Understanding Post-Scan Concerns: Addressing Delayed Views & Heart Rate

Question
Last Wednesday, at a little over 28 weeks, I had an ultrasound because they weren't able to get a good look at baby's spine and heart at the last anatomy scan at 19+ weeks. They spent a lot of time taking pics of her heart and still weren't able to get a good look at her spine because of her position. Her HB was 125 also, which seems on the lower side but the tech said that it's in the normal range. After the tech showed the pics to the dr, she said we were all done and they would give me a call if they needed more pics... I later got a call from my midwife saying they want me to come back for another scan because the nasal bone measurements may be a concern (she said the were borderline# When I got home, I looked at my ultrasound report online and it said she also has Mild pelviectasis in her kidney and a POSSIBLE interventricular echogenic focus. I am naturally a little concerned. I read online that the EIF and the nasal bone issue may indicate down syndrome...I guess I am just confused since at my 19 week scan, everything came out normal including her nasal bone measurements and the fluid on her neck) The midwife said they may have just been slightly off on measurements since it came out borderline. How likely it is for her to have all these problems after a normal anatomy scan? I keep reminding myself that they said POSSIBLE for the nasal and heart concerns but then there is still the enlarged kidney thing...I hate to think that my baby girl may need surgery for it after birth! I have three weeks until my high risk ultrasound so any insight is much appreciated! Thank you

Answer
Hi Vanessa,

I am so sorry I couldn't reply sooner but from what you have told me it looks like you will get more definite answers at your high risk appointment.  It is completely possible to have the measurement of the nasal bone off a little to make it borderline, especially if the image is not zoomed in properly on the screen.  It is measured in millimeters, which is about the width of your fingernail, very tiny.  The possibility of an EIF is a bit confusing to read because it is either there or it isn't, but it could be the reading doctor was not convinced 100% when looking at the ultrasound pictures before him.  EIF's are so common and have no effect on the function of the heart.  The renal pelvis dilatation can be transiet, or come and go.  It is normal for there to be a little bit of fluid there but when it starts to look more pronounced then they will follow up just to be sure.  Do you recall the measurement of the dilatation?  Well to answer your question, it isn't very common to have an abnormal ultrasound after a normal anatomy scan, with some exceptions like the fetal kidneys.  The other findings should have been seen at the first anatomy scan unless it was difficult to scan for technical reasons.  Did you get a quad screen done, a blood test typically done around 15 - 17 weeks that gives you a measurement of risk of having a baby with Down's syndrome?   Well I can imagine how hard it is to wait and not know but when you have your appointment at high risk make sure your concerns are heard about the changes you saw with the previos ultrasounds.  You will find out alot more information then and they know what to look for there since it is more specialized.  I would try not to worry until you hear from the specialist.

I would be interested in getting a follow up to your appointment if you get the chance.  

Take care