Level II Scan

Hi,

I'll be 17 weeks tomorrow. We have di/di twins and no other complicating factors so far. This is my first pregnancy. I am 33. We had genetic testing before we conceived (because we're both Eastern-European Jews) and both came up clear.

Up until now I have been seeing my regular OB who has lots of experience with twins and who I absolutely love. All along she has been telling me that at 20 weeks I'd have the choice of having the Level II anatomy scan with the tech in her office (with her review of course) or having it at the hospital in the perinatology center. She didn't push me either way. Yesterday at our 17 week appointment the tech, who has 20 years experience and who is FANTASTIC, really encouraged us to do it at the center. She said that their technology is better and that they're more likely to see things the first time (unlike at my OB, where we might have to come back because the image isn't clear enough or a baby isn't facing the right direction, etc). She did warn us however, that as peri's, their orientation is much more toward finding problems, since that is their main job. She warned us that many times (like 50%), they'll find something that *might* be a problem but usually isn't. This is actually why I chose to keep going to an OB. I didn't want to be treated like a ticking time bomb, and I didn't want an alarmist doctor. However, it just seems right to get this one important scan done by someone who specializes in high-risk pregnancies, no? And also with someone with amazing technology.

So we went ahead and got the script and made the appointment with the peri. But I broke down crying in the office, barely making it out the door...mostly because my head was spinning and I was caught off guard by the sudden shift in tone. For all of our many ultrasounds (even the one that day) and doctor's visits, everything had been so positive and cheerful. At 17 weeks the babies are good weights and sizes and ratios, heartrates good, their hands open and close, their spines are good, the membraines are good, all their organs are visible. To have all these medical terms and abnormalities thrown at me in reference to my babies was really overwhelming and upsetting.

So here are my questions:
1) Is it okay to do the test at 19 weeks and 4 days instead of exactly 20 weeks? My OB said it would be fine, that 3 days makes no difference, but when we made the appointment the receptionist said it is usually exactly 20 weeks. We wanted to do it that week because we'll be on vacation afterward
2) Would you also opt for the Peri if your OB could do the test too?
3) Why is everyone suddenly talking to me about Downs and Spinal Bifida and heart conditions? I know they are trying to prepare me for the kinds of things the peri will be looking for - but does a twin pregnancy really increase the odds of these things? Does everyone worry this much about these things?
4) How often do they really tell you they've found something but can't really tell you if its a problem? Seems to me I'd rather know that there is or isn't a problem. The hazy in-the-middle is so scary and stressful! Do I really need to brace myself for issues?

Sorry for the long post, and thanks for any insight!
Melissa

 

I think I would do the scan at the Peri. They are looking more closely, but I can't imagine there will be anything too shocking. If you know they have two placentas that rules out a big majority of worries. Good luck and let us know how it goes!

 

QUOTE(teafor2 @ Mar 4 2009, 04:45 PM) [snapback]1214617[/snapback]
So here are my questions:
1) Is it okay to do the test at 19 weeks and 4 days instead of exactly 20 weeks? My OB said it would be fine, that 3 days makes no difference, but when we made the appointment the receptionist said it is usually exactly 20 weeks. We wanted to do it that week because we'll be on vacation afterward Perfectly ok. I think I was offered anytime between the weeks of 18 & 20 weeks.
2) Would you also opt for the Peri if your OB could do the test too? I would do the peri.. no questions asked.
3) Why is everyone suddenly talking to me about Downs and Spinal Bifida and heart conditions? I know they are trying to prepare me for the kinds of things the peri will be looking for - but does a twin pregnancy really increase the odds of these things? Does everyone worry this much about these things? I think it is more that if you find an issue, there is a cut off point where terminating the pregnancy (not that you would if you had bad results) would be possible. It could be just to prepare you too.. I think some OB's have just a 'speech' for everyone, not just twins.
4) How often do they really tell you they've found something but can't really tell you if its a problem? Seems to me I'd rather know that there is or isn't a problem. The hazy in-the-middle is so scary and stressful! Do I really need to brace myself for issues? I wouldn't worry too much. Results can come back and be false while the babies are still inside you. I've heard of the blood test for Down Syndrome coming back postitive and in reality the baby was born without it. I would hope they would tell you if they would find anything abnormal. I always had things very well explained to me.

Sorry for the long post, and thanks for any insight!
Melissa

I hope the rest of your pregnancy goes well! Enjoy it if you can!

 

I ended up having my scan at the Peri's office (the one & only time I saw the peri my whole pregnancy) as per my OB's request.
They were very thorough and had the most up to date equipment.
I don't think the 3 days would make a difference :umm:
The peri's office was very vocal in telling me that they could not tell me one way or another FOR SURE if the babies were in danger of having DS or any other problems.
The unknown can be really scary, but hang in there & try to stay as 'worry free' as you can :hug:

 

I was also terrified about going to the Peri...I had planned a home birth with DS, so to go from the minimal intervention philosophy to the HIGH RISK HIGH TECH peri was insane to me. I was convinced they were going to tell me some kind of horror story and I would worry like crazy for months...only to have (hopefully) healthy babies. Well, we went and nothing weird was said...all was fine and normal and totally great! Go to the peri, and just be prepared to take whatever they may say with a grain of salt. Know that they are rarely100% sure of anything, so just go and see what happens...it will probably all be perfectly fine! Good luck!

 

Melissa - EVERYTHING WOULD BE FINE
do your level 2 in peri office. I just had one. they usually have better machine for u/s and my tech didn't find anything wrong and even after that when doctor came and said everything is good but if I wnat to do amnio he is ok with that. I said NO i don't wnat to do amnio, I think this is there technic to talk with people.
If your 12 weeks scan didn't show anything bad please stop worried. at level 2 they will be checking all organs of the babies. to make sure everything is fine.

 

:hug: :hug: :hug: :hug: I know how your feeling, my OB didn't give me a choice it hospital protocal that multiples have the level two with the peri....But still I was a nervous reck about going and didnt sleep at all the night before with all sorts of thoughts running through my head....But in the end I am so glad I saw the peri.

My level two was done at 18 weeks exactly so I dont see why being inbetween 19 and 20 weeks will matter. I saw the peri at 18 weeks, we go back at 24 weeks and then every four weeks from then on.

As nerve racking as the thought of seeing a peri was,,,, I am so glad I went, My OB is awsome but now I also think my Peri is awsome, he didn't find any problems but did take time to explain to me exactly what a BH was going to feel like, what to watch for and over all he was very upbeat. Peri's are known to look for some thing that could be wrong but there the ones that can help resolve things too. I would go with the peri and try (easier said than done) not to worry about anything till there's a reason to. All your U/S have gone good so far so most likely everything will go fine this time to, and then you'll also know the peri in the future if for some reason you need him (pretem labor, GD, exc...)

My OB never really got into Downs Syndrome or spina bifida, he actually said left getting the blood test done up to me saying it isn't that acurate with twins, so if it wouldn't change anything for you as far as the pregnancy than why get em. He did specify to the peri to look at the hearts closely because my aunt was born with a whole in her heart, luckily everything has been fine thus far. I thought these things were brought up more with my first singleton pregnancy than they have been during my twin pregnancy.

Good Luck and Try to relax....Everything will be ok :hug: :hug:

 

The peri's are trained for high risk pregnancies and the fact that you're pg with twins puts you into that category- this doesn't mean you'll have complications though. My boys were mono/di so I was at the peri's every couple of weeks, but I didn't have any complications, thankfully. My experience with the peri was great. It's whatever you're comfortable with- for me it was the constant monitoring that made me feel better. Good luck and try not to worry!!

 

I love my OB but if given the choice would still go to a peri. As it happens, at the hospital where I deliver, all twin pregnancies start being followed by peri at 20 weeks after the Level II u/s.
As an RN, I feel that you want the highest level of care possible and a peri can provide in terms of the babies. The way it's gone for us is that my OB follow
me and the peri's follow my babies

 

I would think more along the lines of precautions then something is wrong. Because you have twins you are automatically considered high risk even if you have no previous health conditions. So, obviously, having your ultrasounds at the hospital has been suggested for that reason alone. I had all of mine at a hospital with a doctor present at all times because there was "suspected" growth issues--made me very anxious. Turns out everything was just fine, but they wanted to be safe and make sure that "if" anything was wrong it was caught early and with a doctor there to see it right away.

Unfortunately, these conditions that they are talking to you are things that "could" happen, not are going to happen. Doctors sometimes just don't realize how bad they scare new moms with all the "what ifs." Just take it one day at a time!!

 

I agree with others.. go to the peri, it will be a lot more detailed and you'll know you came out of the U/S with all the information you can get. They are just checking to see if there's any anomalies but even if they detect something, the risk of it being an actual problem is still quite low. I always figure it's better to know if something might be wrong so you can prepare for it. It sounds like you're getting great and cautious medical advice, so that's very reassuring. Chances are everything will be just great!

The ultrasounds started out very nerve wracking for me.. but now it's my chance to check in on the little dudes, and it's so fun to watch them tumble around in there. Relax and enjoy the opportunity to check out your kids!

 

Actually my doc told me NOT to do the scan before 20 weeks and the u/s specialist was very grateful for that (I went to one of the best hospitals in the country). They both said that after 20 weeks they can get a much better and accurate look at the heart. It happens too often that they can't see something well before 20 weeks and they have to send you back in after 20 weeks, putting you through additional, not necessary, stress. So I had mine at 20w5d. My u/s specialist said she wished more doctors would do that instead of sending in patients at 18 weeks because they can't wait to find out the sex.