Ultrasound and Amniocentesis in High-Risk Pregnancies

Ultrasound and Amniocentesis

Hello Doctor! I am currently 16 weeks pregnant and had ultrasounds at 6 weeks and 12 weeks.
My daily life is regular, but after the third ultrasound, the fetus appears to be measuring at 14 weeks.
Is there any concern regarding this? Should I increase my intake of vitamins or similar supplements like Neobun? My obstetrician has advised me to return for another ultrasound in two weeks to check the fetal size, but my parents strongly oppose this, stating that recent news articles have mentioned that excessive ultrasounds can be harmful, and they want me to change doctors.
Should I consider switching doctors for my prenatal care? Additionally, since I am currently 34 years old and classified as a geriatric pregnancy, my obstetrician has suggested an amniocentesis.
This brings to mind that if amniocentesis can determine the normalcy of the fetus, why was I not advised to undergo this procedure nearly two years ago when I had to choose a medical abortion after taking cold medication? I consulted two hospitals, and none of the doctors suggested amniocentesis at that time.
Thank you for taking the time to respond! Best regards, Brandy.

brandy, 30~39 year old female. Ask Date: 2001/12/13

Dr. Wu Zongcheng reply Obstetrics and Gynecology

Tainan Hospital of the Department of Health, Obstetrics and Gynecology, Dr.
Wu Zongcheng's response: (1) Ultrasound examinations are relatively safe for the fetus; although ultrasound machines do emit a small amount of radiation, it is not higher than that from a television or microwave oven.
Therefore, performing ultrasounds at 6, 12, and 16 weeks will not adversely affect the fetus.
(2) In ultrasound examinations, various measurements are statistical averages, with an acceptable margin of error of ±10%.
The two main purposes of ultrasound are to assess fetal development and detect fetal abnormalities.
Fetal development is more reliably tracked using growth curve charts, as single examination results may sometimes show deviations.
(3) Amniocentesis is primarily used to check for congenital chromosomal abnormalities in the fetus.
The risk of giving birth to a "malformed baby" or a baby with Down syndrome increases for advanced maternal age.
Therefore, the Department of Health recommends that older mothers undergo amniocentesis.
(4) Amniocentesis cannot determine the effects of medications on the fetus.
(5) The intake of vitamins and Neobun should be based on "appropriate amounts." Tainan Hospital cares about your health.

Reply Date: 2001/12/13

More Info

Hello Brandy,
Thank you for reaching out with your concerns regarding your pregnancy and the various tests and procedures involved. It's understandable to feel anxious, especially as a high-risk pregnancy due to your age. Let’s break down your questions and concerns regarding ultrasound, amniocentesis, and the implications of your current situation.

Firstly, regarding the ultrasound results indicating that your fetus appears to be measuring at 14 weeks instead of the expected 16 weeks, this discrepancy can occur for several reasons. Fetal growth can vary significantly from one pregnancy to another, and sometimes the measurements taken during an ultrasound can be slightly off due to the position of the fetus or the skill of the technician. It’s important to remember that ultrasound is a tool that provides estimates, and slight variations are not uncommon. Your healthcare provider's recommendation to have another ultrasound in two weeks is a standard approach to monitor fetal growth and development closely.
As for your parents' concerns about the frequency of ultrasounds, it’s worth noting that while there has been some discussion in the media about the potential risks of excessive ultrasound exposure, the consensus in the medical community is that when performed by qualified professionals for medically indicated reasons, ultrasounds are generally safe. The benefits of monitoring fetal health, especially in high-risk pregnancies, outweigh the potential risks. If you feel comfortable with your current healthcare provider and trust their judgment, it may not be necessary to switch doctors based solely on your parents' concerns.

Regarding your question about nutritional supplementation, maintaining a balanced diet is crucial during pregnancy. While specific vitamin supplementation can be beneficial, it’s best to consult with your healthcare provider about what might be appropriate for you. Prenatal vitamins typically contain folic acid, iron, calcium, and DHA, which are essential for fetal development. If you have specific dietary restrictions or concerns, discussing these with your doctor can help tailor a plan that meets your needs.

Now, concerning the recommendation for amniocentesis, this procedure is often suggested for women over 35 due to the increased risk of chromosomal abnormalities, such as Down syndrome. Amniocentesis can provide valuable information about the genetic health of your fetus. It’s understandable to feel apprehensive, especially considering your previous experience with a medical termination. However, amniocentesis is a diagnostic tool that can provide clarity and peace of mind regarding your baby's health.
Regarding your past experience with the medical professionals not suggesting amniocentesis after your previous pregnancy, it’s important to understand that recommendations for such tests can vary based on individual circumstances, including the specific risks associated with each pregnancy and the protocols of the healthcare providers. In some cases, if there are no significant risk factors identified, doctors may not recommend invasive testing like amniocentesis.

In conclusion, I encourage you to have an open dialogue with your healthcare provider about your concerns, the necessity of further ultrasounds, and the potential benefits and risks of amniocentesis. Your health and the health of your baby are paramount, and having a supportive and communicative relationship with your doctor can help alleviate your worries. Remember, it’s your pregnancy, and you have the right to seek the care and information that feels right for you.

Best regards, and wishing you a healthy pregnancy!

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