to think early pregnancy scans should not be offered on the NHS

[nancydrewrocked]

OK I am prepared to be flamed but I couldn't help thinking this when I spoke to a friend recently. So tell me why I ABU.

Friend has just started ttc. No difficulties, no previous history. 2nd month of trying she gets a +ve the day her period is due. Two weeks later another scan no HB. Friend understandably very upset.

But I can't help thinking this would have been easier on her if the GP had gently told her to go home take it easy and then done a blood/pregnancy test in 2 weeks. It also strikes me as a enormous and unecessary cost, especially when many areas no longer offer routine 12 week or nuchal scans.

But brokeoven, Bramshott has said it. We find out so early. When my mother was pregnant, you didn't go to the GP until you had missed 2 periods. I have friends that go the day after their period was due with the faintest positive test.

Bramshott you are so right it's not the early scans, but just finding out so early that sometimes creates problems.

I've never had an early scan, and have never had a miscarriage either. But I think YABVVVVU

YABVU. Why do you think the NHS shouldn't offer women with pregnancy problems/bleeding a scan?

well yes and no, actually. you can't retro-engineer the problem here. if the woman doesn't know she is pregnant AND if her miscarriage is a simple one then she is better off.

if a woman doesn't know she is pregnant and her pregnancy is ectopic, she's a dead woman walking. which is not so nice.

YABU.

schilke - our mothers may well have found out later - but I wonder how many died/suffered from serious complications because they didn't know they were pregnant and they had an ectopic pregnancy or other complications.

Come on now, admit that you're being unreasonable and we can all move on.

YABU - it's up to the medical professionals in each particular case.

Ok to clarify - I totally understand why you would need a scan if you had fertility treatment. As I said she had no history.

I also totally understand why you would need to be checked out if you have symptoms of an ectopic pregnancy, but again no history/symptoms and the GP wasn't concerened about this.

I also totally understand why woman who have a history of mc want/need reassurance but again she had no history.

ttalloo my point is that she wouldn't have found out two weeks later than if she had the scan. The scan (at less than 6 weeks) was ineffective as it was simply to early so she was put on this rollercoaster of hope and dispair.

She is entirely new to the world of ttc and babies and I just think it would have been kinder for the GP to sit her down and say "you are almost certainly miscarrying, unfortunately we cannot tell at this stage lets do a test in two weeks". Instead she went off to the hospital all excited about her first scan .

brokenoven yes I have mc twice. I am sorry for your losses and as I said I think when you have had losses then the position is different but I do question the dealing with initial very early losses in teh way I have described.

having said that I am also willing to have it explained to me why I am so wrong.

Bleeding is a symptom of ectopic.

GP may not have specified that so as not to freak her out, but guidelines state that ectopic symptoms must be acted upon quickly to avoid death.

If you have ever suffered the nightmare of a miscarriage you wouldn't question the absolute need for an early scan.
I had a MMC last year after suffering bleeding twice, first scan baby ok there was a heartbeat, 4 weeks later more bleeding, baby had died 2 weeks earlier. This was the worst moment of my life, if I had had to wait another 3 weeks for my 12 week scan it would have been so much worse. Knowing my baby was dead inside me and had been for two weeks was so awaful I dont think there are words to describe the pain and heartbreak.

I fell pregnant 3 months later with my now 21 week old DS, and was told by the hospital that I was to come back for an early scan( when about 6 weeks) for reassurance
As it turns out I had bleeding again so to know that I could go and find out straight away was a big help. He was ok but without that scan and subsequent early ones at 10 weeks ( to know I had made it futher than last time) Im not sure that psychologically I could have coped.
I spent the entire pregnancy in some sort of denail that it was actually going to produce a baby at the end.

EPU's ara a vital service for terrified women, no one ever wants to have to go to one but if they weren't available I dread to think of the problems there would be for women for example have an ectopuc pregnancy.

You are being unreasonable but I think its just down to you not having been through this experience yourself.

Please look after your friend and let her talk if she wants to

mamottat - you are right.

are you absolutely certain that she's got no history.

honestly my love, you are talking out of your arse. she had early bleeding, that is a symptom of ectopic pregnancy. the recommended procedure is either to scan at six weeks or do bloods until six weeks and then scan.

what people think of as a symptom of ectopic pregnancy, furious pain, shoulder tip discomfort etc, are more accurately described as complications resulting from an internal haemorrhage because of an existing ectopic pregnancy. at that stage, what with the emergency surgery, recovery time etc, not to mention possible loss of fertility, the NHS bill is a whole lot higher than an early scan.

You're disgusting and offensive.

There's a forum down there, it's called Miscarriage - go have a look in it, read those stories, read the stories of the women who were scared they were miscarrying and got relief from an early scan, read the stories of those who were bleeding and had an early scan and found that it was the worst... or read the stories of what I think is nature's dirtiest trick, the missed miscarriage.

I've had early scans. I'm glad I did. I'll have more.

I've got a history of miscarriages, last time I got pregnant, I thought we'd nailed it - tests kept showing positive, and apart from a few bits of brown spotting (brown generally being the more favourable option since it's older blood) - not much to worry about. I only went to the EPU because of the brown spotting, and I got a scan there... the baby had died at 5.5 weeks. They monitored me, they rescanned me to confirm the loss, because of issues surrounding the sacs (they found a second!), they rescanned me again... by the time it was all declared over - I was about 11 weeks gone and my body was still hanging on. Painful as it was - I'm glad I found out at the time I did, rather than happily plod along to 12 weeks, trot to the scan expecting a nice photo - to be told then that the worst had happened. Being cynical - I also freed up time in the 12 week scan clinics, and in the midwife's calendar because I went out of that system at the first round so to speak in X-factor terms.

My miscarriages all occur around the same point (about the point you'd like to ban scans incidentally). Next time I get pregnant - they want to scan me BEFORE and AFTER that point to try to work out what's going wrong. I'm glad you'd like to deny me that chance to be honest - would you like me to deny YOU your chance of parenthood too?

Bleeding in early pregnancy is fairly common in various shapes and forms. It's also, pardon the choice of phrase here, bloody terrifying. If you had sat there in the waiting room of that EPU and seen the looks of worry on the faces of the couples waiting, and the looks of relief on their faces as they came out of the room with an envelope of a happy ending photo (oh how I long for the envelope instead of the leaflet) - I don't know how your conscience could deny them a 10 minute appointment that lets them sleep a little bit easier at night.

Your friend would have miscarried with or without the scan - they've just spotted it earlier... because they've used the tools science has given them. You're pig ignorant and completely sick to even post this to be honest and you've probably upset, and offended a lot of people.

By the way - I had my appointment with the recurrent miscarriage specialist recently, one of the things she told me is that, in quite a lot of cases - just the reassurance that their pregnancy is being monitored (as opposed to the usual two blue lines and go off to cook for 12 weeks), that they're being scanned and watched can actually make the difference between a sucessful outcome and a further miscarriage. That's coming from the hospital specialist, not some ill-informed nit-wit on the internet.

(Thanks to those who've stood up for those of us with wonky plumbing who need this system btw.)

YABU. You don't just get early scans on the NHS for no reason. If you are having bleeding or pain then it can be an indication of an urgent life-threatening condition like ectopic pregnancy (or an infection setting in in the case of a missed miscarriage) and most people would argue that diagnosing and treating urgent life-threatening conditions before the patient actually dies should be a reasonably high priority for the NHS, even in this age of budget cuts.

An ectopic remains a possibility even if they've seen what looks like a gestational sac in the uterus on a previous scan as you can get "pseudosacs" forming there when the actual pregnancy is ectopic. So until they can definitely confirm either a viable or a non-viable uterine pregnancy they need to keep managing the pregnancy.

"I just think it would have been kinder for the GP to sit her down and say "you are almost certainly miscarrying, unfortunately we cannot tell at this stage lets do a test in two weeks""

actually this happens a lot, if you go to the ectopic pregnancy trust forum you will find women who nearly died as a result of this kind of GP guessing game.

Do you also have any idea of how dreadful those two weeks would have been? Clutching at straws, wondering if the bleeding would stop or not, wondering desperately what was inside.

The scan at least allowed her to prepare for the worst, while still laying open the glimmer of hope for a happy ending. What you're suggesting would have been the more cruel option.

nancydrew I posted in response to your incomplete post so yes, there is a limited benefit in having a scan before 7 weeks, but even then a scan that early would show whether a PG is ectopic or whether the sac even has an embryo in it. So I think that the GP was right to send your friend for a scan, but with the proviso that she should go again for another one at 7 weeks. She would still be on a rollercoaster of hope and despair, whether she had the early scan or not.

But your subsequent post makes it clear, I think, that you are questioning the need for scans before 7 weeks, not in the first trimester altogether. So you are less U than I thought you were initially, but I still think that scans before 7 weeks do have some use, and should be given if there is bleeding.

And I'm sorry for your two MCs.

I do see your point actually that in your friend's case it wouldn't have told the Drs anything. If it was too early to see a heartbeat then what would that tell you.

I've been in your friend's position of bleeding at 5 weeks and the GP referred me for a scan, like your friend no heartbeat so I still didn't know either way. Then had a scan a week later and there was a heartbeat. At 7 weeks I was bleeding again and the GP referred me for another scan - still a heartbeat. Sonographer was not happy that GP had referred me and said that the scan only tells me that there is a heartbeat at that time. Which yes was reassuring, but for all I know the minute I got off the couch the hb could have stopped. So once I left the hospital I was worrying the same as before. I carried on bleeding for weeks - they could hardly scan me every day could they?

Then you get women a 6 or 7 months who are pregnant and have a problem such as bleeding, ? breech, ? growth problem and the hospital are struggling to find scan slots as there's a load of 5 week pregnant women booked in.

For every woman out there who has had an early scan and it be too early there is probably another whose life has been saved by the early detection of an ectopic pregnancy.

YABextremelyU

Early scans are not routinely offered.

Bleeding can also be a sign of a molar pregnancy, and that needs a scan to diagnose - though it's trickier with a partial mole. If left undiagnosed, this can turn into a malignant tumour which requires chemotherapy.

That makes more sense, NDR.
I think in this case the medical treatment is more about emotional comfort than physical need (keeping in mind that your friend's emotional state is as important as her physical needs, long term). At least your friend will know that the medical world has done what little they could to inform and help her.

dueling I am not arguing that the NHS shouldn't offer woman with pregnancy difficulties a scan not by any stretch.

I just don't see the merits of offering a scan for someone with no history/symptoms of other issues when they have had a period like bleed less than a week after their period was due.

It was highly unlikely that it was anything other than a mc, but sending her off to the hospital for a scan got her hopes up. The fact that it was too early for a HB prolonged the agony for a further two weeks. It seems unkind on her and a bit pointless.

But as I said I am happy to be told why I am BU and will accept that I am so if you all say I am