On my 20 week ultrasound 2 observations stood out. First a variation in the heart that could be normal, but is sometimes associated with Downs Syndrome (I'm forgetting the name) and a small stomach. I am 42 years old and this is a natural conception with progesterone support for the first 3-and-a-half months. The baby's growth has been on target and my risks for Downs came out less than 1 in 4,000 from the combined sequential genetic blood tests and ultrasound. I did have a subchorionic hematoma in my first trimester, which is now completely resolved. I have had no invasive tests as I do not want even the slightest increase of miscarriage risk.
On the follow up ultrasound at 22 weeks the stomach was still small. I am now scheduled for an ultrasound at 28 wks. I was told that if there is a tracheoespophageal fistula it would likely be viewable at that time. I have not been given any percentages or normal ranges for stomach size. The fact that the small size was observed twice now concerns me. How often is a small stomach connected to such a problem? The fistula sounds serious and would require surgery. How often are small stomachs seen that turn out to be normal? Is there a time of day that's more likely to be after the fetus has swallowed? At what gestation can normality or defect be confirmed? I still have 5 weeks to wait for the next ultrasound. The perioneonatologist seemed reassured that there was a stomach. I know it is not standard to be observed this closely, so I know my baby is at increased risk. What are other possible associations with a small stomach? What are possible causes for a small stomach and for a tracheoesophogeal fistula? Could formaldehyde exposure contribute to a possible defect such as this fistula? I was exposed at the end of my first trimester--sleeping on unwashed new sheets 2 nights in a row.
I am hoping that more information and context will help me better deal with the unknown. Thank you.
Congratulations! I feel fairly certain that your baby is healthy and normal. I suspect that what they saw in the heart was an EIF(echogenic intracardiac focus). I absolutely hate those things, because we have to report them and what they could mean, but I have never yet seen it associated with Downs, and I have seen it many times.
As for the small stomach--usually if there is a TE fistula, the stomach is never visualized at all, so I suspect this is yet another non-issue. We can see so much on ultrasound now, that we can't handle all of the information, and we end up scaring the parents to death.
If you were my patient, I would definitely reccomend the 28 week scan (can they do 4D for you?) and I'll bet that you'll see a healthy kid! In the meantime, buy some cute baby clothes and get a pedicure. Take a nap too--at 42 its going to be hard to keep up with a baby--believe me--I KNOW!
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.