crappy quad screen with normal u/s...ugh!

[tzs]

so first of all, i normally don;t do much in the way of prenatal testing. i only do ultrasounds if medically necessary and avoid tests that cause unnecessary worry. now i know why!

so first off, i agree to let my OB do a quad screen with the caveat that he keep the results to himself and he can look at the numbers any way he wants. he really likes to test so i just thought i'd throw him that bone. i did the same with dd and it worked out fine. 

i also do a 20 week u/s with a perinatologist because i take a class C medication so it's specifically to check for heart defects and cleft palate.

anyway, did u/d today and it was 100% fine for everything including downs markers. but then he breaks it down for me afterwards (suspicious b/c he didn;t do this for dd) and there he has the quad screen results that put my risk for downs at 1:10.

great. freak me out.

apparently downs is missed in 80% of ultrasounds.

but on the "bright" side. the markers of the quad test that were elevated could also indicate placental issues such as preeclampsia and low birthweight. and with dd i had HBP bordering on preeclampsia and she was born post-date at only 5lb 13 oz. she went from 5% weight to 50% in a month. when i asked the OB what could have caused such a low birthweight all he could come up with was not-so-great placenta.

so im not really 100% sure what my question is. i guess it's....does anyone have experience with abnormal quad screen levels and placental issues (no downs)????

p.s. i'm not doing an amnio to follow up but we are doing another u/s in 2 months

[Aliy]

i have no experince with this... but wanted to offer a hug. stress like this is no good

[tzs]

thank you so so much

i go from totally rational/ok with it to totally freaked out by the minute. and mad because they told me the results and also mad because i let them do the test in the first place. poop.

[SoonToBe]

No experience to offer, but I did want to tell you that everything I have read says that the majority of "positive" screenings or whatever, result in a totally normal baby.  Like you said, there are other factors that can impact the levels of some of the markers.  Chances are very good that all is totally fine.  Even if that were an accurate result, that means you have a 90% chance of things being fine.  In reality, it's even higher because most "positives" are false.

Good luck.

Bree

[Italiamom]

I just posted about this recently in another thread.  But I've had 5 friends in the past few years who've had abnormal results on that stupid test.  And all 5 of them have perfectly healthy kids.  I'd also be VERY wary of the statistic in regards to the ability of an ultrasound to detect downs.  Where did it come from, and how old is it?  I can see that, no, there wouldn't be 100% accuracy, but considering the things they CAN measure and detect via ultrasound nowadays, an 80% failure rate seems pretty ridiculous, actually.

Also edited to note: You've got my sympathies mama.  That has to be outrageously stressful

[tzs]

well, the 80% came from the perinatologist...the top dog. apparently you can have a baby that shows no physical signs of downs, even at birth, and then markers start appearing a month or so later at the pediatrician.

i did just read a wikipedia explanation, of all things, that really put the statistics into perspective and chilled me out a little.

[Bird Girl]

Yes, 1 in 10 odds still mean that your chances of having a baby that does not have Down's are 90%.

Really, the Quad screen just exists in order to screen women for amniocentesis. It just tells you whether your odds of benefiting from further screening are higher or lower than your risk of miscarriage.

If you wouldn't change your behavior no matter what the amnio might show, there's no reason to worry.

[AngelKissedKids]

Quote:

Originally Posted by tzs 

but on the "bright" side. the markers of the quad test that were elevated could also indicate placental issues such as preeclampsia and low birthweight. and with dd i had HBP bordering on preeclampsia and she was born post-date at only 5lb 13 oz. she went from 5% weight to 50% in a month. when i asked the OB what could have caused such a low birthweight all he could come up with was not-so-great placenta.

so im not really 100% sure what my question is. i guess it's....does anyone have experience with abnormal quad screen levels and placental issues (no downs)????

Hi tzs,

My IPS testing came back with a really low PAPP-A (below the 5th percentile) which indicates likely problems with the development of my placenta and puts me at higher risk of placental related complications (more likely to experience fetal loss at less than or equal to 24 weeks, low birth weight, preeclampsia, gestational hypertension, preterm birth, and stillbirth, preterm premature rupture of membranes, and placental abruption).  The most informative article I have found about low PAPP-A can be viewed here if you're interested:  http://www.healthline.com/blogs/pregnancy_childbirth/2007/09/low-pregnancy-associated-plasma-protein.html  Thankfully, this doctor states that "low PAPP-A levels are not only associated with certain fetal chromosomal abnormalities, but also with an increased risk for a poor pregnancy outcome. BUT, despite this association, the positive predictive value of a low PAPP-A for one of these outcomes is still relatively low. That means the chance of one of these events is higher with a low PAPP-A, but you shouldn’t panic at the outset that something bad is going to happen".  I'm trying not to panic but I'm certainly very worried given my history!  From the sounds of it, your history might warrant a little extra worry too if you've previously had possible placental issues.

My midwife has me set up to have bi-weekly biophysical profiles and fetal dopplers starting at 30 weeks to keep a close on the baby.  I'm sure some people would find that overkill but it gives me great peace of mind since my previous babe was born at only 33 weeks gestation due to PPROM and possible preterm labour, with evidence of the start of placental compromise.

Unfortunately my anatomical u/s revealed 2 soft markers so we're also dealing with the risk of downs and other trisomies.  We've opted not to have an amnio done since I don't want to further increase my risk of PPROM.

Good luck and best wishes for a healthy uneventful pregnancy!