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# of ultrasounds--question
annafine wrote: I'm 35 weeks pregnant and have only had 2 ultrasounds. The first was at 10 weeks and the second at 18 weeks. I've been asking my OB about another, but she won't request one unless she feels it medically necessary. My question is, how many ultrasounds have you had, and when (# of weeks) did you have them? Lets see, I had: 7w4d: to date the pregnancy (which was totally unnecessary because I chart and knew when I ovulated, but I wanted it because of a previous miscarriage, and I wanted the reassurance). 18w: Level II routine US 26w: check placenta position because it was low at the 18 w And a late one (38 or 39 w) to check baby size. Really wish I hadn't agreed to this one, because it just fed the whole fear of "big baby" atmosphere that surrounded the end of my pregnancy. Next time, I'll refuse the dating US, although I'll probably do the anatomy one at 20 w. I may try and do one late to look at the thickness of my c-section scar if I go for a VBAC, have to look into that. Mary |
#12
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# of ultrasounds--question
My question is, how many ultrasounds have you had, and when (# of
weeks) did you have them? Thanks, Anna EDD #1 October 18, 2003 With #1, I didn't have any. My OB at the time felt that if he was doing his job, the u/s wouldn't tell him anything he didn't already know. And he only did u/s if he felt there was a reason for a concern, and didn't do routine u/s. He had delivered over 5000 babies, and was awesome, but unfortunately retired after my DS was born. With #2, I had three u/s. A quick peak at 14 weeks, because the OB couldn't find a hb and while she said she could hear the baby moving around on the doppler, took pity on me because I was a bit worried and we did a quick u/s. I also had them at 18 weeks and 35 weeks, routine for that OB. Amanda |
#13
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# of ultrasounds--question
annafine wrote: I'm 35 weeks pregnant and have only had 2 ultrasounds. The first was at 10 weeks and the second at 18 weeks. I've been asking my OB about another, but she won't request one unless she feels it medically necessary. My question is, how many ultrasounds have you had, and when (# of weeks) did you have them? Thanks, Anna EDD #1 October 18, 2003 With my 1st, I had 1 at 11.5 weeks because I had a CVS. Didn't have any others. With #2, I had 3 - 1 at about 8 or 9 weeks to verify that it was a viable pregnancy - my 2 previous pregnancies ended in early miscarriages. I had one at 15.5 weeks for an amnio, and one at 20 weeks. The one at 15.5 weeks was the only necessary one (necessary given that I was having an amnio, that is). Clisby |
#14
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# of ultrasounds--question
My question is, how many ultrasounds have you had, and when (# of
weeks) did you have them? I had one ultrasound. I was about 6 weeks along, and there was suspicion of multiples (fertility treatments.) Since there was only one, and I never had a medical indication for another, I never had another. I could have had one (my OB practice did do routine scans), but I declined them, because I couldn't see any point. (2 sounds more than sufficient to me, esp. since the ACOG doesn't recommend any at all, unless there are medical indications.) Any particular reason you were hoping to have more? By this point, the only thing they'd be likely to be scanning for is fetal size/weight/lie, and the latter can be determined by feeling your abdomen, while u/s is EXTREMELY innaccurate in determining the former. (In fact, you should probably be pleased that your OB is not doing a late one for that reason. Too many women find themselves being pressured into unnessessary inductions, or even c-sections because a late u/s finds that the baby is "too big" Naomi CAPPA Certified Lactation Educator (either remove spamblock or change address to to e-mail reply.) |
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# of ultrasounds--question
With #1 I had 3. The first at 6 weeks because I had a minor problem, one at
16 weeks (routine) and one at 8 mos by our choice because we HAD to know the sex With #2 I had 3 also. The first at 6 weeks (routine) 2nd at 24 weeks (routine) and the last at 35 weeks because I had slight placenta previa at the 24 week scan and they wanted to make sure it had fixed itself. With #3 I've had 1. It was at 20 weeks, a routine scan but also because I had a high AFP result, I had it a few weeks earlier than I otherwise would have. I dont suspect I will have another scan at this point. Kari mom to Kaylie (7) Noah (4) and #3 due in 2 weeks! "annafine" wrote in message om... I'm 35 weeks pregnant and have only had 2 ultrasounds. The first was at 10 weeks and the second at 18 weeks. I've been asking my OB about another, but she won't request one unless she feels it medically necessary. My question is, how many ultrasounds have you had, and when (# of weeks) did you have them? Thanks, Anna EDD #1 October 18, 2003 |
#16
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# of ultrasounds--question
Thought you might be interested in this article.
Mary G. EVIDENCE MATTERS Efficient Prenatal Ca Fewer Visits, Fewer Sonograms Effective Clinical Practice, May June 1999 In this issue of ecp, Evidence Matters focuses on obstetric care and how it might be done more efficiently. The goal of prenatal care is to ensure delivery of a healthy baby to a healthymother. The standard regimen of care that most obstetric providers have been trained to use is intense—14 visits during a 40-week pregnancy and a myriad of screening tests. Many recommended aspects of prenatal care have not been shown in clinical trials to improve outcomes, but more tests and visits must be better, right? The studies presented in this issue of ecp show the opposite—that more visits and, at least in the case of routine ultrasonography, more tests are not necessarily better. Neither increases the number of healthy babies delivered to healthy mothers. The first study presented here was designed to put the recommendations of the Expert Panelon the Content of Prenatal Care1—a multidisciplinary panel convened by the Public HealthService—to the test of a randomized, controlled trial. This trial, conducted in the Coloradoregion of Kaiser Permanente, found that reducing the number of prenatal visits had no adverse effects on outcome or patient satisfaction. That the intensity of prenatal care can safely be reduced has been confirmed by randomized trials in Britain2 and Zimbabwe.3 By paying attention to what we do in fewer prenatal visits, we can improve the efficiency of prenatal care while satisfying our patients and maintaining excellent pregnancy outcomes. Obstetric providerscan use the results of these randomized trials to safely reduce the intensity of routine prenatal care and continue to deliver healthy babies to healthy mothers. Performing ultrasonography at least once and often twice or more during pregnancy has seemingly become routine. This practice was based on the belief that such screening would improve outcomes. However, the RADIUS trial, presented here and in another paper4 examining the impact of routine screening ultrasonography on maternal management andoutcomes, demonstrated that routine ultrasonography does not reduce adverse perinatal outcomes or obstetric interventions. Keeping in mind the caveat that these trials examined care given to low-risk obstetric patients,it seems clear that in prenatal care, more is not necessarily better. Indeed, when equivalent or better outcomes result from less intense care, resources become available for use elsewhere.To me that means that less—not more—is better. References 1. Public Health Service Expert Panel on Prenatal Care. Caring for our Futu The Content ofPrenatal Care. Washington, DC: Public Health Services, US Dept of Health and Human Services; 1989. 2. Sikorski J, Wilson J, Clement S, Das S, Smeeton N. A randomised controlled trial comparing two schedules of antenatal visits: the antenatal care project. BMJ.1996;312:546-53. 3. Munjanja SP, Lindmark G, Nyström L. Randomized controlled trial of a reduced-visits programme of antenatal care in Harare, Zimbabwe. Lancet. 1996;348:364-9. 4. LeFevre ML, Bain RP, Ewigman BG, et al. A randomized trial of prenatal ultrasonographicscreening: impact on maternal management and outcome. Am J Obstet Gynecol. 1993; 169:483-9. McDuffie RS, Beck A, Bischoff K, Cross J, Orleans M. Effect of frequency of prenatal care visits on perinatal outcome among low-risk women. A randomized controlled trial. JAMA.1996;275:847-51. QUESTIONS. Does reducing the number of routine prenatal visits increase adverse maternal orperinatal outcomes? Are patients satisfied with a reduced number of prenatal visits? DESIGN. Randomized, controlled trial. PATIENTS. Healthy, pregnant, adult women with no past or current high-risk obstetricconditions who presented for their first intake visit in the first trimester. All patients were enrolled in a nonprofit, group model, health maintenance organization (the Colorado region of Kaiser Permanente). INTERVENTION. 1165 women were randomly assigned to receive fewer routine prenatal visits.They were to be seen at 8, 12, 16, 24, 28, 32, 36, 38, and 40 weeks of gestation. For parous women, a telephone call was scheduled at 12 weeks instead of an office visit. 1163 women were randomly assigned to attend the usual schedule and number of visits. They were to be seen every 4 weeks from 8 to 28 weeks, every 2 weeks until 36 weeks, and weekly thereafter. RESULTS. On average, women assigned to fewer visits had three fewer visits per pregnancy. There were no significant differences between the groups in any maternal outcome (Table 1). Other outcomes with no significant differences included mild preeclampsia; preterm labor;cesarean section for fetal distress; preterm, premature rupture of membranes; gestational diabetes; multiple births; choriamaniotitis; abruptio placenta; and postpartum hemorrhage. There were no significant differences between the two groups in any perinatal outcome (Table 1). In addition, there were no significant differences in mean gestational age, mean birthweight, number of babies born small for gestational age, or number of babies with APGAR scores below 7 at 5 minutes. Patients were questioned about satisfaction with their prenatal care. The only significant difference was that more patients in the fewer-visits group rated the number of prenatal visits as "just right" (89.2% in the fewer-visits group vs. 82.8% in the usual visits group, P= 0.002; NNT, 16; 95% CI, 10 to 44). The two groups were equivalent in all other measures of patient satisfaction. CONCLUSION. In low-risk obstetric patients, reducing the number of routinely scheduledprenatal visits from a target of 14 to 8 or 9 visits has no adverse effect on maternal or perinatal outcomes and may increase patient satisfaction. Ewigman BG, Crane JP, Frigoletto FD, et al. Effect of prenatal ultrasound screening on perinatal outcome. N Engl J Med. 1993;329:821-7. QUESTION. Does routine ultrasonography (U/S) on two occasions reduce perinatal morbidity and mortality? DESIGN. Multicenter randomized, controlled trial. PATIENTS. Women at low risk for adverse pregnancy outcomes and no clinical indication forU/S. All centers were in the United States. Academic centers, HMOs, and private practices wereincluded. INTERVENTION. 7812 women were randomly assigned to receive two routine U/S examinations during pregnancy. The first examination was to be scheduled at 18 to 20 weeksof gestation; the second was to be scheduled at 31 to 33 weeks. 7718 women were randomly assigned to have no routine U/S examinations. RESULTS. The rates of adverse perinatal outcomes were equivalent between the screened and unscreened groups. Analysis of the 11 predefined adverse outcomes indicating severe morbidity and of the 8 adverse outcomes indicating moderate morbidity revealed no differences between the screened and unscreened groups. There were no differences in rates of preterm births or postdate births between the two groups. Rates of fetal or neonatal death were equivalent in the two groups. Selected outcomes are presented in Table 2. Women assigned to no screening averaged 0.6 U/S examinations; 55% had no U/S examinations. Women assigned to routine screeningaveraged 2.2 U/S examinations. CONCLUSION: A policy of routine ultrasonography in low-risk pregnant patients does notimprove perinatal outcomes. Key Evidence In low-risk obstetric patients, reducing the number of routinely scheduled prenatal visits has no adverse effect on maternal or perinatal outcome.Reducing the number of prenatal visits does not impair, and may modestly improve,patient satisfaction with prenatal care. In low-risk obstetric patients, routine prenatal ultrasonography does not improve perinatal outcomes. |
#17
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# of ultrasounds--question
"annafine" wrote in message
om... I'm 35 weeks pregnant and have only had 2 ultrasounds. The first was at 10 weeks and the second at 18 weeks. I've been asking my OB about another, but she won't request one unless she feels it medically necessary. My question is, how many ultrasounds have you had, and when (# of weeks) did you have them? Thanks, Anna EDD #1 October 18, 2003 #1 - one per trimester #2 - about 9 or 10 weeks, Level 2 u/s at 26 weeks, starting at 30 weeks one u/s a week (suspected complications) #3 - one at 12 weeks -- Sophie - TTC #4 |
#18
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# of ultrasounds--question
I had 3- 1st at 8 weeks 2nd about 4-6 weeks later and the next was at 21 or
22 weeks. The reason I had 3 however is my first U/S showed bleeding and last year I had a miscarriage. 2 is usually the most someone with no worries has. Shannon 3 days overdue |
#19
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# of ultrasounds--question
DD1: One at around 20 weeks and one quick looke when I went into labor at
the hospital to make sure that she was head down and no placenta previa. DD2: One around 20 weeks and one later in the pregnancy to make sure there were no abnormalities (medical problems with first baby). DD3: One around 20 weeks and one when I went into labor, just to see if she was head down. You really don't need any more ultrasounds. They have not been medically proven safe and really don't change the results, unless it is peace of mind that you are looking for. -- Sue mom to three girls annafine wrote in message om... I'm 35 weeks pregnant and have only had 2 ultrasounds. The first was at 10 weeks and the second at 18 weeks. I've been asking my OB about another, but she won't request one unless she feels it medically necessary. My question is, how many ultrasounds have you had, and when (# of weeks) did you have them? Thanks, Anna EDD #1 October 18, 2003 |
#20
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# of ultrasounds--question
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