THE leader of Scotland's midwives has called on health chiefs to set a deadline for NHS boards to conform to guidelines which state all pregnant women should be offered a second ultrasound scan.

In 2004, health watchdog NHS Quality Improvement Scotland (QIS) set guidelines recommending all women pregnant should receive a second scan at around 20 weeks to check for foetal abnormalities.

However, three years on, a report by QIS found four NHS boards were not automatically offering the service.

Gillian Smith, Scottish national officer for the Royal College of Midwives, said the four health boards in question - Greater Glasgow and Clyde, Lanarkshire, Highland and Lothian - should now draw up a "timeline"for offering a second scan.

She said: "It should be mandatory that a second offer of a scan is made, and because these guidelines have been in place for quite some time, and although we are well aware of the difficulty in resourcing this, if these are best practice guidelines then all the heath boards should be working to achieve that guideline.

"Perhaps rather than saying it should be done today we should be putting a timeline in for when it should be done by.

"I would hate to put a date in but perhaps QIS should now be going back to them and saying this guideline has been in place since 2004 and you have not managed to achieve that."

At present, women under the four NHS boards are only entitled to a second scan if there is sufficient "clinical need" although they all state they are now working towards offering a second scan to all women.

Shona Robison, SNP shadow health minister, said the health department must take more rigorous action to ensure guidance is being fully implemented.

She said: "It's totally unacceptable and I think there should be some kind of target set for them. If we have guidance saying they should be offered a scan at 20 weeks surely then it follows that there should be action to ensure that happens, and that's where the system seems to be breaking down."

NHS Lanarkshire is currently preparing a business case, which will examine available resources whilst NHS Highland had appointed a midwife sonographer and a consultant with an interest in scanning.

An NHS Greater Glasgow and Clyde spokesman said it aimed to provide the additional scan once it has moved to two maternity units - Princess Royal Maternity and Southern General Maternity.

However, as none of the four health boards in question have produced a time frame for when a second scan will be introduced, thousands of expectant mothers have been left feeling let down by local healthcare providers.

Lindsey Easton from Linlithgow is a mother of two and is currently 29 weeks pregnant. After finding out she couldn't receive a second scan she was forced to pay for one through a private clinic.

She said: "I'm over 35 and, as I understand it, that means at more risk of birth defects which can be picked up at a second scan. I was distressed by not having this second scan and I was often in tears over it. I paid £150 at a clinic in Edinburgh but I was quoted £200 at another in Glasgow. It's ridiculous I've had to do that.

Patrick O'Brien, consultant obstetrician and spokesman for the Royal College of Obstetricians and Gynaecology, said: "The advantages of doing a second scan at 20 weeks is that it can show up brain abnormalities, heart, bowel, kidneys, limbs and cleft lip, cleft pallet.

"Most abnormalities occur when there has been no warning whatsoever and that's why all women are mostly offered that second scan."

An Executive spokeswoman said: "We are working with health boards to ensure all maternity units offer foetal anomaly scans routinely."