Necessity of level 2 ultrasound?

CatBus

Original post regarding ultrasound findings...

I met with my doctor first thing Monday morning because I was so freaked out about my ultrasound last Friday. She reviewed the report and told me they also found an EIF, which wasn't mentioned to me at the U/S. I know EIFs are not tied to any problems in most cases, and that they show up in 5% of all ultrasounds. My doctor even said two of three of her daughters has EIFs. 

We don't yet know the results of the second part of my genetic blood test, but she said the first part was well within the normal range, and of course my NT measurement was also low (nothing to worry about). Because of the two U/S findings, she did refer me to a genetic counselor. I have an appointment set for this Friday afternoon. 

So my question: I asked the nurse who set up the appointment with me whether this would include a level 2 ultrasound. She said no, they wouldn't need to do that since I just had an ultrasound last Friday. I thought the point of the L2 U/S was to get a closer look at any abnormalities, regardless of how recent the last U/S was. Instead, she said we would meet with the genetic counselor about our risks, and do an amnio if we opt for that based on the consult. 

Does this sound normal? I'm trying to decide if I should push for the U/S. The hopeful part of me, of course, is thinking the GC has already reviewed my file (which I know they did before scheduling the appointment, to determine what would be needed) and isn't concerned about the findings. The paranoid side is thinking it looks so bad that the GC doesn't see a point in doing another U/S.  

 

sapphiremom13

I think if it looked so bad that the GC didn't see the point in another u/s, they would have told you that.  I think in this day and age, most providers are worried about law suits, so they would not omit that info from you.  I agree that I thought the L2 u/s was to really be able to measure more accurately as well, but I definitely don't know anything about that for sure.  I would probably push for it if it's something you want.  GL.  Keep us posted.

mrsjenni

I only know from my experience with DD is that when they found an EIF on her heart during the level I (no other markers were present), I did go to  MFM for a level II u/s and to meet with a genetic counselor.

With this baby, all of my u/s are level II's through MFM (due to pre-e in previous pregnancies), so when they saw the EIF the doc just came in and talked to us about it and then told us we had the option of meeting with a GC and/or doing further testing.  We declined both, having already done the GC with DD (who turned out perfectly healthy, by the way.)  The doc agreed with us 100% and said that EIF's are so common now and usually aren't an indicator of much of anything.  Especially with no other markers. 

Best of luck to you hun.  I don't really think the level II is necessary.  The fact that they already saw 2 things on your u/s won't change the outcome of your meeting with the GC.  We actually met with the GC right before our level II and she said that even if the EIF was gone on the level II, they still saw it on the level I so that means it still increases our chances for Downs Syndrome slightly. 

ShopperKristi

I just had a Level II U/S on Tuesday and although I have a very non-technical understanding of ultrasounds the only thing that seemed any different to me from my other three 'normal' or level I (?) ultrasounds was that it took a lot longer and they marked/measured a LOT more things (I haven't had my official A/S yet but I imagine it will be very similar to this last appointment) - then the doctor came in and said 'yep, everything looks great!' The Level II didn't appear (to me) to be higher resolution or  3D or anything like that, I felt like the purpose was just to have someone more specialized than my OB's tech looking at the images.  Anyway, that was my understanding.  So maybe your OB's office has a highly trained tech that had a really good understanding of what was going on so they didn't feel the need to order the Level II.

If your GC ends up recommending an amnio then I would certainly ask if doing a Level II Ultrasound might be a less invasive way to get more information.

FirstTimer02

First I'd say go with your gut best you can on whether you're getting enough info.

Second, if it takes a couple of weeks for the genetics tests to come back, maybe you could schedule another ultrasound for around that time.  We are waiting for genetic results, and I've never done this before but I'm telling myself that we might get more detailed info out of the next ultrasound because:

a) the genetic test results (or lack thereof!) may give the team more context to read the ultrasound results.

b) by then we may have looped in more relevant specialists (probably orthopedists for us) who may have more skills for reading results.

c) Our kiddo will have had 3 more weeks to grow, so there may be more to see at that point, or they  may be able to spot & project trends in growth and development.

Just an idea.  Good luck!!!