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Quad Screen

post #1 of 23
Thread Starter 

Sooo... never bothered with the quad screen before. This time, I just went without much thought other than remembering the insanely high rate of false positives, that it is just a screening (odds) deal and not diagnostic in any way, and if it comes back with not so great news- I am going into it in the first place with that being probable, JUST because of my age (41).

 

Did get that call from my MW yesterday - "positive for Down Syndrome."  

 

I did do research before on the quad screen. I did more since yesterday morning.  And I think this "test" is a joke. 

 

What IS the point of continuing this practice? Is it because it funnels MILLIONS of dollars into more expensive testing moms with healthy babies would not otherwise have, if the quad screen didn't scare the crap outta them that is?  Like amnio, higher level u/s, etc...  Because the next step after a funky quad result is always... "further testing"....

 

I am not sure yet what my "odds" were calculated out to be. But I have learned that many women my age, who have an average 1 in 85 chance of having a child with DS ... when taking the quad screen end up with a "positive for DS" result because the cut-off for Down is 1 in 385 with the quad screening.

So, if say, my "positive" for DS is 1 in 150 chance with the quad, I'll take THOSE odds over my general textbook, going only by age, odds of 1 in 85!

 

From a prenatal testing, medical website:

"The screen positive rate varies for the different tests and for women of different ages. However, for all tests and all age groups, the majority of women who screen positive have an unaffected pregnancy."

 

The "majority" of women have unaffected pregnancies. But test positive for a problem. From what else I have learned, the tests do end up catching most of the true problems, because they cast their "positive for X problem" net soooo wideeee - it is hard for them to miss - therefore they can claim super high rates of "accurate detection of problems." Which is great for the 1 out of 1,000 families with a true issue - but just forget about the other 350 families who were also "detected" (inaccurately) yet have perfectly healthy babies.  (Phhhssh.)

 

It is just crazy - this "test."  !  

Ok. Rant over. 

I just wish my youngest child was not home when I got the call. Trying to explain the overheard, "your test was positive for Down Syndrome" to a 12 year old has been almost impossible!  Explaining "screening" vs. "diagnostic" testing, etc etc etc...  ACK!  Honestly - THIS has been the hardest part of ever having made the mistake of going for the quad bloodwork!

 

Level II ultrasound in 12 days ...  can't wait!  :)  Wish I had just stuck with what I have always done.  No unusual testing, just the anatomy scan around 20 weeks. 

 

Rachael

DD, 15y

DS, 13y

DS, 12y

New Baby 12/9/13 

post #2 of 23
Sounds to me like "positive" is a very misleading way to phrase the result.

I probably had the quad screen with my first two, because I went along with whatever they offered, but I don't even remember and I haven't had it since. With this baby, I'm giving birth a hospital with a good NICU anyway, just because it's the hospital I like, so I don't see a need to worry about anything that doesn't change the way I'm going to handle my pregnancy.
post #3 of 23
Thread Starter 

Yup. I totally agree.

It smacks of MARKETING to me.

Because there is nothing "positive" about A SCREENING.

But when put that way, I can understand how couples could be scared into going on for more and more testing. Rather than if the truth of the screening (no matter what the results) where stated instead of "your results are back - positive for Down Syndrome."

Really shitty system.

 

My research brought me to a great little article on the Dr. Sears website:

http://www.askdrsears.com/topics/child-rearing-and-development/down-syndrome/how-frequently-does-down-syndrome-occur

At age twenty you had a 99.95 percent chance of not delivering a baby with Down syndrome; at age thirty-five your chances of not delivering a baby with Down Syndrome are 99.75 percent. Doesn't that figure sound more reassuring? This is why, in my opinion, the "thirty-five-year-old scare" is too young, forty-five perhaps? Even at age forty-five you have a 97 percent chance of delivering a baby without Down Syndrome.

 

Rachael 

post #4 of 23
My quad screen also came back posivite for downs. Im surprised they didnt give you your number. Mine was 1 in 13. Freaked myself and my husband out. Our level II scan is Tuesday morning followed by an amnio if needed. Honestly after nerves settled and I got more info, 1 in 13 is a 10% chance. That is a 90% chance everything is fine. Put like that it doesnt sound at all like we are positive for downs, just that our risk is a little higher than the normal risk. I will never have this test done again.
post #5 of 23

hugs ladies. There is a HUGE amount of false positives with that test...

post #6 of 23

Is the quad a different kind of diagnostic than the 21 noninvasive blood test? Or is it the same? I really wanted to do it for the sex prediction! But maybe its not worth the risk of worry after all. Also, is every pregnancy different, or would a "positive" result in one pregnancy up the chances of it in the next? And, I'm terrible with numbers, so I'm not sure how to really understand Dr. Sear's stats: his 97 percent chance of delivery a baby without Downs mean that for every 100 births in women aged 45, about 3 have a baby with Downs? That sounds like a birth stastistic, but isn't it the case that somewhere around 70% of pregnancies diagnosed with Downs are terminated? Wouldn't that change the stats for birth quite a bit? Its all so confusing...

post #7 of 23
Thread Starter 

Quad screening is not "diagnostic" in any way - it is only a screening that gives you "odds." It looks at, in the mom's blood:

  1. Alpha-fetoprotein - a protein produced by the liver of the fetus.

  2. Unconjugated estriol - a protein produced in the liver of the fetus as well as the placenta.

  3. Human chorionic gonadotropin - a hormone produced in the fetal placenta.

  4. Inhibin-A - also a hormone produced in the fetal placenta.

 

Also factors in mom's age, weeks of pregnancy, etc...   But factors such as smoking, certain health conditions, size of placenta can all effect the results.  

After my experience, and all the research I have done, I think this is just a very not worth it out of date practice.  If I want "odds" of having a baby with any particular condition, I can just go online and do a good job of scaring myself. This screening does not have much to do with the unique baby you happen to be carrying. Other than the bloodwork part, and again- so many factors can effect the lab's interpretation of those numbers.

 

So - I am not sure which blood test you are referring to - but it does not sound like the quad screening (which used to be, and is still offered as the triple screening - same as quad just without Inhibin-A).  

 

In no way can either of these screenings tell you gender.

 

I HAVE heard that a "positive" during a past screening does increase your chances of having a "positive" result in the future. And again - this has NOTHING to do with the individual babies you are carrying! 

 

And Dr. Sears -- it was just a better/different way of breaking down the "odds" you get from these screenings.  Sounds VERY scary when you hear you have a 1 in 100 chance of having a baby with x issue.  He is saying it is better to hear you have a 99% chance of all being well!  ;)    And all this means is -- for every woman like you, who has a baby, 1 baby out of 100 will have the issue in question.   

The national average is 1 in 700-800 babies are born with Down Syndrome. 

Put another way - there are approx 400,000 people who have DS in the USA.  And overall, there are about 313.9 MILLION people in the USA.

 

Most pregnancies that are DS affected end in miscarriage.  And the number for termination after prenatal diagnosis is as high as 90%.  (I have opinions on this, but I will keep them to myself. ;) Suffice to say, unless life threatening, we would not "terminate".) 

 

Numbers, stats, screenings, tests....... ACK!!!!  Like I said - I WISH I never dipped a toe into the world of this crap!  Going forward, I'm doing things as I always have - trusting God, myself and my baby -- and all has gone perfectly well so far - many pregnancies and a homebirth.  DETEST the medical management of women and babies! 

 

Rachael 

DD, 15y

DS, 13y

DS, 12y

New Baby 12/9/13 

post #8 of 23
I agree Rachael, and we are in the same boat as you. If its not fatal, were not terminating. Although I dont judge others for their choice, after all we all can only handle certain things.
post #9 of 23
Quote:
Originally Posted by roisin32 View Post

Is the quad a different kind of diagnostic than the 21 noninvasive blood test? Or is it the same? I really wanted to do it for the sex prediction! 

You're referring to the newer Materni T21. It's still fairly new and very expensive but it is suppose to be a much more sensitive test and it has a lower rate of false positive than the older Quad screen. It screens for the 3 big chormosomal disorders-trisomy 13, 18, and 21. And it can detect gender as early as 10 weeks.  

post #10 of 23

Yes, Trish, that was the one I was talking about. After the info gleaned here, though, I think I just might not fork over the $200 not covered by insurance. I'm not worried about chromosomal disorders- if we had a baby with one, we would welcome and love it (and I would probably become a disability-rights activist mama, haha). Of course I couldn't judge individual cases- not my place, but I can say that if its true that up to 90% terminate for disability, that is tremendously sad, on many levels. I'd like to be able to get connected and prepared, like I said, but listening to all of your experiences right now I'm thinking to just opt out of the testing system.    

post #11 of 23
Thread Starter 

I say - research it more!  I am DONE with all this testing crap.  Like I said - never did it before, and with just one test I know why!

That said - the new test you are talking about -- it is more diagnostic.  I believe it tests fragments of the baby's DNA that are floating in mama's bloodstream (that is why you can get gender).  Which is more a for sure than just "your odds are" freak you out kinda test.

 

I am with you - totally - regarding how I would probably be with a child who had different needs, and all the rest.  

 

Rachael 

post #12 of 23
Thread Starter 

STEPH -- Let us know how the u/s goes!

And I am with you - focus on THE POSITIVE.  Which does not seem to be the way with the medical community, at all.

 

Rachael 

post #13 of 23
Ultrasound was normal! I am measuring 8 days behind so that is likely the major cause of the abnormal numbers. I am so happy for this news. I will never do that stupid test again.
post #14 of 23
Quote:
Originally Posted by Stephaniqua View Post

Ultrasound was normal! I am measuring 8 days behind so that is likely the major cause of the abnormal numbers. I am so happy for this news. I will never do that stupid test again.

So glad everything is fine! smile.gif
post #15 of 23

That is such great news, Stephaniqua!

post #16 of 23
Got the call today...quad screen came back with a 1 in 85 chance that baby das DS. Hugh!
post #17 of 23
Quote:
Originally Posted by Stephaniqua View Post

Ultrasound was normal! I am measuring 8 days behind so that is likely the major cause of the abnormal numbers. I am so happy for this news. I will never do that stupid test again.

That is fantastic news! I'm so happy for you that you can be reassured now.

 

And scary that just being 8 days behind would cause an abnormal result. My best friend had an "abnormal-possible Down's Syndrome" result with this test, and you know what caused it? Twins! Two perfectly normal, healthy little babies in there causes her and her dh all that stress and worry over an abnormal test result. With a better test available I don't get why they even still offer this one.

post #18 of 23
Thread Starter 

I WHOLEHEARTEDLY AGREE with you, Trish!!

 

STEPH -- VERY HAPPY TO HEAR YOUR NEWS!!!!  :)  :)   :)

 

Had mw appointment last week, learned my "odds" are 1 in 58.  Which is still less than 2% chance.

 

Level II ultrasound appointment TOMORROW!!  Cannot wait!!!!!

 

Rachael

DD, 15y

DS, 13y

DS, 12y

New Baby 12/9/13

post #19 of 23
Good luck Rachael!!! And thank you everyone!
post #20 of 23

Oh what an awful rollercoaster. 

I like to know more than less, but I agree, they worded it poorly for you!  ANd I love the stats from Dr. Sears!  

I'm glad it worked out in the end though!

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