Today we’re going to discuss what some moms may have heard referred to as bad news at a 20-week scan—that moment when you go in for the first ultrasound scan of your pregnancy and the technician tells you that something might be wrong with your baby.
It may sound scary, but don’t worry—it’s not necessarily as common as you might think, and most women don’t get bad news at their 20-week scans!
Bad news comes in many forms and it can be a lot to digest, but there are ways you can cope with this type of bad news. One of the most troubling types of bad news is when the doctor informs you that one or more uterine fibroids are developing inside your uterus.
Uterine fibroids often develop around puberty, so it may come as a surprise that they could be responsible for your heavy bleeding. When the fibroid(s) grows too large, it can lead to heavy bleeding. This type of bad news tends to have a definite answer and will usually require treatment from doctors that specialize in gynecology and obstetrics.
Fibroids will grow naturally without outside interference until a woman starts menstruating and reaches childbearing age.
One in every 13 babies born has Down’s Syndrome. Recent studies show that approximately 2% of pregnancies (1 in 100) result in a baby with Downs syndrome. Doctors may tell you and your partner the odds of getting a baby with Downs syndrome during the 20-week ultrasound by calculating how many cases they see per 1,000 babies they monitor or diagnose.
Statistics can be accurate to a point but should never serve as your only indicator of potential risks during pregnancy. Take time to explore your concerns and options when finding out bad news at 20 weekly scan
Chances of abnormality at 20-week scan: You have a one in 100 chance of there being a chromosome disorder, which means that your baby will have an abnormality. There are many different types of chromosomal disorders, but the most common is Down’s syndrome and Edwards’ syndrome.
The chances of bad news at 20 weeks: It’s hard to know what you’ll be told when you go for your 20-week scan. Even if everything seems normal and healthy, there could still be something that needs attention or monitoring later on.
Most heart defects are not diagnosed until later in the pregnancy, or sometimes after birth. Research has shown that around 1 in 4 pregnancies may have a baby with a heart defect.
The chances of having an abnormality at the 20-week scan are about 1 in 10, which means that around 3 in 10 pregnancies will be unaffected by any malformation. A baby’s chances of having a problem with their heart depend on what sort of problem it is.
The most common problems include holes between the chambers and narrowing (stenosis) of the valves. These can usually be fixed with surgery before or soon after birth, although there are some more complicated problems that might need treatment for several years.
Most babies with lung problems grow up to be healthy adults. The chances of having a baby with a lung problem increase the further into your pregnancy you are, but it can happen at any time. You may want to get a second opinion from another obstetrician if you’re worried about this.
It’s worth knowing that chances of abnormality at a 20-week scan are still quite low – only 1 in 100 fetuses will have an abnormality that can’t be picked up on the ultrasound and there’s only 1 chance in 1000 for those who do have an abnormality detected to have something serious.
Abdominal Wall Defect (OBR)
The chance of a baby having an OBOB defect is generally less than 1 in 2,000 babies. The chance of it being any specific type of defect can be calculated using the following formula:
Chance = (100 x Number of Babies with the Defect / Number of Babies Examined)
So for example, if there are 10 babies examined and 5 have an abdominal wall defect, then the probability that a baby will have this defect is 50%.
It’s difficult to say what the chances of a poor outcome are, but it’s usually not 100%. Risk factors include: the mother being over 35 years old, a previous child with spina bifida, and the baby being female.
It’s important to remember that a good outcome may not be the natural course of things for every woman. A large proportion of women will go on to have healthy children. For more information, please see the Spina Bifida Association website.
It’s difficult to know what the chances are of getting bad news from a 20-week scan because some mums will choose to terminate a pregnancy after a diagnosis of severe abnormalities and some don’t. There are so many factors that can make it hard to calculate how often this would happen.
We know that about 3% of pregnancies end in miscarriage, but we don’t know how many women who have miscarriages go on to have an early termination. It seems likely that the number would be higher than 3%, but we don’t know for sure either.
Many women feel worried when they get the results of their 20-week scan. There’s a good chance that everything will be fine, but it’s natural to feel apprehensive when you’re waiting for the results. Talk to your midwife or doctor about what will happen next if there are problems at this stage, as this may help you work through any worries and anxieties.
Try not to worry about something going wrong before you have all the information – remember that statistically most pregnancies go well and many babies are born without any complications.