Monday, March 31, 2008

acog who?

my ob care is through the military, allegedly at one of their flagship institutions. i'm being seen at be.thesdanaval.medicalcenter. interesting then that at such a premier institution i'm unable to get a NT screen, my requests for same and ACOG guidelines nonwithstanding. apparently, they do sequential testing and only offer NT scans to those women whose 1st trimester analytes are abnormal. while this seems like a good idea, serum anaysis alone only detects 80% of possible aneuploidy, whereas serum analysis + NT scan has a detection rate of 95%. if i were working with a tiny clinic in a remote area that didn't have appropriate equipment or trained sonographers i would understand. but that is not the case, at "the president's hospital." if acog guidelines suggested that only women of a certain age or risk factor should be offered the combined NT and serum screen i would understand. but acog guidelines are clear: "Women need to be aware of all the different screening options that are available, including their detection rates and limitations, so that they can choose the test that's best for them." if i didn't want the NT scan it wouldn't matter. but i do. it is very odd to me that i'm being denied such a simple screen at, allegedly, one of the nation's top medical institutions. what could possibly be the reason for BN to be so far outside the normal standard of care? cost cutting? abortion politics?

i heard the hb today by doppler; i'm 11w. i have a retroverted uterus so it didn't come up right away and i scared myself half to death. i'm going to wait a week before trying again. part of me thought, that as i'd made my 1st maternity clothes purchases this weekend, that it wouldn't be there as payback for such a wanton display of hubris. like DD said in her post, i guess things will be ok but it's hard to mentally work myself around that. if someone asks if i'm pregnant, the answer that feels most right to me is "technically". i feel bad because i feel like it's keeping me from bonding with the lil bean, but i keep waiting for the second shoe to drop. maybe it'll get better in the 2nd tri?


Meghan said...

that doesn't make sense. I know that my insurance doesn't cover it necessarily (unless it's indicated) but it's still offered. I'd keep on throwing the guidelines in their face

LJ said...

Your doctors continue to astound, stupefy, and disappoint me.

DD said...

Would you be able willing to get a NT from another physician even if it meant no coverage? Something to think about as just an option. But it is incredible that they just out and out tell you no. Its acuracte and so easy to perform. Shameful.

I'm very impressed you found the heartbeat this early. May it come easily from now until the moment of delivery.

ultimatejourney said...

FWIW, I was nowhere near bonding with my bean at 11w. It gets much, much better. I didn't have an NT scan (though in my case it was by choice) so I was largely petrified until the 'big' u/s at 18w. Don't worry -- 9 months is a long time and you'll have plenty of time to get attached to your little one.

Geohde said...

That is a daft policy and completely goes against the logic of screening. Don't they know that they'll miss a substantial proportion of cases with such backasswards thinking? Honestly.

Can you get a NT elsewhere?