Elevated hCG from Triple Screen- am I really high risk??

[KarenMT]

I keep kicking myself for having the silly Triple Screen test. It came up with a slightly elevated hCG level and slightly lower estradiol level. This flagged me as possible Down's Syndrome. I went through all the hoops of having a level 2 u/s and then a stinkin' amnio only to find out baby is perfectly healthy. I am seeing a regular practice midwife in an OB office and plan to switch to a homebirth m/w in a month when I move.

So, my question- have any of you had this scenario of an elevated hCG not related to Down's and had your m/w say that you are now "high risk"? She said I would need to have a 32 week u/s to monitor baby's growth and then weekly non-stress tests- Hello? I have had a normal un-eventful pregnancy up to this point- no risk factors- no history of GD, preeclampsia, hypertension. I phoned my homebirth m/w and she said she would look at my records and speak with the OB that she consults with. Pretty much none of her clients bother with the Triple Screen and she said one could monitor growth and activity with other non-medical tests. (fundal height, fetal movements).

Anyone else ever deal with this?

Thanks,
Karen

[ReneeC]

I haven't had to deal with this, but I really hope it works out for you, mama.

It sounds to me like your OB office MW is just trying to scare you into keeping you as a patient. Since the Triple Screen is an optional test, I don't see how it could make you high-risk.

I hope you get good news from your HBMW!

[pamamidwife]

there are some studies that show a very, very low incidence of placental abruption and or uteroplacental insufficiency with high hcg levels in early preg.

the problem is that we're not sure if the placenta issues cause the higher hcg or vice versa - and we also know that it is very, very uncommon for the two to go hand in hand.

the risk of that happening is much smaller than any risk with routine early induction or cesarean.

[KarenMT]

Pamamidwife- thank you so much for your reply. I hope my hbmw is able to come to the same conclusion. I've been reading and reading numerous studies and such online and found a great one that sort of debunks a lot of the hysteria around this (basically studies from around 1992), stating that when momma's who do not have either GD, hypertension, or other high risk factors are removed from the study group- and only women with the elevated hCG are looked at - they find there is only a miniscule risk of any of these problems. Here is the link to the article: http://www.pslgroup.com/dg/1541A2.htm

I will play it safe and have the GD screen at 27-28 weeks and be more vigilent if any of the other risk factors start to crop up (ie. hypertension). I just get so worried as I don't birth large babies - I'm only 5' tall and my DD was 8 days late and only 6.5 lbs- and I'm sure they'll say baby is small for dates. I would just hate to have someone stressing me out and pushing me towards induction or c-section for something that doesn't really exist. I would never put baby at risk for a homebirth but I feel this is another example of using old studies and tradition to justify "management" of birth.

I'll be getting my medical records on Monday and faxing them to my HBMW so I hope she comes to the same conclusion.