First u/s at 20 weeks?

aga60154 · August 2013

So yesterday I had my first dr appointment (8w6d) and to be honest because of my age (36) I was expecting a little bit more than with my first pregnancy at 28. I was told my first u/s will be at 20 weeks and since my son was born with a heart defect I might have a Level 2 u/s but if anything that one would follow the 20 weeks one. What’s up with that?
I keep reading about women having their first u/s done even before 10 weeks mark, which I guess would not be considered a first trimester screening for down’s since these are done between 11-13 weeks.
I’m just starting to question my clinic 
How about you ladies, what were you told at your first appt about the screenings?

ProcessofBecoming · August 2013

Wow. Hmmm. I was 39 when I got pregnant with my son and 40 when I delivered. I had my first ultrasound at 8 weeks to confirm a viable pregnancy/heartbeat. Then I had another ultrasound at 12 weeks, wherein they did the nuchal translucency measurement, along with two sets of bloodwork to check for chromosomal issues (the quad screen, I think it was called--Harmony and MaterniT21 were not available 2 years ago yet). Then I had my 20 week ultrasound and it was a Level II. I then had ultrasounds at 24, 28, 32, and 36 weeks (NSTs began at 32 weeks as well, as I have autoimmune issues). My son was born at 37 weeks. I'm thinking my doctor will follow a similar protocol for this pregnancy (I'm now 41, heading towards 42).

I don't know about your clinic, but you may want to start asking some questions, just for peace of mind.

Guennie · August 2013

I know some drs do the ultrasound sooner than others but HOLY COW, 20 weeks??? I have never heard of waiting that long!! Do you have crappy insurance and maybe they don't cover very many ultrasounds? That's the only reason I can think of to wait so long. I was offered screenings in first tri but chose to just do the quad screen and did have a level 2 ultrasound in second tri. If I were you I would ask your dr why they aren't doing an initial ultrasound. I thought that was standard to make sure it's a viable pregnancy and rule out ectopic, etc.

BootsOrHearts · August 2013

I was offered earlier ultrasounds but declined so my first was 18 weeks. I'm surprised they didn't offer you the NT scan though - are they recommending to do Mat21 or something instead?

EmR22 · August 2013

I think it depends on the practice. I got pregnant at 34 but because I am now 35 when DS is due they covered genetic counseling, a NT scan at ~12 weeks, a blood test at that time (if risk would have been high they would have offered Mat21). All this was done at the hospital vs clinic with a MFM doc because I was high risk for simply being almost 35. The nice thing is the doc read the ultrasound immediately. I got the quad screen and my 20 week u/s was also at the hospital with the MFM doc. There was a definite difference in my care compared to my last pregnancy at age 31.

LucyRicardo3 · August 2013

I've moved quite a bit all over the southeastern US, so I've had a different doctor office with each pregnancy.
The last 3 have been in my 30's and I've received a dating u/s each time around my first visit, as well as an NT test. However, my current dr office didn't have the NT listed as an "u/s", but as a "screening". Did your office not mention any screening at that stage?

I have read on TB where others have posted scenarios like yours, usually due to lack of/low coverage insurance, or the particular clinic, military protocol, etc. Or because the mother was not 30+.
I would ask more questions, given your history with your son.
I think what stood out to me with your situation is that you said they told you "maybe" get a second u/s if the first one looked questionable.
If you have IRL friends who've delivered in your town with other drs, ask them what their prenatal experience was. Maybe ask your local board on TB?

aga60154 · August 2013

Guennie said:

I know some drs do the ultrasound sooner than others but HOLY COW, 20 weeks??? I have never heard of waiting that long!! Do you have crappy insurance and maybe they don't cover very many ultrasounds? That's the only reason I can think of to wait so long. I was offered screenings in first tri but chose to just do the quad screen and did have a level 2 ultrasound in second tri. If I were you I would ask your dr why they aren't doing an initial ultrasound. I thought that was standard to make sure it's a viable pregnancy and rule out ectopic, etc.

I have UHC PPO and don't think it's that bad (but don't get me started on it lol). She did mention the first trimester screening 11-13 weeks and I understand it's optional and up to me but I was just surprised they wouldn't make sure everything is ok so far.

aga60154 · August 2013

However, my current dr office didn't have the NT listed as an "u/s", but as a "screening". Did your office not mention any screening at that stage?

I have read on TB where others have posted scenarios like yours, usually due to lack of/low coverage insurance, or the particular clinic, military protocol, etc. Or because the mother was not 30+.
I would ask more questions, given your history with your son.

I don't know if it's their issues with UHC or just the protocol but I thought that because of my age and history there would be more to it than just an u/s at 20 weeks.

I sure will start to question their actions to be on the safe side.

RNmommyof2 · August 2013

I had one at 6 weeks-ish due to bleeding, one around 8 weeks to confirm pregnancy, the nuchal translucency scan, an elective gender prediction ultrasound and the anatomy scan.

Guennie · August 2013

Def ask why they are waiting so long. We had UHC with my last 3 losses and they covered every single ultrasound, and I had a lot of them. So I don't think it's your insurance. You want to know from what perspective your dr is approaching your pregnancy so don't be afraid to speak up.

jkzinck · August 2013

With both of my pregnancies I did not get an ultrasound until 20 weeks. I was offered the 13 week sceeening but did not do it. With my first I had a 20 week one and then got one at 40 weeks. I was 38 years old when I delivered her. This one I just turned 40 I had a u.s at 20 weeks then at 29 weeks because of some spotting and one at 39 weeks after a nst.