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Sonographer V Midwife Diagnosis - Who's Right?!?

5 replies

ConfusedMama · 31/01/2009 12:28

I had a scan recently which confirmed polyhydramnios according to the sonographer She found a single max vertical pocket of 12cm (max usual range is 8cm. NB sonographer didn't do an AFI measure just a single max pocket measure).

I have always had a large fundal measurement, but the MW(s) have all said it is due to my height plus big baby.

Before the scan palpations by both doctors and a variety of MWs all said it was big baby not excess fluid. So when I went back to see my MW I explained I had been diagnosed by scan with polyhydramnios.

MW was amazed and said she had never had an indication of excess fluid (as opposed to just a generous amount), she has always found the baby's HB and established it's position with ease and there was no "ripple" effect when she tapped on the bump in a certain way which would indicate lots of fluid. She still maintains it's just big baby mainly. I showed her the scan report and she said it's possible for the lie of the baby to create a big pocket temporarily (ok it would still show generous fluid but if the baby moved slightly it may have only been a 9cm pocket found, for example).

Who's "more" right?! The sonographer - or the MW?!?! Opinions please, just for "fun" as it were!

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Sidge · 31/01/2009 12:45

I would be more inclined to go with what has been seen rather than felt, but then as she said the pocket of fluid may be positional?

FWIW I had polyhydramnios which was only discovered when I was delivered (by section), it was never picked up antenatally, even by the consultant and my very experienced midwife.

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ConfusedMama · 31/01/2009 13:07

I would agree Sidge, & thanks for your response, because you can't really argue with a scan. However it's amazing that it isn't always picked up in advance, like yours.

Incidentally, did your polyhydramnios have any particular known cause after the event or was it just cause unknown?

Also, if I may be so bold as to ask, was your CS an emerg one or elective? (I am curious because apparently polyhydramnios cases are often CS because of the failure of the baby to engage, due to the extra fluid). I am currently wondering whether or not to have a CS myself too.

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llareggub · 31/01/2009 13:13

I had polyhydramnios which was only picked up when I was induced at 37 weeks, despite having any number of scans in later pregnancy! I was under consultant care, too.

I was induced at 37 weeks because I had some tummy pains, and when monitored it was decided that the DS's heart was racing. I was induced and given 12 hours to labour naturally before the decision was made to carry out the c-section. During those 12 hours I had contractions but labour did not progress.

I am now 26 weeks pregnant with my 2nd baby and I have been diagnosed with gestational diabetes. Due to the polyhydramnios in my first pregnancy, and the fact that DS was 8 pounds 12 at 37 weeks, they suspect I developed GD in my 1st pregnancy although it was never diagnosed.

Incidentally, my fundal height was on the small side at 29 weeks, when they told me that I was "small for dates." Fundal height is not a very accurate method for determining size of baby, I suspect!

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goingtohaveagoodnightssleep · 31/01/2009 13:13

ConfusedMama I had polyhydraminous. It was picked up near the end of my pregnancy when I was measuring 4/5 weeks big for dates. The scan showed big baby and a lot of fluid.
Mine happened suddnely. I literally woke up one morning and realised my bump was much larger than it had been the day before, the babies movements also changed - it felt like he had an olympic swimming pool!
I had a normal delivery though it did take a while (it was only 40 mins or so) after my waters were broken for him to get into a good position. I wasn't even offered a cs section.
No cause was found though I did have to have a GTT which was negative.

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ConfusedMama · 31/01/2009 13:50

That's interesting, & thanks both llareggub & GTHAGNS. Did they induce you too or just break your waters, GTHAGNS?

I wonder if I have had GD too, although the 28 weeks glucose test didn't show anything up and because the MW has always assumed it was just big baby in there she didn't refer for any further scans or tests.

Next time (!) I will know exactly what to look for and ask for.

I will be induced too, which I'm not looking forward to and am mentally preparing for a CS, just in case.