Scan Anxiety- Scanxiety and the truth
There have been lots of talks lately on the newspapers and online about scanxiety - someone created a fancy word to describe anxiety before diagnostic scans such as CT and MRI.
The term quickly included private ultrasound scans mainly private pregnancy scans in a newspaper attempt to grab the reader’s attention.
The Guardian headline reads:
"Scanxiety: why private baby scans are on the rise
Many pregnant women are paying for extra ultrasounds, for reassurance or for ‘souvenir scans’. But does multiple scanning pose a risk to the unborn child?"
The MailOnline article reads:
Pregnant women with 'scanxiety' are told to avoid private ultrasounds as firms offer multiple scans to assuage their fears
- Study found almost a third of mothers-to-be pay for extra scans while pregnant
- Many do so due to anxiety, despite NHS offering scans at 12 weeks and 20 weeks
- Parent site ChannelMum.com says ‘pop-up’ firms target women with 'scanxiety'
Another article on MailOnline reads:
The rise of 'scanxiety': Pregnant women are risking their babies' health by paying for unnecessary scans
- UK and US guidelines advise getting two scans: one at 12 weeks, one at 20 weeks
- A new study shows a third of mothers-to-be pay for extra private ultrasounds
- Too many high-intensity scans may cause harm to the foetus, experts warn
- Anxiety over the baby's health may be doing more harm than good, they say
Going through these articles as a qualified sonographer with more than 15 years experience, i found out that they were full of inaccuracies, misinformation and scaremongering.
Ultrasound is used in pregnancy since the late 70s. There were a few research publications suggesting that ultrasound might affect the growth of the unborn baby but with no conclusive evidence and consequent studies failed to duplicate the results. The medical community, therefore, is suggesting that ultrasound should be used where clinically indicated.
NICE recommends 2 scans at 12 and 20 weeks as sufficient during the pregnancy. A new study in England, however, shows that almost a third of expectant mothers are paying for additional private scans.
So NICE knows better than the pregnant mothers or is it because NICE has to take into account the lack of NHS sonographers and midwives and try to alleviate the stress on the NHS?
If two ultrasound scans are enough in the UK, why they are not enough in the USA, Australia and most other European countries?
So would you say to an expectant mother and her partner who had a miscarriage and sometimes, unfortunately, multiple ones, who are in the waiting room shaking waiting to find out if their baby has a heartbeat that is overreacting and suffering from scanxiety?
Do you think that the ultrasound scan is clinically indicated?
I would say yes as the ultrasound scan will either reassure them, that their baby is alive or at the worst case scenario will confirm their fear but at least they will know and they will be able to deal with it. In very anxious patients, sometimes a quick scan is the best option for alleviating stress which is helpful in so many other ways.
In our London ultrasound clinic, we do not just do pregnancy scans such the early pregnancy/reassurance scan but we do a variety of other ultrasonic examinations such as abdominal, pelvic and musculoskeletal examinations. We have clients from all walks of life including health care professionals who are not willing to wait 6+ weeks to have a scan on the NHS as they want to find out if there is something wrong with them and treat it ASAP. We assume that these clients are suffering from scanxiety too but all these articles concentrated on expecting mothers as a soft target.
Never the less anxiety associated with the results of a scan either ultrasound, CT or MRI between cancer patients is well documented.
Some concerns on these articles arise from the intensity of the ultrasound beam and the length of ultrasound scanning. The intensity of the ultrasound beam is significantly higher on 4D scans than 2D scans as is the scanning time.
In our London ultrasound clinic we do not offer 4D ultrasound scans but most of the ultrasound clinics that do offer them, they offer them later in pregnancy at 20+ weeks, when the baby is well developed and the effects of ultrasound intensity are minimal.
The most valid point of these articles is the use of untrained/unqualified sonographers. I am not aware of any ultrasound clinics in the UK that uses unqualified sonographers and as far as I know, most of the ultrasound clinics are registered with CQC.
Never the less the DailyMail has compiled a list with tips on finding a reputable scanning clinic:
TIPS ON FINDING A REPUTABLE SCANNING CLINIC
· Check that your ultrasound clinic is registered with the Care Quality Commission, to ensure it meets professional standards.
· Look online for clinic reviews and check how long the company has been established.
· Ask the clinic about staff qualifications and experience. Any reputable firm will be happy to help. Your sonographer should be HCPC qualified.
· Some clinics do offer discounts to make the treatment affordable for everyone. However if you are being pressured to buy more packages than you need or can afford, consider going elsewhere. It's your body, your baby and your choice.
· If you feel overly anxious, speak with your midwife. Your ultrasound clinic will work with him or her.
If you have any questions please feel free to contact us.
What can be seen on ultrasound during the early Pregnancy Scan
Pregnancy or baby ultrasound scans are a routine part of prenatal care.
Ultrasound scans are completely painless, have no known side effects on mothers or babies, and can be carried out at any stage of pregnancy: in early pregnancy, ultrasound is being used to confirm the baby's heartbeat and exclude any early stage abnormalities; later in pregnancy ultrasound is being used to evaluate the baby's overall health.
It may be worth noting that spotting is common in pregnancy. Usually, it's nothing to worry about, but it's always best to double check with your doctor or midwife.
What can be seen during the early scan:
- At 5 weeks gestation (i.e 3 weeks after conception) a small gestation sac might be visible.
- At 6 weeks, the yolk sac, the embryo (foetal pole) and the heartbeat might be visible.
- At 7 weeks the embryo will be around 10mm with a fast heartbeat.
- At 8 weeks, the embryo will be around 16mm and the body and the head might be distinguishable. The embryonic movement might also be seen.
- At 9 weeks, the embryo is now a foetus and head, body and limbs start to form.