Advice from sonographers please!

[Mip]

Just wondering whether there were any sonographers around on mumsnet today who could give me some advice...

I had a nuchal fold scan at the FMC in December. The risk from my bloods was high but the rest of the scan was very good so I was given a low risk. The sonographer there was not very happy about the nosebone though, saying she would've preferred it to be stronger. She said I should come back at 20 weeks to see if it was there and if necessary have an amnio. However I live in Sweden (had been in UK for Christmas) so I had my anomaly scan there instead. Because I was worried about the nosebone the doctor did the ultrasound himself and said that there was definitely a nosebone there. This reassured me but I was still worried as to me the nosebone looked the same as at the 12 week scan when the sonographer wasn't happy - I appreciate the doctor was probably a bit better at interpreting scans than me though! .

Anyway (sorry this is so long!) I put the worries aside but now at 36 weeks I'm panicking again having read another post on here about someone who got a high risk at FMC even though scan (heart etc) was great, because of problem with nose bone. She was recommended a CVS. I'm wondering why I wasn't told to have one now.

So my real question is, if the nosebone appears by 18/20 weeks then is that ok? Have read elsewhere and on the other thread that it's its presence at 12 weeks that is the issue. But at FMC they're meant to be experts about the nose. Also would the doctor in Sweden on 'normal' equipment be able to see the subtle difference in the nosebone that the 'nose trained' FMC doctor using top notch equipment did?

Again apologies for such a long posting. I'm going out for the day now so if I don't reply till later it's not because I'm not grateful. Thank you very much in advance!

Sorry I can't give definitive advice but I can tell you that I had two private scans - first at 12 weeks for the nuchal fold measuremtn and the second at 18 weeks for my own reassurance as a general anomaly scan. At the first the scanning person was unable to see the nasal bone - she said because of positioning of the baby, while at the second she was able to see it and she made a point of saying - that it was a good sign in terms of Downs. She said this even though I had been given a good screening result earlier so I assume from that that the nasal bone being visible at a later stage was still important.

Hi Mip,

I don't think it really matters when you see a nose bone, it's whether there is one at all that is important. Apparently, 75% of babies with DS is born without a nasal bone. However, there is still 25% of babies who are born with a nasal bone so it really isn't conclusive one way or the other. This is a rather 'dodgy' way to measure risk at the 12-week scan as I believe the nasal bone forms around that time? I'm not a doctor though! But I think you sound fine...

Ax

mip - I'm not a sonographer, but I'm pregnant with my 3rd and was told at the 12 week scan this time that the nasal bone was 'absent' (or at least 'not good enough to be marked present). I was told that as long as it was there by the next scan it was fine. Which for me is at 22 weeks, and is tomorrow. I'm not particularly concerned. The sonographer told me it is not that unusual for the nasal bone not to have developed at the 12 week scan stage.

Hope that helps

Hi Mip,
Just to correct angel1976 (sorry!) it is actually 75% of babies with DS don't have a nasal bone at 12 weeks, not at birth; but 25% of them DO have a distinct nasal bone at 12 weeks.

It is a marker for DS, but in some babies, it just grows in/hardens up late. It starts to grow around 10 weeks in most babies, but not all. When I had my nuchal scan I was 11 weeks 6 days and they felt it should have been more formed by then, hence CVS. Can you remember how far on you were when you had your nuchal?

Thing is, I would say don't worry, because I am convinced that the FMC would have urged you to have a CVS if there had been a significant problem, which is something they do between 11 and 13 weeks. Good luck.

Thank you so much Mrsboogie, angel1976, Pidge and LadyThompson! Sorry to not have replied earlier but just got home now.

Really reassuring to hear all your stories, thank you, thank you. And good luck for your scan tomorrow Pidge, but you sound like a cool customer! Obviously one gets less paranoid with each pregnancy (it better be that way anyway!).

LadyT, I was following your thread and was going to write with my story seeing as both were FMC and nosebones but instead got freaked out and didn't think that was very helpful! Just checked in on your thread and saw your CVS went well. In a way I wish I had done it then even though they didn't say there was a need as then I would have known one way or another. I really hope you get a good result and the wait isn't too painful (but better than a 6 month wait I guess!). Unfortunately my scan was quite late, over 12 weeks for sure. It's reassuring though that some babies are just late developers. The sonographer did wonder if the baby was not in the best position (a bit like Mrsboogie) so I'm pinning my hopes on that being the issue.

Thanks again all, will sleep better tonight!