To wonder why pregnant women don't get more routine scans

[Sarahh2014]

I had a difficult pregnancy with scans at 8w 10 12 20 24 28 32.All was fine in the end but I often think that 2 scans might be enough to measure growth but a lot of people get anxious before their first and even second scans as a lot can happen in that time.Does anyone know why this doesn't happen? Is it because of cost? Genuinely wondering

There is ongoing research to investigate the incidence of multiple early scans & the affect they have on the developing brain of the baby.

This is one thing they are looking in to for reasearch in to the higher number of autistic children and other such things.

Our sonographer told us this as her data was part of a trial, and we had to agree or disagree to be contacted again over the next several years as I had several early scans and monthly scans during my pregnancy.

It’s difficult finding a balance really and yes, comes down to money.

I do think a scan at say 36w would be good. With DD1, I had a low lying placenta at 20 weeks so I was booked for a scan at, I think, 37. It had moved but they then saw I had much too little amniotic fluid, so they kept an eye and I was induced. By the time she was born there was virtually no waters, she was distressed and the placenta was quite calcified. So it scares me to think what may have happened if the placenta had been normal at 20w, because I’d never have had that late scan.

With DS, I had a normal pregnancy with no interventions beyond normal. Fundal height was big but I had no extra scans. He was born a bit late, but nearly 12lb. Turned out I must have had GD (developed late as I passed the GTT), he also had low sugars which made the first few days a nightmare. So a scan that picked up his growth may have made this clearer, I could’ve been retested for GD and controlled my sugars. OTOH I’m quite glad nobody realised his size because they may have induced early or made me have a CS, when actually the birth was the easiest of my three by far.

With DD2 I was offered extra scans due to the above, and I did have GD, which I controlled with diet, but the final scan at 36w made them panic as she was showing small. Just due to the leg measurement they said the placenta must be failing etc. I was induced a week later and it was the worst experience of my adult life as she wasn’t ready to be born. She was not nearly as small as they thought, quite normal for 37+4, and perfectly healthy. The MW even cut the placenta for me and it was perfect. So I didn’t need to be induced, and I had a breakdown on her due date as I just thought she could’ve still been in there and I may have had a better experience.

It’s so difficult as I have had both under intervention and over intervention I suppose, plus a good level of intervention which only happened because of a random coincidence but may well have saved her life. But that one (ie DD1) is the one that makes me think one late scan as routine would on balance be a good idea, as the still birth rate here is high, and it really scares me to think what may have happened if I hadn’t needed that scan for another reason.

People can refuse scans I think, at least a friend is refusing the growth scans at 28+ weeks as she feels they aren’t necessary

I had regular scans with my 2nd as I had placenta previa & the baby was "big for me", so CS on the cards.

Luckily the placenta moved & baby was 2.2kgs-even I managed that!

Dc1 I had a 6 week scan as I was bleeding heavily they took a wait and see approach as heartbeat was detected, 12 week scan and private one at 14 weeks as dh couldn’t do the NHS one another at 20 weeks, I had another private one at 32 as my midwife scared the shit into me saying she couldn’t see any growth in my bump size, and a nhs one when I went in for monitoring as baby has stopped moving then induction a day later, as heartbeat dropped.

Dc2 I had a 6/8/10/12 week scan I had a massive blob behind the baby which was blood and they wanted to keep and eye on it. I had a 20 week scan and they couldn’t identify a problem as had another about a week later.

Sorry posted too soon.

I had another at 32/34/36 as I had several problems, eventually induced at 38 weeks as they decided the risk was too high.

Cagliostro I had an induction at that stage too and it was by far the worst of my 5 births.

I don't know about the scan thing. I would have benefitted from an early scan with my first baby as he/she died at 6 weeks but I didn't find out until 12 weeks when I had a scan for bleeding (my dating scan would have been at 13+2 so even later). I had complications and lost a lot of blood which the epu nurse said wouldn't have happened if I'd had an early scan at 6-7 weeks. However with my 2nd miscarriage the baby died at 9 weeks so a scan at 6/7/8 weeks would have been falsely reassuring. Although part of me thinks it would have been nice to have seen him/her alive.

I had more scans with my youngest 3 than with my older 2, especially the youngest 2 and including a 4d scan for dc4. My dc3 is left handed, my dc4 has an immature brain (which wasn't picked up on any of the scans) and learning difficulties and my dc5 has suspected autism. I don't know if it's a coincidence or not. My dc1 has autism too but much less severe than dc5.

I had my children in Australia.

We only got two scans.... if something is wrong you get more.

If you wanted more, you go to a private clinic and pay.

My last pregnancy was fine up until the last 3 weeks when I had reduced movement. I just went to my maternity ward had my monitoring and scans done over 3 days twice per day and as it was explained to me; really they can only advise on what they see then and there on the screen once you leave anything can happen. Which is why they also said if you think something is wrong, come straight back.

Risks. Theres a vvvv tiny risk to scan. In a healthy pregnancy theres no need but in a pregnancy with complications you need to

@LisaSimpsonbff. I guess what I am trying to say, is that it is not clear cut, just because it is accepted and routine to have 2 scans, does not support the assumption that it would be safe to increase the number of scans. More evidence is required.

While I accept that without having read all of the papers, I cannot make a complete assessment, and one must also take into account author's bias, both of the article (the author's opinion is clear!!) and the authors of the studies...

The second paper mentioned (which may indeed have other weaknesses associated with it...) was also concerning

'The second landmark paper, also a randomized controlled trial, looked at the safety of repeated prenatal ultrasound imaging. While the original purpose of the trial was hopefully to demonstrate the safety of repeated scanning, the results were the opposite. From 2,834 pregnant women, 1,415 received ultrasound imaging at 18, 24, 28, 34 and 38 weeks gestation (intensive group) while the other 1,419 received single ultrasound imaging at 18 weeks (regular group). The only difference between the two groups was significantly higher (one-third more) intrauterine growth retardation in the intensive group'

I would like to see a study which investigated whether routine scanning had a positive impact on outcomes on pregnancies which were not clinically high risk. (If you have any links, I would love to read them.)

In a perfect world, there would be adequate risk based analysis on every medical intervention, specifically controlled for each individuals risk factors... the reality is we have to go with what we have and the clinical judgement of the decision makers is a huge part of that.

There was a Scandinavian study which linked scans to increased left handedness in boys, which is interesting.

I had to have loads of scans with my DD because of GD and bleeding and then heart rate monitoring 3 times a day which is also an ultrasound I think. DD hated it and would wriggle away from the machine; the midwives said lots of babies did that and they thought the babies could hear or feel it. Don't know if that's true though!

I only had one scan (the 20 week scan) during each of my 3 pregnancies. I think I was offered one at 39 weeks with my 2nd because my consultant was obsessed with inducing births (for some reason) but thankfully I went into labour before that.

I live abroad and you can get a scan at every appointment if you like - my pregnancy is dealt with by a OB/GYN tho and not a midwifes as it’s private care. First pregnancy I have scans at 8,12,16,20,28 and 34 weeks I think? First was to date pregnancy, very quick. 12 and 20 weeks were the standard ones (NT and anomaly scan) and 28/34 weeks were to have a look at growth rate and placenta rather than having a look at the baby IYSWIM.

All pretty standard - yes I had to pay for this care but it was definitely helpful to OB