Triple screen

[NYCVeg]

Now the quad screen, I guess. Dh and I were considering doing this, since it is non-invasive (to the baby, that is--I don't mind having blood drawn). Results would only be to give us some time to research/prepare if we had a baby with Down syndrome, spina bifida, whatever. However, I just read today, in Dr. Sears' Pregnancy Book, that 95-98% of the "positives" on this test are false positives (which is then confirmed by further testing). So...can anyone think of a good reason why one WOULD get this done? The false positive rate is so high that I'm actually astounded that anyone offers this test (well, except for the diagnostic labs, for whom it's probably a great money-making venture).

The only reason that seems plausible to me is that parents might want a negative result to make them feel less anxious during the pregnancy--but given that the test only detects 80-90% of cases of spina bifida and 60-65% of cases of Down syndrome, even this doesn't seem like an entirely compelling reason.

P.S. We are planning on getting one u/s at 18-20 weeks to screen for any problems and find out the gender. It sounds to me like most of the things that this test screens for would show up on u/s anyway, making it seem even more pointless.

I'm really curious as to what people think.

[Mamatoto2]

We debated about this with our first pregnancy. First of all, from what I understand, there is no "positive" or "negative" with this test, just indications about elevated or non-elevated likelihood of there being a particular abnormality. This information could give you the option of doing or not doing additional testing.

I consulted with DH and with my own parents (who I trust a lot) and what it came down to was that I woud rather know if something *might* be wrong and decide where to go from there than not know. Kinda like having an annual pap smear or mammograms. It's a screening, and "abnormal" or "atypical" results aren't definitive, but they can give you a head's up that something (or nothing) of concern may be going on, and you can decide how to proceed from there.

We're doing it with this pregnancy as well.

[LuckyMommaToo]

I didn't do one with my last pg and we won't with this one, either. I personally have three friends who have had false positives -- and then they want you to have an amnio.

We will do the 20-week u/s with a perinatologist. I guess I feel like that would uncover anything major.

My OB said an interesting thing about the triple screen last time. It was: "I used to think that parents were better off knowing in advance if something was wrong. But in my experience, I've learned that that's not necessarily true."

Anyway, good luck with whatever you and DP decide. Parenthood is full of tough decisions, that's for sure!
-Erin

[babydoll]

I am debating too

I did not want to get it last time because I had read about false positives and negatives etc. I had it last time and it was "within normal limits but the mother has a higher than average chance of Down syndrome for her age group". Well that did nothing but worry me and I chose to go for a level 2 ultrasound which was normal. My dd is normal.

I really don't want to have it done, but my doc really suggests it so I don't know.

Babydoll

[Peppamint]

I chose not to because I didn't want to end up with further testing because of a false positive. An amnio is more invasive for example. I'm just more of a take it as it comes person.

[NurseLaurie]

I asked my Mother-baby nursing instructor about this a few weeks ago. She is actually a midwife (CNM) and she said she has NEVER seen a positive test result in a Down's baby, and inversely, the only Down's babies she has delivered were from negative tested moms. Seems to me like a waste of time and energy... and some undue worry in the event of a positive. I guess we will just roll with the punches with this one, but I did decline the quad screen.

[Miranda 0710]

I had this test with DD#1. It came back positive for Downs. They then sent us to a specialist for "high risk" pregnancies. He did an in depth sonogram, and then told me that he can not diagnose Downs with a sonogram. He wanted to do an amnio (which increases the chances of misscarriage, and I have a history of misscarriages). Are you seeing the slippery slope you end up on if things come back other than normal? We declined and decided to hope for the best, but prepare for Downs. Fast forward 5 years. My daughter is 5 years old, healthy, normal and bright. I agonized about this all through my pregnancy unneccessarily. There are enough other things to worry about. Don't have this test done.

Miranda
Mom to 5 yr old dd, 2 yr old dd, and baby due ?end of May

[ChattyCat]

I refused it with ds and this pregnancy. There are so many false positives and the further screening if you get a false positive is an 18-20 week u/s and/or amnio.

I'm going (and did last time) to have the u/s anyway, so any big red flags should show up there. And, there's no way I'd have a 2nd trimester amnio, since the risk of m/c is 3-4% after that procedure. (FWIW- I have had a 3rd trimester amnio at 36.5 weeks, and the risks are different, and I found them acceptable.) So, for me the chance of having a possible positive/elevated score, just isn't worth it. If it came back high, I would just be stressed and worried the rest of my pregnancy. If something's wrong, something's wrong, and I can't really change it anyway.

Also, with IVF the false positives are even more common for some reason. I was reading some studies on PubMed about it.

[NYCVeg]

I did some further research and discovered that about 5% of women will test in the "abnormal" range for Down syndrome--but that 97.5% of these "abnormal" results turn out to be false positive. In addition, the test only detects Down about 60% of the time--so if you are having a Down baby, you still have almost a 50/50 chance that the test will not detect it at all. When dh heard about the 95-98% false positive rate, he got REALLY angry--as a former scientist-in-training, he's pretty annoyed that they even offer a test where the false positive rates are so high. It sounds like this test causes a lot of unnecessary anxiety.

Oh--I also read that the cost of follow-up tests if you do have a false positive can be up to $100,000. Nice. This was on a very mainstream medical site.

[momatheart]

we're not doing it

I agree with the previous posters who're not having it done. We believe that there's a purpose for this little life in my belly and that if there's some abnormality we'll deal with it when baby arrives. There are quited a few resources in our community for families with disabilities and I know how to access them.

Plus, I tend to try and be a super planner in the beginning of things, but in the end I don't ever feel better because I've planned. So during this PG, I'm trying to focus my energy toward avoiding a C/S and not worry too much about everything else.

Good luck in your decision.

[nitareality]

I agree with all of the reasons posted above to decline the test. I declined with my first pregnancy and have already informed my NP that we will be this time as well. Good luck with your decision.

[NYCVeg]

Honestly, it wasn't that difficult of a decision--we pretty much decided last night that we're not going to do it (although I will ask my mw if she thinks there's any deeply compelling reason to). I'm more interested in why people WOULD do it. I understand the peace of mind factor--but given the high false positive rate and the relatively big chance of a false negative, it just doesn't seem like it's offering that much peace!

[Guinevere]

Nope, have never had it...

It's my understanding, as well, that you need to be very sure of your dates, b/c most of the false positives come about due to testing when you're actually outside the "window" for accurate results. So if you're off by even a week in due dates, it can skew the results and cause a lot of needless worry.

Personally, I think there are so many issues with this screening that, instead of pushing this test on pg women, they would do far better to spend their time coming up with a more accurate and equally non-invasive screening.

I'm also one of those who watched her best girlfriend go through tears and sleepness nights waiting for amnio results because the screening came back abnormal. Everything was fine, but she'll never get those two weeks of hell back. She refused the test in subsequent pg's.

Guin

[Throkmorton]

We didn't do it either. The one person I know who has a down's child got a negative.

[KatSG]

Originally Posted by Mamatoto2

We debated about this with our first pregnancy. First of all, from what I understand, there is no "positive" or "negative" with this test, just indications about elevated or non-elevated likelihood of there being a particular abnormality. This information could give you the option of doing or not doing additional testing.

I thought this was worded so well it was worth repeating. In defense of this test, it's not diagnostic and doesn't pretend to be. It's a "first step" for people who are weighing the risks of an amnio or CVS, which is the only way to diagnose problems prenatally. The way we approached it, is we went into it knowing that we didn't want to have an amnio unless there was something nudging us in that direction. If we had a low risk result, we knew we weren't in the clear, but if we'd had a high risk result, we would have considered an amnio. For us, it just gave us more information to help us weigh our options. We'll likely do this test plus the neuchal fold amnio.

[peypeymama]

My sister had a false positive with her first ds. She spent her entire pregnancy worrying. This was after the "super sonic" ultrasound tech ruled out Down's (head shape, nasal passage size, etc). He came out fine and is a perfectly happy, healthy 2.5 yo.

When I declined the test during my first pg, my MW said, "Oh, good. It's not very reliable anyway."

Save yourself the anxiety.

[tiffanyrk1786]

We didnt get it with either previous pregnancy and declined it this time too. Too many false positives and I was told with both of my previous pregnancies, if you get a positive they want to do an amniocentesis.. wtf??? thats a definite NO in my book lol..

[quirkylayne]

I'm not doing it. As far as I know (and I haven't done any research) the only way to find out for sure after having a "positive" is to do an amnio to get a karotype, and I'm not doing that.

[Mama2RMM]

We didn't do it with Rach and have chosen not to with these babies either. Our first midwife, and even my OB this time, didn't bat an eyelash.

[eorr]

Not planning on any of the voluntary testing here, and trying to figure out how to refuse other interventions as well. It just isn't worth it, in my book, and I don't need any more reasons to feel nervous or sick!!