Unable to do NT screening

[ohidoliketobe23]

I had my 12 week scan at exactly 12 weeks. Bc of the position of the baby, they couldn’t take a head to foot measurement and they couldn’t measure the fluid on the back of the neck. They also didn’t take blood for screening bc they couldn’t do the screening scan.

I've been booked in for a rescan at 16 weeks, however I was reading today that the NT screening scan can only be performed up to 14 weeks which will be this Friday coming.

I rang the maternity unit today and they said the 16 week scan will be a 'second trimester screening' but we're evasive when I asked whether it covered the same things as the NT scan.

I feel frustrated that the midwives didn't make it clear at the 12 week scan that by doing a rescan I'll not have the same level of screening.

I'm wondering whether I should insist on an NT scan before I reach 14 weeks on Friday? Or whether a second trimester screening will reveal the same thing? Any words of wisdom or advice?

The screening at 16 weeks won’t be as accurate as the NT one which is only up to 14 weeks. I’d be wanting an earlier re scan or nipt done.

@Overthebow thanks, this is what I've gathered from the research I've done. Don't suppose you can point me in the direction of any data to back that up? I can't find anything.

I'm frustrated that this has been shrugged off by midwives and the sonographer.. if I hadn't done my research I'd never have known this and they'd have let me go without the NT screening that I requested.

I've had some really bad experiences with my local hospital with my previous birth and a recent ectopic, so feeling particularly troubled by being dismissed by them again.

I was rebooked for my scan and they were insistent it had to be before 14 weeks to perform the test.

It’ll be the quad test they want to do https://www.genomicseducation.hee.nhs.uk/genotes/knowledge-hub/quadruple-screening-test/#:~:text=The%20quadruple%20screening%20test%20is,Edwards%20syndrome%20or%20Patau%20syndrome.

NHS says this:

Quadruple blood screening test
If it was not possible to obtain a nuchal translucency measurement, or you're more than 14 weeks into your pregnancy, you'll be offered a test called the quadruple blood screening test between 14 and 20 weeks of pregnancy. This only screens for Down's syndrome and is not as accurate as the combined test.

Quad test doesn’t test for Edward’s or Patau. Does test for Down’s syndrome but not as accurate as NT test.

Thanks all - that's really helpful.

I don't like to use the word gaslit but ffs I've spoken to my midwife and a midwife at the maternity triage and they've both made out like it's exactly the same thing and I'm being dramatic about wanting it this week.

I reckon I'll call up tomorrow and demand a scan this week... if they can't do it I guess I'll have to pay to get a private one done for peace of mind. I hope this is something private clinics offer...

I'm almost certain they have to offer you another scan and to attempt NT measure under 'twice on the couch' https://phescreening.blog.gov.uk/2015/10/29/cant-get-an-accurate-nuchal-translucency-measurement-dont-let-women-miss-out/

I only say almost certain as I'm not 100% if this is absolutely up to date. But I quoted it to PALS when complaining that the hospital booked me in for a 12 week scan too early (by dates, not by measurement!), couldn't do the NT for that reason, and then tried to fob me off with the quad test. I got my rescan!

In fact I'd probably do just that if I were you- get onto PALS rather than trying to chase it yourself, given that it's time-sensitive. Don't feel guilty about doing so, I gave my hospital too much benefit of the doubt the first time round and suffered for it so decided I wasn't going to do the same the second time.

Crossposted- if the people who are meant to be caring for you are being shitty about your reasonable request then 100% go to PALS. Include what the two midwives have said as well. Even if PALS can't do anything they at least will be polite about it.

Thanks @8DPWoah - are PALS quick to act? I worry adding an intermediary would slow things down.

I'm also a bit worried that they'll throw the 'it's procedure if we can't do it in the first scan' line at me, do I still have to leg to stand on just because I want the bloody test?

How frustrating!! I'm sorry you're going through this. I realise it's not the answer to the hospital providing you with rubbish care, but you could get it done privately if you're worried about the accuracy of the test past 14 weeks. Of course you shouldn't have to (and of course it's money you shouldn't have to spend) but at least you'd have an answer

Thanks @neverwakeasleepingbaby - private scan is my plan B if I don't get anywhere with rebooking tomorrow.

I've had such shit care from this hospital over the past 3 years... you'd think being in the news for having over 45 avoidable infant deaths would be enough to make them pull their socks up, but somehow they're still as shit as they were before the investigation!

I emailed Pals the evening after I'd been turned away and I'd got my rescan booked in before lunchtime the next day- that may not be typical but I suspect they have response time targets to hit which the midwives won't have the same pressure of.

If the link I've sent is still current guidance then I think they'd be very hard pushed to argue they've done everything they should. I know the scan departments are very busy but equally there must be some capacity left in the system each day as I had at least one ad hoc/triage linked scan with each baby.

I'm sure I must have had a little negative marker on my notes afterwards but frankly when I found myself having to shout at the midwife in charge on the antenatal ward that paracetamol was not going to cut it and she needed to examine me (6cm at that point) and love me out of the 4 bed bay before I gave birth there I gave no more of a toss about their feelings than they had for mine. Keep us posted!

That is really poor on their part. My DS was in the wrong position for the scan, they poked and prodded for ages to get him to move, and as he refused they sent me for a walk to try get him to move that way (and up and down stairs... lol), and saw me again 20-30 minutes later, and so were able to redo the scan the very same day.

There was no rushing of me or the scan to keep me within appointment times.

After hours of to and fro on the phone, I finally managed to get an appointment for a scan on Friday at exactly 14 weeks at another hospital. I really hope it won't be too late to get the measurement they need!

@ohidoliketobe23 if I were you and could afford it I would do the NIPT if it going to cause you any anxiety. I had it done with both my pregnancies. I think some sonographers have a relaxed attitude towards not getting the NT measurement and don't consider the anxiety this may create. Did they get to see it at all but just struggled with the measurement? For my second pregnancy the sonographer said she couldn't get an exact measurement but she could tell it wasn't large. I had the NIPT done privately for reassurance.

@Purtyburty they didn't see it at all, so very little reassurance. We came away with some very underwhelming scan images 😂 will look into the NIPT, but not sure we can afford it atm (self employed and saving for maternity leave!). Do you remember how much you paid?

Just be aware that not all babies comply, that is that your baby may well still be in a position where they can't get the measurements. Unless you are particularly high risk age wise the blood test is probably a good idea

I suppose if you do end up with just the quad scan try and reassure yourself that the NT in the grand scheme of things is fairly new. We just had the quad scan when I was pregnant. It’s not that it’s inaccurate, it’s just not as accurate as the NT.
Don’t leave yourself short by paying for the nipt which is about £400.

@ohidoliketobe23 it was £350 so definitely not cheap x

I know this is not what you were asking, and therefore possibly not helpful, but if you're thinking of getting a private scan, might I suggest getting an NIPT instead? I would never have the 12 week screening again - in my last pregnancy, I was given a 1/9 chance of Downs syndrome, which led to some very stressful and unhappy weeks. My NIPT came back clear and I've since heard of a number of friends who have had alarming but inaccurate results from the NHS screening.

Please ignore if this is unhelpful, but if you were thinking of going private anyway, this might be a more accurate alternative. Hope it all goes well, whatever you choose.