Posts

Abnormal Fetal Ultrasound?

Consulting Dr. Google About Your
Abnormal Fetal Ultrasound

 

Don’t do it, Moms-to-be! As much as you may be tempted, I have to caution you to not web-surf regarding your abnormal fetal ultrasound. Here’s why…

Because you surf the net for these details, you end up finding an entire spectrum of possibilities ranging from normal to severely abnormal fetal findings. And most of them may not apply to your circumstances at all. The result is usually the same. Your imagination runs away with you, and you start to worry that everything you’re reading applies to you and your baby. I always know a mom has been consulting Dr. Google when I get questions like “Is my baby’s bladder inside its body??” My response is usually the same…I reassure her with an “It sure is!” Then with a little smile, I advise “Quit looking up stuff on the internet!” Moms’ responses are usually the same, too. “I know, I know…I just can’t help myself!”

In this day and age of anything we want to know at our fingertips, it is nearly impossible to NOT research something that piques our curiosity. So, naturally, when you get your ultrasound results from your doctor, and he mentions you have a lot of amniotic fluid (polyhydramnios) or your baby has cysts on its brain (choroid plexus cysts), you freak out a little (or a lot). It’s completely understandable! But these findings may VERY WELL not be a reason to panic!

If Your Doc Wants to Refer You

Sometimes, we sonographers (even the experienced ones) detect things we just can’t explain. This doesn’t mean something detrimental to your baby; it just means we can’t fully explain it. We know this is disconcerting to an expectant parent(s). Usually, if something requires the attention of a high-risk specialist (aka a perinatologist or MFM or Maternal Fetal Medicine), your doctor will tell you when he discusses your ultrasound results. In such a particular case, he/she will usually express that something noted on the examination stands out as abnormal (or possibly a normal variant – something that’s a little different but considered normal), and he would like a second opinion.

In my experience, if your provider feels it is not grossly worrisome, he/she will say so. Your doctor will then refer you to MFM so they can do a more extensive Level 2 ultrasound. The perinatologist should discuss this ultrasound with you, provide an opinion on the issue, and the severity of the problem. MFM will also let you know if they feel there really is no problem.

If Your Report is Normal

If you are not referred to a perinatologist, then it’s very likely that nothing worrisome enough was seen on your ultrasound. Your doctor will also let you know that your ultrasound was negative or unremarkable. At times, we can’t see something well because of Baby’s position or other factors. Usually, it’s something like Baby’s heart or spine. In these cases, your doc may want to look again to ensure a normal appearance. There are many minor findings that we may note on a regular sonogram which may not be alarming to your doctor. Mostly, they just require a follow-up later to see if the issue is resolved. They mostly turn out to be insignificant, especially if no other abnormalities are seen with your baby. In other words…they are likely not a big deal!!!

So don’t make yourself worry! Don’t ask Dr. Google, ask your doctor instead. Make a list of all your questions, and he/she will let you know if other tests are needed. I know it’s tempting, but this is only the beginning of all the things that drive us crazy as moms! Save your sanity for when your kid is a driving teenager!

As always, thanks for reading!

Please feel free to email with any questions or comments at
wombviewerblog@gmail.com.

Whether worried about an abnormal result or not,
subscribe to have reliable ultrasound information
delivered straight to your inbox!

 

Fetal Abnormality on Ultrasound – A Normal Outcome is a Good Thing

Everyone wants a healthy baby. It’s something we, as humans, take for granted unless we know of someone who experienced the misfortune of having a child with problems. Anyone who has ever come up against the discovery of a fetal abnormality on ultrasound can relate to the devastating feeling of receiving the news. No matter how insignificant the issue, even if your physician wasn’t worried, you sure were.

If a patient does not have a medical background, or if not one in OB, the incomplete understanding of what was seen can feel torturous. Moreover, the lack of a definitive diagnosis and waiting on more appointments and tests and results only adds to the anxiety. Sometimes the testing leads to a distressing diagnosis of a baby with life-long complications, a structural malformation requiring surgery after birth, or a syndrome that is not compatible with life. These are some of the most dreaded words an expectant mom can hear from her care-giver.

Why a Referral?

Sometimes, things we see may be cause for concern enough to warrant a referral to Maternal-Fetal Medicine (MFM). This way, a perinatologist (high-risk OB doc) can determine the nature or severity of a problem. They may know exactly what is seen, what to call it, and how to follow it. For those who are very lucky, following a concern for period of time results in resolution of the problem. Hallelujah! Your constant companions, Worry and Anxiety, get kicked to the curb! You feel you can finally exhale, breathe again! No longer do you spend your days contemplating the what-ifs of your pregnancy, your newborn’s life, or how it might impact the lives of your whole family. You can finally get some well-deserved sleep and actually enjoy things like your baby shower, decorating the nursery, or filling the closet with precious miniature clothing.

When Some Don’t Feel Relief

Some patients, unfortunately, never experience the “hallelujah” moment. One of my patient’s some time ago (with a new pregnancy) complained about the extent that her doctors followed one of her previous pregnancies for a suspected problem. A mass appeared on ultrasound in her baby’s abdomen. The area, surveyed for months, spontaneously resolved. Her physician’s could never explain it nor was there any reason for them to see her again. As a result, MFM released her back to the care of her regular OB physician. Though she may have felt relief, her  annoyance with the situation trumped any other emotion. Her impression reeked of disdain, not of “prayers answered” or “great fortune” or “blessings galore bestowed.”

Her only comments were “what a total waste of time it was…months of anxiety and follow-ups for nothing.” This may be an understandable reaction. No one wants a problem to continue or progress to the point it requires surgical intervention at birth. Most patients express appreciation or gratitude; a few, without the ability to see the bigger picture, feel only anger at the diagnosis. They endured inconvenience by a number of doctor’s visits and suffered worry for “no reason.” If providers could magically know in advance whether everything we see will or won’t be a problem, it sure would create a lot less stress for our patients and their docs who manage their care.

A Sonographer’s Job

The scope of a sonographer’s job is to look for and find abnormalities, big and small. And there have been many occasions when my great partner sonographers found something others may have missed. I’m sure this patient ultimately felt relief that her baby was healthy; I hope looking back, she realizes the opposite result of her frustration would have been far worse. Potentially, she may have felt differently if she spoke with someone who didn’t get the good news she did – like maybe the patient whose baby had three barely identifiable heart chambers instead of four. She needed three surgeries in her short little life…one at birth and two more before she turned three.

Ultimately, we are in this field to help everyone. Regrettably, some can’t appreciate the extent, reach, or purpose of the work we do to help them. This particular patient also complained that she couldn’t bring in ten people during her exam, that no one could talk on the phone or video the exam, and that we didn’t give her enough keepsake images. I’ve learned we can’t make everyone happy! Doesn’t this realization apply to just about every facet of life? Career-wise and personally-speaking?

Diagnostic ultrasound aids a physician in finding a problem. In so doing, a physician can better manage the health of mother and baby to prepare for a safer delivery. Also, she/he can prepare the family through education for the challenges that lie ahead.

What’s the Answer?

Unfortunately, there is no crystal ball in medicine. All we can do is our job, which is to find a problem. At the end of the day, I will always prefer to catch an abnormality than to miss one. And we are always over-the-moon ecstatic when we find a potential problem turned out to be nothing! Life is all about perspective, isn’t it? We can either take up residence in the victim mentality or be thankful for the blessings in our lives.

Here’s sending you blessings and well-wishes that your diagnosis turns out to be nothing, too!

You can send your comments, images, stories, and questions to me at wombviewerblog@gmail.com!

Thanks for reading!