What is the most detailed scan available?

[bigbutton]

Hi all,

Can anyone give me some info about the types of scan available?

I'm 1st time pg, 9w 6d, and (to cut a long story short) there's a 50% chance of serious physical birth defects. I'd really like to be able to relax and enjoy being pregnant. However, there's little to no chance of that until I know what's going on with this baby.

My GP has recommended an extra ultrasound at 16w to "set my mind at rest" but (I'm not feeling at my most patient) I'd actually really like it set at rest now, rather than waiting 6 weeks, cheers. I haven't even got my booking in appointment until next Monday.

Also, ultrasounds don't seem to be very high resolution. Will they really be able to tell very much from the first one at all? Is there no way they can get a camera in there?

I'd be really grateful for any information anyone can give me, or any links to somewhere I can read up on the types of scan available.

the trouble is that babies develop. So if it had, for example, a cleft lip, you wouldn't see it at 12 weeks anyway.

You can get private 3D scans but bear in mind that you're still talking about a graphical representation of sound waves so they can throw back some anomalies in the image. AFAIK a camera wouldn't be possible, not least because you wouldn't want to dislodge the mucus plug and get an infection.

I know it must be very difficult but at least we do have scans. 30 years ago routine scanning didn't happen and still doesn't in most parts of the world. Also scans cause a lot of unnecessary worrying, I'm not sure they're great overall. Speaking as someone whose been told that her baby is growing at half the normal speed "we think, or we might have measured badly last time".

12 weeks is too early to see a lot of problems, but some things, such as spina bifida may be apparent. An amnio or CVS would show up any detectable genetic anomolies, such as Downs, Edwards, Pataus etc and these can have associated physical problems, but you'd almost certainly have to pay privately and obviously it wouldn't rule out physical defects as such, just genetic problems associated with them.

Even at 16 weeks, I don't think all physical problems can be ruled out, I don't think the chambers of the heart can be checked then and things such as cleft lip/palate. It might reassure you about a lot of things though.

If you have a good reason why you are concerned about physical birth defects, then your hospital will usually offer a detailed ultrasound at 20 weeks or so and then you'd be able to pay for a 3D scan yourself on top of that.

Scans aren't 'high resolution' because that is not how they work. But given the right operator and machinery, they are very, very good for detecting most problems.

Bigbutton it also depends what type of abnormality you are concerned about and at what stage in the fetal development that part of the baby's anatomy is formed.

I'm 11wks and also have a 50% chance of physical defects, probably affecting limbs/hands/feet. I've been booked in for ultrasounds at 12, 16, 20 & 24 weeks, so I'm assuming they think that by 24 weeeks and possibly earlier they'll be able to get a good idea.

However, I had a private scan last week at 10+3 after a bit of bleeding and having explained the situation to the sonographer she took a lot of time and care to focus in on the limbs for me. As she stressed, this early there are obviously no guarantees but she was able to show me on screen what looked very clearly like the bone structure of fingers and thumbs

Good luck with your pg and I hope everything turns out well for you.

PS I had my private scan at the Fetal Medicine Centre in London and can't recommend them highly enough if you are local.

Thank you all for your replies. As you can tell, I'm not doing very well with the waiting bit.

I know scans can cause worries but I'm already worried sick, so I'll take any opportunity for good news. The defects would probably affect the limbs and/or heart, so even if I (or they) could make out the existence of limbs, it'd make me so happy.

Genetic testing probably isn't worth it, as they've said they only find the relevant gene for this in about a third of cases.

Would a private scan be likely to show more detail, or do they have more or less the same equipment? I don't mind paying for some extra reassurance. We had this news dumped on us 3 weeks ago, and haven't had a lot of peace of mind since.

Thanks for the recommendation Wombat. I'm in Cheshire, so not quite local enough :) but I'm going to look and see if there's somewhere similar around here.

Bigbutton I haven't had my NHS scans yet (in this pg - I did when I MC last year) so I'm not sure how they will compare in terms of equipment, though on here I've seen it said that with great resources at their disposal the private hospitals are more likely to have newer machines. I suspect it depends on your NHS hospital. I'd also say that in my experience to date, the private sonographers have a lot more time to be attentive and "customer focussed" - that's the luxury they are able to have because you're paying. I would make sure wherever you go though that they are geared up for diagnostics scans and not just "fun, extra photos of the baby" scans, if you see what I mean!

Good luck and I feel for you. I was reeling for a long time when we were given our odds so I know just how upsetting and scary it is xxx

face2facebabyscans.co.uk/blog/maternity-scans/ i dont know where in the country you are but i am going to this place on saturday for a 4d scan.......just thought the information on the link will give you an idea of what a private scan can tell you about your baby at different stages!

Private scans won't be better quality than NHS ones. Actually when I had my private 3D scan I'd say the 2D image was better at my hospital (PFI, all equipment new every 3 years). But the 3D image was quite clear and lovely to see.

That wouldn't help for the heart but might for the limbs. The sonographers are very good at interpreting the 2D images though and so far I've found my NHS care to be brilliant (and although baby is fine I have immunology and diabetic problems which mean I have loads of extra appointments).

If you can afford it, then I agree with Wombat that a private scan might be a good idea just so you have one that's a bit longer and where you can ask the questions and dictate what you want to focus on. I paid £125 for a 3D DVD.

The type of scan is not as important as the skill of the person carrying out the scan and so whilst 4D scans are great if carried out by a specialist they are possibly less helful than a scan by a specialist with a regular 3D scan.

Also as has been said many issues simply cannot be detected until the baby is a certain number of weeks. I had specialist heart scans in my current pregnancy and whilst tehy would have been happy to do a regular anomoly scan at 18 weeks the feeling of my professor was there was little point in having an in depth heart scan until 22 weeks.

I understand the wait is difficult but the chances are that whilst you could have a scan earlier it would not be difinitive for good news and you would have to be rescanned at a later date.

Hi, I agree with Nancy that it is quite important to have a top notch fetal medicine specialist (go for a consultant rather than a sonographer; it is worth extra money). Do you live in London? If so, you can try Professor Jaunauix at Portland or UCH or Dr Demetrios Economides at MyScan (or Portland). Both are excellent fetal medicine experts. As someone pointed out, serious anomalities will not be seen until 17-20 weeks. In terms of resolution, I totally hear you. I tried both NHS scans and private scans (live in SW London) and can assure you that private clinics had latest equipment and resolution was much better than NHS... Good luck!

Actually lilly13, you are wrong on your comments. Sonographers are extensively trained and monitored, scanning all day and specialising in this alone means that they are much more skilled at Ultrasound than a Consultant who mearely dips in and out of the speciality...Consultants may appear more knowledgeable and competant simply because they have the confidence and bolsyness of their title behind them and the fact that memebers of the public are smoke-screened by 'oh he's a fetal medicine specialist, he must be the best' Equipment used for NHS screening is subject to strict replacement criteria and Sonographers train for at least 4 years and are there after required to undergo competency checks yearly, usually by bodies like the FMF. Many Sonographers work both in the private sector and NHS. Speaking from experience,and anecdotes from collegues, on attending study days hosted by 'centres of excellence' we have often been shocked by the lack of basic skills in some of the Doctors, hailed as experts by virtue of their title or workplace...Please don't knock the NHS. We do a bloody good job, in very difficult circumstances, sometimes with very difficult customers!

I take it all back! I had no idea how good the ultrasound would be - and it was amazing.

I interrogated the obstetrician about endoscopic scans. He said there was a lot of investigation into that about 10 years ago (ie they tried it in women who were planning to have an abortion anyway). The miscarriage rate was so high that they kind of gave up on it, especially since ultrasounds have become so much better in the meantime.

Anyway, my baby has arms, hands, the correct number of fingers, and a good heartbeat. I could see all that and it's still only 2 inches long! I'm over the moon

Brilliant news :) I'm so glad everything is fine and that you were able to get the reassurance you needed.

I do think the NHS gets a lot of unnecessary stick, I've had loads of complications but so far (36 wks) I think its been great.

Great news about your scan, on both counts!!

I mix private and NHS for my scans as I'm high risk times a few. The NHS does the bare minimum (and with pretty good machines, it has to be said) but for reassurance I head off to a private place which happens to have a newish very shiny machine. Not entirely sure the sonographer there would be as good as many NHS sonographers, but I don't ask for anything complicated and she is certified by the FMF anyway so she's probably fine!

When I want a really detailed scan that the NHS won't give me, because they don't see it as medically necessary to provide reassurance (fair enough - budgets are limited) I've been to the Fetal Medicine Centre on Harley Street and paid out of pocket. Now they really are the best - same doctors/sonographers (often they are both) and presumably same level of equipment as at Kings College's Fetal Medicine Centre.

Hi - Like Sparklies, I simply have to recco Fetal Medicine Centre! I live in Birmingham but found it reassuring to go and see Prof K Nicolaides at FMC in Harley Street.
It cost £200 per scan (so only about the same as other private clinics around the country), and that felt like a small price to see the best fetal medicine specialist in UK. Prof himself is amazing - my consultant was very reverent of his opinion.
Worth every penny should you need that level of insight later in your pg.
Good luck, xx