Saturday 1 October 2016

Routine 20-week scan not available to thousands of pregnant women

Published 25/08/2016 | 02:30

'Figures obtained by the Irish Independent reveal several units, such as Portlaoise Hospital, only carry out the scan for clinical reasons or for women deemed at risk'
'Figures obtained by the Irish Independent reveal several units, such as Portlaoise Hospital, only carry out the scan for clinical reasons or for women deemed at risk'

Thousands of mothers-to-be have no access to routine mid-pregnancy scans to check for major physical abnormalities in their babies, including fatal foetal conditions.

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Pregnant women who would like the detailed ultrasound scan at between 18 and 21 weeks of pregnancy face a postcode lottery, depending on the maternity unit they are attending.

Figures obtained by the Irish Independent reveal several units, such as Portlaoise Hospital, only carry out the scan for clinical reasons or for women deemed at risk.

It does not perform these scans on site and refers women to the Coombe Hospital in Dublin.

These later scans are also just performed on high-risk patients in Limerick hospital, which had 4,726 births last year.

The scan looks in detail at the unborn baby's bones, heart, brain, spinal cord, face, kidneys and abdomen. It allows the sonographer to look specifically for 11 conditions, some of which are very rare.

The conditions which can be picked up include anencephaly and Edwards' syndrome.

These fatal foetal abnormalities can lead to some women travelling to Britain for a termination. The predicament faced by these women has been at the centre of the abortion debate, amid calls to repeal the Eighth Amendment to allow these terminations to be carried out in Ireland.

Expertise

A lack of qualified staff with the necessary expertise is among the main reasons for the lack of routine mid-pregnancy scans. Women who do not have the scan run the risk of having a baby whose anomaly has not been diagnosed.

The infant can have a worse outcome if they are born outside a centre of paediatric surgery.

Others whose baby will die are denied the chance to prepare for the death. And in other cases, a woman may undergo an unnecessary Caesarean section to deliver an infant who cannot survive.

Dr Keelin O'Donoghue and Dr Noirin Russell of Cork University Hospital said the majority of women in their unit, which had 8,113 births last year, cannot routinely access this second trimester scan.

They pointed out: "There is a need for the prompt recognition and timely diagnosis of foetal abnormality, largely through access to detailed ultrasound during pregnancy.

"This is essential if we are serious about equity of care for all pregnant women."

Whether people argue for equal access to either termination of pregnancy or perinatal palliative care in pregnancy with major foetal abnormality, the deficit in the routine availability of these scans in mid-pregnancy must be acknowledged, they added.

The HSE has said that its National Women and Infants Health Programme, established earlier this year, will lead to the development of these pregnancy scans in all maternity units. Women may not get the scan on site, but the plan is to make it available in the wider hospital group the unit they are attending is part of.

Irish Independent

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