20 Week Scan "Technically Difficult" High BMI

[Babyno2mamabear]

So we had an amazing scan today, saw our happy and healthy baby girl, kicking away and wiggling nicely, perfect heart beat and heart chambers and feeling extremely happy. They struggled to get the measurements of the spine as baby was bent over sucking her toes haha and facing the wrong way. Even after jiggling around and going for a wee they cpuldnt get the measurements so I'm back in 2 weeks. I just checked through my notes and it says "Scan technically difficult due to high BMI". My BMI is 36 so yes I know it's high but I carry all my weight on my legs and arms and I'm a size 12-14, I've been so stressed about my BMI since I found out at booking in and have since lost 11lb with slimming world. I was in a good place, and now I've read this in my notes and feel like AGAIN I am failing at this pregnancy thing and never should have got pregnant without losing weight first. And now I feel like packing slimming world in and eating my weight in chocolate because it's all for nothing anyway. Has anyone else had this on their notes? He mentioned nothing when doing the scan and didn't seem to struggle at all other than the spine and laughed about the odd position baby was in, even said it wasn't my fault. So why write it? Feeling frustrated when I should be over the moon xx

It's just a technical thing, not a judgement. Keep going as you are!

Why write it?

Because it was the truth obviously.
No judgement. A statement of fact.

As for why that would make you want to stuff yourself with chocolate when it stopped measurement of your baby is beyond me though.

Just keep doing what you're doing, focusing on eating right, walking or exercising daily and you will be fine. They only write those things because it's the truth and they need to be accurate. Don't beat yourself up, baby sounded very happy and that's the main thing!!

I had a rubbish experience at this scan with a of 30, also size 14.

The chap was very rough, left my bruised by pushing so hard and kept saying that all his scans had been difficult that day as the women were all overweight. It was really upsetting to be treated so roughly. He made me jump up and down which was really humiliating and said he couldn't do the measurements. I was totally shell shocked and didn't say anything at the time.

I got another appt and had a lovely lady the second time who was gentle, got the measurements and didn't make me feel embarrassed about my weight.

Try not to worry, you've done brilliantly losing weight. Maybe give yourself a nice bath and a cup of tea to relax, and know you're doing the best you can at this time.

The second time the lady told me that if they can't get the measurements it's not the end of the world, and it's likely you'll have extra scans because of your BMI anyway which is great as you get to see your little one more than others! X

I can see that would feel like a judgement and make you feel like shit BUT please try to put it out of your mind. Sounds like you are doing great! Most important info from your scan is: baby is healthy! You are acing this

Well done on your weight loss and congratulations on your pregnancy.

Don’t eat the chocolate! Keep yourself on track and be as healthy as you can for yourself and your baby, it’ll make your pregnancy easier.

He wasn’t being mean and it wasn’t your fault, but it’s technically true and okay for him to put it on your notes.

At my 20 week scan the baby was face down and I had to sit in the waiting room for 10 minutes to see if it moved. It did but I was blessed with the grumpiest sonographer ever and she was very critical of my face down baby!

My notes say exactly the same, my BMI is 32. I think they must write it on all notes if it's over 30. But I get your annoyance, as I felt like shit after reading it in my notes too.

My bmi is low and I was made to jump up and down, pretend to hula hoop and was left very uncomfortable after some of my scans. Thats not a weight thing, it's a positional thing.

@Kikidelivers my point is he told me he couldn't get her spine measurement because she was facing the wrong way and because she was practically curled up in a ball? I am fully aware that I have a high BMI but my weight hasn't been mentioned on any of my previous 4 scans (due to my abnormal screening results) and so I don't understand now why 11lb down it's being written as the reason for no spine measurement? He didn't even mention that was a factor. Equally this is and always has been a sensitive subject for me with on going medication to help with numerous health issues, a lot of the side effects are weight gain. I feel I'm fighting constantly with myself to do better for my growing family and when it wasn't a problem with earlier scans but it is now it does add an element of "what's the point".

Thank you for those who have left nice comments, I know the right thing to do, it's just this has been so bloody bloody hard!! Losing weight doesn't come easily to me at all!!! But I've really tried to do my best since day 1 and now feel deflated. No chocolate has been consumed, I think I'll wrap Xmas presents instead to keep me busy!!

I guess my confusion/upset lies with why tell me he can't measure because of baby's position and acrobats to then write in the notes it's because of my BMI.

Xx

This is the sonographer doing their job. They are there to do the best for you and your baby. What would you prefer - a lie on your notes or a lie by omission on your notes? To make you ‘feel better’? A medical fact is a medical fact. Just focus on you and your child’s health.

My point is at no point did he mention he couldn't get the measurements because of my BMI he said I can't get the spine measurements from the 3 angles because she's curled in a ball and facing the wrong way. So why didn't he write in the notes he couldn't get the measurements because of the position? Why did he write it was because of my BMI and not say that to me. It's bloody clear I have a high BMI it's written about 100 times in my notes and all everyone ever goes on about so I don't expect anyone to never write it down! Of course I recognise it's importance and that's why I'm beating myself up so much about it. I wish I could have lost the weight, I wish I was smaller and healthier for my family that's all I want. I just don't want it written AGAIN in my notes when he told me to my face it was because of her position! It's like rubbing salt in the wound when I'm trying my absolute bloody hardest here to do the friggin best I can!

Possibly because he suspected it may be something you were very anxious and sensitive about

Are you sure they aren’t two separate unrelated observations? Observation A: can’t get spine measurements because of baby’s funny position. Observation B: scan was technically difficult due to high BMI.

He didn’t mention it because he didn’t want you to feel shit.

He wrote it on the medical report because it’s relevant clinical.
It’s not an attack on you. Mine say it. My baby moves heaps so that makes it tricky however the fact there is extra layers and a lumpy surface also make it difficult.

It's shit. I had it too. It really upset me. I was so bloody frustrated at myself that it shouldn't have been like that and I should have done something about it. Especially since most of my BMI of 30 at the time was around my arse and thighs. But, rationally, I know they were just stating a fact. Medical professionals shouldn't have to pussyfoot around patients with the fear of offending them.

Try not to worry about it. Keep doing what you're doing. Hope your pregnancy goes well.

Your weight is a medical fact and presumably it impacted the ease of the scan, and potentially explains lower quality images. Mine said BMI++, I didn't get all worked up about it.
Did you want him to mention it? It's just an accurate non-judgemental record of the facts.

My scan notes said it pretty much every time. Sometimes it does cause them issues, not every time. It's just a fact, it's not a judgement on you, the sonographer is just doing their job.

It says the rescan is needed to obtain spinal measurements, scan technically difficult due to high maternal BMI. Says it all in one line.

Perhaps @Kikidelivers but I don't know why he would think that, never seen him before and no mention of weight at all when I was in there. Up until this point I've been growing in confidence because I've been pretty proud of losing the weight so far. I guess I'm just so deflated that my efforts are literally no where near enough yet. Which I knew, i know I have a lot further to go (really wanted a stone lost by Xmas but seems unlikely now Xmas is so close!)

Just to clarify I'm not in denial about my size and the impact it's going to have on this pregnancy, I'm just upset that something totally different got said to my face. If he had told me I'm sorry I can't get the measurements because of BMI, but here's what we can do...instead I'm just sat thinking in 2 weeks time for my next scan I'm going to probably be bigger (post Christmas!) And feeling like more crap. I obviously want medical professionals to notify me of any problems, but why not just say it, why lie 💔

Is there anyone out there who has had a BMI of 36+ and managed to get the measurements needed from a scan? Because now I'm anxious that they won't be able to get them next time either. Our results for Patau and Edwards are inconclusive from bloods (whole other story) and although today was all together a good scan with healthy results everywhere else, I do know how important the spine measurements are and will look at private if people think that could be better? Will have to borrow money for this though, so had hoped it could be avoided.

I'm sure they'll be able to get the measurements from another scan. They can get you to move to try to reposition the baby, they can press harder if necessary and you are ok with it. They will have more time to do so if they are just trying to do the one measurement.

He may not have told you directly most probably to spare your feelings on an otherwise happy scan day. It sounds like he was in a no- win situation with you: mention it and you’ve alluded that that they keep bringing it up which makes you irritated but if they don’t mention it but document it, you’re irritated too. It may be that if you were a bit thinner the baby being curled in a ball would be a lesser issue and they were more likely to get measurements, but the fact he was dealing with both BMI and position made it tricky. Also, it may be a note to colleagues in 2 weeks time who need to understand why you were back for a scan. Maybe raised BMI actually means to them, ‘probably ok but not visualised enough’ etc. I have no idea about the above, but what I am trying to say is that these are medical records and are there to record info and for benefit of the staff managing you. Good luck with next scan.

Thanks @assasinatedbeauty hopefully next time will be easier!

I mean I guess your kinda right, it's never a winning situation to be told "hey your BMI is too high to get this measurement" but I would have thought if he was going to write it in notes it should be mentioned to the "patient" as well. I would have then at least been able to ask the questions that I want to ask rather than over thinking and beating myself up about it now. I don't care about my feelings as like you say the baby's health is way more important, I care now because I'm sat here think for God's sake, this is now another thing my weight has effected. I just don't know how to do more than I'm already doing. All I get from my family and friends is "stop losing weight in pregnancy it's unhealthy" and all I get from medicals is "Obese BMI". I guess I'm just feeling fed up and wish I had been given the opportunity to ask questions x

You don't have to do anything. It is what it is. If you can lose some weight or not gain any then great, if not then that's also fine.

Pregnancy isn't a pass or fail thing. Stuff happens that you have no control over and it isn't worth blaming yourself for things that you can't change.

And I'm not irritated that they write it in my notes, trust me at my midwife appt it's all I ask, because I feel so awful that I've put my baby at a greater risk because I'm fat. I think I'm more upset by it this time because the last few times I've had scans it's not mentioned and now I've lost some weight and it is.

I promise I'm not normally this whingey and moany! I'm normally pretty good at pulling myself together!! But this has just got to me 😣

It’s not a personal judgement OP, it’s simply the laws of physics, a high BMI does make a scan technically more difficult and so this needs to be reflected in the report.

It sounds like he’s managed to get satisfactory views of other things but not the spine because this was further complicated by the fetal position which is why the rescan has been booked and it is highly likely that they will be able to complete the assessment at the rescan.

You’re not failing at all, you’re doing amazingly well. I used to be a HCP before I retired and you duty bound to record details of the patient. I didn’t have my first child until I was in my 30s and remember being horrified in my notes I was described as elderly primigravida.

I put on 4 stone during each pregnancy but I lost it all gradually over the years and I’m slim now. Your weight will vary throughout your life so please don’t let this upset you.