Why no scans done during the third term??

[zahara1]

Morning all!

I am just wondering why the NHS doesn't provide a scan in the last term of pregnancy to ensure all is going well?

I am 29 weeks now and so far all has been really well and easy and both my previous scans were normal and fine (first baby BTW). But I just worry that there is an awful lot of time to wait between the 20 week scan and the birth and don't understand why more ins't done to ensure baby is developing well. By that I mean making sure that the baby is the right size, that nothing has gone unspotted etc.

In most other European countries you have 1 scan per term (or more if you have a complicated pregnancy). What is the reason that it is not the case here?

I guess what I want to know is, is it worth paying to have a scan done privately to make sure all is ok and rest my wandering mind? If so how much do they cost?

What do you guys do? Have you gone for an extra scan or just waited until the birth?

Many thanks!
x

Do you have any stats for maternal and stillbirth for different countries? The only data I've been able to find have been very badly presented and showed most developed countries to have comparable rates of stillbirth.

Franca - that's fine, but it doesn't demonstrate that the 3 scans, monthly blood tests and GBS swab are the reason for the low rates of maternal and infant death.

I'm also not clear on why the anger that the NHS has finite resources. Like it or not, there is insufficient money in the pot to fund every treatment and lines have to be drawn somewhere, be that the latest chemotherapy drugs for children, drugs for early onset Alzheimer's or additional standard antenatal scans.

I'll be very interested in the results of that study, Mrs Gangly. Certainly from what I've heard, one off scans are very bad at predicting a baby's size and seemingly they're not much better when it comes to estimating levels of amniotic fluid. Before additional scans are introduced I'd very much like to see evidence that they are beneficial in terms of outcomes (and that they don't yield a high level of false +ves/-ves) and some research into the long term effects of intra-uterine ultrasound.

I suspect one of the reasons for poor infant mortality rates in the UK will be the health and weight of the mother. We probably have higher obesity and heart disease rates than Italy which will impact on infant mortality.

I read this article a while ago on giving birth in Italy and found the comparisons interesting.

www.timesonline.co.uk/tol/life_and_style/health/article7102178.ece

the hospital i am going to(in northern ireland) have scans at 29 and 35 weeks, although 2 more local hospitals have stopped after the 20 week scan. it is only a quick check though, no photos or anything like the 12 and 20 weeks scan.

i found them reassuring with ds and if you can afford it then i would probably get one done, just to put your mind at ease.

:)

I had a third scan with both mine because of concerns re progress. With DS1 it was picked up at the 20 weeks scan but they needed him to be at least 34 weeks to do the checks they required (he turned out fine with no problems). With DS2 Dr decided after physical exam that baby wasn't growing properly (not that he bothered to tell me of course but that's a whole other story!!)and was sent for a scan to check. Radiographer said DS2 was a perfect size for my dates and there were no problems.

However I remember that when pregnant with DS1 there was a few horror stories re scans and the dangers they could pose to the foetus. I remember a Dr on the radio saying they should be kept to a minimum and only done if there was an actual need and not just to 'see' the baby.

Sorry, I meant maternal death at birth. You can find the league on here www.healthmetricsandevaluation.org/resources/news/2010/maternal_deaths_fall_0410.html click on table 1, it's been reported on many newspapers.

Of course maternal and infant mortality rates aren't just linked to antenatal testing, but surely testing is an important factor.

Intuitively, yes - but that doesn't mean they necessarily are. The medicalisation of birth was thought for YEARS to be the cause of reduced MMR - but eventually they realised it was actually that Dr's started washing their hands. We have a strong belief that action improves results at lots of stages in antenatal care - but there often isn't research to back that up.

I find it easier to associate increased testing with improved stillbirth rates than with decreased MMRs. I'm not doing well on finding comparative data by country for stillbirths. It's fantastic that Italy has such good MMRs and better screening probably does play a part in that, but whether its a significant part still seems very unclear to me.

I had a 4D scan at 29 weeks and Im having another free one at 32 weeks as the company I went with tend to offer out freebies left right and centre. I paid £99 for my scan so its averaging out at just over 50 for each one!Bargain!

Yes Tangle, I've been looking for stillbirth rates and had no luck, apart from an article in the Independent (roughly 2007) discussing how the rate in the UK hadn't really decreased from the early 1990s.

Also, Italy has one of the highest rates of c sections in europe, I believe, and that isn't certainly good news.

Anyway, having lived in the UK for quite a long time, my feeling is that the nhs doesn't deem cost effective lots of tests that are instead quite common everywhere else (I'm not just talking about pregnancy).
So my doubt has always been: are other countries throwing away money unnecessarily and the NHS is wiser or is the NHS saving on prevention? (I'm thinking breast cancer, for instance)

And btw, maybe it wasn't clear from my other posts, I think the nhs is a great institution... I'd love it to be perfect though

I don't know why there are no routine scans in the last trimester but I had to have weekly scans from 30 weeks and that in itself was worrying.

I had third trimester scans in my last pregnancy because of gestational diabetes and they were to check the size of the baby and condition of the placenta as GD can lead to early breakdown which is why they often induce at 38weeks.

I'll be having a 34 week scan this time as I have a low lying placenta picked up on the 20 week scan.

As others have said, in most cases 3rd trimester scans are usually not necessary and the need for one will be picked up by other factors from the 20 week scan or other symptoms.

Obviously there are times when a later scan in an apparently healthy pregnancy would have made a huge difference and for these individual cases it is hard to see why it isn't routine, but the NHS unfortunately has to prioritise on a risk basis and for that reason will always seem not good enough for many cases accross the whole health care spectrum.