For many other women, the 18-20 week ultrasound was the moment when they found out the baby had significant issues.
Sometimes, women were told by the sonographer that they had findings confirming a sign or ‘marker’ of a chromosomal condition, and they had to wait for amniocentesis. Usually, another expert needs to scan the baby again until a firm diagnosis is made, which means that all available evidence about the baby is weighed by specialists or two. Usually, the obvious signs of severe chromosomal conditions such as Edwards’ syndrome are more apparent at the 18-20 week scan, but not always. The 18-20 week scan is also used by health professionals to check the baby’s organs, including the heart, lungs, and brain, and to examine the position and size of the baby. Scans at 18-20 weeks provide clinicians with more information because they are developed better and the baby should be larger and healthier by 18 weeks.
The Royal College of Gynaecologists and Obstetricians (RCOG) has produced a report on the termination of pregnancy for fetal abnormalities in Wales, Scotland, and England in May 2010.
Within it are a number of recommendations for the communication of findings from ultrasounds. The following is a quote from their report:.
It is highly likely that emotional information has a significant impact on women, such as the need for trained practitioners to effectively communicate abnormal findings when performing fetal anomaly ultrasound screening. It is essential for the woman to be informed by the sonographer at the time of the scan, whether there is a suspected abnormality or if the scan reveals a confirmed or suspected abnormality.
This opinion does not necessarily require a second opinion, as guidelines decided by local authorities should be followed. However, if there are obvious major fetal abnormalities, such as anencephaly, a referral is usually required if the abnormality is suspected or confirmed. In order to immediately confirm these findings, the sonographer will ask a senior colleague sonographer for assistance, as is typically done.
Females ought to be recognized and this ought to be troubling for females and its consequences will be troubling for females and this ought to be recognized, any delay in obtaining more information about the irregularity and its consequences will be troubling for females. An appointment should be scheduled as quickly as possible and ideally within three business days. In the event of a suspected irregularity, females should be seen for a second opinion by an expert in fetal ultrasound, such as a fetal medicine specialist. For females who have received troubling news about their baby during the scan, there should be a healthcare professional accessible to offer immediate assistance.
The couple, who knew their baby’s size was small on the scan at weeks 18-20 but were told he was fine, discovered microcephaly at week 32. We talked to several confused parents who had gone for repeat scans, not knowing that there might be a problem with their baby. Sometimes, doctors will wait and give the baby more time to develop and carry on. It may not be possible for clinicians to make a firm diagnosis based solely on the scan or to identify why it has happened. The limitations of the scan at weeks 18-20 can only detect certain parts of the baby’s body when they are abnormally grown.
Some hospitals do not offer scans as detailed as those performed between weeks 18 and 20, but they can offer earlier detection of anomalies in the baby. Some parents wondered if it would be possible to have the same scan done at weeks 20 rather than weeks 16. Sometimes, a post-mortem was needed to confirm the diagnosis of a genetic problem like Fowler’s syndrome, if the baby had inherited it.
Sometimes, in certain cases, parents could see the baby more clearly because scans specialist had a powerful effect on some people, recognizing parts of the baby’s body that were not properly working. Clinicians might feel that there could be scanning problems if scans specialist are not performed in fetal specialist units up to 32 weeks. Specialist scans, such as MRI scans or 3D scans, are used to examine the baby in greater detail.
They expected to see nice pictures of the baby, but several young children had taken them beforehand. The health professionals, as well as those who had received leaflets about the 20-week scan, had been naive about the scan and had underestimated how serious any abnormalities could be at this stage. Many parents were shocked by the findings from the later scans and the 20-week scan.
“After the triple test* (Down’s syndrome screening) you stop considering the possibility of any mishaps,” one woman remarked – and despite receiving favorable results from all the initial diagnostic assessments (such as blood tests and CVS), others expressed their astonishment.
All pregnant women should be given the booklet ‘Screening Tests for You and Your Baby’ by their GP or midwife, which provides detailed information about the various types of scans offered by England Health Public and what they are looking for.
Many people were deeply affected by their experiences with specialist scans and the subsequent 20-week scan. They described how doctors and sonographers were very restrained and didn’t speak until they had analyzed all the details of the baby. Many disliked being kept in suspense and waiting for a definite diagnosis, sometimes for more than an hour. While some parents understood the clinician’s need for restraint and the suspense, others preferred to be told something, even if it was vague, several parents said.