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20 week Ultrasound - stomach full of amniotic fluid



 
 
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  #1  
Old August 31st 07, 07:22 PM posted to misc.kids.pregnancy
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Default 20 week Ultrasound - stomach full of amniotic fluid

I'm 20 weeks pregnant and recently have had 2 ultrasounds. During the
first US, the radiologist noticed that the baby's stomach was full and
asked me to come back to check it in a week. I went back a week later
and the stomach was still full of amniotic fluid. She booked me in
for another US next week and I'm very nervous - she said to check out
duodenal atresia as this is what she was concerned was the case. She
also said this is a warning sign of Down's Syndrome, but also told me
not to worry - right! That's about all the info I have at this time
and hubbie and I are very concerned.
Has anyone heard of this and is the stomach being full normal? What
else could be the reason for the stomach being full? What other signs
should be present in a US to note Down's?
The first US technician said the Radiologist was being overcautious as
they see the stomach full all the time, but that was at the first US.

Any info is greatly appreciated.
Sincerely,
Jules

  #2  
Old August 31st 07, 08:31 PM posted to misc.kids.pregnancy
JCF[_2_]
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Posts: 1
Default 20 week Ultrasound - stomach full of amniotic fluid

wrote in message
ps.com...
I'm 20 weeks pregnant and recently have had 2 ultrasounds. During the
first US, the radiologist noticed that the baby's stomach was full and
asked me to come back to check it in a week. I went back a week later
and the stomach was still full of amniotic fluid. She booked me in
for another US next week and I'm very nervous - she said to check out
duodenal atresia as this is what she was concerned was the case. She
also said this is a warning sign of Down's Syndrome, but also told me
not to worry - right! That's about all the info I have at this time
and hubbie and I are very concerned.
Has anyone heard of this and is the stomach being full normal? What
else could be the reason for the stomach being full? What other signs
should be present in a US to note Down's?
The first US technician said the Radiologist was being overcautious as
they see the stomach full all the time, but that was at the first US.

Any info is greatly appreciated.
Sincerely,
Jules


My son, at his 20 week ultrasound in 11/2005, was diagnosed with duodenal
atresia. That does not mean that your child will be, of course! I'm not a
doctor, and don't consider myself an expert, but I hope the following might
help, or at least provide some insight.

Our doctors continually encouraged us not to be too concerned after the
initial diagnosis. Trust me, I know where you're coming from, when you hear
certain words, it's hard to really really listen and believe them.... but
until you know more and have a closer look, do your best to not worry.
After receiving the duodenal atresia diagnosis, we met with my wife's
obstetrician, who said the following... "Duodenal Atresia is 'associated'
with Down's, but it's not an absolute indicator." Because we were in our
mid 30s, our pregnancy was considered high-risk anyway, so we had done the
genetic screening ahead of time. In our case the numbers suggested a very
low likelihood of Down's/chromosomal abnormalities, and so our doctors were
pretty optimistic. We did eventually do additional testing to rule
everything out, but then again our diagnosis at 20 weeks was unquestionable,
and from what you posted, it does not sound like yours is...again, I'm not
an expert...but that would seem to be a positive thing. In my son's case,
the indicator was not "amniotic fluid" but a characteristic "double bubble"
on the ultrasound. Basically, instead of seeing one stomach cavity, it
looks like there are two. Even as non-medical people, as soon as we heard
the diagnosis, we knew what the condition had looked like on the ultrasound.
In our case, the condition would have been hard to miss. It was really
obvious. Did the radiologist use that phrase at all - "double bubble"?

Our son was born healthy except for this one condition, which was corrected
shortly after he was born in March, 2006. He is now almost 18 months old,
and is a beautiful, funny, smart, loving little boy.

Hope this helps a bit. You'll be in our thoughts...

- Chris
Father to James


  #3  
Old August 31st 07, 08:34 PM posted to misc.kids.pregnancy
Jamie Clark
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Posts: 855
Default 20 week Ultrasound - stomach full of amniotic fluid

Jules,
Hugs. I can understand how scary it is to have something possibly wrong
with your baby. Are you showing extra large, or did they say you have a lot
of amniotic fluid? Duodenal atresia is when the upper part of the small
intestine is closed, and this interrrupts the normal flow of fluids from the
stomach through to the intestines and out the urinary tract. This is what
causes a build up of amniotic fluid, both in the baby's stomach as well as
in the uterus. If you have a normal amount of amniotic fluid, then your
baby may not have this issue.

If your baby does have this issue, as long as it's known about before hand,
it has a very high survival rate. Surgery would be performed to open and
repair the intestine remove the blockage, and baby should be just fine. It
can be fatal if it's not known about or caught in time.

Several websites I saw said that the chances of a baby with Duodenal
artresia having DS were up to 40%. I found a website,
http://findarticles.com/p/articles/m...35/ai_67316721 that lists
the strong, medium and soft markers for DS on u/s.

________________
"For example, a 35-year-old pregnant woman has a 1 in 300 chance of having a
child with Down syndrome. A soft marker in the fetus ups the risk to 1 in
200. A medium marker raises the risk to 1 in 120, and a strong marker may
bring it up to 1 in 60.

Four ultrasound findings qualify as strong markers for Down syndrome,
according to Dr. Hassan, who is the director of obstetrics and gynecology at
LAC-King-Drew Medical Center in Los Angeles.

* Nuchal Fold Thickening. A measurement of 6 mm or greater from the outer
skull to the outer skin line at the posterior fossa signals increased risk.
About 40% of Down syndrome fetuses display this marker on second-trimester
ultrasound.

In a study of 3,865 consecutive fetuses, nuchal fold measurements flagged 9
out of 21 diagnosed with Down syndrome on amniocentesis, for a detection
rate of 42%. The measurements produced four false positives for a positive
predictive value of about 69%.

Europe has had better success in using nuchal fold screening than the United
States, in large part because of better technique. For accurate results the
fetus should be in a neutral position, away from the amnion, and seen in
sagittal section, Dr. Hassan said.

* Cardiac Anomalies. About half of all fetuses with Down syndrome have
congenital heart disease.
"We know that this can be one of the most serious complications of Down
syndrome," Dr. Hassan said.
The anomaly is most commonly an atrial-ventricular septal defect, otherwise
known as an Epstein anomaly. Such anomalies are often hard to pinpoint and
may be missed even with fetal echocardiogram and Doppler ultrasound, Dr.
Hassan said.

* Duodenal Atresia. The "double bubble" seen in this condition corresponds
to fluid in both the duodenal bulb and stomach. Duodenal atresia is probably
the most common single-organ anomaly other than cardiac defects in fetuses
with Down syndrome.

* Hyperechogenic Bowel. A hyperechogenic bowel may be associated with a 20%
risk of aneuploidy. It's seen in Down syndrome as well as nonchromosomal
abnormalities, such as cytomegalovirus and meconium ileus.

Ultrasound markers that qualify as medium markers of Down syndrome include
femur or humerus length below the fifth percentile, intracardiac echogenic
foci, ventricular megaly, and pleural effusion, she said.
Soft markers include bilateral renal pyelectasis, brachiocephaly, and
choroid plexus cysts.

So if none of those other markers are found, your likelihood of DS is
seriously diminished. Not gone altogether, unfortunately, as the only
conclusive way to diagnose DS is amnio at this point. But if you have no
markers, and no excess amniotic fluid in your uterus, then this may be a
non-issue. The fact that the US Technician said that they see full stomachs
all the time is a good sign, so focus on that.

Hugs and good luck. Keep us in the loop.
--

Jamie
Earth Angels:
Taylor Marlys -- 01/03/03
Addison Grace -- 09/30/04

Check out the family -- www.MyFamily.com, User ID: Clark_Guest1, Password:
guest
Become a member for free - go to Add Member to set up your own User ID and
Password

wrote in message
ps.com...
I'm 20 weeks pregnant and recently have had 2 ultrasounds. During the
first US, the radiologist noticed that the baby's stomach was full and
asked me to come back to check it in a week. I went back a week later
and the stomach was still full of amniotic fluid. She booked me in
for another US next week and I'm very nervous - she said to check out
duodenal atresia as this is what she was concerned was the case. She
also said this is a warning sign of Down's Syndrome, but also told me
not to worry - right! That's about all the info I have at this time
and hubbie and I are very concerned.
Has anyone heard of this and is the stomach being full normal? What
else could be the reason for the stomach being full? What other signs
should be present in a US to note Down's?
The first US technician said the Radiologist was being overcautious as
they see the stomach full all the time, but that was at the first US.

Any info is greatly appreciated.
Sincerely,
Jules



  #4  
Old August 31st 07, 08:57 PM posted to misc.kids.pregnancy
Anne Rogers[_4_]
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Posts: 670
Default 20 week Ultrasound - stomach full of amniotic fluid

Jamie Clark wrote:
Jules,
Hugs. I can understand how scary it is to have something possibly wrong
with your baby. Are you showing extra large, or did they say you have a lot
of amniotic fluid? Duodenal atresia is when the upper part of the small
intestine is closed, and this interrrupts the normal flow of fluids from the
stomach through to the intestines and out the urinary tract. This is what
causes a build up of amniotic fluid, both in the baby's stomach as well as
in the uterus. If you have a normal amount of amniotic fluid, then your
baby may not have this issue.


I found a reasonable but fairly technical article on duodenal atresia,
http://www.emedicine.com/ped/topic2776.htm, it seems to imply that the
signs on ultrasound aren't absolute, so an enlarged fluid filled stomach
isn't necessarily found. What I can't find is anything the other way
round, as in, given some deviation from normal is found in stomach
volume, what are the chances of certain things being wrong - it's worth
while remembering that ultrasound is not a video of what is going on
inside, it's an interpretation of reflected sound waves - which means
the things it "sees" are not always accurate, it's also important to
remember that there are lots of things about foetal development that
even the experts don't understand, the info Jamie copied mentioned
choroid plexus cysts, which are cysts on a particular part of the brain,
which sounds serious, but it's not, it is a soft marker for downs, but
only a very tiny percentage of babies with choroid plexus cysts have
downs, and the cysts themselves cause no problems and disappear before
birth.

Have you had a triple test or serum screening, the risk factor from that
needs to be taken into account when considering any action, if it's low
risk then you can be pretty confident your baby doesn't have any
chromosome abnormalities, if it is a medium or high risk, combined with
this ultrasound finding, then you may want to have an amnio to determine
if there is or not - but that's entirely your choice. It may not be
possible to absolutely determine whether or not your baby has duodenal
atresia until after the birth although as the pregnancy progresses you
might get a better idea.

When are you next seeing a doctor and which type of doctor? Draw up a
list of questions such as "what are the chances it is duodenal
atresia?", "if it is, what kind of monitoring do I need?" and so on,
write them down and write down the answers, it's amazing how much you
can forget even when you think you are paying close attention.



Cheers
Anne
  #5  
Old September 1st 07, 05:52 AM posted to misc.kids.pregnancy
[email protected]
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Posts: 3
Default 20 week Ultrasound - stomach full of amniotic fluid

On Aug 31, 3:57 pm, Anne Rogers wrote:
Jamie Clark wrote:
Jules,
Hugs. I can understand how scary it is to have something possibly wrong
with your baby. Are you showing extra large, or did they say you have a lot
of amniotic fluid? Duodenal atresia is when the upper part of the small
intestine is closed, and this interrrupts the normal flow of fluids from the
stomach through to the intestines and out the urinary tract. This is what
causes a build up of amniotic fluid, both in the baby's stomach as well as
in the uterus. If you have a normal amount of amniotic fluid, then your
baby may not have this issue.


I found a reasonable but fairly technical article on duodenal atresia,http://www.emedicine.com/ped/topic2776.htm, it seems to imply that the
signs on ultrasound aren't absolute, so an enlarged fluid filled stomach
isn't necessarily found. What I can't find is anything the other way
round, as in, given some deviation from normal is found in stomach
volume, what are the chances of certain things being wrong - it's worth
while remembering that ultrasound is not a video of what is going on
inside, it's an interpretation of reflected sound waves - which means
the things it "sees" are not always accurate, it's also important to
remember that there are lots of things about foetal development that
even the experts don't understand, the info Jamie copied mentioned
choroid plexus cysts, which are cysts on a particular part of the brain,
which sounds serious, but it's not, it is a soft marker for downs, but
only a very tiny percentage of babies with choroid plexus cysts have
downs, and the cysts themselves cause no problems and disappear before
birth.

Have you had a triple test or serum screening, the risk factor from that
needs to be taken into account when considering any action, if it's low
risk then you can be pretty confident your baby doesn't have any
chromosome abnormalities, if it is a medium or high risk, combined with
this ultrasound finding, then you may want to have an amnio to determine
if there is or not - but that's entirely your choice. It may not be
possible to absolutely determine whether or not your baby has duodenal
atresia until after the birth although as the pregnancy progresses you
might get a better idea.

When are you next seeing a doctor and which type of doctor? Draw up a
list of questions such as "what are the chances it is duodenal
atresia?", "if it is, what kind of monitoring do I need?" and so on,
write them down and write down the answers, it's amazing how much you
can forget even when you think you are paying close attention.

Cheers
Anne


Dear Chris, Anne and Jamie,

You're all so wonderful for posting info. Thank you very much.
People say don't go researching a problem online - it will make you
worry more - but that certainly isn't the case here. You've made me
feel much better. Our next u/s is on Tuesday so I only have 3 days to
wait for more info. I will ask about the double bubble as she did not
use this term with me. She did comment that my amniotic fluid level
was slightly higher than average. And Anne, you're so right, I wish I
had a pen and paper at my last visit! I'll be sure to write down my
questions and the answers.

Thank you again,
Jules

  #6  
Old September 1st 07, 06:27 AM posted to misc.kids.pregnancy
Anne Rogers[_4_]
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Posts: 670
Default 20 week Ultrasound - stomach full of amniotic fluid


Thank you very much.
People say don't go researching a problem online - it will make you
worry more - but that certainly isn't the case here.


what utter rubbish - it's certainly true that using the internet
unwisely and reading article without sources can put false and worrying
information into your head, but so can reading newspapers or magazines,
or even books, but it can work to your benefit too, my mum had
premenopausal breast cancer, she only discovered the lump as she
subconciously self examined following reading something about it, now
you'd think that finding a lump would have had her completely panicing,
but being young and low risk, she presumed she was in the 9 out of 10
breast lump cases that are non cancerous, she'd not have known that but
for reading about it. For her it did turn out to be cancer and even if
she's have been having regular mammograms it wouldn't have shown up as
it didn't when she had one knowing exactly where the lump was. When you
have a specific problem the best thing you can do is research it -
otherwise how would you know what questions to ask and as you've already
discovered you don't always get complete answers in one doctors visit.

It's often said that older, well read parents are more anxious, but I'd
rather be well read and anxious, but doing the right thing, for example,
putting baby down on his back for sleeping, than ignorant of any risk of
SIDS and doing simple things wrong that can change the risk
significantly, such as putting them on their tummies to sleep.

Cheers
Anne
  #7  
Old September 1st 07, 03:41 PM posted to misc.kids.pregnancy
Pologirl
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Posts: 342
Default 20 week Ultrasound - stomach full of amniotic fluid

On Aug 31, 10:52 pm, wrote:
People say don't go researching a problem online - it will make you
worry more - but that certainly isn't the case here.


Glad you're feeling better. But I cannot let this pass without
comment.

1. You are not researching a problem here so much as seeking support.
And this happens to be an open support group without any moderator,
which means it could be really bad, or it could be really good. For
sure, this group has very high "transparency": what you see is what
you get, even if you don't know exactly who you are getting it from.
At least you can check our profiles and read every single thing each
of us posts, in some cases going back over 10 years.

2. The opposite risk to finding things to worry about is finding
false reassurance. (FWIW, I don't think you're getting that here.)

3. Anne suggests you can get bad information only from unsourced
information, but it's more complicated than that.


Re your ultrasound results, a full stomach does not equal duodenal
attresia, and duodenal attresia should not lead to polyhydramnios.
Most amniotic fluid is absorbed in the baby's lungs and stomach. The
rest of the GI tract normally has no fluid in it and never shows up on
prenatal US exams.

I had ~30 US exams with my last pregnancy. The baby's stomach almost
always was very full. Personally, in what you have reported I see
nothing to worry about except the competence of the person who has
been doing your US exams. At this point, if I were you, I would get a
referral to a specialist for any further US exams. A specialist being
a perinatologist (an obstetrician who specializes in high risk
pregnancies), or a radiologist who specializes in US monitoring of
high-risk pregnancies.

My motto: when in doubt, skip the screening tests and go directly to
the definitive test.

I think the radiologist is giving you a medical reason to get the
baby's chromosomes checked out (via amniocentesis and karyotyping),
and with a medical reason insurance should cover the testing. If you
want to go there. That can rule out DS.

Is this your first pregnancy?

Hang in there,

Pologirl

  #8  
Old September 1st 07, 07:47 PM posted to misc.kids.pregnancy
Sarah Vaughan
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Posts: 443
Default 20 week Ultrasound - stomach full of amniotic fluid

Pologirl wrote:

My motto: when in doubt, skip the screening tests and go directly to
the definitive test.

I think the radiologist is giving you a medical reason to get the
baby's chromosomes checked out (via amniocentesis and karyotyping),
and with a medical reason insurance should cover the testing. If you
want to go there. That can rule out DS.


The downside of that, however, is that there is a small risk of
miscarriage with amniocentesis (less than 1% with an experienced
practitioner, but still there). This needs to be weighed up against the
benefits of getting a definite answer to the question of whether or not
this is Down's.

In that situation I would *not* have amniocentesis - I'd rather wait and
find out after the baby was born whether or not it had Down's, rather
than taking even a small risk of miscarriage. This is not to say that
it would necessarily be the wrong decision for you - just that it's not
a no-brainer and there's more than one side to the argument.

Of course, all of this is a stage ahead anyway. At this point you don't
know whether there's even a high risk, because you haven't yet had the
repeat ultrasound, and you may feel that your decision depends hugely on
how great the risk is. It's quite possible that once the scan is
repeated they may say that there no longer appears to be anything to
worry about. Just wanted to point out that, if it does come to a
decision over whether or not to proceed to amniocentesis, that is not an
area in which you should be letting anyone else tell you what to do,
because what they will really be telling you is what decision *they*
would make in that situation, which is not necessarily the same as the
decision you would make. It's an area where you need to find out the
pros and cons and think carefully about the extent to which they matter
to you.


All the best,

Sarah
--
http://www.goodenoughmummy.typepad.com

"That which can be destroyed by the truth, should be" - P. C. Hodgell

  #9  
Old September 1st 07, 07:55 PM posted to misc.kids.pregnancy
Anne Rogers[_4_]
external usenet poster
 
Posts: 670
Default 20 week Ultrasound - stomach full of amniotic fluid


In that situation I would *not* have amniocentesis - I'd rather wait and
find out after the baby was born whether or not it had Down's, rather
than taking even a small risk of miscarriage. This is not to say that
it would necessarily be the wrong decision for you - just that it's not
a no-brainer and there's more than one side to the argument.


the OP poster hasn't mentioned whether or not she had the triple test
and what the risk factor came back to be as that is likely to influence
which route to take

Anne
  #10  
Old September 1st 07, 09:25 PM posted to misc.kids.pregnancy
Pologirl
external usenet poster
 
Posts: 342
Default 20 week Ultrasound - stomach full of amniotic fluid

The US tech is right, a fetal stomach is a normal finding. If
stomach full is the radiologist's real concern, frankly, I would look
for a new radiologist. So I would press the radiologist to explain
what he/she is concerned about. Sometimes a radiologist who sees
something not quite right will play it cool for a while.

In retrospect, I believe the radiologist who diagnosed my baby's tumor
at 20 weeks actually spotted it on the first ultrasound at 16 weeks.
At that time, he complained about a gestational age and position of
baby, necessitating a repeat scan after he returned from vacation.

I don't want to frighten the OP, but on the other hand false
reassurances are, well, false.

Pologirl

 




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