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Antenatal tests

unable to do nuchal measurement

10 replies

zeldapinwheel · 03/11/2012 10:24

I had my 12 week scan yesterday and due to babys position they were unable to get a nuchal measurement. Was sent for a walk twice but baby was determined to be in any position but the one needed. I asked if I could come back the following week to try again but was told in no uncertain terms that wasn't possible and i would just have to have the blood test done by midwife at 16 week appointment.

Have now spent most of the night awake and crying, dh doesn't really seem to understand why I'm so upset. I have a sister who has special needs due to a missing chromosome and I know how hard it can be bringing up a child with special needs , on the whole family.

I know the nt test isn't100% and there could still be other problems but I just can't seem to stop myself being upset. Dh suggests speaking to midwife on Monday but to be honest I have little faith in them and found them to be unhelpful when I was pregnant with dd (now 2) and fully expect to get told I'm over reacting.

So now I'm interested in other people opinions and experiences, am I over reacting? Is it my hormones making me so upset?

The sonographer told me she couldn't see any thickerning but was unable to get a measurement, there were no other issues, everything looked fine.

Sorry if a little rambling, little sleep and a pounding headache.

Thanks for any help.

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SamtheMidwife · 03/11/2012 11:28

Hello Zeldapinwheel,
I am so sad to hear of your distress.
The combined test (a nucal scan and a blood test), can be done any time from 11+0 to 13+6 weeks. The most acurate time to have it done is 12 weeks but if your scan was not adequate there is still time to have another.

There is another test which can be done if the combined was missed. This is called the quadruple test. It is a blood test.This can be done from 15+0 to 20+0, but is most acurate if done at 16-18 weeks.

I would suggest that scan appointments are hard to get but the sonogropher should not be deciding you can not have this test done to an adequate standard. Sometimes the sonogropher is also a midwife. The communication with you does not seem to be good enough as it has obviously left you confused and scared.

I would advise that you ring the Antenatal Clinic at your hospital and ask to speak to the screening co-ordinator or the midwifery manager for this area. Explain your history and your distress and ask for an urgent appointment (same day if possible), to review the scan, discuss all the options face to face and make the necessary arrangements to insure your care meets your individual needs.

If you do not get what you want/need then I would suggest that you ask to speak to a Supervisor of Midwives to help you more. The SoM role is to maintain saftey and quality of care

I hope this information is of help and you begin to feel better about things.
Best of luck
Samantha Lealman
Independent Midwife
www.babymoon-uk.com

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Pizdets · 03/11/2012 22:44

Hi Zelda,

Sorry to hear you're so upset, I would be exactly the same, we had a tfmr this summer and I think when you know the reality of what the tests mean (although obviously for you for different reasons) then you can't just brush off something like this.

Firstly, I think your sonographer was very unfair to say you can't have another scan, and if I were you I'd be taking it up with the midwife and anyone else I could think of.

Secondly, although it's not the way it should be, could you look at getting a scan done privately? If it's going to reassure you and stop you feeling so awful, it might be worth trying to arrange, even though you should be getting that level of care on the NHS.

Best of luck to you, hope you manage to get the resolution you need and that you can then relax and enjoy your pregnancy.

Piz

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brettgirl2 · 04/11/2012 07:51

The Sonographer told you there was no noticeable thickening, so in other words the nuchal fold looks normal. Combined with 16 week bloods that should be enough to reassure most people.

TBH if you are that anxious then rather than paying for a nuchal scan it may be better to go for a CVS or Amnio. Or research carefully where you choose privately. The combined test, particularly on the NHS is really unreliable, the official literature I was given said it picked up only 75% of cases. One in 20 people is worried half to death with a false positive.

Overall and sorry if this sounds harsh you need to get a grip and decide what to do. There is no suggestion that there is anything at all wrong with your baby be grateful for such a positive scan result.

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brettgirl2 · 04/11/2012 08:02

The last paragraph does sound a bit harsh, sorry, particularly if you are really anxious. If you are really struggling with the feelings you have then you need to talk to your midwife to decide a plan of action. As others said, insist on what you want if it really is the nuchal. But I would do some research into your options first.

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manitz · 05/11/2012 10:51

hi i would also suggest you ring the midwife. I have found that htey are sometimes seem unhelpful, because they are busy, if everythng is running smoothly but will really pull the stops out if things are going even a little bit wrong. I would also mention your sister's condition because I think that will really make them prioritise you. Its unlikely it's genetic but it suggests a possibility which may push them to act.

If it helps we found out at a 12 week scan that one of our babies had T21 and it was extremely obvious - the sonographer knew there was something wrong, it was not just the nuchal measurement. I know that's not always the case so I think you need to push to get your scan. If it's too late, again with a reminder about your sister, you could ask for a detailed scan at 16 weeks which will look for markers of classic chromosonal issues - i had one with Ds because of my history, it was with the consultant.

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manitz · 05/11/2012 10:52

sorry i meant inherited rather than genetic

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lambinapram · 05/11/2012 11:03

Exactly the same thing happened to me last week. The antenatel dept refused me another scan & said I had to wait until the quadruple test at 16 weeks. The quadruple test is about 80% accurate so not much different to the nuchal measurement and blood test. As its just a case of waiting a couple more weeks, I'm not too worried. However if you are feeling really worried I would suggest you go private.

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mb2512cat · 05/11/2012 15:12

Hi Zelda, have you had any input from someone with expertise in genetics? In other words, do you know if your sister's condition is inheritable/you could be a carrier? I have a de novo balanced translocation and have had a m/c and two unbalanced translocation babies. If you know the nature of your sister's chromosome issue, you could contact Unique as they would be able to advise who to ask if there's a risk you could be a carrier. Alternatively you could arrange a private nuchal scan and/or CVS if you are that worried. Our first baby presented with abnormalities at the 12wk scan including an increased nuchal while our second baby was perfect at the 12wk scan but showed up abnormalities at the 20wk scan.

Anyway, I hope you are not a carrier and just being a concerned pregnant lady (!) and that all goes well for you.

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zeldapinwheel · 06/11/2012 12:08

Thanks to everyone.

I've arranged for a private nuchal scan on Thursday.

I spoke to midwife who told me that due to hospital funding issues the're not allowed to bring people back on another day for a repeat scan. We discussed the options of nt vs quad and she informed me the nt is much more sensitive at picking up potential problems, the quad test is going to be phased out due to the high number of false positives it provides.

I appreciate people replying, sometimes its hard to tell if its pregnancy hormones upsetting me and making me over react. This pregnancy has been so much harder than my first and while I'm incredibly greatful that I am pregnant I'm exhausted, being sick all day and not sleeping much at night. Over emotional is an understatement! Really needed advice from 3rd partys.

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BryanBeattie · 05/01/2013 21:44

Why not consider a Harmony Blood Test. Harmony and MaterniT21 are both non invasive maternal blood tests for Down Syndrome, Edward Syndrome and Patau Syndrome. Detection rate is 99pc for Down Syndrome. Now available in the UK in centres in London and Cardiff and soon lots more. Costs vary so check if the fee includes an early viability scan and any confirmatory CVS or Amnio if results are positive. Currently samples are sent to USA for analysis.

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