Results of first trimester screening?

Question

I will be 38 next week. The results of my first trimester screening estimate a 1 in 800 chance of having a child with down syndrome. I was satisfied with those results however when I saw the doctor yesterday I didnt get the warm and fuzzy reassurance from him. He reminded me that it was just a screening and asked if I wanted to do the amnio. Would you be satisfied with those odds?

Answer 1

If you would terminate the pregnancy, or choose adoption, if the child were to have Downs syndrome, then you might want to think about an amnio. But if the outcome of the tests results would in no way affect your pregnancy decisions, then no, don't do it. Amnio is painful, and although its a low chance, could result in a miscarriage.
What the Dr's don't usually tell you is that those test have a high false positive rate. Where, it says something is wrong, when everything is fine.
It's really a matter of what you are comfortable with. As far as your Dr. not being "warm and fuzzy", Dr's think alot about liability and law-suits, so they may just feel like they have to give a pretty neutral answer so as not to sway you one way or another?
I would be satisfied with the odds. I would read and prepare myself as best I could for the worst possible outcome, but I would leave it at that.
Best wishes for a healthy pregnancy and birth.

Answer 2

This is really a very personal question. Much of it depends on what you would decide to do depending on the results of your amnio.

If you plan to keep the baby anyway, my feeling is that the risk of a spontaneous abortion with amnio (about 1 in 200) is an unnecessary risk unless you feel that the information would benefit you in preparing for the birth of your child. If you don't feel as if you are capable of raising a child with disabilities then you need to consider the amnio or the alternative, chronic villus sampling (which can be done earlier in pregnancy).

I am 38 and trying for my second child. I was 35 when my son was born and declined to have an amnio, even though I could have had one free, because we knew we would keep the child no matter what and weren't willing to take the risk. My doctor gave me that same kind of skeptical response to my decision but my feeling is that as doctors they are predisposed to do all tests medically available. That doesn't mean the test is right for you on a personal level.

If I get pregnant again I will probably get a transnuchal ultrasound. This is a highly sensitive ultrasound that uses precise measurements and results of blood work to give you a more accurate picture of your developing baby and the odds that they have downs. It is not invasive and while not 100 certain because it too is merely a screening test, much more accurate than a regular ultrasound. However, this test must be done between the 11th and 14th weeks of pregnancy so if you are interested you need to get right on this.

Also talk to your doctor about what blood tests are available. There are a lot of advances being made with what can be determined with blood tests -- with the hope that one day it will replace the need for amnios if they can determine the same info from a pregnant woman's blood -- and one of them might be right for you.

Congratulations on your baby!

Answer 3

Amnio's (besides being painful) carry a small chance of miscarriage. What if you accidentally misscarried your (probably) perfectly normal baby. The chance of miscarriage from amnio is 1 in 200. Generally they advise that if the chance of defect is lower than the chance of a miscarriage you shouldn't do it. However if because of your beliefs or your lifestyle you absolutely can't handle the idea of having a down syndrome baby then you need to find out for sure. Personally I have two young children and if I found out a third was going to be severely challenged I might consider the impact that would have on my other two. More to the point remember doctor's are loath to make a decision for you lest it go wrong and they get blamed. A doctor isn't going to tell you everything will be fine unless he has a 100% test saying so. Let your doctor set you up an appointment with a genetic counselor(they are the ones who would do the amnio anyway) and they will explain all the risks and crunch the numbers with you. I suspect that you will come away from that appointment reassured and even if your not you should have a clear picture of what to do. Good Luck.

Answer 4

Considering that you are older, I would get the amnio if I were you. Remember though, amnios can give false positives. 1 in 800 is not an extremely high risk for having a baby with down syndrome. Your risk for carrying a baby with downs syndrome increases with your age. I am 25 and had a 1st trimester screening done. My results came back as my baby had a 1 in 2400 chance of having downs syndrome.

Answer 5

There's a small risk of a miscarriage with an amnio. Having had one that was positive with our first child, I wouldn't take the risk again. Knowing in advance of her birth was a great thing, but you can get an ultrasound instead. It's not 100% accurate but there's no risk. I am surprised that a doctor would want an amnio at 1 in 800.

Answer 6

My advice would be to get the amnio, even if you don't plan on terminating the pregnancy based on the results. I believe from my own personal experience that it is better to know and be prepared for a child with special needs. I was 36 when I had my first child, so my OB recommended an amnio. I was nervous about it at first, but the risk of miscarriage is very small, about 0.5%. We found out our daughter has Mosaic Down's Syndrome. Learning about it during pregnancy helped us to go through all the normal emotions and learn more about DS. I also had additional tests done during my pregnancy, such as fetal echo cardiograms to check for heart defects. Having a new baby is a big adjustment. I can't imagine adding the stress of learning your child has special needs at birth. Learning before hand really helped my husband, our families and I. I am 38 and 26 weeks pregnant with our second child. I had an amnio again and fortunately the results showed no problems. I wish you all the best, whatever you decide.

Answer 7

I don't think it matters about the odds. The miracle of a new life and the fact that you're already a mother doesn't change depending on the screening results. What if your baby did have Downs? You cannot change this. The baby is still yours and relying on you for love and nurturing.

I would not do amnio because there are more risks involved and you don't have a good medical reason to do so.

Best of luck and congratulations on becoming a mother!

Answer 8

I have a child with Downs. However at this late date I really don't know why you would have an amnio. I didn't have an amnio and my doctors never suspected my son had downs- he didn't have any of the normal Downs markers- his heart was fine, the measurement at the back of the neck was fine etc. I would just relax and wait until the baby arrives. No matter what you will love it and it will love you!!!!!!!!!!

Answer 9

I suppose it depends on what you would do if the result of an amnio was positive for downs. If you would prefer to abort then the amnio would be a good idea. If on the other hand you would keep the child anyway, why would you put yourself through it?

Answer 10

Does it matter? your going to love that baby either way right? I wouldnt do the amnio personally, but at the end of the day its your choice hun