether you want foreknowledge to maximise the chances of best possible care, or if you're happy to play the odds that most babies do not have life-threatening conditions. If you find the one (inconclusive) study more persuasive on safety than the other evidence (no general rise in LHness) and this is a real concern to you, then of course turn the scan down.
A relative's baby had a heart problem diagnosed in utero. Poor scone has had loads of treatments throughout his life but is doing well now at 9. Apart from the clinical reasons I think it would be much emotionally better to know in advance and to get the chance to put support in place.
I know someone who did not have a 20 week scan (was abroad) but luckily had a scan close to birth due to possible breech as they discovered hydrocephalus which meant baby had a big head & would not have been possible for VB.
Had they known earlier they would have induced earlier, meaning baby would've had shunt put in earlier meaning less risk of brains damage.
The scan also meant they could do the section at a hospital which would also do the neuro surgery, meaning no sudden hospital transfers just after birth.
I think you'd be crazy not to personally. For your own health- and for your baby.
If my son's heart defects had been picked up at his 20 week scan or his post natal check, he would have been put on medication at birth until he could have his op. As it was, he collapsed with a cardiac arrest before we knew what was wrong and wasn't expected to survive. Thankfully he did but the long term effects on his heart are a lot worse then they could have been.
So many responses, but I think no one has mentioned checking the baby's growth/ condition of the placenta, for which they can help whilst the baby is in utero.
I personally think that the 20 week scan is very important, not matter what you think you may do in response. I had a 20 week scan that detected a much smaller than expected baby and a major heart condition. Each on their own would have had treatment options, during and immediately post pregnancy.
Unfortunately following further investigation it was found that our beloved baby daughter had a fatal chromosomal condition called Edward's syndrome and that she would not survive outside of my body. Suddenly there were no options but to tfmr.
I think it can be easy to be blasé about the 20 week scan until you or someone you know gets bad news. In the heartbreak of my situation, I was grateful that I had discovered this at 26 weeks rather than at her birth.
I guess it's just all about weighing up the risks but I would say that knowledge is power.
Just a thought.
I had the same experience as MyAngelAva.
I had previously felt the same as the op.
I too used to feel the same as OP.
At my 20 week scan we discovered my DS had no kidneys and as a result no amniotic fluid or developed lungs- a condition incompatible with life. The 20 week scan can at the very least prepare you for having to say goodbye to your child - whether one chooses to take no action or induce the pregnancy . This is not meant to scaremonger but as the question was asked i wanted to answer- It is a desperately horrific situation which made me realise why the nhs offers the 20 week anomaly scan.
hi I had a 34 week scan privately, and as indicated above, it wasn't particularly helpful for any of the diagnostics done at the standard 20 week anomaly scan. I had it for reassurance as a very close family member had a still birth that week due to problems with the placenta ( which weren't and couldn't have been picked up at 20 weeks). They were able to check condition and blood flow through the placenta but not much else as baby was too " squashed".
I had DS1 at UCH,a friend had a son born with a serious heart condition there. This should have been picked up at 20 weeks, but wasn't for some reason- guess they are not infallible. The UCH medical team didn't pick up any problems for several hours and he was extremely sick despite proximity to GOSH. It's usual practice at UCH to discharge after 6 hours even with first baby if normal delivery and all seems ok. fortunately they were kept in overnight otherwise outcome might have been different- he had emergency surgery and is now fine. Thus I'm adding to the view that a ( properly done) 20 week scan will help you be prepared as well as the medical team.
My DS4 has just been diagnosed with a cleft lip at the 20 week scan. We've been referred to various people and a lot of support has been offered. It's not essential to know beforehand but I'm glad I do.
20 week scan is important, even if you're adamant you would never have a termination(As I was until I was faced with the heartbreaking decision 14 years ago) a lot of heart defects can be picked up , Neural tube defects, some are lethal some aren't but cause paralysis, even if you are prepared to look after a disabled baby would you really not want to know in advance? My first was born with a cleft lip and palate and it wasn't picked up on the scan,16 years ago. My daughter is doing great now but i'll NEVER forget the m/w announcing 'IT's got a cleft lip and palate' (I had chosen not to find out the sex of my baby after a 32 week scan so for her to be called IT in that manner was very distressing) I badly wanted to breastfeed her but it was never going to happen. I would have liked to have been prepared, I didn't even buy any feeding equipment.
A friend of mine found out baby had hydroccephuls (sp?) at their 20 week scan. Without knowing this the specialist treatment could not have been in place o. Birth and a gorgeous little baby boy would have almost certainly have died.
There is no real evidence that scans cause harm and why would you not want your baby to have the best possible start?!
Apart from the fact you could be prepared for any eventuality that might occur you have to consider that 34 weeks is too late for anything to be done if baby isn't growing as expected never mind the hospital prepared for problems with placenta position.
It is ultimately your choice but think very carefully. The study you have read was not completed and was inconclusive.
I think you've been given plenty of reasons to have the scan, and I would just like to dispute your claim that they haven't been in place for a generation: my dm had scans (I know because my scan picture is in my baby book) and there is no obvious ill effect on me and my contemporaries compared with the cohort born in the previous decade.
How Woolf you feel if your lo was one of the rare cases that it wouldmake a tell difference for to find out at 20weeks gestation?
I have to say, I agree with the overwhelming majority here who are advocating the scan. I never thought twice about having it, and tbh, would need far more compelling scientific evidence that scans are more dangerous than they are helpful than you appear to have.
As an example, there was the baby on OBEM a couple of weeks ago with the diaphragmatic hernia and the crash team was in the delivery room ready to intubate the baby should his lungs be too small to cope. Heartbreakingly, the baby died at 6 days old, but can you imagine the scenario if the medical staff were unaware and expecting a healthy baby. I presume he would probably have died shortly after birth leaving his parents bewildered and devastated. I got the sense that they felt better able to cope with the eventual outcome because they'd had 20 weeks of knowing what was ahead.
I had a 20 week scan which failed to pick up my DS2's life threatening heart defect. He arrested at 10 days old and had to have surgery.
I am now 18 weeks pregnant again and will be having both a 20 week scan and a 22 week cardiac scan.
Hopefully everything will be fine with this baby, but if it is not we will be prepared as much as we can be for any consequences, and more importantly, the medical staff will also be prepared.
Join the discussion
Registering is free, easy, and means you can join in the discussion, get discounts, win prizes and lots more.Register now
Already registered with Mumsnet? Log in to leave your comment or alternatively, sign in with Facebook or Google.
Please login first.