Please could you help with some questions about scans?

[CouldBeAGreatMum]

Complete newbie here with no knowledge or experience and no-one to ask IRL about all this stuff. For context I am 40.

I am currently 6 + 3 pregnant and have a scan booked in for the 9th January, all being well, which will be 13 weeks. I have seen a few threads about early scans being a good thing (people paying privately). Is this something I should consider? At £90 I could afford it if it is a good idea. Just wondering the reasons for early scan, and if at my age it is sensible?

Secondly, please can anyone shed light on the tests they do for Downs Syndrome? I'm aware it's a heightened risk at 40+. Will I be offered this test and how does it work? Is it invasive? What happens and when should I have this?

Thank you!

Sorry I forgot to ask as well - do people bring DH's to the first midwife appt? Thank you!

Maybe look into something called the harmony test. It’s more reliable for downs that the basic nhs test. You get a scan included too.

Forgot to add I took my dh to the booking appointment and all scans, but it’s not necessary to do so

Firstly congratulations!

Early scans aren't necessary but offer lots of reassurance as you can see the heartbeat at 6 weeks and your risk of miscarriage reduces.

The downs syndrome test is a blood test thats usually done around the time of your first scan, if that comes back as high risk they then offer more testing which you can opt in or out of.

Its helpful for the husband to go for the booking in appointment as they ask lots of questions about family history on both sides.

My mum had me at 40 and no issues so sending you lots of luck xx

Congratulations!

I don't think there is much of a reason to pay for an early scan. Unfortunately, if you are going to miscarry, there is nothing that can be done to prevent it at this stage. So I would wait till the 12 week scan.

From memory, for Down's (and Edward's and Patau) syndrome screening, they combine a blood test with results of your scan (thickness of nuchal ligament at back of neck, and other measurements), and factor in your age etc, and give you a "risk" factor. You could decide on other, more accurate screening tests after that, but I believe only amniocentesis is fully diagnostic.

If you’re nervous, have had bleeding or any previous losses an early scan can be great to set you at ease. But it still doesn’t guarantee everything’s ok, even if the heart beats present I speak from family experience. And from personal experience you can’t see much just a pulsing jelly bean, if you keep the cash till your closer to or past 20weeks you could use it for a 4d scan.

The test for downs is optional, it’s not accurate really it can give a high risk result (1:5 etc) and babies born completely fine. Harmony is much more accurate but more expensive.

Early scans aren't necessary but offer lots of reassurance as you can see the heartbeat at 6 weeks and your risk of miscarriage reduces.

To clarify, I'm pretty sure this PP means that the risk of MC goes down when heart starts beating, not that the risk reduces due to having the scan. I think this is false reassurance because MCs are still reasonably common after 6 weeks.

Congratulations first of all!

I had an early scan as I had to tell work really early because of my job so I felt too scared to be waiting that long. I don't think they're necessary, more just personal choice. I couldn't see anything, just a small yet longish 'blob' haha but it helped me feel better.
I don't take my OH to appointments but he came to all of the scans. The booking in appointment was more for info on me so as long as you know their basic family history, it's not needed, but of course if you want to!
The NHS combined screening was blood test and some measurements from the first scan. They may be able to tell you if the measurements look okay but can't define your risk as it goes off different factors including age. In my area you get a call if it's higher risk and a letter if not.

Wishing you all the best 🤗

You don’t need an early scan. I wouldn’t get one.

Ask your midwife but I think they routinely scan for Downs at 20 weeks.

Congratulations!

Unless you don’t know your husband’s family medical history I wouldn’t bother taking him - it’s a lot of boring form filling mostly and it takes ages where I have to go, with obs then midwife then bloods then back to midwife etc. Other places are more efficient I expect.

Early scans are really up to you in terms of whether you want to and you can afford it. I knew that they wouldn’t reassure me any more than any other scan so I didn’t bother. On the other hand I am lucky that I haven’t had miscarriages etc and I can understand why many women want to pay for additional scans. It won’t harm the baby or anything.

The combined screening test takes age into account, but also hormone levels, weight, nuchal fold etc, so you could find out that your own individually calculates probability of having a baby with one of the conditions is lower than a much younger woman. But it is just a probability, it doesn’t rule anything out.

Congratulations! There’s some info about the screening tests you might be offered here: www.nhs.uk/conditions/pregnancy-and-baby/screening-tests-in-pregnancy/

“Ask your midwife but I think they routinely scan for Downs at 20 weeks.”

They check many aspects of the baby and its environment at 20 weeks for risk factors and anomalies that might point at down’s among other conditions, just to be clear

Also here: www.arc-uk.org/tests-explained

I had an early one cos after finding it at 4 weeks, 13 week scan seemed impossibly fat away. It's peace of mind, that's all.

12 weeks thryll measure the nuchal fold and take bloods to give a combined risk factor for t12, t13 and t18. Your age will increase your risk but plenty of women your age have healthy, chromosomally standard babies.

20 week scan is the anomoly scan which looks for congenital defects in general.

I took DH to the 12 and 20week scan but no midwife appts

If you can afford it, you could get the harmony/ nipt test. I have just had it done - it was £350 and looks at the baby’s dna so is v accurate. The combined screening looks at fluid behind the neck, your age and blood results (hcg and papp-a). You age will automatically increase your risk factor which might be unnecessarily worrying.
Congratulations!!

Congratulations on your pregnancy! There is quite a lot of choice about scans and screenings as previous posters have already mentioned.
The harmony test is one of a number of Non-Invasive Prenatal Tests (NIPTs) and are genetic tests based on a blood sample from the mother. They are able to screen the fetal blood within the mother's blood from a certain gestational age. I think the earliest is 9 weeks, but most are from around 12 weeks. The results are also given on a probability basis, such as 1:10,000 so are not a diagnosis. NIPTs can also tell you the sex of your baby.
An early scan will tell you the location of the pregnancy, size of the CRL measurement, the size of the gestational sac and whether this is roughly aligned with your dates, and whether there is a heartbeat but that's about it.
For context, I'm 39 (40 in February) and 14 weeks pregnant with our second child. We just had our NIPT results through and they have given us the reassurance we were looking for. Good luck with your pregnancy

Depending on where you are having your baby you might be offered Harmony for free so worth checking that before you book and pay for anything.

We found early scan to be very reassuring (did it at around 9w) - it helped seeing baby's heartbeat and it helped us make it to the regular 12w scan. There are no medical benefits but psychologically it can help calm you down and bridge you over to the 'big' scan. I'd also recommend doing a private NIPT. Our hospital did the combined test at 12w which came high for Downs (mostly due to my age - 37) and they offered to do NIPT before any invasive procedures (amnio). However, we already booked a NIPT privately (it can be done from 10w of pregnancy) so by the time we got the bad result from the combined test, we only waited for a day to get the private NIPT test which was good (low risk for all 3 - Down, Patau, Edwards) and there was no need to do amnio.

Also, yes, my husband came with me to all appointments - midwife and ultrasounds. It is not needed, but he wanted to be involved and supportive and no one minded he was there.

I went for an early scan at 8-9w (found out i was actually 10) and it really helped me relax a bit.

6w you might be a bit early i think i have read that for some women that at this age you are not guaranteed to see a heartbeat perhaps due to not being as far along as you think.

At 10 weeks I saw the heartbeat, identifiable legs and arms and it moved. Fascinating. And i think out really helped my other half bond. Before i think to him it felt more like a medical condition. I was going through lots of changes physically so he treated it as "must look after fonxey" but upon seeing that blob he became much more aware of it as somnething separate from me too.

I'm really glad i went for an early scan. I waited 3 weeks for my 12 week (so was actually 13 weeks) scan. It current seem like a long time now, but then every week counts.

I would personally wait for your 12 scan where they test for downs and the other two, before deciding to fork out near on £400 for the Harmony test. Unless you feel it would give you peace of mind, or if you feel that there is an increased risk perhaps from family history.

I took my oh in to the booking appt because as my first it was exciting for us. But he was a bit of a spare part really. I do think men should be involved more and not made to feel secondary. He kinda felt the same at scans. Obviously the concentration is on the baby who exists inside mum but he did help put it there! I kinda felt that they only introduced themselves to me and didn't always resister his existence.

But that's another issue and I digress.

Don't bother taking him to your other ante-natal appt as they really are boring especially the first few times because all they do is measure your bp, dip urine and ask if you're suffering any abuse at home.

Take him to scans obviously. And as I said... it's good for you both to feel involved during
the first appt even though he will have little input unless there is something I his genetiic history that is relevant.

“I do think men should be involved more and not made to feel secondary”

Strongly disagree. How much you want him involved is up to you, but for this area of life men need to just deal with the fact that they are not the centre of attention and get involved regardless. Staff don’t have time to make them feel special and men shouldn’t need them to. I found it rather refreshing that for a change he was just a body in a room and actually it was my opinion that counted, though I consulted him of course because that is what I wanted. But I digress also.

There’s no need to pay £90, most hospitals have an early pregnancy unit where you can get an early scan if you just explain that you’re worried. I’m on my second baby and actually had my Down’s syndrome screening yesterday along with my routine 12 week scan. They combine a trisomy 21 (downs) blood test and an ultrasound measuring the fluid behind the neck of the baby to get a result of how likely your child is to have Down’s syndrome. They will give you a figure (for example mine was 1 in 18,000). A lot of people take the baby’s father/their DH to appointments and scans but it’s not necessary, my DH only came to the scans with my first and for my second I’ve gone on my own for the scans too.

Staff don’t have time to make them feel special and men shouldn’t need them to.

Fully agree.

There’s no need to pay £90, most hospitals have an early pregnancy unit where you can get an early scan if you just explain that you’re worried
This is not an acceptable use of NHS resource. The EPU is there for people with bleeding, pain or another genuine reason for thinking something is wrong. It is not for people who want an early scan because they have unfounded concerns without any symptoms. I've been in EPU and had the shitty news that I was about to miscarry. Next pregnancy we were terrified it wouldn't make it either so paid for a reassurance scan at 8 weeks.

I've seen people on social media suggest women go to the EPU claiming to have pain and bleeding to scam an early scan. It's disgraceful advice.

One thing to bear in mind if paying for a private scan is the possibility of bad news. If the scan shows you have miscarried it can be horrible finding out in a private clinic surrounded by cute pictures of healthy babies where they won’t be able to answer your questions, will still take your money and all they will do is tell you to go and see your GP to arrange further care. There have been a few stories on here of people who have had horrible experiences along these lines.

As far as Down’s screening goes, it is offered on the NHS but there is a new, more accurate test called NIPT which is available on the NHS in some areas. I was 37 when having my baby and paid for it privately as I wanted the extra reassurance. Your midwife should be able to tell you what is available where you are.

My partner only came to the scans but not the other appointments. There’s no need really as they’re pretty boring and the first one especially just consists of lots of questions about your family history and some blood tests.

Also totally agree with what @DappledThings said. The NHS has limited resources and if people lie to get scans they don’t need then people having miscarriages, suspected ectopic pregnancy etc. will end up waiting longer to be seen. By all means ask for a scan but don’t lie about symptoms!