What to expect from your 20 week scan

The mid-pregnancy scan can (and should) seem like a natural part of the process in any pregnancy – between 17 and 21 weeks, your OBGYN will either conduct the scan himself or send you off to a sonographer who will perform an in-depth scan of your baby.

To a mom wary of Congenital Heart Defects (CHDs), this is the scan – the results of which will leave them filled with relief or fear because it is also the scan that shows the presence or lack thereof of a CHD.

This scan highlights potential defects in the foetus. It’s also the most important scan as it gives you the time you’ll need to prepare for life with a defect.

Checking for anomalies in your unborn baby

Sometimes referred to as the “anomaly” scan, it is exactly that – a check for anomalies in your unborn baby.

The sonographer will examine your baby’s organs and take measurements. He or she will look at;

• The shape or structure of the baby’s head
• The baby’s face (to check for a cleft lip)
• The spine to check that the bones align
• That the skin covers the spine at the back
• The abdominal wall to make sure that all the internal organs are covered; and
• The stomach, kidneys, arms, legs, feet and hands which will also be checked for defects here.

Checking your baby’s heart

It is during this scan that your baby’s heart will be checked. Your OBGYN will ensure that the top two chambers (atria) and bottom two chambers (ventricles) are the same size. He or she will also make sure that the valves open and close with each beat of the heart and that the major veins and arteries carrying blood to and from the heart are in good shape.

Asking the right questions

As part of our awareness efforts, we ask expectant parents to make sure they ask five very important questions during this scan:

1. Is the heart rate normal?
2. Is the heart function normal?
3. Do you see four chambers in the baby’s heart?
4. Are the heart and stomach in the right position?
5. Do you look at arteries as part of your anomaly scan?

For the moms who want to delve a bit deeper, you are also fully within your rights to ask:

1. Are there two upper chambers (left and right atria), each with a valve controlling blood flow out of them?
2. Are there two lower chambers (left and right ventricles), each with a valve controlling blood flow out of them?
3. Do the vessels of the heart (aorta and pulmonary artery) cross each other as they exit?
4. Is the wall between the two lower chambers intact, without any holes?
5. Does everything in the heart look normal?

Some heart conditions (and bowel obstructions) might not be seen until later in the pregnancy or even after the child is born (which is why asking for a pulse oximetry test to be performed on your baby before taking him home is so vital) but having a thorough scan at this point can rule out these conditions and put your mind at ease.

What if the news from this scan is bad?

If a problem is found or suspected, you will be told immediately and will probably be advised to set up a more thorough exam with an actual cardiologist. Here, what is called a foetal echo scan dives a bit deeper (so to speak) for a more thorough look at the heart.

Detection leads to preparation

Why is this scan important? The answer is simple – knowledge is power.

Detecting a potential CHD before birth allows for planning. Planning for the rest of the pregnancy; planning for a safer delivery; and planning for the necessary teams to be prepped and ready to go following the birth of the baby.

Natural birth, for example, might be too traumatic for a CHD baby and planning for a Caesarean could be an option to ease the path.

Some babies are “born blue”, which means they would need immediate attention and knowing that this is a possibility would mean parents and their birthing teams can prepare to have the right skills ready and waiting.

1 in 100 babies

Any pregnancy should be a special time for moms but the reality is that 1 in every 100 babies born will have a CHD.

Many of these are minor, some even fix themselves and most of those that don’t, can be corrected through surgery – but asking the right questions during the 20 week scan and then demanding a pulse-ox before you take your baby home can make sure these pregnancies have the happy endings that they deserve.

About the Author: Andrea Slater is mother to a CHD angel and all she wants is to help other tiny people get a fighting chance in this life. Readers are welcome to visit her blog for more on Hudson’s journey or visit www.hudsoninitiative.org and www.facebook.com/thehudsoninitiative

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Andrea Slater

Andrea Slater is mom to CHD angel, Hudson – a boy who changed her little part of world and whose memory is going to change the rest of it. Amidst her grief is a fight to make sure the 1 in 100 babies born with congenital heart defects every few minutes are not sent home undiagnosed. She will make CHDs a recognised term if it kills her and can be reached on [email protected]

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