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Today there was first pre-natal check up for my wife. It was with a RN. We will be seeing the doctor later this week. My wife has completed 8 weeks of pregnancy.
We were eagerly expecting a ultrasound to be performed today, but RN just took the usual pregnancy test (the ones we use at home) and confirmed that it is a positive pregnancy. No blood work or u/s. She just made an inquiry on how my wife feels, if there is any bleeding or cramps etc and said my wife was doing perfectly fine. The remaining session was about the usual medical advises of do's, don'ts and stuff. When we asked about the u/s to know about the heartbeat, RN said, unless there is a medical need, it will not be done until 20 weeks. She said it may not take 20 weeks for first u/s, but it might happen a little earlier.
It was pretty wierd as we have seen most of our friends do get an u/s somewhere between 6-8 weeks. Although I understand that this u/s sound serves no medical purpose other than giving a peace of mind, this was totally unexpected.
Our only concern now is about the NT scan that is done between 11-13 weeks. We are worried if they would skip or refuse to prescribe that. I am planning to request it during the doctor's visit later this week. But what should I do if the doctor feels that it is not required (my wife is 28) and won't prescribe it at any cost? I know changing clinic could be one possible option. But given the essence of time, I am not sure if we would be able to get appointment with another clinic in short span (to meet the 11-13 week window).
Where I am at, there is a place called Peekaboo, or something like that. They do ultra sounds there. All you need to do is make an appointment. No doctor prescription or anything required. It cost 60 bucks and we found out at 12 weeks that we are having a girl. Something to look into.
All obgyns are different in what they recommend. Many will only do an 8-week one if there is some concern or question about viability due to known high risk (i.e. prior miscarriage, there had been bleeding, advanced maternal age, known uterine defects, if the pregnancy is the result of IVF, etc.) For many "normal" pregnancies with low risk of complications, no ultrasound will be done until usually 12 weeks at the earliest. Nuchal Translucency screening is standard at that point. What are your reasons for feeling it might be skipped? It's completely noninvasive, and it's generally done regardless of maternal age. Other, more invasive DS-related screenings (including CVS, amniocentesis, and the newer maternal-fetal blood chromosomal screenings like Panorama, Harmony, Materni-T21and InformaSeq and the like) are unlikely to be routinely done unless there is a prior flag in an ultrasound, or if advanced maternal age is an issue. But NT is standard, because it's done during the ultrasound.
Thanks all for your responses. I got a feeling that it might get skipped because they hinted that first u/s will be done only at around 20 weeks. They told about Cystic Fibrosis test in today's visit. They recommended it if it is covered by insurance and if we wanted to do it. They didn't mention anything about NT.
I also got to read in couple of forums where doctor refused to prescribe a NT saying that there is no high risk associated (old age etc) with the pregnancy. Hence I felt concerned. I don't know anything for sure until we speak with doctor later this week, but just wanted to make sure we have a plan B to do that.
Docs are all different and the size of your clinic may make a difference. My first pregnancy, I went to a big, busy clinic. The doctor had an old school u/s machine in each exam room and he did a quicky u/s at each of my early appointments for piece of mind I guess. The routine/medically necessary ones were done by an u/s tech with new, fancy technology in a separate room. The results were given to the doctor for review. So I had tons of them there.
I switched doctors for number 2. This clinic was much smaller. One doctor, one u/s tech. This doctor only does u/s at the anatmony scan, so if everything in your pregnancy is going well you only get one. There was some question about my due date, so I did get one first trimester scan just to determine a due date.
I used the same doctor for number three. I thought I would only be getting the one scan that time, but I had a few bouts of bleeding early on and had several first trimester scans. After everything resolved itself, I didn't get another scan until I was around 20 weeks.
Early scans are not necessary unless there is a problem. I think most do them just for the parents to have piece of mind and see that, yes, there is something going on in there! Though it's kind of a bummer you didn't get to see your little bean, just be happy all is going well .
Where I am, we have 3 ultra sounds. One at 6-8 weeks, one between 12-14 weeks and one between 18-21 weeks. O
I've had four so far. The number is determined by maternal age, risk factors, complications that arise, potential genetic factors, etc. and is determined on a case-by-case basis.
I had an eight-week one, to determine viability. I have a bicornuate uterus, and they wanted to be sure that the embryo had implanted in an area with a blood supply, or it would not have developed. One at this point was necessary to determine that it was an actual pregnancy, and not a blighted ovum.
I had a 12-week one, which was when NT screening was done, as well as genetic testing (recommended due to being 35+).
I had one at 20 weeks that was an anatomical screening, to see that organs were developing as they should. It's also the one where we would have found out that we were having a boy, due to gonad development, if we hadn't already known from the blood test that was part of the genetic screening at 12 weeks.
Because a light spot on a heart ventricle was seen at this time, another was scheduled for 28 weeks, to see if the light spot was still present. At the 28-week ultrasound, the light spot was no longer there. I won't have any more, unless issues crop up in the next eight weeks that necessitate one.
OP, have you simply ASKED if they will be doing the standard NT scan as part of a 12-week ultrasound, as is common? It would be much more beneficial than reading horror stories from people on pregnancy forums about doctors REFUSING to do NT scans. Your doctor may not have mentioned it because A. it is pretty standard and B. it's not a separate procedure from the ultrasound. It's simply a measurement the tech takes on-screen while doing the ultrasound that measures the translucent space in tissue at the back of the neck of the fetus. It's just part of the ultrasound exam. NT scans CAN'T be done past the first trimester, because that portion of the anatomy is no longer translucent enough to measure the fold.
The only reason I can think of that a 12-week ultrasound and accompanying nuchal fold measurement would be refused would be if the hospital did not have access to the technology for some reason, and in that case, a referral to a hospital that did would be appropriate. Just doing a cursory internet search, I only found a couple of instances where an NT scan was not done, and these were all in other countries (are you in the U.S.?)...European countries and Australia, and it was because of differences in what was offered by private and publicly funded hospitals in each country. In the U.S., in the very off chance that an NT screening would not be offered at a first trimester ultrasound, you could request one. It may or may not be paid for by insurance if it's not recommended by a physician, but you could request one (and change doctors if the doctor would, for some strange reason, refuse to recommend one).
The other thing to keep in mind about NT screening (and nearly all in utero chromosomal abnormality screenings) is that they are NOT diagnostic. They (at absolute most) give you a picture of potential risk, and that is it. Getting a flag for DS or another chromosomal disorder is not a definitive diagnosis of that disorder. I have four nephews and one niece, and every single one of them had a flag at some point in gestation for a possible chromosomal anomaly. None of them was born with any chromosomal anomaly. It's not uncommon. Likewise, no flags doesn't definitively indicate that there are no issues, either. The screenings are simply predictive tools, in most cases, and are not diagnostically foolproof.
Thanks tabularasa for the exhaustive response. We live in NH, US. I'll meet the doctor this Friday and let you know how it goes. From what you say, it looks like NT is a standard procedure. Will keep you posted. Thanks to everyone again. Appreciate your responses.
Did I mention this...? At clinic, they gave an option for cystic fibrosis test if the insurance covers it. They have just asked to check if insurance would cover it or not and let the doctor know on Friday. Has anyone ever done it? What is the test like?
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