May 152011
 

“The doctor is pushing back your 20 week scan to 24 weeks because of all the extra tissue on your abdomen.” – OB Nurse

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 May 15, 2011  Fatness, OB, Ultrasound  Add comments

  17 Responses to “"The Doctor Is Pushing Back Your 20 Week Scan To 24 Weeks Because Of All The Extra Tissue On Your Abdomen."”

  1. Then it isn’t a 20 week scan anymore, now is it? It is an anatomy scan that happens to be easiest at that point. Sheesh. Call her fat and say the wrong thing at once, why don’t ya!

  2. stupidest.thing.ever.

    I may be mistaken, because I’m not a “professional” or anything, but I am keen on common sense. Despite a womans size, body fat, body shape, etc… doesn’t the growth of a baby and size of the uterus generally the same size for most women?? And isn’t the magic of an ultrasound to see through tissue, skin, fat and such?

    Dumbness.

  3. i have a friend, who just so happens to be a very big girl, i can’t actually fathom how much she weighs, probaby as much as my husband who is over a foot taller than her, and he weighs 400 lbs, and the Dr’s harassed her with each of her 3 very healthy pregnancies, and each time they can see the baby JUST FINE through all her extra tissue. she has great u/s photos! the tell her the machine might not see anything, but it does every time. so maybe they just can’t operate it very well..

  4. Also, in the event that the scan does show something wrong enough with the baby that termination is an option, it’s not anymore at 24 weeks in most places.

  5. and then they’ll probably tell her the baby is measuring big at 20 weeks and induce her at 37 weeks. or just section her.

  6. I’ve had the ‘we won’t be able to see much’ line for all my recent pregnancies. I’m the same size as I was for all but my second pregnancy(when I weighed more), and yet now the machine’s potentially won’t see through my fat. Which leads me to conclude that either they’re really not making the machines as well as they used to…or else it’s fallout from the (UK) government’s policy on fat people, which has made it normal and acceptable for doctors to demand ‘fatties’ lose weight and insult or embarrass them until they do. I know GPs lose part of their budget for having overweight/obese or high BP patients who show little or no ‘improvement’. It wouldn’t surprise me if hospitals had the same constraints.

    As to pushing the scan back, I personally do that anyway, so that I can prevent the bullying to persuade me to terminate should it be ‘bad news’…my last OB, however, kept moving it earlier. I wanted a 30 week scan, she wanted a 20 week scan, and I think it was at 22-25 weeks or so in the end (at which point I walked out and refused to return!).

    I’m very aware how much fat they have to try scanning through, and it isn’t a pleasant experience (for either me or the scanner), but I am sick of the negative and rude comments I get (mainly from the midwives and OBs sending me for the scan)…if I’m too fat to get an accurate scan on your super-expensive machine, then don’t bother sending me!

    BTW if anyone was wondering about the ‘foot may not be there or attached’ comment (one of the many reasons I walked out and didn’t go back!), my son was born, at home, with both feet fine and fully attached (!), both kidneys, a healthy heart and no sign of Downs or brain damage.

  7. So you’re saying I’m fat. And insinuating that I have 4 weeks to tone up my abs so you can see my baby with an U/S? Great. I’ll just go to a different doctor that doesn’t go for fat comments because their U/S tech is not confident in his/her abilities to see a baby through a little belly pudge…..

  8. I am NOT the poster, but this happened to me as well. The nurse told me I was too heavy to do a 20 wk US and had to wait until at least 23 weeks. Ofcourse I was upset. When I asked my midwife about it, she said that it was because I have a history of solitary kidney in my family and that the organs would be easier to see at 23 weeks. Needless to say, the midwife doesn’t make me see THAT nurse anymore.

  9. Ultrasounds are harder in women of size, and research shows that delaying them a few weeks can often make a big difference in accuracy, esp of fetal heart structures. I don’t find the delay of this u/s unreasonable or outrageous, but I find the explanation to be less than sensitive. It could be explained more clearly and sensitively.

  10. This one was mine. My clinic was composed of midwives and one OB to do ultrasounds. I suspected him of grouping my care together since I was a medicaid patient. I switched OB’s and got my 20 week ultrasound done on time… and with perfect clarity.

  11. The heavier a woman is, the more difficult it is to visualize the fetal anatomy. The ultrasound wave gets attenuated and distorted by the increased amount of fat it has go go through, as fat transmits sounds less efficiently than water.

    If a woman is bigger, we often wait a bit to do the scan, as the larger fetal structures are easier to identify.

    It also depends on the equipment. A $40,000 machine in a generalists office would have trouble seeing the anatomy on a 250 pound woman at 20 weeks. With the $400,000 GE Volusons that MFM offices have its not a problem.

    So now that you all know this, how you you put it to the patient?

    • question – I don’t have a weight issue (but am a “bad” patient) and sort of “forgot” to get a morphology scan done at 18 wks because my husband was away and he wanted to be there for the scan. We went into get it done at 25 wks and the u/s tech was so rude about how it was useless to come in at 25 wks because she couldn’t see if the organs were formed correctly because the baby’s bones would be too well formed and doing the u/s was just a waste of time.
      I am honestly curious, if I was obese, would going in at 18 wks been a waste of time because of too much adipose tissue and going in at 25 wks too late because baby would be too developed?

  12. >> A $40,000 machine in a generalists office would have trouble seeing the anatomy on a 250 pound woman at 20 weeks.

    I’d just edit that to say “might have trouble”. Depends on how tall she is and how much of her adipose tissue is in the way.

    This is just a technical issue here, and what the nurse said was correct.

  13. @Nicholas Fogelson-
    Actually, I was about 275 at 20 weeks and I had an amazingly clear scan. Done, I might add, at a military clinic with not-so-great equipment. Oh, and I’m 5’8.

  14. 225lbs, 5’9″, and physically active. I also lost weight while pregnant.

  15. Great, I was wondering why my OB ordered a repeat ultrasound at 25 weeks because they weren’t able to see anything last week at 20…been working so hard to lose weight while pregnant this time, I’m just going to crawl somewhere and never come back out…

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