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View Full Version : did you opt to have the level II ultrasound? update in 1st post



brgnmom
08-24-2010, 08:01 PM
update: my sister has decided to schedule the detailed level II ultrasound, and I'm glad that she reconsidered, given the benefits of having this medical procedure done. Thank you again for your input!


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I did for both pregnancies when I was 26.5 yrs old & currently 31 yrs old, and I have no regrets. I actually thought it was standard procedure to have the level II ultrasound to confirm that everything looks fine.

But apparently I've spoken to quite a few moms-to-be recently and they have refused the level II ultrasound, citing that they didn't want their babies to be at risk for developmental issues from the sound waves. I'm usually an open-minded person, but I think the comment really caught me by surprise. Since my DH is a radiologist (M.D.), he has reassured me that the ultrasound is one of the safest procedures available today in his field, and it helps doctors identify potential issues.

I'm just wondering what your perspective is on this procedure during pregnancy. I'm concerned b/c my own sister is one of the moms-to-be who has rejected getting the level II ultrasound done. She found out the gender of her baby, but that's it.

SnuggleBuggles
08-24-2010, 08:24 PM
I think that an occasional, medically necessary u/s is ok. I think that some women and practices get carried away and overuse them. Yes, I think there are risks but I think they are very small. I think it is better to avoid them if you can but a 20w u/s and maybe 1-2 more seem reasonable to me- benefits outweigh the risks. I would never go to a novelty, keepsake u/s place though.

Beth

swissair81
08-24-2010, 08:48 PM
I didn't have a choice. I had a serious issue for the beginning half of my pregnancy & I needed frequent u/s to keep an eye on it.

citymama
08-24-2010, 09:26 PM
What's a level 2 u/s? With both pregnancies, I had a first and second trimester screening, which involved a blood draw and u/s. The second tri u/s was about an hour long. I'm really glad we had them, both times!

rkold
08-24-2010, 09:41 PM
I had one, but at the time had not realized they were optional. :/ I probably would have picked to do it still had I known, but I do wish I had been told it was optional and had been my choice if that makes sense.

WolfpackMom
08-24-2010, 09:43 PM
I also had no idea it was optional, but I don't regret having it!

citymama
08-24-2010, 09:51 PM
Well, isn't everything optional? I don't understand. No one can force you to have an ultrasound, right? It's not a medically necessary procedure.

AshleyAnn
08-24-2010, 10:09 PM
I had two.

I had the usual 20 week full scan to check everything. I didn't consider any reason not to. I wanted to see the tiny person who had been wiggling around in there for 4 months and I wanted to know the sex.

My 'big' u/s where the checked everything out at 20 weeks showed some possible complications and they wanted to get a better view. It looked as if there was a spike of 'something' going thru her heart but they had no idea what it was or how life threatening it would have been. They also found they could not see the portion of the brain that connects the right and left sides (hypothalamus). I wouldn't have ever considered not having the u/s even though I fully intended to carry my pregnancy to term if there was a complication I wanted to know what to expect and give the doctors the best oppertunity to prepare. In the end the spike in her heart ended up being a shadow only visible at one layer and the brain was perfect.

Had something been wrong with the baby I would have been thankful to be informed before delivery day. I would have wanted to give her the best chance at survival.

newg
08-24-2010, 10:56 PM
Boy. I had a ton with both DDs. Being a high risk pregnancy I had the reg. ultra sound at week eight and twenty and then had one at week 28 to check the heart. Then every four weeks I had a complete US ...and starting at week 30 I had an NST with a quick fluid level check every week 'till they were born.
In my mind all were necessary and I wouldn't have refused any of them.

bubbaray
08-24-2010, 11:05 PM
OP, that is funny that your sis will have an u/s for gender (hello, not medically indicated!) and not the level 2, which does detect medical issues.

I had a level 2 u/s with both girls. I was AMA with both, though, and also had amnios with both of them. The level 2 u/s is part of the amnio workup here. Plus, I was highrisk with both and under the care of a perinatologist.

My peri was very much against u/s for gender or "optional" reasons -- like the 3/4D u/s where you get the video, etc. With both of my girls, I had minimal u/s on his recommendation: at 8w for "dating" (to schedule the amnio, even though my dates were accurate b/c of IF procedures), with the 16w amnio, and around 21w for the level 2. With DD#1, I also had an u/s at 10w for bleeding. That was it. No late term u/s for size or anything like that. Obviously, if it had been medically indicated, I would have, but he was very opposed to using u/s "just because".

I would have zero hesitation have a level 2 u/s, though. They are very detailed and pick up all sorts of things that can have an impact on antenatal care and at L&D -- for example, a friend of mine found out at her level 2 that her son had a heart defect. The birth was scheduled at a high-risk hospital with a pediatric cardiac center. If they hadn't known about the defect, he would have had to have been life-flighted to Children's instead of being born there, KWIM?

sunnyside
08-25-2010, 12:42 AM
Well, isn't everything optional? I don't understand. No one can force you to have an ultrasound, right? It's not a medically necessary procedure.

THIS!!

My dad is a radiologist also and he did an ultrasound when I went home for Christmas. It was fun for my family to hang out in the office and do the U/S. I didn't think it's a big deal and he certainly didn't think so either. In fact, when I was a child my parents used to do field trips to their office to show kids a radiologists office and they did ultrasound on me to show the other kids!

brgnmom
08-25-2010, 02:43 AM
Thank you all for your helpful responses! citymama, I think that the level II ultrasound is the detailed one that is given at approximately 18-22 weeks, and it's when the U/S tech records images of the different organs and their measurements for a radiologist to interpret. I'm glad that I had mine done for both pregnancies, especially for this pregnancy, because I found out that I have a low-lying placenta. I'll need a follow-up ultrasound later during this third trimester -- I'm hoping that the placenta moves up fully b/c I'd rather not have a c-section.

bubbaray, I agree that my sister's response to having the level II ultrasound is funny and well, unexpected, to me. She says that she's uncomfortable having the longer level II ultrasound done, because it exposes the baby to harmful soundwaves for a longer duration. But I think that the benefits of having the detailed level II ultrasound done outweigh the risk, considering that the ultrasound procedure is widely performed and doesn't emit ionizing radiation (http://www.radiologyinfo.org/en/info.cfm?pg=genus). And I'd rather know in advance if my baby had any medical issues to prepare for.

I'm relieved to know that the large majority of you have also had the level II ultrasound done. I'm hoping my sister will have a change of heart... I've already told her what I know and she has gotten upset at me for telling her my perspective. I'm also concerned b/c she has already decided to set up a different immunization schedule for her baby-on-the-way, based upon how the vaccines were administered in the 80's (instead of the basic schedule set today)... I guess I just need to let go of my protective sibling instincts and trust that she knows what choices she is making.

Thank you again everyone.

rkold
08-25-2010, 06:48 AM
Well, isn't everything optional? I don't understand. No one can force you to have an ultrasound, right? It's not a medically necessary procedure.

Nearly everything is optional, but if it is your first pregnancy and you've not had a chance to start reading pregnancy books yet and your doctor says "This week is _____________ test" I don't think many people would think to argue or debate it with their doctor.

The only test I had done that my doctor had specifically said was optional was Tay-Sachs genetic testing. Since I was having so many other genetic tests done at the same time and it didn't cost us anything additional w/the insurance I figured why not.

Had I realized all tests were optional I probably would have skipped the AFP one since it is known to have a high rate of false positives. I'm also not sure I would have done gestational diabetes.

SnuggleBuggles
08-25-2010, 08:15 AM
I'm relieved to know that the large majority of you have also had the level II ultrasound done. I'm hoping my sister will have a change of heart... I've already told her what I know and she has gotten upset at me for telling her my perspective. I'm also concerned b/c she has already decided to set up a different immunization schedule for her baby-on-the-way, based upon how the vaccines were administered in the 80's (instead of the basic schedule set today)... I guess I just need to let go of my protective sibling instincts and trust that she knows what choices she is making.

Thank you again everyone.

Her choosing to forgo the test really isn't irresponsible though. Everyone is entitled to look at the risks and benefits and come to their own conclusions. For example, I opted not to do the quad screen or the nuchal fold test. I know other moms want all that possible info so they can plan. I didn't feel that way and decided to not do them. (I also do an alternative vaccinating schedule with my pediatrician's ok :).) I wouldn't go out of my way tpo persuade her on either front or any other issue that comes up provided she has done her homework and reached an informed decision.

Beth

luckytwenty
08-25-2010, 08:52 AM
I had it done, all three pregnancies. And this pregnancy, being 36, I actually had 2, one at 16 weeks to see whether amnio would be recommended (it wasn't), and one at 22 weeks to get a better view of the heart. If there were some kind of major problem, I'd want to know about it ahead of time to prepare (emotionally, financially, medically). Since my cycles are irregular, I also had ultrasounds at 6-7 weeks all three times to date the pregnancy. And I had the nuchal fold this time at 12 weeks.

Everyone has their own opinions on all of these prenatal screenings, including the blood tests, but I believe knowledge is power. I personally would not want to find out for the first time that my child had a congenital problem the day he was born when I could find out this problem earlier--and digest it and prepare for it, too.

BabyBearsMom
08-25-2010, 09:02 AM
I'm relieved to know that the large majority of you have also had the level II ultrasound done. I'm hoping my sister will have a change of heart... I've already told her what I know and she has gotten upset at me for telling her my perspective. I'm also concerned b/c she has already decided to set up a different immunization schedule for her baby-on-the-way, based upon how the vaccines were administered in the 80's (instead of the basic schedule set today)... I guess I just need to let go of my protective sibling instincts and trust that she knows what choices she is making.

Thank you again everyone.

Unfortunately, no matter how much you want to help your sister, you need to let her make her own decisions when it comes to parenting. You aren't going to agree with everythign she does, but interfering could have a major negative affect on your relationship in the long run. Personally, I had the detailed U/S done, nothing came up, but it gave me a lot of piece of mind knowing that my LO was maturing. And I can personally attest that she is perfect in every way and has had no negative outcomes, but everyone needs to make their decisions. As far as vaccines go, delaying them isn't a risk that I am willing to take (especially with the recent pertussis outbreaks!), but there are a lot of people (many on this board) who aren't comfortable vaccinating their children. We just have to accept that they have weighed the risks and the benefits and made the decision that is best for them and their family. It's hard, but I would rather have a relationship with my sister than try to convince her of my way of thinking and lose that relationship. Good luck!

llama8
08-25-2010, 09:13 AM
The Level II unltrasound is the most important one because it truly can tell any issues with the development of the baby. By this ultrasound, most issues will show up. Why would anyone want to skip it and have issues later.

I lost my first child at 17 weeks and found out at the level 2 ultrasound. It was probably the worst moment of my life, but I am glad I didn't wait longer. I have a friend who found out her child had a terminal condition at the level 2 ultrasound that survival would have been o% and she (the mother) could have died if she went to term. She was able to make an informed decision and terminate the pregnancy (with guidance from her priest). She now has healthy twins.

I had many ultrasounds with my healthy DD (weekly non-stress tests). She was fine and there were no issues with me (the first was an isolated incident). I would never miss an ultrasound. (I do have issues with people getting the cosmetic picture ones for fun, but I support it for medical reasons with a trained technician. It is also such big peace of mind to have your child monitored).

Roni
08-25-2010, 09:22 AM
I had the Level 2 with this pregnancy because I am advanced maternal age. With the other two, I just did the regular ultrasound--but both ended up having a few of them.

Everyone has different ideas and comfort levels when it comes to screenings, vaccinations, etc. Don't sweat it. If your sister is making informed choices, based on accurate information, it's okay for her to do things differently from the way you do them. If she's receiving bad information, that's the only time I would worry.

mushka
08-25-2010, 09:42 AM
2 ultrasounds seems like nothing to me. I had ultrasounds every 3 weeks during my pregnancy. They were monitoring my baby for Rh disease, anemia, and possible intrauterine transfusion. Thankfully, she never needed transfusions and developed only mild Rh disease. However, I had so many ultrasounds I've lost count.

sste
08-25-2010, 09:53 AM
Well, we are all biased by our experiences. My friend learned of a heart defect requiring special treatment and was able to change the hospital she delivered at. My SIL learned of a birth defect that was incompatible with life and made it a near-sure thing she would deliver a stillborn or miscarry. Personally, these are things I would like to know earlier in a pregnancy . . . the medical and financial and emotional ramifications to not preparing for them can be devastating.

I tend to think information is power. Particularly if there is no established down-side risk to a couple of ultrasounds per pregnancy.

The only bad thing I can think of to say about the level II ultrasound is not medical risk from the ultrasound but my genetics counselor friend has told me there is a higher than you would expect rate of abortion for cleft lip (I don't think it is a majority but for a fully operable cosmetic thing you would expect zero!) . . . apparently the visual just absolutely freaks couples out.

swissair81
08-25-2010, 10:26 AM
The only test I had done that my doctor had specifically said was optional was Tay-Sachs genetic testing. Since I was having so many other genetic tests done at the same time and it didn't cost us anything additional w/the insurance I figured why not.

I have a relative who lost a child from Tay-Sachs. The disease is such a tragedy, that if you could do something & don't, I would wonder why. If both parents are carriers, the rate of likelihood is 1 in 4. It is relatively easy to screen for. They had 2 kids before their child with Tay-Sachs was born. They have had about 6 children since & all of them are fine. I think they do some kind of modified IVF & they genetic test the embryos or something.

luckytwenty
08-25-2010, 10:36 AM
I was screened for Tay Sachs and it was just a blood test letting you know if you were a carrier. I don't think the test actually determined if your fetus had Tay-Sachs...maybe that's something you take if you are a carrier?

AnnieW625
08-25-2010, 10:38 AM
With the baby we lost I had to have one to completely diagnose why the baby wasn't growing and why it had a small ecogenic focile (sp?) that was picked up at the 17 week u/s. If I had the option to have it with DD2 I would've had it just to make sure everything was okay, but there was no reason as everything at the 13 week and pre AFP test came back okay. At first I was nervous every time I went to see my OB and the u/s cart wasn't in the room, but in the end I was fine with it. I was soo thankful for the first trimester screening program with DD2 as we didn't have that with the baby we lost and it would've made it soo much easier to do an amnio after those results and find out about the tri 18 diagnosis then and not at 21 weeks.

I chose not to do a 3D or 4D u/s because honestly it just really freaked me out and since we didn't want to know the sex of the baby I felt it would've been a waste.

momtoonegirl
08-25-2010, 10:47 AM
I had several ultrasounds with DS, mainly from being AMA and increased risk of first trimester loss. The level II ultrasound at 18 weeks was the last one I had with him. I did not have 3/4D ultrasounds with either pregnancy. The level II ultrasounds were reassuring that both pregnancies were progressing as expected given my medical history.

swissair81
08-25-2010, 11:42 AM
I was screened for Tay Sachs and it was just a blood test letting you know if you were a carrier. I don't think the test actually determined if your fetus had Tay-Sachs...maybe that's something you take if you are a carrier?

The Tay-Sachs test is a maternal blood test, AFAIK. Or maybe they test both parents? I don't know.

I personally had extensive genetic testing done for Jewish genetic diseases in high school. There is an organization that tests for the really awful ethnic diseases for Jews of Ashkenazi descent (Tay-Sachs, Canavans, Fanconi Anemia, Cystic Fibrosis & others) in 12th grade & the idea is to check genetic compatibility with guys before we ever start going out with each other. Among the population that participates in this program, the number of carriers are going down & certainly the number of children born with these diseases have decreased dramatically.

So when my OB offered me a Tay-Sachs test, I didn't bother.

lovebebes
08-25-2010, 11:55 AM
I totally agree we are all biased by our experiences.

I am personally biased because I had lost a baby at full term before and for me u/s are something that keeps me sane, period.

However, that aside-there has been NO proof that ultrasound waves are "harmful" to the developing fetus.

rkold
08-25-2010, 12:05 PM
I have a relative who lost a child from Tay-Sachs. The disease is such a tragedy, that if you could do something & don't, I would wonder why. If both parents are carriers, the rate of likelihood is 1 in 4. It is relatively easy to screen for. They had 2 kids before their child with Tay-Sachs was born. They have had about 6 children since & all of them are fine. I think they do some kind of modified IVF & they genetic test the embryos or something.

Tay-Sachs though is not very common genetic disease and I personally had strong doubts I was a carrier let alone thought there was any chance that my husband was a carrier. Had it cost us a lot of money out of pocket to take that genetic test I am not sure we would have decided to do so. It is a horrible disease, but according to the papers we eventually received from the lab it is also one of the more expensive genetic tests.

Many pregnant women in the general population do not have the test to see if they are a carrier done, just like my first OB/GYN did not even suggest to me Sickle Cell Anemia carrier test.

However with my first OB/GYN it was one of the ONLY test I was told was optional of all the tests I took with him. I'm an over 35 first time mom and some of the tests I would have picked to do for my own peace of mind, the Nuchal, and level 2 Ultrasound and some I feel I might have chosen otherwise had I been educated about the tests and not just told by that first Ob/Gyn that at appointment __ I was taking _________ test. I passed the AFP one, but I had no idea it had a high false positive rate and that it was only a diagnostic test not anything definitive. Yes, it's perfectly safe and non-invasive, but if you receive a false positive, you can end up with an amnio which is not perfectly safe and does have a 10% chance of miscarriage.

daisymommy
08-25-2010, 12:11 PM
I had one level II ultra-sound done with each of my babies. That was it as far as ultrasounds go. I think that if you are at high risk, have some issue going on with your pregnancy that mandates a higher level of ultrasound or care, then that is one thing. But I don't think that most people realize that there ARE indeed studied and published risks associated with all ultra-sounds. Women need to be armed with information to be able to weigh the risks against the benefits, and make the choice for themselves as to what is best in their current situation. Not just blindly believe that ultra-sounds are as safe as listening to your heart with a stethoscope or having a blood draw done. I could list all sorts of studies, but it would be easier for me to link to a great informative blog post, in which she lists out many studies herself (they are towards the middle to end of the article. http://www.kindredcommunity.com/articles/ultrasound-scans-cause-for-concern/p/1279

swissair81
08-25-2010, 12:12 PM
Many pregnant women in the general population do not have the test to see if they are a carrier done, just like my first OB/GYN did not even suggest to me Sickle Cell Anemia carrier test.

I thought it was implied that you would only test for it if you were in the high risk group for a particular disease. My doctor didn't offer me sickle cell testing either.

liamsmom
08-25-2010, 12:24 PM
I'm glad that I had mine done for both pregnancies, especially for this pregnancy, because I found out that I have a low-lying placenta. I'll need a follow-up ultrasound later during this third trimester -- I'm hoping that the placenta moves up fully b/c I'd rather not have a c-section.


This happened to me too, brgnmom, but don't worry too much because your chances that the placenta will move are very, very good. My CNM explained that this happens a lot. At 20 weeks, the uterus isn't very big and is very crowded with the baby and placenta. So, the placenta often is lying low at the bottom--it has no other place to go. I googled this and found out that most of the time--between 87-90%--the placenta moves up the uterus on its own and everything works out just fine. Definitely get the f/up ultrasound, but I'd relax for now.

I feel really differently about u/s and testing in general after this happened though. It seems that tests often lead to more tests--and more stress. I completely understand and respect that others are comforted by knowing, but I wanted to be left alone. I felt healthy (for being pregnant anyway) was growing and didn't feel the need to be monitored.

I ended up having 4 ultrasounds all together. The first one was at my first pre-natal appointment, where DS kicked the heart-rate monitor, so we did a quick u/s instead. Then we had another scheduled u/s to determine the EDD because I have a really irregular period. (And I was right about the "real" EDD so I felt that the u/s was really unnecessary.) Then we had the 20-week u/s where we discovered the low-lying placenta. And the tech decided to begin typing up her report while we were still in the room, so DH saw the gender on the monitor. Needless to say I was upset. As it turns out, that report was wrong--either the tech was wrong, or the screen was set to a default gender, or DH needs glasses--but I was upset anyway. And then I needed a fourth u/s at 32 or 33 weeks to find out about the placenta.

Sorry that was so long, but my point is I can see why someone might find out about gender and then refuse a 20-week u/s. I probably won't refuse mine when I have another DC, but I'm certainly not going to have four. I never felt that emotional connection people talk about. I was looking at a TV screen; it didn't look "real." My DS kicking me--a lot--that was real.

rkold
08-25-2010, 12:25 PM
I thought it was implied that you would only test for it if you were in the high risk group for a particular disease. My doctor didn't offer me sickle cell testing either.

No, it wasn't, which is probably why my first OB/GYN said it was optional for me. Both my mother and my husband converted to Judaism so the chances that either of us were a carrier were not very high.

o_mom
08-25-2010, 12:48 PM
Yes, it's perfectly safe and non-invasive, but if you receive a false positive, you can end up with an amnio which is not perfectly safe and does have a 10% chance of miscarriage.

Was this a typo? Most studies I have seen put the risk at 0.5-1%, nowhere near as high as 10%.

sste
08-25-2010, 01:02 PM
I think that was a typo - - o-mom your figures are similar to what I have read. Also, those are national numbers. I have always rec'd amnio/cvs from providers whose OWN track records are more in the 1 in 500 to 1 in 700 miscarriage rate.

luckytwenty
08-25-2010, 01:04 PM
Was this a typo? Most studies I have seen put the risk at 0.5-1%, nowhere near as high as 10%.

:yeahthat:

I was told it was 1% when I had my perinatology workup this spring.

rkold
08-25-2010, 01:14 PM
Was this a typo? Most studies I have seen put the risk at 0.5-1%, nowhere near as high as 10%.

I think I got it confused with the false positive rate with the AFP test which was surprisingly high.

Yeah the book, I am reading is saying the risk with amnio is 1.5% of a miscarriage but it is still not a risk I would necessarily want to take, especially if the main reason you are picking to get an amnio is because of the AFP test with its high false positive rate. I resent very much that the first OB/Gyn I saw did not inform that the AFP was optional, the it has a high false positive rate, and that is it merely diagnostic. I am not saying that anyone else is wrong for making the choices they do, just that I would rather make my choices with informed consent and I really resent that my first Ob/Gyn did not make sure that was the case and just made it seem like I had to undergo whatever test he wanted to give me if I wanted to avoid an amnio.

luckytwenty
08-25-2010, 01:23 PM
I'm not sure how your OB or peri is handling this, but I was really happy with how they handled mine.

I had the nuchal fold ultrasound and the blood test (called a quad screen but it's similar to an AFP) at 12-15 weeks (two part blood test.)

At 16 weeks, they had me and DH in for genetic counseling. They said that a woman my age (36) had something like an almost 1% (.9 something) chance of a birth defect like trisonomy, my earlier screening results not withstanding, and that was slightly lower than the risk of miscarriage from amnio. Factoring in the results, my odds were even lower, maybe .8 percent or something like that.

Then they did an ultrasound anatomy scan, found no markers, and said my risk was now down to .3 percent--so much lower than the odds of something going wrong during amnio. So they did not recommend amnio for me. If the ultrasound had detected markers, they would have recommended amnio.

Anyway, I found this to be a much more rational way of going about the testing, especially the invasive testing. Half a decade ago, anyone over 34 was recommended amnio. Now they won't do it unless (at least my OB and peri team wouldn't) unless your odds of a significant problem were above or at least equal to the .1% amnio miscarriage rate.


I think I got it confused with the false positive rate with the AFP test which was surprisingly high.

Yeah the book, I am reading is saying the risk with amnio is 1.5% of a miscarriage but it is still not a risk I would necessarily want to take, especially if the main reason you are picking to get an amnio is because of the AFP test with its high false positive rate.

sste
08-25-2010, 01:30 PM
Rkold, this is a big issue - - my OB says she always tries to educate her over 35 patients that they have a very significant likelihood of failing the first trimester blood screening. I don't understand all the details but your age is factored into the matrix with the blood test (and I think the nuchal??). I think that is what drives the false positive rate - - at least my OB feels like that particular screen is much more reliable for comparatively younger moms.

The reason counseling on this is important is because if you know this going in you can opt to: 1) rely on the nuchal (which I believe is more reliable than the blood test, especially if you combine it with the second level ultrasound actually - - there are statistical formulas for doing this); 2) get cvs and just be done with it at 10 or 11 weeks -- this is currently not the rec of acog, they now rec the combined screening for women of all ages but I will say that I did this because I did not want to mess with false positives, wanted certainty, wanted a broader range of genetic testing (my geneticist and CVS ob tested for some 65 disorders), and perhaps most importantly wanted to know earlier in the event I decided to or needed to terminate; 3) get amnio; 4) do nothing - - caveat that if you want to prepare for a serious birth defect by choosing hospital, provider etc. you may want to then have the level II ultrasound to give you that info.

Gena
08-25-2010, 02:22 PM
I had two Level II ultrasounds, after an early Level I ultrasound (for size and dating) revealed that DS had a cystic hygroma. My Level II scans were done at 12 and 20 weeks. CH can be an indicator of chromosomal problems and can lead to fetal death, so it was a very stressful time. Even so I declined all other prenatal testing, including the triple screen and CVS/amnio.

Thankfully, the CH had resolved by the 20 week scan, although DS does still have a small growth on the back of his neck.

I have heard the theory of a connection between developmental issues and ultrasounds before. It's something that comes up in my autism discussion groups from time to time. Personally, I've never seen anything convincing about it. Yes, I did have several ultrasounds during my pregnancy and my son does have autism, but I don't see it as a cause and effect. I believe it's more likely that whatever caused his CH played a role in his autism, even though there is no scientific evidence of that either (because no studies have been done). We do now know that DS does in fact have a chromosomal anomaly (although it is not one that would have shown up on an amnio), so maybe that plays a role in both the CH and the autism.

rkold
08-25-2010, 02:27 PM
I'm not sure how your OB or peri is handling this, but I was really happy with how they handled mine.

I had the nuchal fold ultrasound and the blood test (called a quad screen but it's similar to an AFP) at 12-15 weeks (two part blood test.)

At 16 weeks, they had me and DH in for genetic counseling. They said that a woman my age (36) had something like an almost 1% (.9 something) chance of a birth defect like trisonomy, my earlier screening results not withstanding, and that was slightly lower than the risk of miscarriage from amnio. Factoring in the results, my odds were even lower, maybe .8 percent or something like that.

Then they did an ultrasound anatomy scan, found no markers, and said my risk was now down to .3 percent--so much lower than the odds of something going wrong during amnio. So they did not recommend amnio for me. If the ultrasound had detected markers, they would have recommended amnio.

Anyway, I found this to be a much more rational way of going about the testing, especially the invasive testing. Half a decade ago, anyone over 34 was recommended amnio. Now they won't do it unless (at least my OB and peri team wouldn't) unless your odds of a significant problem were above or at least equal to the .1% amnio miscarriage rate.

I really wasn't happy with mine, but I've since left his practice. ^^;;;

We were extremely blessed and conceived much faster than we ever anticipated, but I also had pretty strong morning sickness for more than 1/2 the pregnancy, (and we sold our house and moved about 1 hour away) and so I was nowhere near as informed or prepared for everything as I would have been otherwise. I read that the chances for someone my age (37) of having a baby with Down's starts at around .7-.8% and is even lower for Trisonomy 18 and neural tube defects.

We had our first appointment at week 9 to confirm the pregnancy (fast u/s and saw the baby's heartbeat) and then I was immediately given genetic testing (not counseling, just taking my blood so it could be tested) to see what I was a carrier of, to test to see what I was immunized against and to test for sexually transmitted diseases (I think this one is required by my previous state, I know the current state I live in does require a 2nd HIV test towards the end of the 2nd Trimester.) I was given the option of testing for Tay-Sachs and the other Ashkenzai Jewish genetic diseases, which I took, though again I was not overly concerned as my husband converted. And was told I needed to schedule my Nuchal by week 12 or 13.

We went for the Nuchal and accompanying blood prick, which along with the 2nd u/s was my favorite of the tests, because we really got a clear picture of the baby. I went to see the 1st Ob/Gyn for my 2nd appointment post the Nuchal and was told all the testing from the last visit were fine, no individual results, we had to wait to get the info from our insurance co in the mail and that at the next appointment (#3) I would have a AFP (It could have been a quad screen, again the first Ob/Gyn was not good at getting my informed consent. He pretty much worked under the assumption he would tell me what tests I would have, particularly if I wanted to avoid an amnio.) I got my Nuchal results a few days later directly from the office that did the u/s. They didn't give percentages but said my chances of having a baby with Down's/Trisonomy had dropped to the same as a woman who was 20.

Appointment #3 at about 17 weeks I had a AFP. Trying to get the results from that were like pulling teeth.

At week 20 I had my 2nd stage u/s where we found out the baby's sex and that everything was developing correctly. They were very thorough.

I can't remember when I officially switched to Ob/Gyn #2 but I do remember trying to get my records from Ob/Gyn #1 took forever and it involved a lot of rigamarole and the fact I could not just go into the office and request copies of my own records and receive them.

And as of this week, 32, I've now switched to a nurse midwife since as I am low risk I would prefer to birth naturally in a birth center (and preferably in the water) The only test I have left besides the usual protein/glucose in urine and blood pressure tests is StrepB.

I do understand that a lot of things can go wrong in pregnancy and in childbirth, but I also think that generally if someone is informed enough to decide they do not want any particular test, that they know the risks and are prepared to accept them and more than likely have their own reasons why they want to avoid said intervention. (like for example if I had turned down testing for Tay-Sachs. It's not that I don't think it is a serious disease, just that the chances both my husband and I are both carriers is highly unlikely.) If OPs sister does not want a 2nd stage u/s, even if it is one of the tests of the ones I've gone through I would definitely pick again, I don't think I or anyone else here should try to talk her out of it since I am sure if she is actually rejecting a test she knows both the perceived advantages and disadvantages.

bostonsmama
08-25-2010, 03:18 PM
Embarrassingly, I'll have had 9 u/s by tomorrow. I have had an extremely high risk pg b/c of thyroid problems and a residual mass in the cornual part of my uterus that miraculously dissolved by wk 20. It had been my one-way ticket to a C-section, but now that we've seen it's gone, I'm able to attempt a vaginal delivery, so I see the benefits of u/s in tracking abnormalities as HUGE. Ironically, I declined the 12wk nuchal translucency scan AND triple (quad) screen, so I definitely opted for the Level-2 to make sure there weren't any spinal abnormalities, brain problems, etc. I would have carried to term anyways.

To each his/her own. I'm anti-blood testing for abnormalities b/c of the high false positive rate, but I'm not averse enough to not want proper medical assistance on stand-by at birth should baby ever have an abnormality detectable by u/s.

DrSally
08-25-2010, 03:43 PM
The only bad thing I can think of to say about the level II ultrasound is not medical risk from the ultrasound but my genetics counselor friend has told me there is a higher than you would expect rate of abortion for cleft lip (I don't think it is a majority but for a fully operable cosmetic thing you would expect zero!) . . . apparently the visual just absolutely freaks couples out.

Wow, I'm stunned by this.

I had one b/c my quad screen came back positive for downs. There were no markers on the ultrasound, and the genetic counseling was very helpful. It was interesting to hear what info goes into setting the probabilities, from a scientific perspective. I think it's a balance of risk/benefit. I don't think there's an established major risk, so I don't have a problem doing ultrasounds when they're medically necessary. But, I wouldn't be going in just to have them for fun (didn't Tom Cruise buy his own ultrasound machine so he could look at the baby whenever they wanted to?)

DrSally
08-25-2010, 03:46 PM
I personally had extensive genetic testing done for Jewish genetic diseases in high school. There is an organization that tests for the really awful ethnic diseases for Jews of Ashkenazi descent (Tay-Sachs, Canavans, Fanconi Anemia, Cystic Fibrosis & others) in 12th grade & the idea is to check genetic compatibility with guys before we ever start going out with each other. Among the population that participates in this program, the number of carriers are going down & certainly the number of children born with these diseases have decreased dramatically.
.

That's interesting and prob a really good practice. I know someone who had a baby with Cystic Fibrosis and they didn't figure it out until the baby was very sick--the mother had to push to have the baby continually looked at b/c something "didn't feel right". I guess they didn't have the prenatal testing?

brgnmom
08-26-2010, 10:54 AM
update in first post.

Dream
09-01-2010, 05:39 PM
Is the level II US dangerous compared to other US? I'm asking 'coz a PP mentioned that some opt not to have because they didn't want to interfear with brain growth?

I'm schedule for a nuchal scan next week, I'll be 12 weeks then. I didn't have this scan with my first. But I had an US at 20 weeks with my first. Apart from that by OBGYN office does an ultrasound at every visit. Doesn't take long time, we get a quick peek and they usually print the picture and does some measurements. Is this bad?

brgnmom
09-01-2010, 05:49 PM
Is the level II US dangerous compared to other US? I'm asking 'coz a PP mentioned that some opt not to have because they didn't want to interfear with brain growth?

I'm schedule for a nuchal scan next week, I'll be 12 weeks then. I didn't have this scan with my first. But I had an US at 20 weeks with my first. Apart from that by OBGYN office does an ultrasound at every visit. Doesn't take long time, we get a quick peek and they usually print the picture and does some measurements. Is this bad?

My sister was hesitant to have the level II ultrasound done b/c her OB estimated that the procedure would last for around 45 minutes. In the end, however, she decided to have the detailed scan done, not by a tech but by her OB who promised her that she would take less time (15-20 minutes, as opposed to 45 minutes).