firstScan Conditions

Miscarriage

Miscarriage is more common than most people realise….1 in 4 pregnancies miscarry (and maybe even more when the woman is unaware she has conceived)

The most common cause of miscarriage is chromosomal abnormality, as many as 60% are due to an abnormal number of chromosomes. There are other causes such as:

• Infection
• Medical conditions such as diabetes or thyroid problems
• Uterine abnormalities
• Immune system responses
• Hormone problems
• And many are of unknown cause

Anti D Immunoglobulin

• Anti D Immunoglobulin is an injection to prevent a Rhesus negative woman reacting to her baby’s blood if it is rhesus positive.
• Rhesus positive blood group means there is a protein on the surface of red blood cells which is not there in rhesus negative blood group
• If the woman is also Rhesus Positive then NO action is required
• If the woman is known to have a Rhesus negative blood group or blood group is not known and pregnancy is less than 12 weeks on scan then NO action required
• If the woman is known to have a Rhesus negative blood group (or her blood group is not known) and is more than 12 weeks (by scan measurement) and has had vaginal bleeding or bleeding is noted on the scan then needs referral to Early Pregnancy Unit and needs an appointment either the same day or within 24 hours.
• 85% of the population are Rhesus positive so it will not be very common to see a rhesus negative woman who requires any action from First Scan at Window to the Womb.
• If a woman is Rhesus negative and has had no bleeding she will have her first lot of Anti-D at 28weeks. If she is 12 weeks or over and has had 2 or more heavy bleeds (each more than a period) she will need an anti D booster. 
• This condition should not effect first scan as we will be referring women to the hospital straight away with their first heavy bleed; light spotting will cause no concern.

Sub Chorionic Bleed

• A Sub chorionic bleed is a collection of blood outside the pregnancy sac. It may be an implantation bleed so when women have early pregnancy scans they may be seen but by the 12^th week of pregnancy it should not be seen.
• If a bleed is noted on the scan the Sonographer should inform the woman and reassure her that it is unlikely to have a negative effect on the pregnancy. The bleed should be documented on the text on scan report. She will have the bleed reassessed at her first antenatal clinic appointment.
• If the Sonographer notes a transonic area (what looks like an empty gestation sac) alongside a viable pregnancy, then the woman should be informed and told that this will be looked at again at her antenatal appointment. The findings should be documented on the text on scan report. Areas of bleeding (and non viable 2^nd or 3^rd gestation sacs) are seen in early scanning and are probably more common than actually seen but are thought to be present in around 5% of pregnancies.