Having a baby is such a special time! Most women with a stoma do very well during their pregnancies and have no complications before or after the birth. An ultrasound scan is one of the many exciting parts of being pregnant and the good news is, it won’t be massively affected by having a stoma. The ultrasound scan is an important part of your antenatal care whilst you are pregnant.
Ultrasound scans use sound waves to build a picture of the baby in the womb. The scan is painless, has no side effects on the mother or baby and can be carried out at any stage of the pregnancy. Having a scan is usually a happy experience but be aware that the scans can also detect some serious health conditions, so try to be a little prepared.
The scan is carried out by a sonographer in a dimly lit room so that the sonographer can get good images of your baby. You are normally asked to lie on your back and reveal your tummy. During your scan you will be asked to keep your stoma bag on. The sonographer will easily work around it. It may be a good idea to empty it prior to the scan for your own peace of mind. To be able to get a good picture of your baby the sonographer needs to use a large amount of gel, which can interfere with the adhesion of your stoma bag by seeping into the skin barrier. Therefore, don’t forget to take some stoma supplies with you to your scan appointment so that you can clean your skin of all traces of oil/gel and change your pouch if needed. The scan itself usually takes about 20-30minutes during which the sonographer passes a probe over your tummy to gain a picture of your baby on the ultrasound screen. The sonographer will usually give you the results at the end of the scan.
When do pregnancy scans happen?
Hospitals in England usually offer at least two scans during pregnancy. These will be at 10 to 14 weeks and another between 18 to 21 weeks. The first scan is the dating scan, where the sonographer estimates when your baby is due based on the baby’s measurements, known as the EDD (estimated date of delivery). This dating scan can also include nuchal translucency (NT) scan, which is the combined screening test for Down’s Syndrome, if you choose to have this screening.
The second scan offered during pregnancy usually takes place between 18-21weeks of pregnancy, it is sometimes called the mid-pregnancy scan. This scan checks the baby is growing normally by checking the baby’s bones, heart, brain, spinal cord, face, kidneys and abdomen, as well as the position of the baby and the placenta. It also detects for 11 rare physical conditions in your baby and whether you are having more than one baby! At certain hospitals (depending on their policy) this scan can disclose the sex of your baby…. if you wish to know.
When you have a stoma, you may be offered more scans than usual, to monitor both you and your baby during your pregnancy. This is purely down to your medical history, the reason you had your stoma formed and any medications you may be taking which may/may not have an impact on the baby’s growth and development. But try not to worry about this, as the scans can give you peace of mind that all is well.
For those who have a urostomy, abdominal ultrasounds may be an issue. The absence of a bladder means that a clear view of the baby in early pregnancy may not be possible. Further along your pregnancy, scans become slightly more complicated due to the position of your baby. If the baby’s head is directly beneath the stoma, the measurement of their head is not an easy task! You may be offered a vaginal scan, which can be offered to detect any early pregnancy problems, as an alternative to abdominal scan where this is not possible.
Will my stoma get larger throughout my pregnancy?
As your abdomen gets larger with your pregnancy, you may find your stoma changes shape and size slightly due to the big changes which are happening inside your body. Depending on where your stoma is, there is a chance you may experience a prolapse or retraction of your stoma too. Prolapse means that your stoma pushes its way further out so that more bowel is outside of your body, whereas retraction is when your stoma pulls inwardly. Neither of these issues are a cause for concern and are common amongst pregnant women with stomas. However, they can create a few difficulties with your stoma appliance and therefore it is a good idea to try out a few different products which will feel comfortable during your pregnancy. Your stoma care nurse will be able to guide you in finding the best fitting appliance as your bump grows.
Changing your stoma appliance during pregnancy:
It’s important to get the size (aperture) checked and measured regularly, to make sure your appliance is fitting correctly. It becomes a little tricky to change your appliance when the stoma is slightly below your baby bump, so try using a mirror whilst standing up as this maybe a little easier, or hopefully a partner could help you when needed. You may even want to consider a larger pouch to hold a little more than usual, if you are struggling to bend and empty it. Try using a jug to save you bending over the toilet.