Ultrasound Tests

By Bill Compton

I have been reading with interest the messages on ultrasound during pregnancy. I perform and interpret ultrasound studies as part of my work (I am a board certified radiologist in practice for 20 years). I performed several ultrasound exams on Debbi during her pregnancy with Marilyn (now 13 years old with a BK Symes amputation for fibular hemimelia). I was just as surprised as Debbi when Marilyn was born with the defect. You see, routine scanning with ultrasound during pregnancy does not entail a search for limb anomalies. The femurs (thigh bones) are measured for fetal age, and if the one measured was short this would alert one to a possible femoral deficiency syndrome or other fetal growth problem. The other extremities are usually just checked to see if they are present. No attempt is made to check the length of the humerus, forearm or tibia/fibula (lower legs). Certainly hand and foot digits are not normally counted. This is not to say that this information cannot be obtained with this study. A special focused study can be done to concentrate on the extremities if there is a concern in this area. Even with this, some smaller or more minor problems may not be detected. The quality of the machine, position of the fetus, and the expertise of the person scanning all come into play here. As many of you have said in your posts, many of these problems have no known explanation. They certainly occur very early in the pregnancy while the limb buds are forming. No one should feel guilty in any way! It is nothing you ate or did that caused the problem. Amniotic bands can form during pregnancy and can constrict the growing limb and cause some of these problems. Sometimes we can see these bands on ultrasound depending on their size and location which can alert the doctor of a possible problem. An early placental or fetal interruption in blood supply from a clot or infarct can cause these problems too which has been mentioned but this will not be detected by ultrasound.

So don’t feel bad that nothing was detected on the ultrasound exams. Nothing could have been done to correct the problem, even if it had been found. The important thing is how we respond as parents to the less than perfect child we are blessed with. Yes, we have had many challenges as Marilyn’s parents, but the joys of raising such a special child are precious indeed. The love shared and triumphs achieved far outweigh the heartbreaks. The resolve and determination of her soul to overcome obstacles and handicaps is truly amazing. It is through these experiences that we see the love and power of God manifested in our lives.