U/S - can you limit them with twins?

Can you limit the number of U/S with twins? My husband heard on the news and then found articles online that said there was a link between autism and ultrasounds. There is some speculative articles on midwiferytoday.com (??) which cite circumstancial evidence linking the increase in autism with the increased use of ultrasounds and that twins have an increased rate of autism that they speculate is due of the increase in the # of U/S. These reports I guess started from some research from Yale on rats saying that "excessive" exposure to U/S caused brain cells to not locate properly in a developing arat fetus. Has anyone else heard this? My husband has a cousin with an autistic child and he is freaked out by this and wants me to do NO ultrasounds if possible (but I did one at 8 wks after declining one at 7 wks and then caving in at 8 wks). He's now come to the conclusion that no ultrasounds is not realistic, but wants to limit them to the ones that are absolutely necessary. The midwife I was seeing (who had a peri as a backup Dr.) just told me to see someone else cause I gave her a hard time about getting an ultrasound last week (getting one done with amino this Friday). She totatlly dismissed any concerns I had before even listening to me, so I'm kinda glad to be rid of her. I'm not totally against ultrasounds and medical intervention (getting amnio) but I need to find a new DR. I think a Peri will want even more ultrasounds than an OB, is that right? I've read posts here saying that women have U/S every week. My husband will freak out about that and subseqeuntly freak me out. He keeps saying they told women that X-Rays were safe for fetues for years and then thalidamide was safe etc....

Am I crazy?? I feel like I'm the only one in the world who may doubt the safety of U/S, and feel like such a freak, but god forbid one or both develop autisim, I will never forgive myself.... But it's sooooo routine nowadays I don't know what to do about my fears and my desire to have as few U/S s as possible. Any advice ?

 

This is not something I have heard of, but that does not mean that it is not possible. I think that there are a lot of women who would prefer to limit the amount of medical interventions during pregnancy, labor and delivery... With that said I think you need to talk to your doctor, tell him/her your concerns and feelings about this and ask if this is something they feel comfortable working with... If they say no, then ask them to recommend someone who is comfortable with a more natural approach. Good Luck!

 

I think you need to talk to your dr too and weigh the pros and cons of having them or not. I am not sure I believe the study but it could have some merit. But on the other hand, what if something did go wrong but was not caught due to lack of u/s? Its such a catch 22 situation huh?

 

I had 9 u/s during my pregnancy, I am sure more than the average singleton but definitely not close to one a week (well it was one a week when I hit my 30's in gestation). I think these studies relate more to the people who rent u/s machines to do them at home or who go to the places you can pay to have an u/s done not on the recommendation of someone with a medical background.

 

Yeah, the midwife that I will not see anymore said the same thing. That there was this possible link. When I told an u/s tech, her jaw dropped to the floor. She said that all the pg women who can scan themselves all the time would have children with autism.

I do not think have NO u/s's with twins is a good idea. They are there to make sure that both babies are growing properly, your cervix is being checked and made sure that all is ok there, and blood flow through the cords. I think that the pros weigh out the cons by a great deal. You definetly need to talk to your doctor.

April

 

I had around 25 u/s in 10 weeks(from the point we found out it was twins until their birth) Every u/s we had was comepletely nessary and most drs don't do them for no reason. We had a cord defect that had to have constant monitoring and we are glad they did or we could have lost our twin b. I would discuss your fears with your dr(new or otherwise). He may have missed crucial parts of the article(ex. how many u/s) or misunderstood parts. I would rather have a child with autistic child than to have lost the child due to not enough monitoring. As you said most of what you read was circumstantial evidence. Like Dianne said though I wouldn't be renting a machine and doing it all the time.

 

i've never heard of this before - i wouldnt hang my hat on one research study - you need to look at the risk/benefit ratio of getting u/s vs. not getting them...

 

I've heard that before, and the australian study that linked frequent u/s with more children being left handed. I think that the point of the study is that we should use caution when using technology, not throw it out alltogether. As for the incredible increasing rates of autism, it's really hard to say. Since they do not know what is going on exactly with children with autism, they can not pinpoint where something is going on. Many things have been*linked* with autism(epidural, pitocin, u/s, vaccinations, diet) yet in depth studies have proven that none of these things is entirely the cause.

I agree with the other ladies, find a dr who will talk to you about your concerns, who will explain and who will work with you.

 

I don't mean to offend or come off sounding brash, because autism is a serious condition that affects so many people, and as an occupational therapist, I have worked alot with children with autism, but I am a bit skeptical on the research that too many u/s cause autism. There have been so many things that have been linked with causing autism (from bad parenting being popular a few decades ago to vaccines being the scapegoat now), and the reason is that they don't know what causes it. If there was one or two definitive causes that can truly be linked in the research, than these theories would prevail and the rest will fall by the wayside.

In a high risk twin pregnancy, I think the risks of not having frequent u/s to make sure that the babies are growing properly and have enough fluid outweigh the possible risk of causing autism, which has not been substained in the professional literature.

Again, I know that this can be a very touchy subject, and I am not trying to offend, but merely offer my 2 cents.

 

Personally I would be very skeptical of anything I read on a midwife site in terms of medical studies... I'd have to see the actual study. Many midwives are diehard naturalists... to the point where I've seen in our local papers here several lawsuits against local midwives... I personally know a woman who had a 25 week baby b/c her midwife wouldn't check her properly with an u/s after many, many complaints of constant backpain, pressure and loss of mucus. This woman loved her midwife, but now says that "if I were the type I probably would be suing her." Thank God her baby is okay. Yes, this is all anectdotal...but the study on autism probably is too...

The other thing to remember is that autism is a very, very broad spectrum of disorders... it's diagnosed in kids who sometimes seem almost completely normal with just some attention issues. (I know this from my years in education). So part of the reason why the numbers seem so dramatically increased is b/c they are diagnosing many kids who wouldn't have been diagnosed years ago... or they would have been improperly diagnosed as "mentally disabled, retarded or hyperactive." So don't get too worked up over the scary stats.

As an educator, and what I've seen, I'm far more inclined to believe the studies that are now linking hours of high speed TV exposure at a young age to autism and attention defecit disorders...Clearly, I don't think this is always the case...but I'd rather cut out the tV than worry about the u/s...

If you are still really worried, please start looking around on credible medical sites for actual studies on it...if you find anything feel free to link it here so we can all read it...

 

I should add that I do totally respect what midwives do... I think it's totally awesome that we still have a group of women willing to help younger women through the birthing process... It's just that I feel like any responsible midwife should have a healthy respect of the "what if's" that can happen and should be more than willing to refer to a physician or do an u/s if it seems necessary. I do not agree with NOT doing an u/s simply b/c you want to stay as natural as possible... I think that's kind of silly, especially when there are extenuating circumstances that indicate that an u/s should be done.

 

From what I have been told, the many u/s are to make sure that the twins are progressing together along the way. In a case of Twin to Twin Transfusion Syndrome, the u/s would catch if one of the twins was getting smaller than the other.

My friend had that happen and she had to have surgery to fix it. In return, she delivered two healthy baby boys.

 

I also am very skeptical about the ultrasounds linked to autism theory. I had over 50 ultrasounds during the 29 weeks I was pregnant with my twins and they are definitely NOT autistic. I would not in any way avoid an ultrasound that was used for monitoring -- if your husband is upset with the thought of autism, he will REALLY not like having a brain damaged child. Typically they are not as useful in the early stages of pregnancy as there are fewer complications that can arise, as well as the fact that there is little intervention that can be done. This is the time when the worst damage can be done by any outside means (i.e., thalidomide was most dangerous to take in early pregnancy). But 2nd trimester and above they are VERY useful in identifying issues that could put a baby at risk. You have to consider the ramifications of NOT doing an ultrasound and what could happen vs. the unknown/unproven risk of autism, which may not even be there. In a fraternal twin pregnancy an ultrasound every other week or monthly is fairly normal; in a monochorionic pregnancy, ultrasounds should be done at least weekly in order to monitor for TTTS. I have yet to know a mother who has an autistic child that thought it was due to ultrasounds. One of my neighbors has 2 autistic daughters and had very few ultrasounds -- they think theirs has a familial aspect to it. It is a very personal decision, but I wouldn't let that specific issue have anything to do with my decision. In the spectrum of issues that could happen, autism is one of the better ones that you could get. And brain damage leads to autistic tendencies as well. Lack of growth associated with IUGR or poor placental perfusion could be easily seen on ultrasound -- but if it continues on it could have devastating neurological consequences.

 

I think the number of u/s you have depend on your doctor and any health issues with you or your babies. I had I think 6 u/s. We found out it was twins at my first u/s at 18 weeks. After that we had them every 4 weeks until I delivered.

 

I only had 2 ultrasounds with my girls, my first at 20 weeks and the second one about 6 weeks later. My babies were perfectly healthy and I had no issues with the pregnancy. If you are having any kind of problems you can expect to have more ultrasounds for the safety of you and the babies. I would talk to your doctor about it. Remember that this is your pregnancy and if you are concerned about having too many ultrasounds that's ok. As long as you are healthy and the babies looked good on your last u/s there's no reason for you to have numerous ultrasounds.

 

I agree with all of the previous posts and I don't think your doctor will be doing weekly ultrasounds unless there is a true problem that they are watching for. We had one at 12 and 18 weeks and then after confirming at 18 weeks they were mono/di twins, they upped them to weekly. It was only when my babies started showing signs of TTTS that they started doing them twice a week which is what we have been at ever since and I hope to continue until they are born. Along the lines of what Brook said, I would much rather have two babies with autism than risk that I only bring home one or neither of them because the TTTS got really bad and I didn't know it. But if there truly were a link I would think that all of the mothers out there who were diagnosed with a problem that required weekly or twice weekly monitoring would have children with autism and we know this isn't the case. I do understand your concern though, I had the same concern with vaccinations and all I wanted was a doctor who listened to my concerns, didn't act like I was a crackpot for voicing them and addressed them with me. I think that is what you should seek in a OB or midwife...whether she agrees with you or not she should listen to you without blowing you off and fully explain her reasonings for the ultrasounds she does feel are necessary. Hopefully once she understands your desire for as few as medically possible and you understand her reasonings for the one she does want you will feel more comforatable with the whole thing. Good luck

 

I don't believe it, and honestly it doesn't surprise me this is coming from midwives, who are in general more pro-natural birth, less intervention, less u/s, etc. (I am not saying this is wrong, but sometimes things need to be done and checked and decisions need to be made). Too many things are being linked to autismn these days. It's sad that we don't know what really causes it, but I personally think we're trying to hard to link everything with autismn, just because it sometimes gives us an explanation. We want to know why, but we don't always know, it's hard to accept, and therefore we start linking things that shouldn't be linked together.

Just my 2 cents.

 

I think the doctor should do as many U/S's as they need to make sure things are progressing normally and make sure there are not any developing issues. U/S's measuring my cervix are what saved my pregnancy. I had approximately 25 U/S's during my 31 weeks of pregnancy, and my girls are not autistic.

With twins, U/S monitoring is important, especially if there are any problems.

 

I hear more and more that researchers are finding evidence for a genetic link to autism. And it's not one just gene that causes or determines it; there are a number of genes on different chromosomes being studied; mutations in these genes can lead to a predisposition to autism. Here are some links to articles:
Multi-Center Research Team Discovers Genetic Link to Autism
Stanford Q&A: Largest-Ever Study Shows Possible Genetic Links For Autism
New genetic link to autism:QUOTE
“But the new data suggests there are more genes involved than we would have expected before,” said Stephen Scherer, a senior scientist at the Hospital for Sick Children and co-author of the study published online yesterday in the journal Nature Genetics. He estimates 100 genes could be involved or work in combination to cause autism.

 

With my first baby, I too must have had at least 25 ultrasounds. I'm now really glad my Dr. was so cautious because there was a problem that was detected in one of the later ones that was able to prepare us for a possible issue my daughter was going to have right after birth. Thanks to those ultrasounds, I now have a very healthy two year old.

I completely understand your worry, however, if you look hard enough on the internet, you would probably be able to find hundreds more studies linking autism to many other things. If you tried to avoid every possible link to autism you would go crazy. I myself have a condition that has no known cause and no cure (Crohn's disease) and I have read thousands of articles on possible causes. If I avoided everything that was sited in an article or study to be a possible cause for Crohn's, I wouldn't be able to eat anything.

I hope I haven't offended you because I do understand; but until there is more evidence, I think it's probably safer to follow your Dr.'s orders than rely on the results of one study.

 

I think thats a bunch of bull! all an u/s is high-frequency sound waves.

So far I have 5 ultrasounds. Some Transvaginal Ultrasound & some normal. & I am sure there will be more. Everything I got to see my doctor they break out the u/s machine.

Don't worry so much!!

 

QUOTE
In a high risk twin pregnancy, I think the risks of not having frequent u/s to make sure that the babies are growing properly and have enough fluid outweigh the possible risk of causing autism, which has not been substained in the professional literature.


DITTO!

I had an u/s every 2 weeks with my twin pregnancy, and have had 3 u/s (tomorrow will make 4) with this pregnancy.

 

Thanks so much for everyone's comments. I wasn't offended by anyone's statements at all. I appreciate all the different view points. Many of you bring up good points about how important U/S is for some conditions. I was not aware of many of them, and appreciate everyone's experience. This is my first pg and I'm the first in my family/friends to have twins so all your advice is really beneficial to me. I'll be having a good discussion with the new O/B I have an appt with on Monday regarding this. I hope she is able to hear what I have to say as I'll be listening intently to her.

Here is a link to the article about the Yale study. This was done on Mice and not Rats as I had stated. This seems like it is a ligit study and it just opens up the possibility that U/S may have an influence on neurological development especially early on in development.

http://www.autismspeaks.org/science/research/ultrasound.php

The other things my husband, than I read were articles and not studies, although, they did refer to studies, but I did not research the studies it was based on. I too have heard about the genetic link to autism, but from what I've seen they believe the gene may be "triggered" by some outside environmental influnce. Whether that be vaccines, U/Ss, diet , or whatever, I wish they could figure that one out now! Hopefully, sceintist will discover that soon as autism seems to be getting a lot of attention lately.

I found the articles that I read for anyone who may want to look at them:
http://www.midwiferytoday.com/articles/ultrasoundrodgers.asp
http://merzenich.positscience.com/2007/05/...und-and-autism/

 

This is one of those you have to weight the positive with the negatives. Had I not gotten the amount of u/s, we may not have seen my cervix shrinking and i could have gone into spontaneous labor. Having my girls at 23 weeks and the long intensive care and almost guarnteed longterm effects of being that early, makes me fine to take the risk of "possible" autism, since it's not yet proven, but a child born at 23 week is fact.

 

I had multiple u/s (one per month from 6 weeks until I delivered at 36w) and our children are definitely not autistic - it was something I worried about as my dh's nephew (his brothers little boy) has numerous issues - legally blind, deaf (can hear with a cochlear implant) and has mental difficulties that they have diagnosed as autism but they aren't sure as they can't really test him well...I think that autism is is genetic more than environmental - however they just can't find a definitive link at this time, therefore they have to try to link something so they're grasping at straws....

 

My oldest son has an autism spectrum disorder, I had one ultrasound when I was pregnant with him. Forty years ago studies "proved" that autism was caused by "refrigarator Mother" - it was all the Mom's fault for not loving their children enough. Today different studies have linked autism to too much T.V., older father, vaccines and other things I just don't remember at the moment.
I understand your husband's fears, the newest data shows a rate of autism as 1 in 150 and much lower in boys since it is 4 times more common in boys. One of the most important things he will have to learn howver as a parent is when to let go of the things you can't conrol.
With my twins, I had somewhere between 15 and 20 ultrasounds - honestly I lost count. I do know that the last one at 35 wks showed a sudden growth difference, led to an NST which one twin failed and a walk across the hospital hall for a C-section that probably saved one or both of my twins. By the way, my twins have been in a study at John's Hopkins since they were 8 wks old to identify the earliest markers for autism since early intervention can make such a huge difference in spectrum kids. They do not show any signs of autism and most likely will be neuro-typical.
I think you and your husband need to find the medical team you are most compfortable with and I think it is very important that when you are interviewing new OB's and/or midwifes your husband also attends the meetings.

Debbi
DS- Daniel 7/12/95
DS - Andrew 8/13/97
DS - David 10/14/04
DS - Samuel 10/14/04

 

Theres also a lady suing because she said that immunizations cause autism.


*shrugs* theres alot of opinions out there that go to what causes almost anything. But not many have scientific backing.

 

If your babies are obviously fraternal, I think you can safely limit the number of u/s you need. Many fetal specialists view a fraternal twin pregnancy as not much higher risk than a singleton pregnancy as far as the babies are concerned. If they babies look like they are monochorionic though, it really isn't safe to have u/s less than every other week because of TTTS. TTTS can happen very suddenly and you need to catch it fast and treat it quickly.

BTW, there's nothing crazy with being worried about u/s. Like your DH said, it's difficult to know what is "really" safe and what isn't. It's obviously not a good idea to go with no u/s since you are dealing with two babies here but you may be able to limit the number if it is safe to do so.

 

Thanks again for everyones opinions. You've really driven home how important U/S can be in some cases. I think I'll be a lot more open minded now about them.

Hopefully, they'll find the cause for autism soon, cause all this speculation isn't good for anyone. People not getting their children vaccinated, people not getting a needed U/S... all cause of *speculation* . But I still have the small knawing thoughts in the back of my mind that the medical community & FDA has been wrong in the past about the safety of procedures, drugs, etc... But I guess that will just lead me to have better discussions with my Dr. about the pros & cons of what they recommend doing. Thanks everyone!!