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Original poster

Need to re-do anomoly scan due to +BMI

34 replies

PDR · 30/09/2010 21:14

I had my 20 week anomoly scan today and the sonographer said he could not see the heart properly and could I come back to redo the scan in a couple of weeks.

As it happens I am going on holiday tomo and won't be back in time so said no... I asked if I should organise private scan whilst I am away he said yes if I can becuase basically if there is a problem I can only terminate up until 23 weels His words not mine.

He didn't say why he couldn't see the heart properly and I assumed it was because I am only 19+6 today and it wasn't yet developed enough but I also left feeling a bit anxious that he saw something he was not sure about and wanted to look again in a week or so...

When I read my notes later at home he had put in a report clearly stating that he could not see the heart in enough detail due to my raised BMI. That's fine - I am aware I am overweight but why did he not explain this to me? It would have put my mind at rest...

Has anyone else had this...?

OP posts:

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emma31177 · 30/09/2010 22:10

my 12 week scan they couldnt see the babys bladder and wrote on my report due to me havin high bmi and said dont worry things will be better at the 20 week scan but still worried me so i booked a private scan at 16 weeks they are so much better than the nhs scans try not to worry but if u are book a private scan

Original poster

PDR · 30/09/2010 22:22

Thanks emma I have booked a private scan for the end of next week so hopefully the baby will be a bit bigger then too.

Just can't understand why he didn't explain to me the reason!

OP posts:

Maclaren · 30/09/2010 23:23

They never do sometimes I think they write it as a cop out! funny how the private ones can see just fine! I also had a private scan as was not happy with the NHS one! It is a good excuse for you to see your lovely baby again x

AlpinePony · 01/10/2010 06:55

It's nothing to do with your BMI! So do not torture yourself about that! As Maclaren states - the private people don't seem to encounter this problem!

roulade · 01/10/2010 08:35

My sister had this problem but it was just due to the baby's position, when she went back two weeks later all was fine.

Original poster

PDR · 01/10/2010 10:49

Yes I did think it was funny becuase this is my 2nd and noone mentioned it to me during that pregnancy and so far in this one I've had 4 scans and they have been quite clear... All of those were private though this is my 1st NHS scan so perhaps that's why...
Feel a bit better now thank you!

OP posts:

kellestar · 01/10/2010 10:58

I had this, the sonographer said it was because LO was lying awkwardly and wouldn't get into the right position. But when i went back for the next appointment they said it was because of my BMI. Second scan was much better, LO was settled in a good position for scanning and 10 minutes later scan complete and no worries.

yellowflowers · 01/10/2010 10:59

very insensitive of the doctor. If you can afford private scan have it because it will put your mind at rest pre holiday. I was called back for a kidney anomaly and actually there is a problem but it is not life threatening - just needs observation. But I convinced myself they wanted me to come back at 23 weeks in case I had to terminate it before 24 weeks and no one told me otherwise so I spent a week very stressed. Then when we saw the expert for the second scan they were appalled no one had explained to us that actually it was a viable baby with just a little problem.

Original poster

PDR · 01/10/2010 11:10

Yes he was very insensitive - he actually said I needed to get it done before 23 weeks so I could still have a termination! Nice!

I have booked a private scan in Oz for next Friday so fingers crossed.

OP posts:

angels1 · 01/10/2010 12:07

urgh, this is so annoying and frustrating. At my 12 weeks scan the lady said she would get a better view from an internal scan, which was fine, didn't bother me, but then she wrote in notes this was due to my fatty tummy (well, not those exact words). It's odd as when I paid for a private scan a few weeks earlier they could see just fine by pressing on the tummy and there was no question of an internal scan, and it was earlier in the pg so presumably trickier to see everything well via tummy scan. I;ve got my 20 week scan in a week and dreading she'll make more comments on my fat tum in the notes or having to be the ONLY person I know to have an internal scan at 20 weeks (I know noone who had internal at 12!). I'm not incredibly huge either, about a size 16

yellowflowers · 01/10/2010 12:44

I have had internals every time I have had a tummy scan too. They never say anything though my notes say obstructed view due to being fat though not in those words. Sod them - the baby is nice and cosy in there!

Original poster

PDR · 01/10/2010 12:53

I just don't understand why they don't explain what they are doing! Especially if they are going to write it on the notes which you are bound to read anyway!

I didn't get the option for an internal scan as I wouldn't have minded at all! It was very quiet at the hospital as well and there was nooon waiting after me so he could have tried a bit harder IMO!

Grrrrrrrrrrrrrrrrrrrrrrrrrr!

OP posts:

debka · 01/10/2010 13:57

angels really don't panic, I am a size 24 20 with loads of flab on my tummy since I had DD, and the scan was fine.
I think the OP was just unlucky.

lainey1981 · 01/10/2010 16:00

angels don't worry. I had to have an internal for part of my 12 weeks scan - at the time the sonographer said it was cause the baby was lying funny and i might need to go for a walk or have internal - couldn't see his nasal bone as face was wrong direction.
on notes it read restricted view due to maternal habitus. I am size 14-16 so fat yes, but not enormous.
on my 20week scan i was terrified i would have to have another internal cause they thought i was the fattest person ever to have conceived, but they had no problems seeing everything, and was over quite quickly.though on my notes again think still mentioned restricted view. not sure why - i could see everything fine.
Part of me wonders if that was written because they calculated my BMI wrong (as they made up my height as 5ft4 when i am sft9 rather than measure me) so my BMI was calculated at 36 instead of 31.
in the end they asked if they could check the length of my cervix - and for this had to be internal but think even if i was size 8 would have to get this measurement via vaginal scan not abdominal.

angels1 · 01/10/2010 16:17

thanks guys, feel a bit less of a freak now

Swazzee · 01/10/2010 16:20

Like Debka I am also a size 24 20 and on all my scan notes they put something along the lines of 'adiposity restricts view somewhat' but no one's ever said that to my face!

I had my anomaly scan at 22 weeks and the sonographer couldn't see either of the hearts (twins btw) but she said it was nothing to worry about - they were just facing the wrong way. She was able to see and measure all the other bits and pieces fine. Was booked back in for 25 weeks (no mention of terminations or anything of the sort) and at that appointment we saw both hearts no problem.

Lots of people have to have a re-scan after the 20 week one - they have to measure so many different bits it seems to be impossible to find a position from which they're all visible! I wouldn't worry, but am shocked on your behalf of the insensitivity of the sonographer.

angels1 · 01/10/2010 17:09

yes swazzee that's the word they used with me - 'apiposity'. I looked up what it meant and cried :(

Maclaren · 01/10/2010 17:22

Oh we are all in the same 24 20 gang lol! I t was only my 12 week scan that they put at the bottom about raised BMI I just thought thats Boll*cks very easy way out for them I think! I am on my 3rd DS and have always been this size whilst pregnant I really do think it is down to the machine they use! Have a lovely Holiday and enjoy your scan x

nancydrewrocked · 01/10/2010 17:31

I don't know if there is any truth in the assertion that BMI causes difficulty in scanning but the reason that more can be seen at private scans is that the scanning equipment is frequently better.

I didn't realise this until my MW explained earlier this week that I was going to be scanned on the hospitals "best scanner" because of a potential anomoly. Apparently they have a number of scanners but use their most modern one for when there are issues.

Also as someone who is about to be scanned at 23 weeks for a potential heart issue both my NHS and private consultants have made it absolutely clear that you can see a great deal more at 23 weeks than you can even at 21 weeks.

The termination comment was both insensitive and also plain wrong as you can terminate due to an abnormality at any stage in a pregnancy and I am amazed that he was not aware of this very basic fact

prettysunset · 02/10/2010 10:18

This reply has been deleted

Message withdrawn at poster's request.

nancydrewrocked · 02/10/2010 11:46

andyflo I realise that all scanners have to be to a set standard but is it not correct that some of the scanners in use in both NHS and private hospitals are better than others?

In other words they all have to be of a minimum standard but there are machines that are better than those minimum standards in use?

I visited a private clinic in London where I was scanned by a professor of fetal medicine who also practices (and is head of dept) at one of the major London training hospitals. I had forgotten but he also told me that the quality of the machines vary from clinic to clinic.

xMrsSx · 02/10/2010 12:50

I'll back you up here andyflo...

There is of course some variation in the quality/age etc of scanners and I suppose with the extra funds they have it is possible that private clinics may have slightly newer scanners and so the images may be better.

Also agreeing that probably not many people are aware of the lack of training that some private scanners may have (NOT all of course - i know plenty of ex-NHS sonographers in private clinics) but please please check they hold a qualification to scan (and that training is up to date) as it is true that anyone who can buy machine can setup in business. The regulations are quite lax on this and particulrly with the pure bonding scans there can be a sense of reassurance to the parents that everything is ok with the baby but the scanner is actually not qualified/able to determine this. Also the safety aspects of using this equipment with little knowledge of the physics/safety implications is worrying!

I also agree that BMI makes a huge difference to the scan. Whilst it may seem a cop out to write 'difficult scan due to adiposity/BMI etc' on a patient's notes I am sure that you must realise that not everyone would take the comment if made verbally very well. And it does have to be documented, for legal reasons. Sonographers are often sued and so it is no suprise we want to try and cover ourselves.

I think the assumption that private clinics dont have the same problem is probably wrong, just that they don't have the same comeback as NHS sonographers, they also quite possibly do a lot less scans in a day (and MAY be using better equipment).

I agree the sonographers comment re: termination was insensitive and I am NOT justifying it, only adding that he will have been referring to the process of termination which IS effeted by gestation. Of course as Nancydrew says it can be done at any time.

PDR I am sorry you felt you had a bad experience and this is wrong. I'm just trying to add some more info to the mix here, not justify the bad experience you had. And I am also a larger lady who had my anomoly scan at 21 weeks then had to go back at 22 weeks as they couldnt see the heart properly and I also was terrified, even knowing we do this all the time!! All was ok in the end. Will be for you too PDR.

nancydrewrocked · 02/10/2010 19:19

xMrsS he can't have been referring to the method of termination if it was a 20 week scan though. A termination carried out at 20 weeks will be the same process as a termination carried out at, for example 26 weeks. Most hospitals/clinics wont carry out a surgical termination post 14 weeks so he was a long way off that point.

Hopefully · 02/10/2010 20:30

Just thought I'd add my experience - the complete opposite o everyone else! The only private scan I've ever had they couldn't see very well due to 'adiposity' (I was a size 12/14 at the time of the scan), and none of the NHS scans I've had have had this problem.

xMrsSx · 03/10/2010 00:24

No Nancydrew, I think he will have been referring to the need for a potssium chloride injection which is done if the gestation is more than 21weeks and 6 days, hence gestation important. Not really a subject we should discuss on here which is why I was a bit vague originally.

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