Sharon Cook
3rd November 2016
Every year 1,000 babies go home from hospital with undiagnosed heart defects. Most are born to mothers who have no known risk factors.
With these facts, sonographers will understand the importance of a vigilant and thorough clinical examination of the fetus at the anomaly scan, within given limitations of ultrasound resolution. I know through training students how nervous and unconfident heart scanning can be for them. Having a systematic programme in place should alleviate these concerns and improve the clinician’s technique and ability. However, as with all scanning practises, the understanding between the professional and the patient can be so different.
Throughout my years as an Obstetric sonographer I always find it hard to deliver bad news to parents at such a poignant time in their lives. They arrive at the scan with huge expectations and hope at seeing their unborn baby for maybe the second time during their pregnancy. Our perspectives on the reason behind the scan can be so different. The sonographer is performing a clinical examination to note for abnormalities, whereas the parents main priority maybe obtaining a good picture or finding out the gender. This ‘expectation mismatch’ (1), can make it difficult and challenging for the sonographer to deliver unsuspected bad news.
Tiny Tickers research findings suggest that 75% of parents know nothing about congenital heart defects (CHD) before their 20-week scan. This is a worrying statistic. However, our charity has developed leaflets and tick charts for parents to take with them during the 20 week scan. We hope they will help to educate parents-to-be about the importance of the 20 week scan and gain some understanding of the difficult and complex clinical process that their sonographer is completing.
Pressure to perform scans and not to breach government targets causes undue stress and anxiety to the sonographer in an already tense environment. With input from charities like ours we can try and alleviate some of that pressure by promoting our 3 R’s of training:
- Review of normal heart views
- Renew knowledge of abnormal heart findings
- Reinforce practical skills and confidence in their ability.
With these values in mind we offer support and encouragement to professionals. Updating their existing knowledge and making them feel valued, will benefit all who are involved. This may not solve all the issues within the unit, but it will enable the sonographer to perform part of her work in a more confident and knowledgeable manner.
Tiny Tickers main aims and objectives are to continue this support and guidance to improve the detection of heart conditions, through creating an environment at the regional hospitals where education and training of fetal hearts is maximised. Parents need to have confidence in the system so they can have the time to make an informed decision regarding their pregnancy and unborn baby.
I will keep the reader up to date with the progress we are making and how we are making a difference.
(Click here to see information about our Think 20 campaign, and here for our Think HEART campaign).
References
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Society of Radiographers (2015). Synergy News. (Online).Available from: sor.org. (Accessed 6th September 2016).
