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

I doubt it would have gone down well if he'd said "ultrasounds of the abdomen are hard when you are obese" to your face.
You've done the right thing by losing some weight but technically BMI >35 is "obese" and ultrasounds are notoriously difficult with extra fat layers to get through.

I'm geriatric and fat - 36 with a BMI of 30.5 - I'd try not to take it personally. I didn't have any issues with my scans and I haven't been offered any extra scans....I do have the joy of blood thinning injections nightly though!!

If he'd said it was because of your BMI you'd have felt just as shit. He was trying to spare your feelings- it's not like you can do an awful lot about it now (as in immediately, at the scan, it's wonderful that you are doing slimming world).

People who are overweight almost always have internal fat (I'm overweight too). This makes ultrasound imaging difficult, whether your knee or shoulder or uterus. It's a statement of fact. If he'd lied on your paperwork he could have lost his job.

Your BMI is just fact. My BMI is over average. Because I am a bit fat. Because I eat a bit too much. It's just science.

I say that as I drink wine and eat sausage and mash.

I guess I had just wished he was more honest to my face though, came home from work to look at nice pics and read through notes and that was the first thing I saw and felt like crap. Because now I have all these questions about the next scan and nobody to ask. I've had lots of questions about this whole pregnancy and we have a lot more hurdles to jump through until she's safely here and I guess I'm quite matter of fact about things now, don't like to beat around the bush and would have rather it was just said so I could have processed it there and then. But you're right, it is what it is. And I really am so pleased that she seems to be very happy and healthy in there xx

Haha @ghostsauce I wish I could have a friggin glass of wine right now! Water doesn't quite have the same impact! Enjoy x

I'll have another one for you! It's a nice chianti.

Try not to worry for now. It's winter, we need a bit of extra meat to keep warm. Enjoy being pregnant and eat some cosy winter dinners, and worry about it next year. Or not. I'll probably still be a bit chubby next year. I'm not arsed this side of Xmas, everyone is a bit fat at Xmas

I haven't RTFT but I know that the sonographer will have written that for a good reason. As you have to go back for another scan, he has to provide a reason and that is a perfectly good reason why you need another scan (which ultimately costs money so he has to justify it) don't worry about it.

I currently have a high bmi, plastered all over my notes. No problems with any scans so far but it is always recorded on the scan report. I have my 20 week scan this week for dc4. In my two previous pregnancies there was difficulty in getting spine measurements at the 20 week scan, due to their lie, was asked to cough, move etc but nothing had to go back later for re-scans. My bmi was much lower then. I have had the same sonographer for all but a few scans and she is lovely, with a great sense of humour and is very experienced, which all helps. I do feel that as I have a high bmi that seems to make me lazy, thick and a bit daft in the eyes of the health professionals I have so far encountered. I have an anaesthetic consultant appointment for pain relief soon, as "I won't be able to cope and will require intervention". I have never had any pain relief in any of my previous deliveries, all drug free and fought to be active throughout, aware of the risk of complications. It's all a little infuriating when none of them seem alarmed by all dc being born with low birth weights though. Try not to take it too personally, look after yourself and baby.

Hi OP I also have a high BMI. Sonographer got all except the 4 chambers and arteries due to baby being back to my tummy. My BMI was written at the top. But her note for the rescan said "Difficulty due to foetal lie" which sounds like what yours was. I have also lost 14lb and have passed the GTT and keep myself guarded waiting on someone commenting on my weight but even has been lovely. Even the consultant midwife and dietician who are monitoring my diet and weight throughout.

And it is horrible if a comment or statement is made when you're working hard eating well.

Some people don't need to be so bitchy on this thread with their responses.

^everyone

36 BMI is high. Its not like you are slightly overweight. I would have to put on 3 stone to have this BMI and mine is currently 25.

He isn't being harsh, just telling the truth.

I think the comment about high BMI is just a general statement and not specifically about the spine measurements. I work in healthcare and often see that statement written on ultrasound reports. It’s usually just the sonographer covering themselves by explaining why the images might be slightly less clear.

It’s not a personal thing and he probably didn’t mention it because he didn’t see any need as he’d already explained that the difficulty with the spine measurement was due to your baby’s position.

Well done @Dermymc for pointing that out for OP she really just needed you to clarify that

I just ignore it! My midwife read my BMI and was like 'oh that's quite high' 'but you don't look it so we will just ignore that, you carry your weight well' I though hmmmm thanks I guess 😂

Aw, my BMI was 28 (size 12 but all my weight is on my belly) and all my earlier scan notes had ‘view restricted due to Maternal habitus” I googled it and was really upset. They never had a problem so far as I know in seeing things but think they have to cover their back in case something wasn’t spotted because of my belly pork

@dermymc congratulations love on having a good healthy weight. You must be so proud. You're right, it is really overweight, I had no idea, it's not like I'd ever looked into my self or ever looked in a mirror! So I'm super glad you're here to tell me or else I might never have known.

If you read back you'll also see I never said he was being harsh, so not sure where that came from. And also love, just incase you aren't aware, people come in all shapes and sizes! My best friend and I share the same jeans, dresses and some tops almost daily, both size 12 - 14 and she 3.5stone lighter than me! My waist pre pregnancy measured "ideal" and my 38G boobs way above normal. Thighs on the other hand, flipping massive but I've got my mother's genes to thank for that! Speaking of my mum actually, she's a size 16-18 and 1.5 stone lighter than me...remember what I said about people coming in all different shapes and sizes?

Try and be slightly less judgemental next time, might actually make you feel good 😚

@HJWT my midwife was the same! She could clearly see I was a little mortified when she told me and she said she was shocked herself! She said she hated BMI as it doesn't take into account bone structure or density, then looked at my chest and said or big boobs either 😂🙈 fully fully appreciate I have a hell of a long way to go and 3stone would be a goal of mine!! I'll just keep plugging away and see what I can do. I've not been referred for dietician, consultant or anything like that yet and she's really not hugely worried! But I am 🙈!

Thank you to everyone who has taken the time to offer advice and stories on here, it's been really helpful to read things from a different perspective. Especially those who are from a healthcare background. Taken everything on board and just going to keep chipping away whilst I can at my weight xx

Mine was 35vin my first pregnancy, and although my scans were fine, they all had the same comment. It confused me, especially when the sonographer mentions that it's a very clear image etc, so I think it standard butt covering text

For my current pregnancy, it's 30.2, and it's not on my notes. My scans haven't been any easier this time round, and in fact I don't think the pictures are quite as clear.

Don't be too harsh on yourself, a little of what you fancy is OK.

It comes up automatically. They weighed me wrong and the bmi message came up on the scan report despite there being no issues with the scan. I also had one a few weeks before having been weighed and the scan was fine with no disclaimer. I think some trusts just do it to cover themselves. Of course, there is also the possibility that they have struggled due to BMi and have needed that to be noted but at mine it seems to go on regardless.

@Babyno2mamabear the best thing you can do is to eat healthily and in moderation for the baby! Don't worry about anyone else or there opinion! We all know your baby won't be effected by your BMI! Just be happy and enjoy your bump 🥰

@Dermymc was there really any need?

If you did your research you’d also find that BMI is a wholly inaccurate way of determining a healthy body weight. It doesn’t account for muscle, fat or bone density. It’s literally a guideline.

Don’t feel bad @OP. My BMI is much higher than yours and I’ve had this plastered all over my notes. I don’t see it as a judgemental thing though. All of the midwives, sonographers and consultants I’ve seen so far have been very respectful and nothing but kind.

If you did your research you’d also find that BMI is a wholly inaccurate way of determining a healthy body weight. It doesn’t account for muscle, fat or bone density. It’s literally a guideline.

It was originally devised for use at the population level, yes, but for the vast majority of people who are not high-level athletes in sports that require substantial muscle mass, it is accurate and useful at indicating unhealthy levels of weight.

The fact that it is not perfect and that some people don't superficially "look obese" does not make it "wholly inaccurate".

To be exact, it is estimated by experts that BMI is inaccurate (in the sense of people scoring as "overweight" when they actually have very low body fat) for less than 1% of the population, all of whom are high level athletes.

OP, I'm sorry you're upset, but what would have been the point of him saying to you that the scan was difficult because of your BMI? It's not something you were going to be able to change at the scan or at the rescan. It's a technical notation that the images are poorer quality because of the adipose tissue between the probe and the foetus.

It's nothing personal. The sonographer has to be specific in their notes. Keep going with your healthy lifestyle changes and well done on losing 11lb.