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.

"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."

Bleeding is a Symptom of Ectopic pregnancy.

You are being VERY unreasonable and you asked us to tell you why.

What do you want? Women to wait until they have the pain of a ruptured tube?

"Instead she went off to the hospital all excited about her first scan"

really, even though she was bleeding?

Well I'm sorry that I'm not allowed to have an opinion that's different to someone else. I've had miscarriages, I've had bleeding in pregnancy, one of which was ok others weren't.

I never said that women should not have scans to make sure its not ectopic. Just that I don't see the benefit in repeatdly scanning every day if you carry on bleeding for 7 weeks. Yes, I spent those 7 weeks worried sick after previous miscarriages so I do know what its like. In my post I said that I wouldn't have got any reassurance through repeated scans as a scan only tells you that baby is ok at that second, not what it will be like in even 5 minutes time.

that just means you have ignorant doctors, tbh, nancy. not at all uncommon, as was demonstrated recently on a thread where for five days a poster in enormous pain and with every EP symptom in the book was sent back home from hospital, despite actually asking them about EP.

of course she had an ectopic pregnancy, and had they scanned her on day one and taken bloods as they should have done, she would have been spared much of a horrifying and life-threatening experience.

be grateful, given the inadequacy of the medics around you, that you didn't have an ectopic pregnancy, as you might not be here today.

The GP wouldn't have had that option. I showed +ve for weeks after my miscarriage,, my missed miscarriage, which I had suspected but been laughed at by my midwife at booking in for my concern...

For a blood test, the GP would have had to do a blood test then, and have her come back to do more blood tests, to see if hormone levels were rising or falling.

I don't see why you've got an issue with how your friend was dealt with, unless it relates to your own miscarriages, and how they were dealt with, which is perfectly understandable, although still unreasonable.

"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."

VivalaBeaver - it would tell the doctor if the pregnancy was in the right place for a start!

Aitch - that was the thread I was remembering too. I learned a lot through that very and scary thread

YABVVVVVVU. RIDICULOUS!

Viva, where do the scan every day? Mine were at weekly intervals.

I started bleeding at just before 8 weeks, second pregnancy, no history of miscarriage. I assumed I was miscarrying, but went to the doctor for advice. Luckily I was scanned, as I had a molar pregnancy and spent the next couple of months in and out of hospital (had to have three D&Cs, severe haemorrhaging, was in for a week at one stage, narrowly avoided hysterectomy and chemotherapy) and was followed up for a year.

Certainly I don't think there is any point in early scans just to confirm pregnancy, but as soon as anything starts going wrong, there are good reasons to check what is going on, in case of molars, ectopics etc.

My GP tried to send me for a third scan the day after my second scan as I was still bleeding. He rang up the ultrasound dept who politely told him to bugger off. I think he'd have happily referred me every day if they'd let him.

"Loopy - she called me an ignorant fool. I think thats a personal attack"

to be fair, if you work in Maternity then you might not necessarily have the knowledge of Ectopics so you may be ignorant about the need for scans to check where the embryo has implanted. maybe 'fool' was an insult/personal attack but perhaps it is foolish to say you have knowledge which is relevant when clearly you don't?

Anyone working with early pregnancy problems should surely know how useful a scan can be for locating where a pregnancy is, particularly when the woman is bleeding?

OP - the resounding answer is yes YABVVVVVVU now leave it, you are never going to win this one

there are 100s of reasons why early scans are done, are necessary, for mother and babys health - if you are ignorant of these reasons lucky you!

MaMoTatt I know for certain she has no history because of numerous things she has said to me over the years. Trust me I am absolutely 100% positive on that.

aitch I am sorry that I have pissed you off - not my intention to piss you or anyone else off. I do realise that ectopic pregnancies are very serious - as I have said I didn't realise bleeding alone was a symptom and I have accepted on that count that I have BU .

I take the points about ectopic possibility and presumably so does NDR. OTOH, I thought that there was bleeding with every m/c, but presumably not every m/c gets scanned in case of ectopic... or does it? Is that now the protocal, to offer a scan to every seemingly miscarrying woman? For her mental well-being as well as physical needs? But is that cost-effective? Is that part of what NDR is asking? Is it so outrageous for her to ask?

My mom had loads of m/cs but no scans back then, just had to wait. She wasn't upset about any of her m/cs, though. I think that I would respond like Schilke, too, and prefer to wait and see if possible.

ah yes, but that means the whole thread is unreasonable, i'm afraid, and nothing less than a penitent retraction will do. on your knees...

exexpat, god, that sounds grim. sorry to hear that happened to you.

YABU.

The idea that some-one shouldn't get an early scan if there is bleeding and/or a history is cruel at best.

the royal college protocol for a bleeding woman with some discomfort (and everyone reports discomfort the minute they have bleeding, let's face it) is to go to an EPU and do bloods every two days until a scan will help. this is dependent on scanning equipment, like i say, most big hospitals have scanners that can see useful info at 5 weeks, some later. the protocol is 6 weeks for everyone, if not before.

they have done the sums, ljkk, it's strange that you don't think this has occurred to the nhs. an emergency operation plus after-care (inc mental health) is a lot more costly to the NHS than some scans.

all women who are pregnant for the first time 'have no history'.
Not sure if every miscarriage is scanned, probably not. My SIL had a suspected ectopic and was scanned several times because they couldn't find where the pregnancy had implanted. The EPU were the only people who could locate it.

dueling yes she went off to the scan excited

She visted the GP who apparently really didn't say anything other than I shall refer you to the EPU. The fact he did that (along with a quick word with another friend who had told her that spotting in early pregnancy was very common) made her think that being sent for a scan was positive thing (if that makes sense) i.e. if it was hopeless why would they bother.

This of course was then compounded by the sonographer not being able to tell her anything at all, but reiterating that it really was too early for a HB and so not necessarily a bad sign. Followed by the two week wait in which her hopes were really up.

I just think it would have been easier on her if someone had given her an idea of a "likely prognosis" rather than give her false hope.

true, df. my first and second pregnancies were ectopic. no history of fuck all with the first.

Hi - I had concerns early in my last pregnancy as the symptoms were fading. I went against my GPs advice and had a (private) scan at 7 wks, and there was no embryo visible. I then went to an EPU where they repeated the scan with the same result, and was told to come back a week later, fasting,as I would need an ERPC. At that scan a week later twin heartbeats were found. A week later the next scan showed the babies had died and I then rather spectacularly miscarried at home (Because I knew from the scan I might miscarry I wasn't at work). I had to be rushed to A and E and was dangerously unwell. If I hadn't had the scan, it would have been disastrous as the mc could have happened on the street, in work, and would have been even more traumatic in being unexpected. I was prepared, had pain medication, childcare sorted etc.

However, in a way, the whole rollercoaster, the waiting and so on were very difficult so I can almost see where the OP is coming from and also, as in my case, scans don't necessarily give you closure or definite answers especially in very early pregnancy. There is a wide margin of error regarding dates and equipment and so on.

i went off to my first scan excitedly, believing that spotting was common etc. shame, really.

so now you are changing the goalposts, nance. she should have been scanned but they should have managed her expectations better?

i guess that's where friends and the internet come in, tbh. but iirc, the epu are not given to upbeat diagnoses where none is possible. more likely your friend was clinging on to hope, which you cannot fault her for.

Why is it a false hope? I had spotting/bleeing with three successful pregancies. I had spotting with another that did turn out to be a missed miscarriage.