Worrying 20 week scan

[FrozenNorthPole]

I had my 20 week scan this morning, and I'm around 19 weeks now. Everything looked fine and I thought I'd be in and out until the midwife sonographer said "now, I don't want you to get worried but there is a small amount of fluid around the baby's heart"
Who the heck truly believes you can say that to a pregnant woman and expect her not to worry?
Anyhow, she said the fluid is sometimes caused by an infection the mum has had during pregnancy (like parvovirus or CMV) or by rhesus negative status (not applicable to me). From my reading it can also, usually in combination with other signs, indicate a heart defect or chromosomal abnormality.
The midswife said that it was probably nothing, but that she'd like the consultant to check it in the next couple of weeks. She also remarked that it might have been seen because I'm "very easy to scan". I have NO idea what that means.

Has anyone experienced similar? She basically wouldn't tell me anything about what it might mean, and she didn't say how deep the fluid is. My DH is a GP so he rang my consultant to ask about it but consultant wasn't there (never is ... we've been trying to ask him an unrelated question for the last 4 weeks ). I will be scanned by my own consultant on Monday, assuming he remembers to turn up, so hope to know more then but I've been led to expect this might not be conclusive either.

Even if you haven't been through similar, anyone willing to metaphorically give my hand a squeeze would be appreciated

[iloveholidays]

Hi FrozenNorthPole. No experience, but can you give your midwife a call to find out a little more? I'm sure she will know a little more about it.

Hope someone comes along who knows a little more for you.

[MissPenteuth]

That must be a worry. As you say, how could any pregnant woman not worry? We worry (or at least I do) even when there's nothing to worry about!

But bear in mind that she didn't see any other indications of anything wrong (presumably the heart looked normal apart from the fluid, and she made all the other necessary measurements of other internal organs, body parts etc.) so the chance of a heart defect or chromosomal abnormality is low. And if she had thought it was anything serious I'm sure she would have sent you to the consultant ASAP.

I suspect the "easy to scan" comment meant that it was such a small amount of fluid that she might not have picked it up on a less clear scan?

Try not to worry (I know, I know). Monday is only a few days away and hopefully your consultant will be able to put your mind at ease.

Hopefully someone who has been in a similar situation will be along soon to give a more useful answer.

[Onlymydogunderstandsme]

Hi OP, at my 20 week scan I had a similar thing. At the end the sonographer said she didn't want to worry us but the brain ventricles measurement was in the upper range of normal so we were to come back in two weeks for a re scan. Although she kept saying she was sure it was ok it was a worry and was on my mind the whole two weeks. The other thing was that when we asked what it meant if there was a problem she was really vague and w

[Onlymydogunderstandsme]

Sorry hit the button to early ....she would t tell us what it meant! Anyway when we went back the measurement was well within the normal range and all was ok which I think most of the time is the case they just like to be thorough! I know it's not the same thing but take some comfort that quite a few people get called back and most of the time everything is fine!

[strawberrypenguin]

Hi frozen it's tough waiting for a consultant scan, we had to aswell (they thought our son might have had a heart condition, turned out he didn't the first was just a bad scan) would the notes from the scan have the depth of fluid? Stay strong and try not to google x

[FrozenNorthPole]

Thank you all Feeling all weepy - think I might leave work early for the day. Don't want colleagues to notice. Logically I know things are probably fine, but I'm really bad at tolerating uncertainty and the research literature on this (myocardial effusion) is really sketchy: it can either be fine, or utterly dreadful when combined with other findings. Bugger, I'm meant to spend my weekend finishing the write-up of my PhD thesis but HOW can I concentrate through this?

[FrozenNorthPole]

PS - the midwife who scanned me phoned up and I asked her about the fluid depth but didn't get a clear answer. I wonder whether she didn't measure it? Seems unlikely. I've done a bit of googling. Stupid, stupid me!

[HerrenatheHHHarridan]

Hi frozen - that sounds scary and I'm not surprised you are feeling weepy.

I think the midwife may have remarked that you're easy to scan due to your weight; I had a blurry crap sonogram of DS2 due to my 'increased BMI' and have noticed that skinnier friends have lovely clear pictures of their 20-week darlings, so it may well be that.

If you can manage to block it out for long enough to focus on your PhD write-up (hard enough at the best of times; been there, got the t-shirt) then at least that will be one less thing to worry about and you will feel like you've done something constructive.

And I agree with the advice to stay off Google....hope this is helpful

[oohlordylordy]

Virtual hand here.

I never ever considered the possibility of bad news and actually took my DS (who is only just 14 months older than DD) to all DD's scans. Never ever thought to worry.

[Need a naieve and bloody luck emoticon here]

Good luck. x

[FrozenNorthPole]

Thank you again. Do you think ARC might be useful people to talk to about this?

[BellaOfTheBalls]

Un-MNetty hug to you!

Try not to worry! It is probably nothing. You tend to be easier to scan if you are slimmer. They put something about how scan wasn't very clear "due to maternal habitus". That's a posh way of saying still carrying the extra 1.5 stone from DC1

Try to look at it positively - this way you get a chance to see your little babba again! And don't quote me on this but several of my friends who've needed a consultants scan have got a bit of 4D scan as well

Did you find out the flavour?

[Hpbp]

Frozen, another hand here for you.
I have had the same worry although the concern was with bone length. EVerything else was normal. But the bone length could be a marker of chomosomal issue.
I know how it feels. You feel good during the scan and happy to see baby etc... and all of a sudden, you get hammered on the head with some very vague and little info. You don't know if it is a big problem or not, and of course you worry, who would not ?
I was sent for another scan 2 days later and end up having to decide or not for amnio which I chose after one full week of indecision and another 4 weeks stressing over what if the results of the amnio were bad ?
Everything came back clear and normal but I felt I deprived of 5 or 6 weeks of my pg because consultants just want to cover themselves.
After all only one marker was slightly out of the stats. And it is the same for your baby. I am sorry you are going through this as well. But feel confident. Monday is very soon. It is probably nothing.
And as Bella said, look qt the bright side, you will get to see your baby a bit more often. I have 2 other scans scheduled on top of the usual ones :) even if I don't get a 4D one, I will see her more often.
Good luck on the PhD writing
ANd let us know how it goes on Monday

[potas]

Hi
At my 20 week scan the ultrasonographer thought there was a cyst on the kidney - 2 weeks later she thought it was a dilated bowel - 3 weeks later the consultant thought it was a liver cyst! - we didnt know how worried to be at any point and lurched from crying uncontrollably to complete acceptance of the fact our new born will need surgery soon after birth and be in hospital for the first few weeks at best. The only thing that helps is finding out more information from the experts who know what they are talking about. It doesnt make the problem disappear but it makes it easier to deal with. We spent a lot of time worrying about conditions that really probably hadnt even entered our consultants head - we just read about them on google and imagined worst case senario of every situation - the ultrasonographer didnt help as she couldnt answer our questions and made us worry more. Having seen two consultants now and had an extensive scan looking for other abnormalities we both now feel a lot happier - our baby isnt going to perfect but which baby ever is - and he`ll still be ours :-).
It is easy to say dont worry but impossible not to worry. However worrying wont improve the situation. Taking care of your self by eating well etc and exercising will help and reducing your stress levels by sorting out your course work etc will help in the long run. Try and focus on your phd thesis as once its out of the way and you can fully concentrate on making sure the pregnancy is as healthy as possible to give your baby the best chance you can. Fingers crossed you get good news on Monday and this is just an over cautious ultrasonographer.

[FrozenNorthPole]

I love mumsnet - you have all made me feel much better than I thought I could.

DH spoke to the midwife this evening and it turns out that she didn't actually measure the fluid. DH tried to pin her down to more, or less, than 3mm - and she said she thinks less.

It's really helpful to hear about similar experiences and reassuring to hear that things have turned out okay. Like Potas, I'm not after a perfect baby, just one that will live. I've been trying to confine myself to only searching academic journals but actually that's not necessarily any more reassuring than googling, it just has a veneer of respectability! 'Case studies' are just depressing anecdotes by any other name and there's not much epidemiological stuff out there.

Re: amnio, I'm not sure what we'd do. I hope we don't get offered, in a way, because that would force more choices that none of us want to make.

[HowlonguntilFriday]

My scan showed 2 markers, one that could have pointed to CMV or Parvovirus. I had blood tests to check for this. Think that the parvovirus showed previous infection and therefore immunity while the CMV was negative. While it didn't explain the markers, it was reassuring to rule that out. All turned out to be fine in the end. The consultant did say that 10 years or so ago, the scan wouldn't have picked up these anomalies.
Take Care

[FrozenNorthPole]

Howlong - really glad to hear that it turned out okay. Trying to hang onto the positive evidence:
this
and
this
rather than the more terrifying stuff.

Had a couple of minor meltdowns last night - okay, not minor. DH really, really believes that everything will be fine. I really, really hope he's right - but I can't help worrying, or wondering whether I've done something to cause this

[Hpbp]

Frozen, don't feel guilty, 1st you don't know for sure there is something wrong
2nd this is not your fault, every baby is a miracle, a gift, stay strong, listen to your DH. Monday is not far.

[Buglove]

I really do think unless something can be done I'd rather not be told. I'm also terrible with uncertainty. Not as serious I know but my hv glanced at me across the weighing room and said 'when you come in for your check up I will be referring your son to an eye specialist' and then walked off! I was so worried (thought one eye was lazy but turns out he just has a wide bridge of his nose!)

[FrozenNorthPole]

I think my key worry about causing it is to do with viruses - I had no real idea that I was risking parvovirus / similar by letting my DDs occasionally kiss me near the mouth (we aim for cheeks but they miss!) or sometimes letting the youngest eat food from my fork. I know that sounds stupid but apparently the virus can cause severe B12 anemia in the fetus and sometimes adults don't even realise they have the virus ... although to my knowledge neither of the DDs have had it (I think it's known as slapped cheek virus). I also think I would have noticed if I had listeria but that worries me too

Okay, I'm clearly over-thinking this. this time tomorrow I will know what the consultant thinks. I really don't know how I'll cope if he doesn't give a good prognosis I've had three previous miscarriages but none after 12.5 weeks, so this is unknown territory.

Crap, crap, crap ... I wish this had been another of the 'soft markers' (okay, there's none I'd rather have, but there's definitely some with a better surrounding literature and prognosis). This particular symptom has so many ominous variants. My worst case scenarios would be progressive hydrops or trisomy 13 / 18.

Thinking positively is not my strong point

[scummymummy]

Poor you- I think pregnancy escalates worry levels when it's anything to do with the baby. I was always beside myself at the smallest thing. Sounds like there's a very very good chance that your dh is right about there being nothing to worry about. Good luck for tomorrow. Fingers tightly crossed that your mind will be put at rest.

[FrozenNorthPole]

Hello, thought I'd update now I'm back from the scan. It was generally reassuring, although the fluid can still be seen around the pericardium. The consultant tried to measure it but the baby was wriggling around far too much. He said that it was so small that many sonographers wouldn't have noticed it, but now it had been noticed they had a duty to get it checked out by a specialist at the tertiary referral centre (which turns out to be the hospital where I currently work).

Interestingly, the consultant said it was very rare to see pericardial fluid at all - whereas the first of the links I posted indicates that actually the majority of women have some, but usually less than 2mm of it. So perhaps that feeds into the idea that 'easy to scan' women (I'm not skinny though!) are more likely to have this kind of thing picked up, although obviously women with more fluid are also more likely to have it spotted.

He also said that the risk of anleupoidy was very low, and that he could not see any structural abnormalities in the heart. Generally, therefore, it was reassuring although the best outcome of course would be the fluid vanishing. Appointment with the fetal medicine dept at the tertiary centre is on 10th May, so not ages to wait. I must admit, though, last week I booked a private scan at the same place, so DH and I could go along together and ask questions - this was mainly in case there was a long wait for further referral. The private scan is on Wednesday evening.

I'm still quite scared, but I can accept that I'm getting good care and that they wouldn't have been doing their jobs if they hadn't highlighted this. Hoping that Wednesday's scan provides further reassurance. Still a bit annoyed that the midwife didn't answer any of my questions though - it really does leave you fearing the worst. I think I rather interrogated the consultant today but he was honest enough to say that he didn't know the answer to a few of my questions which is always better than implying you know the answer but won't say!

Thank you for holding my hand. I will keep you updated and will keep hoping that this resolves or doesn't turn out to be a bigger / progressive problem.

[Hpbp]

Frozen, you must be relieved, I am glad it does not sound too much of a concern, let us know how the scan goes on Wed and hopefully the scan on 10th will complement and be coherent with this Wed one.
Can you explain what are the implication/s of having this fluid around the heart? Sorry to be illiterate but I have no knowledge of medecine... But I am very curious :)
Have some rest and relax. It is important for your baby too.

[scummymummy]

Arrgh! The reply I wrote you yesterday has disappeared, Just wanted to say I was pleased it went pretty well yesterday and hope it goes even better on Wednesday.

[potas]

Glad you got some reassuring news - sometimes just having someone who can answer all your questions makes it seem a lot less of a problem. fingers crossed your next scan is a good one too:-)
We had another scan today and now the consultant is more certain in what is wrong he can give us more detailed information and even though it isn't great its a lot less scary.

[FrozenNorthPole]

Thank you for your replies

Hpbp - one of the unnerving things about the fluid is that the implications can range from zero to fatal. If the fluid is 'isolated' i.e. not associated with fluid elsewhere in the baby, or structural abnormalities of the heart / other organs, then there's no evidence of it being harmful. The fluid could be a simple response to a passing virus, during which the baby's heart has had to work harder than usual.

Unfortunately, some serious structural abnormalities can be very hard to spot, particularly when they are found in the heart (which is only about 2cm in size at the moment). If such abnormalities exist, and if they prevent the heart working effectively, then the fluid can increase. The fluid can also increase if the baby struggles to successfully fight off a virus (e.g. parvovirus, which may cause severe anemia in the fetus). Too much fluid can prevent the heart (and lungs etc) developing fully. If fluid begins to accumulate elsewhere in the baby too, this is known as hydrops fetalis (it has 'immune' and 'non-immune' variants, but as my blood is A+ my baby is more likely to develop non-immune hydrops than immune hydrops). If hydrops develops, and does not resolve over the course of the pregnancy, then between 60 and 90% of babies die.

Scummy - thank you! The day feels like it will never end already, but it's good to be at work taking my mind of things a bit (even though I'm sneakily mumsnetting )

Potas - I'm sorry to hear that the news isn't great, but understand that it's better than not knowing and fearing the worst. Feel free not to answer this, since you may not wish to, but what was the doctor's conclusion? How are you feeling? Sending lots of unmumsnetty hugs in your direction. x