There are many ultrasounds after pregnancy, and one of the most important and scary ones is the “macromorphism screening”. There are many questions about the screening for macromas, so let me tell you more.
What is the “macroscopic screening”?
The term “large malformation screening” is a common term, the standardized term is “mid pregnancy system prenatal ultrasound examination”, mid pregnancy ultrasound examination, in addition to fetal growth and development, placenta and amniotic fluid and other general conditions, but also to the fetal organs and systems for detailed examination. The purpose of this examination is to find out if there are any major structural defects in the fetus, so it is called “screening for major malformations”.
”Why is screening for macrosomia done at 20-24 weeks of gestation?
There are two main reasons for scheduling the screening for macrosomia at this time, one is that most of the fetal structural abnormalities can be detected at this time, but if it is done too early, the fetus is too small and the corresponding organs are not well developed to detect the corresponding structural abnormalities.
Secondly, for termination of pregnancy, if done late, large abnormalities are found and the fetus has already entered a viable stage, then termination of pregnancy will have complicated ethical issues, and termination of pregnancy at large gestational weeks will bring both physical and psychological blow to the mother. The main reason is that in many developed countries in Europe and America, the latest time to terminate a pregnancy for large structural malformations is no more than 24 weeks, and the standard of ultrasonographers in these countries is generally higher. The ultrasonographer branch of the Chinese Medical Association has set the “screening for large malformations” at 20-24 weeks to take into account the reality of our country.
”What is the detection rate of macrosomia screening?
You should not expect too much from “macrosomia screening”, because the thickness of maternal abdominal fat, the position of the fetus, the amount of amniotic fluid, the experience and level of the doctor will affect the detection rate of structural abnormalities. According to international experience, the average detection rate of “large malformation screening” can reach about 80% is already a relatively high level, once the fetal malformation is missed, the practice of blaming the ultrasonographer is unreasonable, the adults themselves have a disease to go to the ultrasound examination may not be able to detect 100% of the problems.
Do not ask the ultrasonographer questions when doing the “big malformation screening”
1, want to “incidentally” know whether the fetus is male or female doctor can not tell you, because the state has a law, without special medical indications can not use ultrasound or other methods of gender identification.
According to the current regulations in our country, ultrasound doctors are auxiliary doctors and cannot communicate with patients about fetal abnormalities and their management.
Why is this possible in foreign countries? Because foreign countries allow obstetricians to do their own ultrasound and write their own ultrasound report, so they can communicate with the patient while doing the ultrasound. It seems that China is the only country that does not allow clinicians to do ultrasound and send reports. So when you do ultrasound you ask the sonographer questions, if the TA does not answer you do not blame the TA, not a bad attitude, it is the rules are not good to say, if you say it does not count.
”How to do if there is a problem with the “large malformation screening
1, first of all, “large malformation screening” found to have problems is not necessarily a big problem, no problem found does not mean that there is no problem. After the problem is found, the most important thing is to choose the right doctor to consult, not every obstetrician has the corresponding ability. For complex problems, a team of doctors from different specialties may be needed to consult together.
2.Compared with single malformation, fetuses with multiple malformations have a higher risk of chromosomal abnormalities and need further investigations.
For fetal central nervous system anomalies, fetal MRI (magnetic resonance imaging) can be considered if available, because fetal MRI can provide more information and help improve the detection rate of fetal central nervous system anomalies.
4.For large and complicated fetal anomalies, it is better to go to prenatal diagnosis center (fetal medicine center, consultation with the ability of follow-up treatment.
”Consultation principles for large malformation screening abnormalities
A truly professional prenatal specialist will not simply say YES or NO, nor will he or she give ambiguous statements when it comes to screening for macrosomia abnormalities. Specialists are there to help patients make decisions, not to make decisions for them. They should provide patients with as much correct information as possible so that they can choose the right course of action for their situation, not make decisions for them.
So don’t keep asking: What would you do if you were a doctor? Because doctors are not you, they have different “outlooks”, different education and family backgrounds, so how can they agree on anything. If you still feel unclear or unsure after a consultation, you can get a second opinion from a different doctor or hospital.
Learning to accept an imperfect baby
In the past, everyone wanted to have a perfect baby, so when they encountered fetal structural abnormalities, even if they were small, many people chose to terminate the pregnancy. With the progress of social civilization, people’s concept has gradually changed and more and more people are willing to accept a baby that is not perfect. Our hospital once encountered a case where the mother of the baby was Chinese and the father was American. They knew in advance that the baby was a child with Down’s syndrome with defects, but they decided to have the baby anyway.
After the baby was born, our colleagues were very upset and didn’t know how to communicate with the parents of the baby. The father of the baby held the baby and gave our colleagues happy candy, he was happy and his eyes were full of love when he looked at the baby. He said, “Thank you for all your hard work and for bringing me joy in life. Look how beautiful she is, just like a little angel! Our colleagues were instantly melted, and they were all happy that this child was born into this family.