Scan dilemma

Hi... right now I'm so angry and I feel like punching someone in the head (don't worry, you're all safe). I'm not sure if this should be here of punching bag room, it's a combination. I went to get my 12 wk scan done and was told they can't do transnuchal at that site because they don't have the equipment. My referral says uterine with nuchal thickness. Apparently there are only 2 places I can go.... not that anyone told me that and no one asked me when I booked in. Also, my doc didn't get bloods. I asked if they can just do the measuring of the thickness and they said they can but not as well on their machines....but they wouldn't do anything at all, not even a scan to check size or anything because it said transnuchal (but it doesn't have that word specifically). So, I'm also confused because if they can do the thickness why didn't they just do that...I said I'm happy with that and would only do any further tests (eg: the whole blood test and better scan) if it showed high risk!! Something to do with some stupid study that they have going which they are checking between bloods and scans or some crap. The way it was worded might be up for debate, maybe I could've argued that it didn't say "transnuchal" therefore not the one with bloods? I only have one week left if I do get this...also apparently there is no medicare rebate on this particular scan. I have been between crying (which I've done and still doing on and off) and wanting to scream at the surgery where the doc works! Now, I have to try and find another doctor because I'm not going back to this idiot again!!!

What am I supposed to do?? Why can't you be given the correct information in the first place?? My doc when he gave me the referral told me he couldn't refer to the hospital for the scan because the surgery isn't part of QLD Health...apparently that is bulls**t because the hospital told me anyone can refer the hospital...but it was too late by then cos there wasn't enough time as they need 2-3 wks notice. The stupid doctor should have told me about bloods, about only 2 places doing this scan but no...told me choose which one is closest to me and go there.....stupid idiot...!!! Don't they know not the mess with pg women?

Awww Cass, I hate when they don't tell you all the info!! And that does sound unusual that the doc couldnt refer you to the hospital for the scan.. Maybe they wouldnt do the scan there because if their machines arent that great, it might mean they arent really meant to do the scan for the nuchal thickness. It might also have something to do with their insurance, or something.. not sure.

Is that scan you are talking about the same thing as NT scan? If so, I got a medicare rebate of $60 or so for it when I did it. I had to pay in full then go to a medicare office and get the money back for it, they woudlnt give me the rebate on the spot, and it does count towards the safety net.

Well I hope you can find a place in time to have the scan. Hopefully theres somewhere a little more helpful.

Is the NT scan for nuchal thickness? Did you do a blood test that went in conjunction with the scan? I was told today only after I'm standing at the counter mind you that it would cost $150 with no rebate. So, I have no idea anymore :(

Hi,

That all sounds very strange to me.

As far as i knew any place that does scans can do the NT scan. Its just a matter of zooming in on the the space at the back of the neck and measuring it i thought. And with conjunction of the bloods you get taken it gives you your results.

I would be ringing/seeing the dr for clarification cos it sounds like someone is giving you the wrong information. Im not sure i would get a new dr right now, just go back to your old one and get them to sort it out, otherwise you will go over the time in which you are allowed to have this scan done.

Yes, you do have to pay for the NT scan. Its only covered completely if you are high risk and have to have it done. If you choose to have it done you have to pay for it.

How frustrating for you.

OK - You do have to get a specific referral for the NT scan - at least in Victoria. The 12w checkup at the hossy is just a dating scan, where they check the CRL and ensure that your dates all tie up OK. At our hossy they really dont have the correct equipment in that part of the hospital for this scan. I'm not sure whether this is what you mean or not...... Maybe I'm on the wrong wavelength from your post? I apologise if I am.
Most drs dont make a big deal of the scan unless you are more likely tobe at risk. Soif you have had previous problems or you are older (normally 35+). This is another reason why its not covered under Medicare.

If you want to get a check done, can I suggest the Triple screen test, where at about 15w they takea blood sample and give you a risk of abnormalities (I believe downs, and trisomy) based on your age and your blood. This is fully covered by Medicare. No out of pocket costs.
From here - if you have an elevated risk, they will refer you for an amnio, which would be covered under Medicare I believe - or at least some portion.

I get that you are pi$$ed - this happened to me too with my first pregnancy, and I was a little miffed, but then I got the blood test back and I had next to no risk, so it may have been a waste of money.
But the important thing to ask yourself is - will the blood test give you the answers you need, and what would you have done if the scan had shown something.
I know its not much consolation, and you must be fuming inside, but maybe a call to the dr tomorrow will help sort things out.

i had my NT for my first pg done at maters mothers if that helps - they were great there - bummer your dr didnt tell you all the right info

Cass I had the EXACT same thing happen to me here in Brissy.
I got a referral for a NT (nuchal translucency scan) and I booked an appt with QDI (Queensland Diagnostic Imaging). When I showed up for my scan, I was then told that they do not do them there, or at ANY QDI's anymore.
I was in tears with frustration, but luckily my GP was able to get an appt at the RBWH for a scan within the time frame .
I would go back to your GP and demand that they get you booked in for a scan on time! I'm fairly certain that any doctor should be able to refer you to a hospital for a scan....

All the best Cass... *hugs*

Hi,

Maybe its different over here in WA. Cos for one of my pregnancies i just went to my local x-ray and ultrasound place and they did the scan no worries. The only thing i remember them mentioning is that they had to have the right technician on to do it as she was the only one trained to know what she was doing. All my others i have had at the hospital i am having my baby at and the scan is routine there.

Thanks everyone.

Kristi, I am still considering changing doc's because this is the second time he's not given me correct information in 2 visits. I'm afraid to really see him or speak to him again because he seems to lead me up the garden path...strange this is he's done ob training!

Ambah, I was even tempted to write an email to Premier Beattie telling him if he gets re-elected this weekend that he HAD BETTER fix more than what he's saying!! lol. Well, it was QDI I went to at Chermside and they said they used to do them and could still do a measurement but not as well as Everton Park and Strathpine where they have the latest equipment for it. I called the Royal yesterday afternoon and they can't just "squeeze" me in, it has to go through normal way of fax my referral (even though it's on a QDI referral) and see if I get in on time. The lady did see if she could shortcut it for me so that was nice. They also told me that YES, any doc can refer to the Royal which is NOT what my doc told me...he told me because the medical centre isn't part of QLD Health he couldn't refer there!! I did think it sounded really weird, but took his word for it at the time. Anyway, have faxed off the referral this morning and am now taking it as if I get in I do, if I don't, then I don't.

Fi, I might just look into that blood test screen especially if I miss this window. Thanks for that information. Once again, something no one has mentioned...I start to wonder sometimes if doc's actually study and know what they're talking about!! They don't appear to OFFER you information and you have to scrounge for it yourself.

Hi,

If this isnt the first time he has offered you misleading information then i think you shoud absolutely change drs, you must be given clear, concise information by your health professional at all times and if you cant trust them to do that then you should definately change. I was just saying to maybe not change until you get this scan sorted out so as to avoid anymore delays. But if you are happy that if you get in you get in and if you dont, you dont then i would go ahead and change now.

I really hope they can sort it all out for you and get you in, in time.

Good luck with it all :)

I am so sorry this has happened to you. There a couple of things to consider. Firstly, there are NOT only two places in Brissy that can do these, obviously they meant only two QDI places. So if you can't get into the Royal on time, you can try other places. Secondly, the full medicare rebate is only available for a limited time. You can have the scan up to 14 weeks or something, but the full rebate is only available if you have it during the so called most accurate window, which is something like 11 wks 6 days to 12 wks 6 days - the exact dates are listed in another thread somewhere. So if cost is an issue you should check on this (the Royal should be able to tell you, the place where I had my scan gave me this info).

I would also be wanting another dr after this. I wish you lots of luck and hope it all works out.

melanie

Cass i horpe you are able to find somewhere to get your scan done.
I got no rebate for having mine done and i did try in the medicare office yesterday to claim for it but as it's a screening test it's not covered unless you are high risk before you have the scan done.

Well, just had a call from the hospital and they can't fit me in for a scan within the "window" for nuchal thickness....so I guess that I'm not meant to get it done. Part of me is like ok at least if it showed on the higher end of the scale I now won't know and therefore can't worry about it. Then there's a part that is like "what if" there is something I just won't know at all now...aaargh! Although I will look into what Fi said about the bloods at 15 wks. Also, what if there were twins I won't know until 18-20 wks...although I don't think it is, but you know what I mean. So many things just go through your mind :(

Kristi, tis cool... I understand what you meant, I just don't trust him anymore now.

There's even conflicting information over the whole medicare thing huh!

Thanks so much for your replies and input, it's much appreciated.

Hi,

Thats a bummer.

Why dont you request a dating scan?

The lady yesterday said because I already have EDD that I don't need it, good suggestion though, might have to see if a new doc could help there. Or maybe find a doc who has one of those little portable u/s machines.... I'm now shrugging my shoulders about the whole thing...lol At least the hospital was really nice and they have given me much better information and I will be having my first visit there in about 4 weeks :)

Ozzy, It sounds like you have had the run around you poor chooky. It is inaccurate and totally false that there are only two places in Brisbane that do NT u/s. It is true that you need a machine with high resolution to be most accurate in measuring the nuchal fold which is the little fluid filled'bag' at the back of the baby's neck.

I hear from the above posts that some women have not been able to claim a rebate for NT u/s. I am not sure why. You should get a rebate if the scan is done within the accurate window time frame.

YOu do have choices though. Dr Frank Carmody is a Foetal Medicine Specialist and works out of private consulting rooms at the Wesley Hospital and also has rooms at Sunnybank. I believe Frank is one of the best at NT u/s. I feel certain you would get in to see him if you phoned for an appointment and explained your dilemma. He always has "spare" appoinments - just be persuasive! It costs about $190 and you the last time I had this done was in Feb and I received about $80 back. You will need a referral from a doctor - any doctor and Frank's receptionist will fax the pathology form to a QML branch so you can have your bloods done.

I hope this helps in some way.... :hug:

Deb, thanks for that information. I might chase that up on Monday. I have started wondering though, is it better to know or not to know? I don't want to spend months worrying *sighs* I will have a chat to DH tonight when he gets home. Thank you so much though, it's always very helpful when it's someone in the same area as you that has had things done that you're asking about.

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I have started wondering though, is it better to know or not to know? I don't want to spend months worrying *sighs*.

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Cass, I think that depends on what you intend to do if you discovered there was a problem (ie. Down Syndrome). If you would continue the preganancy regardless, then it may not really matter if you don't find out until your 18 week scan. However, if you were to consider the option of terminating the pregancy, then of course, the earlier you know the better IMO. HTH's somewhat.

No problem OZzy - the questions you ask are really valid and as Jac says parly hinge on what you would do with that information.

NT u/s can be an absolute nightmare in the hands of some operators and I have seen professionally women who have been left in a complete state of despair from info received from operators. Thankfully when they sought out a second opinion their fears were allayed. It is my *personal* belief - so please no one shoot me down that NT u/s should only be done by a foetal medicine specialist. This is an obstetritian whose speciality is prenatal testing and diagnosis. It's kind a like you don't go to an auto electrician to balance your wheels - sure he may have some knowledge but he isnt' the expert. When you go to a foetal medicine specialist the doctor is there in the room - he looks at your baby - not just the nuchal fold but other soft markers, he looks at your blood results and he talks to you then and there and gives you your risk factor.
YOu can ask as many questions as you like and you are speaking to "the horses mouth".

There is a terrible fear of trisomy 21 (Down's Syndrome) however the reality is that in the great majority of cases this can be excluded and you will leave with the knowledge that in all probability your baby is perfect. Of course nt u/s doesn't preclude other conditions but a foetal expert looking at your baby has a very astute and trained eye. In Frank's case he has had one case slip through - in all the years of doing nt u/s. To explain this woman had a 1:290 risk of her baby having trisomy 21 - she decided against amniocentesis but her baby indeed was born with trisomy 21. NT u/s isn't fool proof but it gives an extrmemly accurate picture. However, I do believe the accuracy hinges on who does the scan. With a foetal medicine ob with good stats I believe you could feel very comfortable with her/his opinion.

I guess the question on weather to test lies with how you feel. If you believe that you would feel more relaxed if this was done then it's probably a good idea. If you feel that it doesn't matter what the outcome then it's probably not necessary. I have seen women go ahead with pregnancy when there has been definitive diagnosis of abnormality. A large number of these women (though not all) felt glad tht they had pre warning - they kind of did some of their grieving for the baby they thought was coming before it came. So when the baby was born they could welcome her/him with the full knowledge of who she/he was. Do you follow?

I think the whole prenatal testing thing is really difficult. I know personally I find myself very stressed before the nt u/s. However, thankfully each time I have left feeling very relieved!

It's a big decision and I think that you are very wise for considering all angles and not just accepting but asking questions. Good luck with it all - I would love to hear what you decide....

Cass you have to work out what you would do with the results if they come back that you are high risk.
If you would go ahead with the amniocentsis it will show if you baby has any of the Trisomy's and not just the one for Down Syndrome. Also think what you would do with the amniocentsis results. How you will cope for the next 28wks not knowing if everything will be okay with your baby.

It is a lot to think about and trust me it's hard when you get the results that you are high risk and it's a very stressful time.

If you want to talk and ask any questions please email michelle@antique-locks.com
I had a amniocentsis a month ago and it was a great refief to find out everything is going to be ok.

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Is the NT scan for nuchal thickness? Did you do a blood test that went in conjunction with the scan? I was told today only after I'm standing at the counter mind you that it would cost $150 with no rebate. So, I have no idea anymore :(

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Hmm maybe its different where you are (but I dont see why it would be)...? Maybe they have already taken the rebate out so thats why theys ay you cant have a rebate?
I had mine at the ultrasound place at a private hospital. It was to measure the nuchal thickness (for downs symdrome and stuff like that, so it sounds like the same thing you were going to have) and also included a blood test. The scan cost me $240 and I had to pay this in full then go to the Medicare who gave me $60 back for it. The blood tests were done through a public clinic so they were fully paid for by medicare.

I was told its fully paid for by Medicare if you are over 35 or 37 or something, or need to get it done because you fall into a high risk category like youve had a baby with Downs Syndrome before... Otherwise you have to pay something out of pocket for it.

RE only having two places in Bris who can do this scan : I would have thought that all or most Obstetric and Gyn Ultrasound places would be able to do this scan for you!

I hope you can get a scan sometime soon.
I had mine done for my own sanity and because I thought I would like to know now, rather than find out much later(I'm also impatient!) and also because I was feeling uneasy about my pregnancy because I had been so sick and had a wierd idea in my head that this could mean there was something wrong because I wasnt eating so maybe I wasnt nourishing baby enough! My Doctor thought I was a bit crazy when I told him that!

good luck with everything!

Karina,
There does seem to be conflicting stories with regard to the rebate. I am going to find out on Monday because it's puzzling. For my last 3 nt u/s I have been over 35 and I haven't got any more than $80 back. I am confused by women not getting any rebate. I will phone someone in the *know* on Monday and post in here what I have learnt. I t shjould make no difference what state you are in either as Medicare is Federal Govt.. Mmmm....

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I have seen women go ahead with pregnancy when there has been definitive diagnosis of abnormality. A large number of these women (though not all) felt glad tht they had pre warning - they kind of did some of their grieving for the baby they thought was coming before it came. So when the baby was born they could welcome her/him with the full knowledge of who she/he was. Do you follow?

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Deb, that is pretty much along the lines of why I was going to do it...just in case and then I would have time to get my head around it and not be sprung with this HUGE surprise so to speak. My mum kinda had a go at me about it but she just doesn't understand. I was adopted, so she hasn't been pg and doesn't know the feelings and questions you get in your head. There isn't any history of it that I know of, although I haven't really stayed in contact with my birth mother, but she was around when I was pg with Joshua and would've mentioned it then anyway. This will probably be last baby so I'm guessing that I just wanted to make sure that all was perfect IYKWIM. To be honest I would feel upset if I didn't know and then my baby was born with D/S. Not to say that I wouldn't love them all the same, just would take away some of that bonding time whilst getting your head around something you were not expecting.

Is this something that does get picked up in the 18-20 wk scan as well?

Michelle, thanks for that offer :) I think that I do my own head in sometimes lol. Overthink, over analyse and just worry too much in general when there's probably nothing to be worried about at all. Right now, I think just hearing my baby's h/b would do me some wonders!! Must try to find a doc with a doppler I think.

unfortuantly it is true that not all medical imaging places do the NT scan. I would ring around to see if there are anymore places in your area that can do the scan. Some places also bulk bill if you are shared care with the public hospital and GP. I wouldnt give up yet , just make some more calls.

Cass they can look for markers at the 18-20wks scan but it doesn't mean your baby will be born with Down syndrome. They will have a goodlook at the heart and they could see a problem but that doesn't mean the baby will have Down Syndrome. But sometimes they can't always get a good picture of the heart and you would need to have anothet scan around 24wks.
I was going to wait till my 18-20wks scan until i talked to a Genetic counsellor and she pointed so much out to me and that is why we went ahead with the amnio.

Cass, I had one of my scans done at a place at Spring Hill (I noticed you're in Brissy) and I know they do the NT there, because I know someone who had theirs their. I think they're called diagnostic imaging for women, or something like that. I had a scan at 8 weeks and my doc was able to get me an appointment the same day.

Good luck with it, and get your bloods done asap!!!

It might be overstating things a little bit to say NT gives an extremely accurate picture. When combined with maternal age, it will let about 1 in 5 DS babies through screening as "low risk". And at the same time, it will class 5 out of every 100 tested as "high risk" while most (~99%) of these high risk ones will actually be fine. Is a "high risk" 1 in 240 chance really that much worse than a "low risk" 1 in 260? I'd only call something extremely accurate if it gave a definitive answer - amnio and CVS are extremely accurate, NT is not - it can only give an estimate of your risk using statistics, not an actual answer.

NT scans, and other soft markers are just hints. Some babies (differs depending on the study but say about 20%) with chromosome problems have normal NT and no soft markers. The presence of soft markers also doesn't mean the baby definitely has a problem.

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When you go to a foetal medicine specialist the doctor is there in the room - he looks at your baby - not just the nuchal fold but other soft markers, he looks at your blood results and he talks to you then and there and gives you your risk factor.

NT u/s isn't fool proof but it gives an extrmemly accurate picture. However, I do believe the accuracy hinges on who does the scan. With a foetal medicine ob with good stats I believe you could feel very comfortable with her/his opinion.

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It might be overstating things a little bit to say NT gives an extremely accurate picture. When combined with maternal age, it will let about 1 in 5 DS babies through screening as "low risk". And at the same time, it will class 5 out of every 100 tested as "high risk" while most (~99%) of these high risk ones will actually be fine. Is a "high risk" 1 in 240 chance really that much worse than a "low risk" 1 in 260? I'd only call something extremely accurate if it gave a definitive answer - amnio and CVS are extremely accurate, NT is not - it can only give an estimate of your risk using statistics, not an actual answer.

NT scans, and other soft markers are just hints. Some babies (differs depending on the study but say about 20%) with chromosome problems have normal NT and no soft markers. The presence of soft markers also doesn't mean the baby definitely has a problem.

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I don't know where you got your statistics from jja, but my pamphlet on Ultrasound Screening for Down Syndrome (obtained from Women's Imaging Centre Freemasons) says that the combined ultrasound with first trimester maternal serum screening has a detection rate of Down Syndrome of almost 90%. I would consider this fairly accurate and certainly worthwhile as a method to help you decide whether to access further invasive testing. I agree with Flowerchild.

Ozzie, as you know the baby is still tiny at 12 weeks and though all the ground work is done there is still much forming to do. The obs doing your u/s will not just look at your baby's nuchal fold but the nose, shape and other soft markers that are relevant. I stand by my comment that NT U/S married with bloodwork done by a well recommended foetal medicine obstetrician is extremely accurate. As Jac said the figures are around 85-90 percent accuracy - meaning in up to 90% of cases an abnormality is detected. In Franks case the percentage is higher. So, again it rests upon the operator. The higher the percentage the more comfortable you can feel with the result.

Yes, you will be able to pick up soft markers at your 19 week u/s if there were any. However, where this can be tricky is that if an accurate NT wasn't done there would be query as to weather the baby was at risk or not. To explain if you had a NT done by a specialist and you were given a 1:1700 chance of your baby having trisomy 21 you would also be then given a risk factor for other trisomies and that would be say 1:4000 (the others are less common). If you see the same specialist he may see something at your 19 weeks scan that were seen as soft markers but in comparison with your previous results it would lessen the concern - do you know what I am saying, or am I confusing??? If your risk was 1:200 and then at your 19 week scan there were soft markers the concern would be greater. The reason that the nuchal fold is helpful is that if you do want a definitive diagnosis then you can have CVS or amniocentesis if you decide this would be helpful to you.

I want to clearly state that NT U/S is not a definitive diagnosis however it is my belief that in the hands of an experienced foetal medicine specialist it gives a very accurate picture of what is going on for your baby... I would always suggest going to the same specialist to do your 19 week scan also - there is a measuring stick then.

Good luck Ozzie I have been thinking of you I do understand that the decision to have a peek at your baby is a big one. The whole prenatal testing debate can be emotional. :hug: to you and I look forward to hearing what you decide...

JUst an aside I agree the cut offs can be confusing - the figures given by JJe are not necessarily those used of all practitioners.

A great number of foetal medicine obs will use the amnio risk rate as their cut off. So the risk of foetal loss with amnio is around 1:250 (again this depends on the practitioner - I personally know one with a rate of 1:350 - it also must be remembered that these rates are using figures of foetal loss in the 4 weeks after amniocentesis/cvs. If you took me as an example I have lost 2 babies at around 16 weeks had I had amniocentesis my babies deaths would have been put on my practitioners stats...)

So if the amnio risk rate is 1:250 then any risk figures less than that are considered for amnio. Some practitioners use 300 so anything under 300 then the woman/family is counselled with regard to further testing. This is because the risk of the baby having a chromosomal disorder equals the risk of the loss of that baby through amniocentesis.
I fear I am sounding confusing!

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I stand by my comment that NT U/S married with bloodwork done by a well recommended foetal medicine obstetrician is extremely accurate.

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I don't know where you got your statistics from jja, but my pamphlet on Ultrasound Screening for Down Syndrome (obtained from Women's Imaging Centre Freemasons) says that the combined ultrasound with first trimester maternal serum screening has a detection rate of Down Syndrome of almost 90%. I would consider this fairly accurate and certainly worthwhile as a method to help you decide whether to access further invasive testing. I agree with Flowerchild.

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I definitely agree its a worthwhile method to help you decide whether to do more invasive testing, and that is its purpose.

But I think you might have misread what I wrote sorry. My figures were for the NT test accuracy *alone*, whereas your figures are for *combined* NT with serum screening which indeed improves the screening accuracy. The only reason I mentioned it was Flowerchild's original post just said NT was extremely accurate without mentioning the combo with serum screening, and I didn't want anybody to get the wrong idea about it. Also I suppose it comes down to semantics and what your definition of extremely accurate is, because personally I would never even describe the combined screening that way but thats just me :rolleyes:

Even in the combined tests with a circa 85-90% detection rate, the false positive rate is still in the 2.5-5% range. This means that up to 1 in 20 people screened will get a "positive" screening result, but as we all know, the actual occurance of Downs is not 2.5 to 5% of pregnancies. So the usual result of a positive screening test is actually a normal CVS result - so I can't call that extremely accurate. The combination screen is only "accurate" in the context of being a screening procedure, just like Flowerchild said. As a diagnostic test its crap - not accurate at all - well its not really a diagnostic test I know, but hopefully somebody will get my point.

To me a diagnostic test like CVS is "extremely accurate" because it gives you a definite result and is extremely rarely wrong, but a screening process isn't because its just a way of calculating your odds by comparing your results against statistics - sort of like using a form book to calculate odds at the horse races. And if using odds was even just a bit "accurate", we'd all be millionaires from correctly picking all the horse races by now :) Except for me because I'm not much of a betting person.

Its just a matter of semantics and I'm probably being too picky :rolleyes: :rolleyes: Sorry...

Yep, I would agree a little bit picky but we're all welcome to our opinions that's what discussion is about.

Cass,
Just popping in to see how you went. I just remembered I was going to find out about the rebate issue. I will try to remember tomorrow....

In regards to costs of scans/rebates etc... My NT scan was bulk billed because I fall into a High risk catagory... but, I yesterday booked in for my morphology scan, and I was told that as of the 28/8, you will be charged a fee of $160 (for concession holders) and the rest of your scans through the pregnancy will be bulk billed. I am not sure if this is the same everywhere though.

Deb, after the whole "schamozzle" shall we say, I was really put off and really did wonder if it would only end up possibly making me worry for nothing...so I figure seeing as they can pick it all up better at 18-20 wks that it's just going to wait until then. The whole experience really left me feeling upset and with a bad taste in my mouth and I just didn't want to stress myself more. I am still a bit upset because I was excited about seeing my baby and hearing the h/b. Thank you for your concern though :D

That's a shame. You can always just have a routine u/s without NT if an u/s at this time is something that would make you feel better.
Good luck. :hug: