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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:
northernlurker · 10/08/2013 21:30

No the silliness in this situation is you Op, failing to think this through. The NT (as has been explained several times) does not only indicate potential Downs Syndrome but other abnormalities too. You say you didn't want the NT test - meaning you didn't want the measurement but you accepted the anomlay scan which includes viewing the NT as an indicator. Did you think they just wouldn't look at that part of the baby? Hmm How is the sonographer - or any of us - supposed to know which abnormalities you want to know about? A scan IS an intervention. I think actually mums accept scans as 'standard' without much consideration but when it's done it's done.

Original poster
maja00 · 10/08/2013 21:31

My point is that it wasn't made clear that in declining a nuchal translucency test, nuchal thickness would still be checked. I think I should have been fully informed about this.

OP posts:
Poppy4453 · 10/08/2013 21:31

She should have respected your wishes.

Why when a women is pregnant is it ok to ignore her requests?

Complain, she need to respect her patients and understand her job.

Original poster
maja00 · 10/08/2013 21:33

It's been explained here, it wasn't explained to me before or during the scan. Yes, I totally did think that declining the nuchal translucency screening meant that nuchal thickness wouldn't be checked - that seems like a pretty reasonable assumption for an ordinary person? Certainly many posters on this thread made the same assumption.

OP posts:
Platinumstart · 10/08/2013 21:34

Sorry for some reason I didn't see this last page and bodecia's helpful posts.

My DC4 had a very high NT measurement at 9 week scan, it meant the consultant carrying out the scan was able to schedule an appropriate program of follow up care.

HenWithAttitude · 10/08/2013 21:34

I thought 10 years ago that all pregnant women should have to sign a tick list of what they would like screening for. This should be after they have signed a disclaimer saying they had read a comprehensive booklet describing all tests, risk of tests, risk of incorrect result, consequence of test result, next step in diagnosis, chance of seeing something unexpected and not covered by the booklet and a disclaimer either saying they did not wish to know anything or a disclaimer saying they understood they might be told things they were not expecting.

It would be the only way to remove all misunderstanding or remove the opportunity to complain because of a misunderstanding.

Plus....they should allow twice as long for the scan and the first 30 minutes should include a full discussion and counselling to establish the above

Original poster
maja00 · 10/08/2013 21:35

Oh yes, how awful that women should be given information!

OP posts:
VivaLeBeaver · 10/08/2013 21:36

Well during the anomaly scan they will also look at things which may be an indicator of Down's syndrome. Maybe you ought to talk to your midwife before going for it so you can decide what to do?

northernlurker · 10/08/2013 21:36

Ok - what did you think the sonographer WOULD be looking at? How do you think they date the pregnancy?

Blu · 10/08/2013 21:38

Maja - YANBU.

You had a right to decline the test and hospitals need to take the ethics of this seriously. It may not be so bad that she told you that the Nuchal result looked 're-assuring', it would have been completely out of order had she identified and then mentioned a measurement which showed a high chance of DS..

It may be that units typically look - they may be gathering research material - I don't know what hospital guidelines on that are.

I don't kniow why posters have given you a hard time.

Many many poeple may know that a termination is out of the question whatever the chromosomal status, but nevertheless do not wish to be put in the position of a dilemma. And so the result should not have been divulged.

On the other hand many people might actually wnat to know the resut in order to be prepared for the birth of a child with DS. An 'anomlay' was found at our 20 week scan, and I was actually very pleased that I had had the chance to do the research before DS was born and not have it come as a surprise or something I knew nothing about when he was born. I could get on and enjoy his birth without dealing with any feelings or questions in those first blissful newbirn days.

I can't think why a sonographer would have a duty of care to disclose a high chance of DS - it is or isn't. No amount of 'care' will change the chomosomes of a feotus! Any associated issues - such as a heart problem - would be picked up in the scan anyway.

You made your choice for your own reasns and it should have been respected. It doesn't matter what anyone else would ahve done or wanted to know oe thinks is best. Probably no harm done, but if you asked not to be tested, there should be no mention. Apart from anything else, if the next person who asks not to be tested has read this thread and her sonographer does NOT tell her, she will be thinking 'but if it was normal they would have told me....'.

Up to you whether you tell your mw, but whatever you decide to do, you are right, she had no business talking to you about anything she saw in respect of the nuchal fold.

Original poster
maja00 · 10/08/2013 21:38

Seriously, you're saying that I should somehow know that if I don't have a nuchal translucency scan, they still check nuchal thickness Confused

OP posts:
VivaLeBeaver · 10/08/2013 21:38

Poppy- she did respect the OP's wishes. She didn't take a NT measurement nor was a blood sample taken, therefore the OP doesn't get a 1 in whatever figure.

The OP presented herself for a scan, the sonographer scanned her and looked at what I imagine any other sonographer would look at.

candycoatedwaterdrops · 10/08/2013 21:40

Poppy If you're not going to bother to read (at least some of..) the thread, then why bother posting at all? Hmm

Bodicea · 10/08/2013 21:41

What difference does it make what it is called? It is actually a combined screening test. Nt is just a common name for it.
You have declined a screening test for Down's syndrome. That is comprised of three factors, the nuchal thickness, your blood results, and you background risk based on your ages and obs history.
The nt can be raised for a number of reasons as has been explaind now quite a few times -only one of those reasons is Down's syndrome. Unfortunately they can't be separated and they second the sonographer starts scanning they have a duty of care to assess the baby fully.
You want it all explained before you go in I am sure it is there in the paperwork you are give. But seriously we can't be expected to explain every little nuance an complexity of our job every time we scan someone.

ICBINEG · 10/08/2013 21:41

OP I can see how the sonographer could detect abnormalities of nucal fold without doing the nucal translucency test, however I certainly agree that you were not kept in the loop properly about what would be tested or not in your dating scan.

It isn't okay to take a blood test on the pretext of looking for sugar and then come back with a full list of genetic susceptibilities to cancer...and it isn't okay to do a 'dating scan' and then report back on anything and everything without making it CLEAR in advance what is tested and reported.

There are more options than do EVERYTHING they suggest, and do NOTHING they suggest. One should be given the right to make an informed decision over each possible test.

The attitudes on this thread highlight how much the shut up and put up meme is inappropriately directed at pregnant women.

OP you are an intelligent reasoning adult woman. They have a duty to allow you to have the testing you want and only the testing you want!

Bodicea · 10/08/2013 21:42

Ps sorry about typos. Fat fingers !

ICBINEG · 10/08/2013 21:43

I would complain about the information provided before the test by the way - not the sonographer...she was doing her bit right...it was the midwife that stuffed up by assuming you would sign on the dotted line because she automatically knows best!

HenWithAttitude · 10/08/2013 21:43

I repeat.... looking at the nuchal thickness is not a nuchal test for Downs..... The NT test was NOT performed.

Nuchal testing is a test in it's own right and involves a blood test and then a result giving risk which is received several days later

A scan on it's own is not a nuchal test. A dating scan dates and does a preliminary anatomical assessment which includes the thickness behind the baby's neck...and anterior abdominal wall, limbs... etc

I wasn't joking earlier when I said that all patients should be asked to sign to say they understood what the tests included and what they couldn't do....before having the test. This is a misunderstanding

northernlurker · 10/08/2013 21:44

I ask again OP - what did you think the sonographer WOULD be looking at? How do you think they date the pregnancy?

Original poster
maja00 · 10/08/2013 21:44

Bodicea, again I am totally not shocked that obstetrics gets the most complaints if the attitude of midwives and sonographers on this thread towards providing women with information is representative.

How hard would it be for someone to explain that although you can decline the nuchal translucency test, nuchal thickness is still checked as an indicator of heart problems?

The difference what it's called makes is if it is misleading.

OP posts:
Blu · 10/08/2013 21:46

I am sure sonographers work hard and do a fab job, Boudicea, but are not all 100% perfect.

Mine looked at the screen and said 'well your baby will never play football or dance'. What page on the training manual suggests that as an OK thing to say?

As it happens I am a tough cookie and worked with people with no legs at all that danced so took no notice.

Things feel very different on our side of the gel on the belly, you know.

ICBINEG · 10/08/2013 21:47

northern do you genuinely think they can't measure the head size and length without mentioning out loud what they think of anything else?

They could have done the dating without telling the OP anything about the nucal fold.

If the OP wanted to know of 'gross life threatening abnormalities' but not of chromosomal abnormalities then that could also easily have been accommodated.

The sonographer can form whatever opinions s/he likes, but put a sock in it.

Original poster
maja00 · 10/08/2013 21:47

northernlurker - I am not a sonographer, I don't really know what they look for. At my last dating scan I was told there was a heartbeat, 2 arms, 2 legs, all looked good. I don't know if they measure the length of the umbilical cord, the size of the head, anymore than I know that they look at nuchal thickness. When I had my last dating scan the NT scan wasn't available and nuchal thickness wasn't mentioned at all - I had no reason to think it would be at a dating scan this time.

OP posts:
poppingin1 · 10/08/2013 21:47

OK, I read this earlier and didn't think what the sonographer did was a big deal.

But now I think about it, I'm pretty sure what the sonographer did is exactly what my sonographer did and DH and I were not candidates for an NT scan. I'm pretty sure our sonographer just checked these things and informed us anyway as she went along.

Or am I confusing things here Confused

Portofino · 10/08/2013 21:48

The 12 week scan is not meant to be a dating scan anyway, surely?