An IVF patient posted a blog complaining about the possibility of only receiving two ultrasounds during her pregnancy and I could feel her pain. Quite recently I had a protracted discussion with an imaging center that kept denying my patients an ultrasound based on Medicaid’s rule of only one ultrasound per pregnancy.
Medicine has become a BUSINESS and many clinical decisions are now based on whether or not someone will be paid. Those who know me or read The Smart Mother’s Guide to a Better Pregnancy know that I abhor “keepsake” ultrasounds that are done for gender determination and entertainment. However, I value legitimate fetal ultrasounds that are reviewed by radiologists because they have saved lives. The earlier the fetal ultrasound is done, the more accurate the fetal dates. This could become an issue if you unexpectedly need an induction of labor.
An ultrasound done at 20 weeks provides information regarding the anatomy of the baby. Is there a 4-chambered heart? Are the baby’s intestines normal? Has the brain developed properly? Everything’s okay? Great, but what happens at the end of the pregnancy? The real-time information that ultrasounds provide to determine fetal well being is priceless. This year alone at least seven of my patients’ were spared stillbirths because we detected poor fetal growth, abnormal placentas, low amniotic fluid and umbilical cords wrapped around their babies necks, thanks to a third-trimester ultrasound.
So how do you get around the only-one-ultrasound-per-pregnancy rule? Your physician must write an order as a “follow-up” of a condition previously detected or diagnosed. Did you have previous abdominal pain or bleeding? Was there a suspicion that your baby wasn’t growing properly? Was the placenta in the correct position? These conditions justify obtaining a follow-up ultrasound. If you have a high-risk condition, don’t hesitate to request a referral to a high-risk specialist who can monitor your baby using 3-D ultrasounds.
Visual access of your baby is extremely important. The one-ultrasound-per pregnancy rule is total nonsense.