Nuchal translucency ultrasound
Today we got back from our trip to Hawaii. Because Fred just took a bunch of time off, we had to schedule the nuchal for today so he didn’t miss work again. We were home by 9:30am and really tired, so we napped before our 3:30pm appointment.
I found out which doctor was on the unit that day (the perks of going to the hospital where you work) and texted her in the morning. I wrote, “are you in FEU today?” She wrote back and said “yes, see you at 3:30! :) “ I was really happy she knew already I was coming, even without me telling her.
The wait time to be seen wasn’t too bad (I’ve heard otherwise at times). The tech we got was not super friendly or talkative. She barely spoke to us through the scan. It was so different than our first ultrasound. I told her my due date and she said, "well we base it on your period." I said fine and didn’t argue, knowing I would talk to the doctor afterwards to get it revised.
Midwife note: An accurate due date is really important, especially for a first baby. The most accurate time to have a pregnancy dated by sonogram is around 7-8 weeks. At this time, the due date is based on your last period, but if there is a discrepancy of more than 5 days, the due date is changed.
At 9-13 weeks, the due date is based on your last period, but if there is a discrepancy of more than 7 days, the due date is changed.
An accurate due date is important, especially for women who go past their due dates. It can help you to avoid an early induction (the cutoff for induction is no more than 42 weeks in most cases, but often practices say even earlier like 41 weeks).
The fetus was in there and now looks like a baby! Crazy! The fetus was also not very cooperative. It wouldn’t move in the right position for the nuchal. Finally she got it and it was normal. Phew. She printed us two pictures (that honestly aren’t very good).
Midwife note: The nuchal fold is an area of the back of the baby's neck. This is measured as a screening for chromosomal abnormalities. In things like Trisomy 21 (Down's syndrome) the nuchal fold can be increased.
It is still considered a screening and there are times where the neck fold is elevated that things are normal with the fetus. If it is elevated, further testing (like NIPT or invasive testing) are recommended.
I asked that the doctor come into the room and she did. She was super friendly and awesome, as usual. We talked about the due date and showed her the first scan. She changed my due date in the system. I’m so happy because it would have been 10 full days off had we not changed it, and the new measurement wouldn’t have indicated a change from last period. Long story short, really happy we had the early scan.
We left, happy with everything. We went to dinner at a place called Empanada Mama, which is an old favorite restaurant, and had a great dinner. We sent pics to our parents which they were very happy about.
Fred and I had both taken off the day since my mom was here visiting. We decided that it would be good to have the first ultrasound that day so we could have proof to tell our parents over Christmas. So we lied to my mom and told her we were working.
The tech was really nice and chatty. I told her who I was and what I did. I was really, really nervous (is the embryo in the uterus, does it have a heartbeat, is it twins). I was a bit shaky. I held Fred’s hand really, really tightly.
Midwife note: A pregnancy outside of the uterus is called ectopic pregnancy. This is most commonly found in the fallopian tube. It can be very dangerous if not diagnosed early.
First we saw the gestational sac. I said “thank god”. The we saw the embryo and then the heartbeat. She even played it a little for us. And just one embryo in there. Phew.
I watched pretty intently. I noticed I had an ovarian cyst and I said “is that a cyst?”. I was really chatty and kind of distracted her, I think. She actually forgot to get the heart rate reading and had to do it again. Luckily the uterus is tilted up and she could do this abdominally.
Midwife note: At early gestations, the ultrasound will likely need to be done transvaginally. This is because the uterus and embryo are still small and it is hard to visualize abdominally.
We asked her for the extra pictures and she happily printed them for us.
The ultrasound showed my EDD to be two days earlier than I calculated. I requested that the estimated due date reflect my measured results from ovulation tracking. They did this for me and I was happy about that. Two extra days makes a difference!
Midwife note: A later EDD is usually preferred because of the common occurrence of going "late" or past your due date. A few extra days can make a difference at the late stages of pregnancy.
It was so great to see the heartbeat and just confirm. I have no idea how people wait until 12 weeks or don’t do scans at all. I definitely understand why someone would want to go for an early ultrasound!
A pregnant midwife living and working in New York City