Help with 1st Ultrasound Results

QUESTION

Dear Ms. Ultrasound,
Hi, At 17.5 weeks, I had my first ultrasound. At the ultrasound, the tech said that I most likely would have to be seen again, since she couldn't get everything that she needed. The baby would not cooperate.

When I went back to midwife today, she referred me to a Maternal Fetal Med. doctor who will perform a level II ultrasound. She said that the scan was incomplete. It didn't show the upper lip, all parts of the heart & the bladder. Also, it showed that the baby had a choroid plexus cyst. She said not to be concerned but how can I not be?

I know that cpc's are common and are soft indicators when paired with other abnormalities. How often do incomplete scans happen? Along with cpc's? Should I be concerned? Please help. The wait is going to be hard for me and I really need some answers and/or comfort.

Thank you.

ANSWER

Hi There
Well, I can honestly say that I have never finished any ob ultrasound and called it incomplete. To me this sounds like you may have had an inexperienced sonographer.

The results of an OB ultrasound should state the facts. For example: the fetal bladder was not observed and a 4 chamber heart could not be documented. Just the fact that the sonographer said the baby would not cooperate makes me think you need someone with more experience.

Because the sonographer could not find certain anatomy and found a choroid plexus cyst, a Level II ultrasound is the next step.

One study showed when an isolated choroid plexus cyst is found, about 1 out of 477 will result in the fetus having a genetic problem (trisomy 18). I have also seen statistics that show a 1 in 374 chance.

The incidence of a choroid plexus cyst in the normal population is 1.4% .

So, as long as the fetus has no other problems documented on the level II ultrasound you have a low risk of abnormalities.

The Level II ultrasound should assess all the babies anatomy, with special attention to the the heart, the extremities and to documenting an open hand. A typical picture of a fetal hand with trisomy 18 shows an index finger overlapping a clenched fist . There will also be an increased amount of amniotic fluid with trisomy 18.

Please write back and let me know if you have any further questions after your Level II ultrasound.

With Regards,
-- Jane RDMS

Jane Foley

Jane Foley has worked as a Sonographer (Ultrasound Technologist) since 1979. Jane has lived and worked in many parts of the world including Saudi Arabia. She is a Registered Diagnostic Medical Sonographer or RDMS. She pulls a wealth of information from her experience in the field of Radiology and her interactions with such a broad cross-section of cultures she has visited. She now makes her home on the island of Maui with her English husband, Michael.