Posted by My OB said WHAT?!?.
Nov
14
Posted by My OB said WHAT?!?.
“It Wouldn’t Show Anything Anyway.”
“It wouldn’t show anything anyway.” – Nurse practitioner denying a sonogram to a mother whose tests indicated that she was experiencing a miscarriage.
There are 10 comments to this post.
How can they justify this? They tell us that early ultrasounds are rich with information and then, when other tests indicate a problem, this mom hears that early ultrasounds “won’t show anything anyway.” Either they provide useful information or they don’t.
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Actually, depending on how far along the pregnancy was, the nurse may not be wrong. Does that mean she handled this correctly? Oh, heck no. There are about 100 better ways to explain this to a mother. Not to mention, sometimes you just simply do the test, even if you think it’s pointless, to help with a patient’s peace of mind.
When I miscarried at 5 weeks, they sent me for a transvaginal ultrasound, but also told me that it was highly unlikely that they would be able to see anything yet. They were right. It was close, but I just wasn’t far enough along for the ultrasound to see (they said 6 weeks is usually the tipping point).
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Kasondra Reply:
November 14th, 2012 at 6:18 am (Quote)
Personally, I’d still need to see “nothing” for peace of mind. If I’m supposed to be 5 weeks I expect to see a yolk sac…and if I’m miscarrying I need that reassurance that it truly is gone or not developing any further. ESPECIALLY if a D&C is being discussed.
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genniemom Reply:
November 14th, 2012 at 7:47 am (Quote)
It’s very unlikely for a D&C to be recommended for a very early miscarriage. They tend to resolve very easily, usually just like a heavier period. I would be very skeptical of any doctor who recommended a D&C for that early of a miscarriage. In fact, I think it is a highly overused procedure and the risks are often not fully explained.
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genniemom Reply:
November 14th, 2012 at 7:44 am (Quote)
Yes! Even though ultrasound was not beneficial to me when I had my early miscarriage, there was still a lot that they could do to help my peace of mind. Hcg levels were taken, and they offered to schedule an ultrasound for next week, pending the results of the hcgs. It turned out that I didn’t need one, because by that time my levels were back down to less than 2, and the miscarriage was complete. I was so vulnerable and uneducated at the time, but I am so glad that they handled the situation sensibly and didn’t try to coerce me into unnecessary procedures.
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Umm, yes, yes it would! It would either show a viable embryo/fetus, or one without a heartbeat. And it could possible provide closure for the mother, or reassurance that her baby was doing ok, depending on what you could see on the screen. It could ALSO indicate that maybe you should look at wether she could benefit from progesterone supplements, if her levels are dropping on the test, but heartbeat is still strong.
But then… The nurse would actually have to CARE about the mom and the pregnancy, and it doesn’t really sound like she does.
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genniemom Reply:
November 14th, 2012 at 7:40 am genniemom(Quote)
Not to be antagonistic, but if the pregnancy is less than six weeks in gestation, there might not be anything on ultrasound. The heartbeat is usually visible by six weeks, but before that you may not even see a gestational sac, or there might be no heartbeat. I have heard of people being misdiagnosed with miscarriage because of this, especially if the due date was unclear. However, the doctor at my practice was kind enough to let me know this, and recommend that I have my hcg levels tested instead, to see if they were dropping. An ultrasound would have been recommended if they were falling too slowly or rising, to find out why I was bleeding.
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Angela Reply:
November 21st, 2012 at 10:15 am Angela(Quote)
The flip side is that after 12 weeks it could be very useful, so it’d be good to know what the timescales were. I was reliably told I was miscarrying at 15 weeks due to low hcg levels with my first and only a scan proved that wrong. Turns out hcg levels are unreliable after 12 weeks. I had low hcg throughout my first pregnancy after 12 weeks.
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