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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

To be irritated by what this sonographer said?

456 replies

maja00 · 10/08/2013 13:09

I recently had my 12 week dating scan. I declined the nuchal translucency scan, so was just going for the standard dating/measuring.

As soon as we got into the room the sonographer confirmed that I had declined the NT scan. The scan went as expected, baby looks fine etc.

At the end of the scan the sonographer said "I know you declined the NT scan, but I had a quick look at the baby's neck and it all looks normal. I would tell you if there was an obvious abnormality there".

Now, is it just me or is this not really in the spirit of us declining that test? If the sonographer had said it looked abnormal, then we would have been in exactly the position we wanted to avoid Confused

I understand that the sonographer was trying to be helpful, but AIBU to be a little annoyed by this?

OP posts:
Original poster
maja00 · 10/08/2013 22:25

I believed I had been informed Lorem, how would I know if I hadn't been?

I also think it's fair to assume that if you decline a nuchal translucency test, then nuchal translucency isn't checked.

If I had declined a "foot length test" for example, I would assume that the length of the foot wouldn't be checked.

OP posts:
LynetteScavo · 10/08/2013 22:27

YANBU.

From NHS website.

"All women should be offered a dating scan between weeks 8 and 14 of pregnancy, and a nuchal translucency scan between 11 weeks, 2 days and 14 weeks, 1 day of pregnancy. If you choose to be screened for Down's syndrome, the dating scan and the nuchal translucency scan can be carried out at the same time, between 11 weeks, 2 days and 14 weeks, 1 day of pregnancy.
The blood test measures two proteins associated with pregnancy. At the ultrasound scan appointment, the sonographer measures the thickness of the nuchal translucency (a pocket of fluid) at the back of your baby's neck. The information from the blood test is combined with your age and the nuchal translucency measurement and used to work out your individual chance of having a baby with Down's syndrome."

Some women, for their own reasons definitely don't want to know if there is a possibility of DS. I didn't with one of my pregnancies. Which is why I declined the blood test. I would have been Angry if I'd been told.

I wasn't best pleased the sonographer told me DD was a girl when I asked "Can you tell if it's a boy or girl?" I didn't actually want to know, I was just curious if she could tell or not, but I accept it's my fault for phrasing the question that way.

Angloamerican · 10/08/2013 22:32

Yes, I imagine it must have been incredibly distressing to be told that your baby is completely healthy. Poor you. When I had my first ultrasound the sonographer told me that there was a massive cystic hygroma at the nuchal fold, and that the chances of my baby surviving were slim. And she was right.

LaVolcan · 10/08/2013 22:37

Angloamerican - she can't know that the baby is completely healthy - only that no anomalies were detected. A cousin gave birth to a baby a few years ago, who is severely disabled. The scans were fine.

Some people don't want to know that their baby's chance of survival is slim. You did, that was your choice, but we don't all make the same choices.

mamamidwife · 10/08/2013 22:37

Angloamerican, I'm very sorry to hear that Sad

Dueling, it gets a bit complex but if you interested read the green top guidelines it talks about the rates you were asking

maternalhealthtaskforce.org/component/docman/doc_view/1124-amniocentesis-and-chorionic-villus-sampling?Itemid=220

mamamidwife · 10/08/2013 22:38

Sorry I don't know how to make it a link

DuelingFanjo · 10/08/2013 22:40

That's really sad AngloAmerican.

Though the op surely has a right to expect her wishes to be respected. She didn't want a nuchal test done (or part of it) so I can understand, even as someone who did want it, why she might feel annoyed. Plus there's no way that she can be sure that her baby is completely healthy at this stage anyway. Even a 'good' NT result doesn't guarantee a healthy baby.

spotscotch · 10/08/2013 22:41

Op, you said that you only want to know about abnormalities that you can do something about, or which will change the outcome of your pregnancy. Surely at the 20 week scan there will be lots of abnormalities that you could be told about that don't come under either of these categories. Are you going to make a list of what you specifically do and do not want to be told about?

spotscotch · 10/08/2013 22:43

What if, at the 20 week scan, they find other markers for Down's syndrome? Do you not want to be told?

Gruntfuttock · 10/08/2013 22:43

mamamidwife Directly underneath where you typed your post there was a small box with "Convert links automatically" beside it. Clicking on that small box would have places a 'tick' in it and would have made your URL a clickable link.

Like this:- maternalhealthtaskforce.org/component/docman/doc_view/1124-amniocentesis-and-chorionic-villus-sampling?Itemid=220

Isitaboyoragirl · 10/08/2013 22:44

The Combined Test for Downs requires

A nuchal translucency measurement
A CRL (crown rump measurement of the foetus)
Age of the woman
Weight of the woman
Has the woman smoked within 10 days of the test
Blood test to measure hormone levels.

Then you are given a risk of 1 in whatever.

If you decline the test none of these things are done.

If the nuchal translucency looks subjectively enlarged on the scan then that is an abnormality in its own right an will need to be discussed with the woman.

If you decline Down screening but still have a scan to date the pregnancy, major problems can be picked up at this stage and cannot be ignored.

Original poster
maja00 · 10/08/2013 22:44

Presumably the point of the 20 week scan is so abnormalities can be identified and plans can be made for treatment either before or after birth (or decisions can be made about continuing the pregnancy). Which abnormalities are identified which don't change the outcome and nothing can be done about?

OP posts:
DuelingFanjo · 10/08/2013 22:44

Mamamidwife, what irritates me is the way that these figures are framed by some as 'there's a HUGE risk of miscarriage with an amniotic' rather than 'you are much more likely to continue with your pregnancy than miscarry'. I Know that women should be informed when they choose testing like an amino but it's really not a huge added risk of miscarriage, particularly not when you research the individual statistics of different doctors and hospitals.

LoremIpsum · 10/08/2013 22:45

You declined to have the NT test for the odds that the baby has DS, maja, that your concerns are about unnecessary worry caused by that as you wouldn't have further tests. They didn't perform that test.

Even if I declined a foot-length test, I wouldn't assume that meant they wouldn't look at or check the foot, just that they wouldn't perform the foot-length test.

MollyHooper · 10/08/2013 22:46

I think some posts are really unkind and unfair. The OP, I'm sure is as delighted and relieved as any parent that her baby is healthy.

She just isn't happy with the lack of information given to her about the scan she would be getting, that's perfectly valid isn't it?

I am sorry for you loss though Angloamerican.

VivaLeBeaver · 10/08/2013 22:47

You might find this leaflet useful.

www.fetalanomaly.screening.nhs.uk/getdata.php?id=11679

NF (sometimes referred to as nuchal oedema) is the term used to describe the tissue or fat pad at the posterior aspect of the fetal neck in the second trimester of pregnancy. Increased nuchal fold is not to be confused with increased nuchal translucency (NT) at the first trimester scan.1

You said the sonographer said she'd looked at the baby's neck. So the nuchal fold not the nuchal translucency.

TheBleedinObvious · 10/08/2013 22:47

You are not unreasonable to be annoyed by it.

But I wouldn't report her.

Isitaboyoragirl · 10/08/2013 22:48

Left out ethnic background.

Dayshiftdoris · 10/08/2013 22:56

Ok maja if you had declined a foot length test would you expected them to look at the foot?

And what would you expect them to do if the foot was missing...

Come to that what would you expect them to do if you specifically said 'Don't look at the feet' and they put the scanner on to be faced with the feet?

( this happened to me with my son's genitalia - luckily I was keen to know the sex!!!)

Dayshiftdoris · 10/08/2013 22:59

I think you need to go back to your midwife and discuss screening in more detail, face to face, BEORE your 20wk scan

Pobblewhohasnotoes · 10/08/2013 22:59

There's a lot of focus on Downs here. The 12 week tests show other chromosomal abnormalities as well. It's not just Downs.

MollyHooper · 10/08/2013 22:59

That's interesting Viva, DS2s issues were with increased nuchal fold rather than translucency, I just assumed the two were connected.

Do you think there is perhaps and assumption that we are all out researching and Googling everything ourselves?

I remember the cardiology consultant actually saying "But we won't go over all that as you have probably Googled it to death"

I hadn't, I was too frightened of what I would read and just wanted the facts from him.

mamamidwife · 10/08/2013 23:03

Gruntfuttock, thanks for the tip and for putting the link on properly Smile I don't think it's an option on my iPad though?

Dueling, your right the way something is presented can change a persons view, and the stats for amnio do change depending on experience of the person doing the sampling.

I know myself I wouldn't choose one, which is why I never went down the screening route with my pregnancies.

midori1999 · 10/08/2013 23:29

YANBU.

I declined the NT screening as I already have a son who was born with Downs Syndrome that was not detected during any of the screening tests I had during my pregnancy with him, nor were his heart defects picked up on scans.

It was at no point made clear to me that the nuchal fold would be measured anyway, I was simply told I would get a 'dating scan' and not a 'NT scan'. The letter confirming my appointment called it a dating scan and when I got there the sonographer confirmed I just wanted a dating scan and not a NT scan.

However, like you, declining the NT didn't mean I wouldn't want to be made aware of any physical problems, which may or may not be due to Downs Syndrome or anything else at my subsequent scans if they were seen. Downs Syndrome may or may not cause physical abnormalities, but I feel these are very different to the actual DS itself and these may be things that could actually be treated and would be likely monitored with further scanning, not invasive tests.

northernlurker · 10/08/2013 23:30

I honestly can't work out the nuance of what the OP does or does not wish to know. However I do not believe that she presented for this scan not knowing that part of it's remit was to look for abnormalities in the baby. Her consent to the scan implies she wanted that information and she has been told that everything looks fine. It's really remarkable that somebody could spend so much energy complaining that they were given good news they didn't want.