Preparing for the anomaly scan – scared but afraid to admit it
Anxiety, alarmist thoughts, sleepless nights and an inability to think about much else: these are very normal emotions before the mid-term anomaly scan.
The 12-week scan can be scary enough, but the period leading up to the anomaly scan can feel like the slowest and most agonising of tortures.
It is during this scan that a number of serious problems can be flagged up. These include the following:
- Anencephaly
- Open spina bifida
- Cleft lip
- Diaphragmatic hernia
- Gastrochisis
- Exomphalos
- Serious cardiac abnormalities
- Bilateral renal agenesis
- Lethal skeletal dysplasia
- Edwards’ syndrome, or T18
- Patau’s syndrome, or T13
The worst part of the lead-up to the scan can be that your partner is busy worrying and having alarmist thoughts in exactly the same way you are, but you must keep quiet about your concerns because you are trying your best to be “the rock”, an unshakeable pillar of support. However, you may feel like quietly retiring to a soundproofed room, closing and locking the door and letting out a big scream.
Be reassured: the truth is that although it is entirely possible that you might discover something wrong with your baby at this stage – particularly if the 12-week nuchal translucency (NT) scan indicated there might be a problem – statistically, you’ll probably be fine.
But sometimes, in the throes of an anxious mind, it can feel like simply by imagining there could be a problem, that this will actually cause it to happen, while conversely we might worry that if we are too blasé about it, we’ll be punished for our complacency. When there is so much on the line and all we can do is wait, it really feels like we can’t win.
Being there
You can at least arm yourself with as much information as possible. For example, the NHS’s Fetal Anomaly Screening Programme provides a useful booklet entitled “Screening tests for you and your baby”, which provides all sorts of information about the scan. You can find a link to it here.
Whatever the case, at the very least make an effort to be there for the scan, so unless you have the biggest meeting of your working life and it is all the way on the other side of the world, show your support so that whatever happens, good news or bad, you are there, in partnership, experiencing the whole thing together. If you already have a child, it’s probably best to find some childcare so that if there is any unwelcome or unexpected news you can give yourselves time to process it properly.
How the NHS prepares to deliver bad news
The Royal College of Obstetricians and Gynaecologists (RCOG) recommends that all sonographers who undertake fetal anomaly scans should be properly trained in how to communicate findings with full regard to the emotional consequences.
Sometimes the scans’ findings will not be final and will need to be confirmed by a second opinion: however, in cases of major fetal abnormalities, the problem is likely to be obvious so no second scan will be needed; it can be hard to break this news to prospective parents and the right demeanour is crucial to how the parents cope immediately.
When a ‘probable’ abnormality is detected, the second opinion should be arranged within three working days in order to minimise distress.
Lastly, it is important to remember that the anomaly scan is not foolproof, some anomalies may be missed. The statistical accuracy of the scan for specific conditions is outlined below:
- Anencephaly – detectable 98 percent of the time
- Exomphalos abdominal wall defects – detectable 80 percent of the time
- Gastroschisis abdominal wall defects – detectable 98 percent of the time
- Spinal cord defects – detectable in 90 percent of cases
- Hydrocephalus – detectable 60 percent of the time
- Kidney problems – detectable 84 in percent of cases
- Missing limbs or improperly formed limbs – detectable 90 percent of the time
- Cleft lip – detectable 75 percent of the time
- Serious heart defects – detectable in 50 percent of cases
- Diaphragmatic hernia – detectable in 60 percent of cases
Being there – because it’s important
Whatever the outcome, being engaged is paramount and being there to support each other is vital. If the news is good, then it might be an idea to spend time with your partner after the scan: have a nice meal, go to the movies, do anything to reward yourselves for coping with the stress – just don’t go to play footy with the lads!
And if it’s bad news, it’s even more vital to support each other. While you both may feel like spending time on your own, being together to work through the feelings of fear and anxiety is paramount to helping you cope. And remember, help is out there, so ask for it.
