Ultrasound question - heart chambers not visible

carlye wrote:

We aren't happy with this OB or this hospital. Unfortunately, there
really are no other options for hospitals for about 200 miles. I
initially tried to find a general practitioner out of the hospital's
family practice clinic (I had a GP for my first pregnancy, and he was a
-wonderful- low-intervention great bedside manner type) but there is
only one GP in this whole hospital system who takes OB patients, and
after our initial interview, I found out she was a high-intervention
"scary" type. There are no birthing centers here. I'm pretty well
stuck. I am considering switching to a different OB, but it is more
than the OB. This hospital has been less than ideal in many respects.
(e.g.,pediatrics failing to tell us DD had Fifth's Disease when they
knew she did, even though I was pregnant).

I honestly don't know what to do.

I understand that this is upsetting, but you do have
some tools available.

1) A change of OBs may help, even if the hospital is a pain.
An OB who is actively working to get you the experience
you want *does* have the ability to cut through some of
the crap at the hospital.

2) You can still choose out of hospital birth. It may not
be your ideal choice, but on the other hand, birthing
at a hospital whose policies you don't like isn't an
ideal choice either. You have to weigh which is less
acceptable--the risks of having a hospital birth at
a hospital you don't trust or the risks of having a
birth at home with a trusted (presumably--otherwise
why would you change?) caregiver. You might be ahead
to at least interview your options and see how you feel
after doing that.

Best wishes,
Ericka

"carlye" wrote in message
oups.com...
Excuse my French, here....**** playing good and obediant patient next
time.
Next time you should find an OB that you don't have to fight with to get
a
basic dating u/s. Heck, there is still time in this pregnancy to make
the
switch to a new OB and have your level II u/s done at 20 weeks at a new
office with a new tech. I get the feeling that this is just how this
pregnancy is going to go at this office.

(feeling properly chastised) I know, I know... I don't really mean
that I want to be the good and obedient patient. I mean that after all
my stupid fighting for this stupid ultrasound for a date, they took the
thing about 5 steps too far and ended up scaring the living sh!t out of
me. If I'd just gone along with everything they wanted, chances are
the ultrasound I'd have gotten in a few weeks would show a normal
heart, though the dating may be even less reliable than this one (since
I think almost 17 weeks is still on the less reliable side for a dating
ultrasound).

I think part of the reason that this happened is that your doctor had no
intention of letting you have a dating u/s, and just went ahead and
scheduled you for a Level II u/s around 20 weeks. Then you begged to have
it earlier, so he bumped up the date, but it was still on the books as a
Level II u/s. Plus, it wouldn't make sense for them to do a simple dating
u/s at 18 weeks, which is about what they thought you were, then have you
come back in a week or two to have a full blown Level II u/s. So unless you
were planning on forgoing the Level II u/s all together, it just makes sense
for them to lump it all together. I mean, the first thing they do on a
Level II u/s is figure out how far along you are. Bing, Bang, Boom, killed
two birds with one stone. Again, your problem is the doctor here.


We aren't happy with this OB or this hospital. Unfortunately, there
really are no other options for hospitals for about 200 miles. I
initially tried to find a general practitioner out of the hospital's
family practice clinic (I had a GP for my first pregnancy, and he was a
-wonderful- low-intervention great bedside manner type) but there is
only one GP in this whole hospital system who takes OB patients, and
after our initial interview, I found out she was a high-intervention
"scary" type. There are no birthing centers here. I'm pretty well
stuck. I am considering switching to a different OB, but it is more
than the OB. This hospital has been less than ideal in many respects.
(e.g.,pediatrics failing to tell us DD had Fifth's Disease when they
knew she did, even though I was pregnant).

I honestly don't know what to do.

-Carlye
DD 9-29-04
"Butterball" EDD 6-2-06

Why don't you go meet another OB or two. You don't have to switch if it
feels like there are no better options, but just having a better feel about
a new OB, just having more of a bond, and more trust in a new person, might
make all the difference in how the rest of this pregnancy progresses, and
even with your dealings with the hospital, as Ericka suggested.
--

Jamie
Earth Angels:
Taylor Marlys, 1/3/03 -- Little Miss Director, who says, "No Mama, you have
to do it THIS way!"
Addison Grace, 9/30/04 -- My Little Communicator, who, when asked if she was
ready to take a nap, shook her head no and said in Baby Signs, "Night night
all done, downstairs."

Check out the family! -- www.MyFamily.com, User ID: Clarkguest1, Password:
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carlye wrote:
Does anyone have experience with this? Despite the
fact that I keep telling myself not to worry and that everything is
fine, I'm really worried. Thanks.



Actually I do have experience with this. In my first pg I had a touch
of bleeding at about 16 weeks, so they gave me an u/s. They went ahead
and did part of the level II u/s, and couldn't see everything. The
heart was one of the things they couldn't see well yet. When we got
the rest of the level II u/s 4 weeks later the heart was fine. They
also guessed me as a boy at that 16 week u/s, and changed it to girl 4
weeks later, but they couldn't get a super great view of the genitals
due to the babies position.

KC

16 weeks is too early to look at the fetal heart.

hmm, my friends who had a baby with a fairly minor heart defect (a valve
stenosis, I can't remember which valve) has an indepth check of number 2's
heart at 16 weeks, I'm sure that that included ultrasound where they do some
clever analysis and show and image with the blood flow as colours.

Anne

That may be the case for her. I don't know what they were looking for
or what the findings were from her 16 week scan. Stenoses are
relatively easy to detect because one does not have to visualize the
small structures clearly - all one has to do is measure the velocity of
flow (much like constricting the spigot on a water hose will make the
water come out faster - the faster flow demonstrates the presence of
the constriction).

Also, the ability to image small structures clearly with ultrasound
depends greatly on maternal body size and fetal position. Occasionally
it is possible to see structures clearly at an earlier age than one
normally does see them - but that is more a matter of luck than skill
or technology.

If you see something you're looking for at an early age, then you have
seen it. If you look at an early age and don't see it, then you look
again later on. That doesn't mean anything is wrong. It just means you
looked at an earlier gestational age than optimal, and couldn't see
what you were looking for.

16 weeks is earlier than optimal for detailed studies of the fetal
heart. In my fetal diagnostic center, we schedule overall surveys of
the fetal anatomy at 18-20 weeks. If we are particularly concerned with
the heart, we schedule a heart study for 20-22 weeks. That doesn't mean
it is always impossible to see things earlier, it just means that the
chances of an unsatisfactory study are much greater when the study is
done at an earlier-than-optimal age.

Oh, thank you KC. This is very reassuring. We do feel a lot better
today than yesterday. I realize the chances of something actually
being wrong are slim, and even if something *is* wrong, that doesn't
mean anything is life threatening or not "fixable." I have to remain
positive, at least long enough to get through the stress of the
holidays!

As far as the boy/girl thing, I don't think there was much in dispute.
We had a, well... *very* cooperative little boy. :-)

Thanks again.

-Carlye
DD 9-29-04
"Butterball" EDD 6-2-06

carlye wrote:

How worried should I be? The doctor was very casual about it and said
for 17 or 18 weeks it's not abnormal to not see the chambers, and we
shouldn't be worried unless next month's ultrasound also doesn't show
the four chambers. Does anyone have experience with this?

I don't have any experience at all but it seems that doctors tend to be
overly cautious on most things so if the doctor is casual about it then I'd
take that as a big "Do Not Worry" Sign!! :-)

--
Nikki
Hunter 4/99
Luke 4/01
Thing One and Thing Two :-) EDD 4/06