20 weeks ultrasound didn't find a stomach bubble

On Jul 6, 2:57 pm, Pologirl wrote:
kvicky wrote:
When I asked my doctor regarding the test, she said they didn't find
the black spot(amniotic fluid) in stomach.

To reiterate, the US report does not say the stomach was absent or
small, only that the contents were not as clear as expected. And that
may well be a (minor) technical issue.

I had 30 ultrasounds with Hungry Girl, and in most of them my AF
looked somehow cloudy. No big deal.

Here I think the problem is that your doctor (obstetrician?) is
interpreting the US report, perhaps incorrectly, and does not
understand the point you are concerned about. "no stomach bubble" and
"no AF in stomach" are bad news, but that is not what the US report
says. I would want to talk to the US tech directly, or at least ask
the doctor to get clarification from the tech.

Pologirl

The doctor exactly told that it seemed the baby had not swallowed
enough amniotic fluid, hence there was no black spot in stomach. I
guess I related it to a bubble, is it similar? or am i just relating
it. and what does AF means?

thanks

kvicky wrote:
The doctor exactly told that it seemed the baby had not swallowed
enough amniotic fluid, hence there was no black spot in stomach.

Understood. Your doctor said your US shows no fetal stomach bubble.

The question is why did you doctor say this? Your doctor was not in
the room during your US, correct? And the US report does not say
"stomach absent" or anything similar. I think the doctor
misunderstood the US report and is giving you false information. Or,
the doctor is correct and the US report is false information.

What the doctor says and what the US report says are not the same.
One of them is wrong.


what does AF means?

Amniotic fluid.


thanks

You are welcome. Many of us came here with pregnancy concerns and
this group helped us. I hope to return the favor, by helping you. So
ask any questions.

Pologirl

Amniotic fluid volume is normal.
No uterus or adnexal abnormalities are seen.
Cervical length is measured at 4 cm.
The STOMACH also does not appear as sonolucent as
usual. We suspect there is some type of technical reason for this .
Recommend follow-up fetal evaluation of the above parts of the
anatomy after 2 or 3 weeks.

ok, so what the technician is saying is he sees the stomach, but isn't
getting a normal result for it, but he's also saying that he suspects
it's a technical issue, which most likely means he's not seeing images
that correspond with any standard abnormality. So I would take that as
an unknown result, rather than any elevated risk of anything.

It sounds like there hasn't been great communication between the
technician and your doctor, or the doctor and you. Did either of them
appear anxious? You're at 20 weeks, so if either thought the results
were indicative of a serious problem, they'd probably be following up
more promptly and also discussing other tests, as they are not saying
that, it kind of agrees with the conclusion that it's simply an unknown.
I know that doesn't really help as you want to go away from an
ultrasound with an all clear - but it is important to remember that
ultrasounds are screening tests that give both false positives (thinking
the baby has a problem that it doesn't) and false negatives (failing to
find a problem that is one that can be found via ultrasound).

I think the good news is for you, that everything else is fine, because
amniotic fluid fills the lungs and is swallowed and passes through the
digestive system, a problem in one part of that loop can show up as low
fluid volume, which you haven't got at the moment.

Good luck, and let us know how you get on.

Cheers
Anne

Anne Rogers wrote:
amniotic fluid fills the lungs and is swallowed and passes through the
digestive system, a problem in one part of that loop can show up as low
fluid volume, which you haven't got at the moment.

Well, no AF in the stomach more often is correlated with too much AF
(polyhydramnios) than with low AF (oligohydramnios). But that reminds
me to ask if the US exam looked at the bladder. If the bladder was a
normal full volume, that would be a good sign.

Isn't 20 weeks too early to expect a fetus to be filling its lungs
with AF?

Well, no AF in the stomach more often is correlated with too much AF
(polyhydramnios) than with low AF (oligohydramnios). But that reminds
me to ask if the US exam looked at the bladder. If the bladder was a
normal full volume, that would be a good sign.

oops got it the wrong way round, but the fact it's ok still applies!
you've probably seen an awful lot more detailed ultrasound reports than
I have, but the ones I've seen haven't had the bladder mentioned, I
wonder if that's one of the things that would get looked at if something
else flags a problem. When DS was a baby and needed an ultrasound, they
were looking for the bladder to be empty as a sign of normal - no idea
whether that would be something that would be the opposite in the uterus
or not.

Isn't 20 weeks too early to expect a fetus to be filling its lungs
with AF?

again not sure, they are obviously very underdeveloped but I think
they've got to be filled with something, obviously it's not air, so it
must be amniotic fluid, did you mean that they wouldn't be actively
doing this? I think it's got to be a passive state of things, not sure
about the other, babies born at this stage do gasp at birth, to the
reflex is there. I think in saying this, I was much more meaning that if
the fluid is fine now, even if there does turn out to be a problem later
then it's probably still a good sign it's fine now, but as I got mixed
up on the words it's probably irrelevant, I'm pretty sure excess fluid
regardless of cause doesn't cause knock on effects with development the
way insufficient fluid does.

Cheers
Anne

kvicky wrote:

I had a 20 weeks ultrasound done and the tech didn't find a bubble in
baby's stomach, she has written maybe due to technical reasons. So I
have another one scheduled at 23rd week, doctor says not to worry till
the next ultrasound.

Get a second opinion. Go to another ultrasound
facility and pay out of pocket if necessary. Our
u/s doctor told us that Pillbug's brain did not
develop at 29 weeks and followed that sentence
with the information that there are two places
in the U.S. that do late-term terminations. To
this day, I hate him! He did, at least, tell us
that UC San Francisco does fetal MRIs, so we went
there and they told us that Pillbug's brain did,
indeed, develop, but we were to watch for possible
hydrocephalus (which did not happen, thank goodness).

The point is that, when faced with any possible
serious medical diagnosis, get a second opinion.
If I were you, I would go to a different facility
first. Going back to the same facility later will
give you some information, but it's still the same
equipment, possibly the same tech. You want to
get a second, independent opinion.

-- Anita --

On Jul 7, 4:34 pm, Irrational Number wrote:
kvickywrote:
I had a 20 weeks ultrasound done and the tech didn't find a bubble in
baby's stomach, she has written maybe due to technical reasons. So I
have another one scheduled at 23rd week, doctor says not to worry till
the next ultrasound.

Get a second opinion. Go to another ultrasound
facility and pay out of pocket if necessary. Our
u/s doctor told us that Pillbug's brain did not
develop at 29 weeks and followed that sentence
with the information that there are two places
in the U.S. that do late-term terminations. To
this day, I hate him! He did, at least, tell us
that UC San Francisco does fetal MRIs, so we went
there and they told us that Pillbug's brain did,
indeed, develop, but we were to watch for possible
hydrocephalus (which did not happen, thank goodness).

The point is that, when faced with any possible
serious medical diagnosis, get a second opinion.
If I were you, I would go to a different facility
first. Going back to the same facility later will
give you some information, but it's still the same
equipment, possibly the same tech. You want to
get a second, independent opinion.

-- Anita --

My ultrsound results came out to be normal, thanks for all your posts.

Thanks

On Jul 12, 12:09 pm, kvicky wrote:
My ultrsound results came out to be normal, thanks for all your posts.

Wonderful! Now will you be looking for a new obstetrician?

If anything else comes up, drop us a note. We always like to read a
birth notice. Even better, a birth story!

Pologirl

Sorry, caught this one late.

In case anyone else ever has this same issue, let me clear up a couple
of points from the discussion above:

Not seeing the stomach, not seeing fluid in the stomach, not seeing a
stomach bubble, not seeing amniotic fluid in the stomach, and not
seeing echolucent fluid in the stomach, are all exactly the same
thing. The fetal stomach cannot be visualized on ultrasound unless it
has fluid in it. One never really sees the stomach per se, rather, one
sees the fluid inside it. This is why knowledgeable and precise people
say they weren't able to visualize a stomach bubble, rather than
saying they weren't able to visualize the stomach.

If there is no fluid in the stomach, one of the following things is
going on:
1) just by coincidence, the stomach is empty because the fetus hasn't
happened to swallow any fluid in a while. If this is the case, the
amniotic fluid volume will be normal and the stomach bubble will
likely be seen on a follow up exam. This is the most common scenario.
It's a little bizarre that they said "likely due to technical
reasons," because this is really better described as "likely due to
bad luck," or "probably due to bad timing."
2) there is some kind of tracheo-esophageal malformation that prevents
swallowed fluid from getting to the stomach. In this case, the fluid
volume will be increased because the fetus is producing normal amounts
of fluid but not getting rid of it via swallowing. In this case, the
fluid level keeps increasing on subsequent exams and the stomach
bubble will never be seen.
3) the fetus could have some kind of neurologic condition that
prevents swallowing. Again, rising fluid and no bubble on subsequent
exams.
4) there might not be any amniotic fluid at all (as in renal agenesis,
for example). In this case, the fetus can't swallow fluid because it
isn't there. This would be the least common scenario and the absence
of amniotic fluid would certainly be commented upon.

Fortunately, it seems kvicky was in Club #1, which is the best one to
be in.

On Jul 12, 12:56 pm, alath wrote:
1) just by coincidence, the stomach is empty because the fetus hasn't
happened to swallow any fluid in a while. If this is the case, the
amniotic fluid volume will be normal and the stomach bubble will
likely be seen on a follow up exam. This is the most common scenario.
It's a little bizarre that they said "likely due to technical
reasons," because this is really better described as "likely due to
bad luck," or "probably due to bad timing."

[deleted 3 other possible causes of "no bubble", clubs #2 - #4]

Fortunately, it seems kvicky was in Club #1, which is the best one to
be in.

I think kvicky was in Club #0: the stomach bubble was seen clearly
and was a normal size but its shade of black on the US image was
slightly different than usual. There are several technical reasons
for this to occur, that have nothing to do with the baby. The
obstetrician seems to have hugely misinterpreted the US report.

Pologirl