Pregnancy scans a vital tool for health of mother and child

JENN HOOPER
Last updated 12:38 13/03/2012

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I was interested to read the response of Christine Cave to the recent letter from a grandfather commenting on a misdiagnosis of a pregnancy scan. For an example as to why, please read the following statement:

"It is incredibly disappointing to see this trend for wearing seatbelts. It is important that the public understand that it is not compulsory to wear seatbelts [pretend for a minute we are back in the days before the law – based on international research and evidence – was in place].

"There is no evidence that seatbelts improve the outcomes for the general driving/passenger public. In fact, the opposite is true.

"Claustrophobic people or those with a fear of being trapped inside a vehicle can experience unnecessary worry and grief and it may also trigger avoidable panic attacks, hypertension, discomfort, or wrinkling of clothing.

"Vehicle users before they dutifully apply an authorised safety device to their bodies should ask, `Is this necessary? Will I, in all likelihood, crash today? Will it change anything?'.

"There are less than 5 per cent of vehicle users who are involved in serious motor vehicle accidents."

(Disclaimer: actually, I have no idea, but that doesn't seem to be important when writing an opinion piece – say it with confidence and it will be so. I actually do need a seatbelt and am grateful that they are available.)

Back to reality ...

I am concerned to see blatant opinion-based (as opposed to evidence-based) comments being made publicly on such an important matter as the health and wellbeing of mothers and their unborn children.

Clearly, Ms Cave lacks thorough knowledge or experience in this field, especially since her comments are accompanied by quotes of statistics that simply do not exist.

To do this spreads misinformation and potentially confuses the public into going against (again, evidence-based) medical advice and it can be very harmful.

There is no evidence that scans, during pregnancy or otherwise are harmful. In fact, the opposite is true.

I wonder if Ms Cave had considered the families who discover renal/cardio issues at the 20-week anatomy scan. They, of course, can end in termination, birth and subsequent death of babies, or medical attention that can heal or vastly improve the condition.

Dating scans can often assist with the expected due date and prevent a stillbirth at, say, 43 weeks.

Predicted low birth-weight babies can have their chances of survival improved if diagnosed with a scan (and subsequently treated).

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The knowledge of a breech presentation in later pregnancy can assist with decisions made around the birth.

Surgery in utero relies on early detection, as do some procedures that can then be planned ahead for performing immediately after the birth using vital information from scans (check out the following example, ironically published the same day as Ms Cave's letter, at http://today.msnbc.msn.com/id/46403634#.T0RpwXpxuSo).

The possibilities are endless. Options are always available to families – decisions that can only be made by families.

But they need to be able to make fully informed decisions, which are often not possible without scans – since no-one has a reliable crystal ball.

It should be noted that current (non-compulsory) protocol for testing of Down syndrome is to combine the results from a nuchal translucency (NT) scan and blood taken from the mother in the first three months of pregnancy with other information, such as the mothers' age and weight, to calculate the risk. There is now also an improved blood test that can be done in the second trimester, which is more accurate than the version it has replaced.

It is important to keep in mind that these tests are predictive only – their goal is not to give a 100 per cent diagnosis, but to indicate the percentage probability so that further tests can be offered if the risk is deemed to be high.

Amniocentesis (testing a sample of the amniotic fluid) or Chorionic Villus Sampling (CVS – testing tissue from the young placenta, otherwise referred to as the chorionic layer) are diagnostic tools that will provide certainty of chromosomal issues in the foetus.

Action to Improve Maternity (Aim), a Registered Charitable Trust that supports families poorly affected by the maternity service, holds the stories of hundreds of families (both on our website and elsewhere) who have learned the hardest way that there are far worse experiences to be had in our maternity system than "unnecessary" scans.

For the record, the most recently published Health Ministry data show 24.2 per cent of women give birth by caesarean and a further 8.9 per cent have an assisted vaginal birth with forceps, kiwicup or Ventouse delivery.

New Zealand research shows that at least 50 per cent of pregnancies will require medical assistance or intervention of some description during their pregnancy/labour/birth/postnatal period for the safety of mother and or child. (References are available upon request to support@aim.org.nz.)

But let's not let facts get in the way of our opinions.

Jenn Hooper is the founding member of Action to Improve Maternity (Aim).

- Waikato Times

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