Hi Marilyn and everyone,
Ref the dating. I checked with my other half who is a sonographer and he agreed that US up to 20wks is accurate for dating. He indicated that US at 20wks was usually +/- 3 days, earlier than this it was +/- 5-7days and later than this could vary considerably - especially in 3rd trimester (hence the reason US is not a good predictor of fetal weight and birth size - another scare tactic often used to encourage early induction or csec).
The problem with anatomical ultrasound of the fetus much before 18wks is that fetal measurements are too small to diagnose some major deformities - particularly of the heart and other organs - hence the recommendation for the US at this stage. However I personally would question how many women actually have terminations at this stage even if they are told bubs condition is fatal.
You are quite right about nucal fold it is only relevant if done between 11 and 14 wks, but like all US is only an indicator of a risk not a definative diagnosis. He also indicated that a competent sonographer can get an accurate nuchal fold measurement abdominally in over 90% of clients, it is rare for them to have to do vaginal US - does this raise doubts about the sonography competence of some of the OBs doing this procedure? Maybe they should leave it to those who do years of training in it - the sonographers and radiologists - but then their own pockets wouldn't be lined (cynical I know).
But of course all these "facts" still don't seem to justify the argument for routine early first trimester vaginal ultrasounds - so we really still don't have a justifiable answer - except the power thing.
Debby
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