12 week scan at Kings

[prm]

Hello ladies,

I am going to have my 12 week scan at Kings tomorrow (first pregnancy).

I have read the leaflet, I know more or less what to expect, but naturally I am a little bit anxious hoping all the news are good etc. and was wondering if there are any words of advice from mums or mums-to-be who have had their scans already at Kings.

A very unimportant question but I read here about buying the tokens for your scan prints before you go in...how many should I buy? I.e. do you get several "angles" of the baby or is it just one?

Many thanks in advance.

[Sanne Panne]

Good luck tomorrow! You'll be fine, bring a book though as it can be a long wait, especially if you don't have an early morning appointment (the delays obviously build up over the day).

The sonographers and the staff who take your blood and your blood pressure are usually lovely and they're willing to take their time to answer questions and reassure you.

Your appointment will probably go as follows (based on my 2 NT scans): you'll be called in first to have your blood and blood pressure taken and be weighed. After that, you're sent back to the waiting room so the blood analysis can be completed before your actual scan is completed. You'll probably wait for 30-45 minutes and will then be called into the ultrasound room. Staff will introduce themselves, tell you to lie down and they'll start the scan (the first bit is transabdominal, the second bit, which I think they only do if you agree to take part in the research, is vaginal). It's important to know that they usually don't immediately tell you "ah, that looks all great and perfect". They have to measure everything twice so you will see them staring at the screen and talking to each other without necessarily explaining you a lot. They will tell you "look, this is the abdomen, look this is the femur" and they may sometimes say something reassuring that they can judge immediately (like the blood flow to and from the placenta being good) but they can't officially tell you whether the neck fold is within normal range until the scan is over because they need to put it in an equation with the exact gestational age and the blood results. Unofficially I know that, roughly, anything under 2mm is fine anyway and anything a bit above that is usually fine too. Don't go by this though, just use it as a reassurance when you see 1.6mm on that screen but don't start worrying if it's a bit more than 2mm (again this is the neck fold measurement, not the abdominal circumference and brain size etc which are all a lot bigger).

As for the pictures, just buy two little tickets from the machine, bring 2x ?1.50 exact change. The sonographers will probably not even ask you for the tickets but it's good to get them anyway. Just tell them you got tickets for a couple of pictures and they'll give you the two nicest ones they have.

Sorry for the "book", edited a few times to add things I forgot!

Again, good luck tomorrow!

[prm]

Thanks so much Sanne Panne.

I really appreciate all the advice, especially knowing that they won't immediately tell you "it's all fine", I would have started panicking for sure!

I don't suppose at this stage they can tell the sex of the baby right?

[lorraineliyanage]

They can't tell the sex just yet, but at your next scan (20 weeks, I think, but can't remember) you can find out.

[Sanne Panne]

Nope they won't even try to look at the gender, I know they sometimes do a guess at NT scans in the US but it's almost always too early. If you're very impatient (like I was) you can have a private scan done in one of the Harley Street clinics at 16 weeks (earlier is sometimes possible too but 16 weeks gives you the best chance of getting a 95%+ certain answer). PM me if you want to know which one I went to. Cost is absolutely crazy though, ?150... you may find a cheaper place...

[peckhamboy]

To add to the above, from our experience I would say really don't expect them to tell you (even at the end) that everything is fine - which is all you actually want to hear. For a start, they're generally researchers rather than nurses and don't all have a great bedside manner and secondly English is a second language to a lot of them. We found that in practice, you will be given a huge amount of information but very little guidance on what it actually means. Also, presumably because they don't want to be sued, they don't seem to ever want to commit to saying anything other than "there are no major problems but we can't tell you if there are minor problems and the scans can't pick everything up anyway". And don't be surprised if you have to go back for more scans - so far we've had four scans (including a heart scan) by 24 weeks, but everything seems to be fine (no "major" problems at any rate!). I think they just like to get as much data as possible for their research!

They also do a lot more tests than most other NHS hospitals (like checking for the nasal bone) so don't worry if they seem to be doing tests that friends of yours didn't have.

And finally - good luck! Hope all goes well.

[Sanne Panne]

Very true Peckhamboy, they don't seem to want to commit to any kind of 100% overall good news. Just ask them "are the measurements you took all within the range of what's considered normal?" and they'll say yes or no. You'll see that on your final report that they print out for you as well (there's a kind of slider next to each measurement that will show you how far above or below average the measurements are - everything that fits on the slider is still normal though).

[edanna]

Good luck prm! Take some snacks as well as reading material - depending on your appointment time, do be prepared to be there for a long time!

Re the token machine, it doesn't give change so if you put in ?3 it won't give you two tickets - you'll get one and lose the money. So put the cash in for one ticket and then press the button, then put the cash in for another one etc.

I do know someone who was told the sex at their first scan at King's - there's a new technique - but I think it's luck whether you get offered it and it's not 100% whereas at 20 weeks they can often be pretty sure.

The way that the sonographers talk to you varies - some are almost entirely silent or mutter so quietly you can't hear. For my second scan before Christmas I had a really good one who kept saying 'I'm happy with that' etc but they probably won't say 'normal', 'normal', 'normal' and that doesn't mean there is anything to worry about. I think some of them forget how nerve-wracking it is for the parents.

When they give you the combined results of the scan and blood tests then you get a probability of the baby having Down's. If you have any questions this is a good time to ask them, when you have their full attention! But please bear in mind that however nervous you are, they don't have any concerns about the vast majority of babies they see. Good luck!

[jollybaby]

I had my twelve week scan a few weeks ago and agree with much said above. I didn't have a transvaginal scan though despite agreeing to take part in their pre eclampsia research project. I don't know whether that was because they could get adequate views transabdominally. They did take my blood pressure 4 times on each arm though!

They scan you for ages taking loads of measurements- not just of the baby but of the uterine blood flow etc. I thought I was finished and then someone else repeated all the measurements. It became a little uncomfortable towards the end particularly when they were trying to encourage my 'naughty little baby' to turn over so they could measure the nuchal fold.

Once they've got your blood results they will spend some time going through your scan and estimated risks of Down's etc. The person seeing you may have the title research fellow - but that often means that they are a doctor doing a period of research so if you have any questions do ask.

And don't be too worried if they call you back for another scan - I think they are almost too thorough . My fetal heart rate was 1 beat per minute outside the normal range and so had to have another scan a week later. I was so disappointed at the time. All I wanted was to be told everything was fine move onto the next stage. A week later heart rate well within normal range and baby had grown 1 1/2 cm!

Good luck - it's a very stressful time.

[Sanne Panne]

Hm, maybe I'm mixing things up and the transvaginal scan is only done at the 20w scan? (also don't worry if that scan is booked for when you're actually 23 weeks along - quite normal apparently).

[Smiler]

We got told the likely sex of our daughter at 12 weeks by a big-mouthed research doctor - they turned out to be right! Tried to get a guess out of them again this time but they were giving nothing away!

As others have said, the first bit of the scan is weird as they don't immediately say that there is a heartbeat or that things look OK. I explained in advance that I was anxious about the scan and my reasons for this, and they did seem to make an effort to be nice.

At the end, if you have not "opted out" of the relevant tests, they will give you a print out with all the key measurements, due date etc. and your personal "odds" of Down's syndrome and another genetic abnormality, which they should explain to you in a private room (I saw some people getting their results in the waiting room or corridor, and this happened to me with my daughter, so this time I asked to be taken somewhere private).

The tests at Kings are extensive compared to lots of other hospitals, but they emphasise that only invasive tests like amniocentesis (which I think they offer to any women who ask for them) can provide an answer. There is another thread on this forum about the invasive tests.

Good luck for your scan.

[prdarling]

It's not usual for them to b able to tell the sex at this stage but it is possible. At my 12 week scan with my second child, the first thing the sonographer said when he put the scanner on my stomach was "there are the male genitals." We didn't want to know the sex, it hadn't occurred to me to mention it at this scan as I'd always understood they couldn't tell, but there it was. I was terribly upset and it really spoilt things for me.

Ditto what other people have said about bedside manner - they have none, so don't be alarmed when they talk amongst themselves and largely ignore you. Unfortunately they are not in the business of reassuring you, they are just number crunchers. It's a bit of a shame when you are keen to have this perfect, exciting experience but they are THE experts in the UK in this field so as long asyou remember that you are in the best hands you'll be fine.

As above it can be a LONG wait so take plenty of reading material. They will usually book your next scan with you while you are there - this is a good chance to get an early morning slot where you'll have minimum delays.

Let us know how you get on!

[sanity girl]

I have to disagree about the bedside manner - I had my 12 week scan at Kings last week and the polish research doctor who did the blood tests and most of the scan was absolutely charming - used humour to put me and my partner at ease, let us know everything that he was looking at/measuring and when we asked letting us know whether they were in the normal range or not. I felt that they were extremely thorough and was so reassured by their manner. We both left on such a high and with big smiles on our faces.

[edanna]

Sanitygirl, so glad you had such a positive experience - sounds like it could be the same guy that did my second scan recently and he was very nice and communicative - I told him how much I appreciated that. But they're not all like that -he is by far the best of the several I've seen - fingers crossed you get another good one for your next scan.

[Sanne Panne]

I had two good experiences too, Brazilian and Greek research fellows, all lovely and very knowledgeable.

[newcomer]

Top Tips for Scans:

1) I agree with Sanne Panne, edanna and prdarling - bring a book or two, something to eat & drink, change for the coffee machine, etc. For my 23-week scan at KCH I had to wait almost 4 hours so I was very bored indeed by the end.

2) If your doctor doesn't volunteer inforamtion, feel free to ask questions during the scan.

3) I have always found the doctors to be nice, although one or two of the reception staff have come across as rather harsh at times (though I think they were probably just busy).

4) If anyone says anything you don't understand, ask them to explain it again until it makes sense - there's a lot of new terminology when you're pregnant and sometimes doctors forget that not all of it is 'general knowlege' to the average first-time mother.

5) I didn't buy enough coupon thingies, but the person carrying out my scan was v kind and gave me some 'extra' photos anyway. They aren't meant to though...

6) If you do have an internal scan, try not to tense up (I know, I know, easier said than done!) as the more relaxed you are, the less uncomfortable it will be. It's not meant to hurt though, so if it does hurt, tell them.

7) Bring your maternity notes, even if they are only a page or two, and your appointment letter. I forgot both on my first scan, and was almost turned away.

Finally, enjoy it! I hope everything goes really, really well for you.

[sandy_rose]

I was really nervous too for my first scan, I think that is very normal. Be prepared for a long wait in a hot waiting room with lots of screaming children running about! Bring something to read, some snacks and water. Don't worry too much about the coupons, buy one or two just in case but they seem to just give you a few photos without asking for the tokens. It's worth asking for a few extra though, this is the only scan where you will see the whole baby and they are so lovely. By your next scan the baby will be so big you can only fit a head or an arm on each frame.

Once in the 'scanning room', there are usually quite a few people in the room or coming an going and they don't always explain who they are or why they are there. I did get a bit worried at my first visit when I ended up with 5 people standing behind me and staring intently at the screen without saying anything for what felt like ages! Also, the sonographers were all south American and actually spoke Spanish between themselves! I speak Italian so I could understand what they were saying and knew it wasn't because they were keeping any terrible news from us but I would have been very worried otherwise! Also, the sonographer kept saying 'baby bad' which I totally freaked out at and my poor fiance was sitting there with eyes like saucers - we soon realised that what she meant was to say the baby was being naughty by moving around so much and turning away from her! This also meant that they had problems picking up the heartrate as the baby kept moving away. One minute you could hear the heart beating, then it would just turn in to one long bleep. By this point the senior sonographer had taken over, again without explanation. After a few minutes of this I asked if everything was ok with the baby's heartrate and he just hushed me and carried on. Needless to say MY heart nearly stopped at this point! Eventually they managed to get all the readings and basically told us everything looked fine and rushed us out of the room.

I don't want to alarm you, just thought it might help you to know it doesn't mean anything is wrong with the baby if they ignore you or seem to spend a lot of time looking at one small detail - it probably just means the baby is either too busy or that it's not in a great position for them to be able to see everything properly.

All in all it was still a really lovely experience to see our baby for the first time, waving its little hands about and doing somersaults!

Also, I wasn't offered the vaginal scan until the 20-week scan (which I didn't have until 24 weeks). I chose not to have it (when you see the probe you'll know why!), it is just for measuring your cervix to see if there is any indication of an early delivery. As I understand it, it's all at research stage yet, you should not have to worry about an early delivery anyway if you're healthy otherwise, and it doesn't tell you anything more about the health of your baby so I didn't see the point in having it.

Good luck for tomorrow, I'm sure you will enjoy it!

[buggie]

Transvaginal scans are done if they've not been able to get a good view transabdominally - if you've got a bit of a belly anyway it can be tricky (the research fellows doing my scan the other day joking called it a "cloudy day"). Transvaginal gives a clearer view and being a different angle if bubs is being stubborn and not moving when poked they can try and see from this angle too.

My experience has been the research fellows are lovely, yes some are quieter than others, but they are all wanting to check your baby is ok.

Having had my 12/40 on Fri I had to go back today for a 2nd peek as they wanted to check bubs was growing ok (is growing ok but 4/7 less pregnant than dates suggested) and really can't complain about their care and appreicate the thoroughness/attention given.

....course having Jeremy Kyle on in the wt room was an interesting touch (esp as it was a DNA testing one!!)

[Smiler]

Sandy-rose, on the internal cervical scan at 20-weeks, I disagree that there is no point in having it. It is really good to be offered this on the NHS - lots of places don't. It can be helpful in identifying some women (though of course not all) who are at risk of premature delivery due to a short or weakened cervix. If they identify a potential problem, there are things that they can do to help the baby to develop well and stay put for longer.

A member of my family (who is healthy and had no previous history of gynae problems) had a premature baby, so I feel that these kind of tests are valuable.

[edanna]

And actually - whatever the probe looks like - it's not that bad. Way better than a speculum in my experience!

[Magpie]

My wife just had the 20 week scan there, found that much more confusing compared to the 12 week scan, because, as mentioned above, you can't see the whole baby - sounds awful but images of Sigourney Weaver flashed through my mind whenever the spine came into view!

Our experience was very good, the researchers are all Doctors rather than Nurses, and were very friendly, sought to reassure us, and responded to our questions. All measurements were done twice by two different people, hence why they swap over. My wife had the internal scan at the 20wk one, but wasn't really asked whether she wanted it, just told she was going to have it (think she may have signed up prior), this was rather surreal as I got to see a male doctor manoeuvring a rather large device between my missus' legs! (all discretely shielded by a blanket I should add) Agreed that you need books, water, etc for the wait, but otherwise a great experience. We were also lucky as for the first scan we were allocated to the room with the 3D scanner, and got to see a little animation of the baby on the screen.

[Indiana]

I agree with Smiler....definitely good to have the extra vaginal scan at 20 weeks as this shows whether you are at risk of an early delivery or an incompetent cervix.

The latter is pretty rare but a friend of mine went into labour at 24 weeks because of this and unfortunately lost the baby. Second time round they did a small op to strengthen her cervix and she carried to full term. If she had had the vaginal scan at 20 weeks they may have picked up the weakness and been able to deal with it and prevent the loss

The vaginal scan was fine - and besides you will get used to all sorts of prodding during pregnancy and birth!

Also agree re reading material and trying to get your next scan in the morning

[Ann]

Just to put this all into perspective. I was first pregnant in 1993. The early scan in those days were very basic indeed, I'd be surprised if it took more than 5 minutes. The world renowned Nuchal Test was still at the research stage then. Two years later when pregnant with my son we were one of the first ever 'nuchals' to have been performed as a proven screening test. Happily I was given a low risk, with my first pregnancy I was given no risk at all. Older mothers were offered CVS or Amniocentesis based on age alone

They have continued to fine tune the tests ever since, even those of you with ,say, Reception age children will not have had the scans offered today, especially not the early scan.

I agree the communication skills are not always the best but you are getting the highest level ante natal scanning pretty much anywhere in the world. Professor Nicholaides is a probably one of the most pioneering doctors of our time.

We are very lucky to have that level of expertise on our doorstep. King's also do scans for other hospitals and take referrals for specialist scans from all over.

Not meant to sound patronising, sounds like most of you appreciate Harris Birthright at King's but I've read posts in the past that have made me cross.

[Pecanpie]

You can sometimes find out the sex at 12 weeks, when my hubby left the room i said to Dr, 'that looks like a willy', and she agreed, saying it definately was. Having had more than my fair shair of scans in my experience some people were lovely, some were downright horrid, and some were totally incomprehensible. Hope you have a happy scan.

[The Nappy Lady]

Scans have moved on hugely in the past 6 years - from having a scan in 2003 with our first, when it was just general measurements, nucal fold and nasal bone, to the scan in 2008 when they also took blood to assist with predicting the likelihood of downs, plus measuring blood flow through the baby's heart and also digestive system. My hubby and I were really amazed by how much better the latter scan was, the images we saw were much better quality too, similar to the 23 week scan with DD1.

I have always felt so lucky to be close to Kings with access to cutting edge medical knowledge/testing that is not available at all other hospitals.

Have had quite a few transvaginal scans (due to miscarriages and going to the Early Pregnancy Unit for checks from 2 weeks onwards each time) - below 12 weeks this is the only way they can do a scan, and have to say I have never found them to be uncomfortable, though I agree the 'probe' can look a bit daunting, it really is fine. Also took part in the Harris Birthright research in terms of measuring the cervix etc and the only thing I recall was it being a bit annoying to have to hang around even longer until they were ready for me, having already done all the other bits and being ready to go home really.

All the sonograhers have been OK, some friendlier than others but never had any issues with them (apart from getting there at 9am for our appointment and seeing most of them roll in at about 9.30am!!). For our 12 week scan in 2008 we actually got a very well spoken English Lady and my hubby and I looked at each other in amazement when she came out to call us because we were fully prepared for someone who would struggle to pronounce our name, it was quite a funny moment. She was a lovely lady, and with our history really took a lot of time to reassure us and told us to go away, stop worrying and finally enjoy the pregnancy...which we did!

Oh - re the scan pictures, don't do what my hubby did - decided to laminate them to keep them safe - and of course they are on heat sensitive paper so he destroyed them :-( Thankfully I had retained one of the three to take into my work, so we didn't lose the lot (otherwise he would have been in BIG trouble).

Hope all goes well tomorrow prm and you enjoy seeing your baby for the first time.

Molly

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