Amnio or not?

Hi,

I haven't been on these forums in forever, but wanted to ask now I'm just over 13 weeks pregnant what thresholds people chose to have an amnio at 15 weeks.

I had my 12 week scan about a week ago results were good NT, 1.2mm, nasal bones present, but when the bloods came back the risk for downs is 1/235, (Tri 18 was 1/390) considering my age (41) this seems like a good result but the ob said they consider anything over 1/250 for ds as increased risk.

As the risk for a miscarriage in ds is about 1/250 I feel really torn about this test and now the anxiety it is concerning both me and my partner. In fact it's stressing us both out more than it should.

What are peoples experiences here? Please don't hold back if they're negative I need to know! Did you chose a level where you would have an amnio or did you take the obs advice? What were the results?

Thanks

I had an an amino at 21 weeks with DS2, but we knew something was wrong. It wasn't T21. In fact, he was chromosomally normal. Our risk with him was 1:6000 for T21. We'd decided we'd think about it if the risk was 1:300 or worse. I'm 38 now, so the risk level jumps up.

Given our history of loss, I'm reluctant to consider amnio unless there are other risk factors identified. It's a tough decision. What was the risk before the blood test? An OB we had for scans told me the bloodwork is only 10% of the final result.

Perhaps you need to discuss with a genetic counsellor before making the decison.

Btw, the amnio was painful but quick. For us, the grief was a compounding factor. I just breathed through it.

I'm not sure what the risk was before the bloods, I think it would be low based on the nt scan, however my age alone put me at risk of 1/90 (with no tests) so technically 1/235 is an improvement!

I have only been toldthe results this evening (ob rang me at home) and I haven't been able to relax since the call.

(Lionsandbears, that quote in your signature is one of my favourite Shakespeare quotes.)

If you're about 13 weeks now, you have time. I'd call the OB back tomorrow and ask for a referral to a genetic counsellor. Or call your state genetics service and ask for one. They're based at the main hospitals. In Victoria, it's VCGS.

An amnio can be done at any time up to birth. You may decide to wait to have a morphology scan first to see if something else is picked up. Or you may decide you'd rather know for sure sooner than later.

If you do have an amnio, ensure it's done by an expert OB who specialises in perinatal diagnoses. The general risk of miscarriage from an amnio is about 1 in 500. The experts should have a much lower risk.

Thanks, I think I will do that.

hi buggirl, sorry to hear you have some extra stress going on right now.

my risk for downs for this PG was 1:291. which is only just within the 'high risk' of 1:300 (might be different in vic?) & wasn't too bad considering i am 37. i didn't see a genetic counsellor (although i think that is great advice) because the dr that did my scan is a specialist & was able to talk through the situation with me in great detail (he even gave me his mobile number & said to call at any time if i wanted to talk). i also talked to my GP (i'm going public & hadn't been to the hospital at that stage so no ob). we decided to go ahead with a cvs (we got our results at 13 weeks) - even though the risk of a m/c was there i was compelled to know the answer, i didn't think i could relax for the rest of my PG without knowing.

i was the same as you - fairly good results from the scan but the bloods put the risk up. i found the procedure to be quick & not too painful. we opted to pay extra & get the FISH results that are back quickly, rather than just waiting for the full results that take about 2 weeks. our results were good & i felt like i could relax knowing we'd had the diagnostic test. it's not for everyone but i think i would have been a mess if i'd had to wait another 27 weeks to find out. whether or not you'd act on the results is another consideration.

one other thing - because the procedure does carry a risk of m/c, i chose to go private & have the same doctor who'd done my scan. he's head of perinatal surgery at a big hosp in melb & very experienced. it was expensive but i could get in quickly & felt comfortable with him. i also discovered that the risk of m/c depends on the person doing the procedure so it's worth asking what their rates/experiences are as you will find some of the doctors have never had a patient who has miscarried following the procedure.

:hug:

Hi Buggirl,

I was pregnant with DS at age 40 and we chose to have the CVS procedure, without even having the 12 week scan purely because of my age. I would have had the procedure regardless because at our age the numbers are always going to show high risk. That was just my personal choice. It's a difficult decision to have to make and I agree that you may benefit from speaking to a genetic counsellor for answers to alot of the questions that are going through your mind.

FWIW, and I'm no expert - your numbers look good for your age. Remember that you can have the best of results and still have a chromosomal abnormality present.

Hope you have a healthy and happy pregnancy.

Thankyou to all who have replied.

After a sleepless night and long conversation with my partner about what we should do (he is freaking out way more than I am), and a long chat with a close friend who is a doctor (who also did amnios for both her children - she was over 37) I think I’ll now be be opting for the amnio. I’m feeling as Sloane is, I don’t think I or my partner can relax until we ‘know’ for certain. The only way is the amnio.

I guess after looking at the actual numbers and the calculation they came up with I am actually feeling a little more comfortable about the fact that it really is just ‘a number’, and although on the borderline, you can never be certain of the result.

I’m feeling that it might actually bode well for me given my scan was excellent and presence of the nasal bones. Either that or I am just too damn positive for my own good.

Sorry to hear that you had a sleepless night, it can be such a stressful time making that decision to have/not to have the amnio. Now that you have made the decision I hope that things progress well from here for you. I think your positive attitude it to be admired, it certainly makes things easier to handle when you have a positive attitude. I hope the amnio goes well and I look foward to hearing back from you when your results come back. Take care.

i hope the amnio goes well & you feel a bit better now that you've made the decision.

i forgot to say as well in my original post that our result was a good one.

stay in touch :hug:

I had a 1/82 chance at 26yrs old with DD, based solely on my bloods, the scan was fine, but my bloods were very bad. we opted for the amnio just so we knew adn could be prepared. The result would not have changed my decision to continue with my pregnancy. this is a completely personal decision and is a very hard one to make. I found the procedure itself very painful, and as DD tried to grab the needle, my uterus had to be punctured twice which meant it was longer than normal as well. The results were all clear, and it really helped me to know where to go from there. Has your dr told you the blood tests can be an indication of other things as well? I was told the low PAPP-A and high HCG could also be an indication of a heart defect which was ruled out at 20 weeks, or could be an indication of placenta issues which were ruled out at 32weeks. I would definately talk to a genetic counsellor, and the advice to get the procedure done by an experienced specialist is really good advice as well. Goodluck with your decision and i hope whatever happens, you have the best possible outcome.

Thanks again all, I'm to have an appointment with the ob on the 15th and then I'll speak to him then about scheduling the an appointment with a counsellor and for the amnio (I have few more questions to ask first!) I'll let you know what happens later, and cross fingers all goes well.

Jen, yes I heard they were painful! But I'm a tough old nut so hopefully I can get through it. The Ob told me it was only DS they were concerned about as that was what the bloods indicated, everything else was okay (as much as the numbers will tell you!)

Hun glad you have decided to have the amnio for piece of mind we had the low pap A results and bad NT results we had a cvs and amnio both came back normal for chromosonal abnormalities our probem was a genetic issue which can not be tested for unless you know what your actually looking for so my advice would be still speak to a genetic councillor they are great but also those numbers are not so bad so try not to worry so much we had a 1 in 2 with Abbi who was effected with SLO and a 1 in 4 with Ella who was pefectly healthy.

Hi all,

Just a recap, had the amnio on Friday (17th) just got the call from my ob and he told me that all is good, no chromosonal anormalities detected with FSH - full results in a couple of weeks but I feel I can rest a little easier now (and finally tell my friends too.) Now I feel like I can start planning (even if its what I need to buy for the next couple of months so I fit into my clothes!)

Hoping and praying the rest of my pregnancy goes well!

Cheers, and hope that all of you are well too.

Buggirl - That is wonderful news! It's made my day infact. I remember the happiness and relief that I felt when I got that phone call. Did you find out if you are having a pink or a blue one? ;)

that's wonderful news :happyforyou: it is such a relief to get that call. i hope the rest of your PG is very boring :lol: