1st Trimester Screenings? - Mothering Forums

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#1 of 40 Old 11-15-2014, 03:24 AM - Thread Starter
 
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1st Trimester Screenings?

This is my first pregnancy being of "advanced maternal age" and I'm not very familiar with the newer types of screenings available.

I saw someone mention screening in the roll call (due date) thread.

What, if any, will you be doing? What's available?

Mama
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#2 of 40 Old 11-15-2014, 08:46 AM
 
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I won't be doing any screenings except a 20 week US to check for any major abnormalities. But there is a new one out there called the Verifi test by progenity that checks for trisomies (trisomy 18,21, 13) Turner's and Klinefelter's as well as a host of other chromosomal abnormalities and you can also check baby's gender with this anytime after 10 weeks. You can google itThere's also one you can do if you're Rh negative to check baby's blood type so you know if you need RhoGam and that one can also test baby's gender. These are both blood tests.

Here's a link to progenity's site for more info: http://progenity.com/non-invasive-prenatal-testing.

I think the max cost is $200 if your insurance won't cover it.
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#3 of 40 Old 11-16-2014, 07:21 AM
 
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I think we will be doing the Harmony or Verifi for peace of mind (my son has Down syndrome) however the result will not likely make a difference about whether or not we have a baby in July. I am very at peace about the whole thing. If anyone has questions about what having a child with Down syndrome is REALLY like (not the scary stuff you read on Wikipedia, in most cases anyway) feel free to PM me. Our son is absolutely wonderful and at almost 2 1/2 is a major stinker. He talks and walks and is extremely healthy and smart.
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#4 of 40 Old 11-16-2014, 09:05 AM - Thread Starter
 
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I think we will be doing the Harmony or Verifi for peace of mind (my son has Down syndrome) however the result will not likely make a difference about whether or not we have a baby in July. I am very at peace about the whole thing. If anyone has questions about what having a child with Down syndrome is REALLY like (not the scary stuff you read on Wikipedia, in most cases anyway) feel free to PM me. Our son is absolutely wonderful and at almost 2 1/2 is a major stinker. He talks and walks and is extremely healthy and smart.
I asked you in another thread which test you were going to do. These are the two I've heard about. Do you know what the differences are between the two?

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#5 of 40 Old 11-16-2014, 10:58 AM
 
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There's panorama and materniT21, too. They are all quite similar from my quick Google search results.
I just turned 35 and am considering...but on the other hand I live abroad and not sure what is available...
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#6 of 40 Old 11-16-2014, 11:05 AM
 
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I'm interested in these tests as well. We had a huge scare with my third pregnancy and dh is terrified of something happening again. It was a long, horrible month, of testing and amnios and ultrasounds. Seems like this could clear it up in one simple test.

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#7 of 40 Old 11-16-2014, 11:17 AM
 
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My last pregnancy I had genetic counseling and the nuchal screening. I was planning on doing that again (my cousin has CF and I'm a carrier). These tests look interesting - I'm wondering what the differences are in the tests. Sounds like some light reading...
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#8 of 40 Old 11-17-2014, 05:53 AM - Thread Starter
 
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I don't have the brainpower right now to do the reading. I bet there's a handy chart somewhere....I'm going to look around...

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#9 of 40 Old 11-17-2014, 06:49 AM - Thread Starter
 
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Not easy to find comparisons! So far, I've found this one, with a handy-dandy chart.

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#10 of 40 Old 11-17-2014, 07:24 AM - Thread Starter
 
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This article is interesting as it explains that it isn't fetal cells that are tested in the mother's blood but placental cells.

This can result in false results:

Quote:
In one of the presentations, the presenter explained how a patient had received a positive NIPT result that ultimately was found to derive from what’s called “placental mosaicism.” “Mosaicism” occurs in the case of triploidy where there is a triplicate of a chromosome in some, but not all, of the cells. In placental mosaicism, the placenta can have cells with triplicates of chromosomes while the fetus does not have any triplicate chromosomes in its cells. Indeed, the diagnostic test that can be performed in the first trimester, chorionic villus sampling (“CVS”), tests placental cells, and has returned results of Down syndrome even when the fetus does not have Down syndrome, because the particular placental cells tested had a triplicate of the 21st Chromosome.

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#11 of 40 Old 11-17-2014, 01:29 PM
 
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You can also get false negatives, but they're pretty rare. I know hundreds of families of kids with Ds and I do know TWO moms who got a negative result on MaterniT21 and they did indeed end up having a child with Ds. So the tests are not infallible. No test is.

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#12 of 40 Old 11-17-2014, 08:33 PM
 
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1st trimester screenings

Hi Mamas!

The tests you are referencing are all called cell-free DNA testing. It is able to differentiate maternal DNA from fetal DNA from the placenta. The tests listed above are different companies that offer the test. I believe that individual OB practices typically work with certain companies/labs. I don't know if you can pick your own. I work with an HMO group in an OB/midwifery office, so lack of choice could just be part of my setting, if you are going through insurance. The test is just a screening, so if it's positive and you want confirmation, they typically recommend amnio or cvs.

My first pregnancy I didn't do any testing besides the 20 week anatomy scan...now that I have a child my decision-making feels different. I anticipate having a baby in July, but feel strongly about having more information this time to prepare. Now I'm feeling protective of 2 babies, I guess!
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#13 of 40 Old 12-02-2014, 07:15 AM - Thread Starter
 
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I'm reconsidering my initial thoughts on the chromosome tests after reading a mama's story in the December DDC.

After getting positive results from a MaterniT21 screening, she went on to have an amnio and began leaking fluid from that point on. Ended up on bed rest IN the hospital from something like 23 weeks onward (when her membranes fully ruptured.) Ended up holding on to her babe until 31 weeks, iirc and she seems to be healthy, afaik.

I read one of her posts where she said something like: All because of the MaterniT21 because I wanted to find out the gender.

Eek.

And then there are the stories of the mom's whose babies were scarred by the needle during the amnio (one mom told that story, how her son was born with a large scar across his lower back) and others who lost their babies after amnios - some of whom were found NOT to have chromosomal abnormalities after all.

That's a lot to think about....

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#14 of 40 Old 12-02-2014, 07:58 AM
 
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Well, I am only getting the maternal blood draw. I won't get an amnio... I would get a high level sonogram if needed to check something out but my reasoning for the test is that we homebirth. If I were to be carrying a baby with DS that could have a host of problems (one that is in my thoughts is heart issues) I would want to know what to expect so I could evaluate my birth choices. I would consider a hospital birth (and even then my hospital choice would change depending on the severity etc...)

Theblood test is not invasive to the baby at all and the results are really accurate. just my reasoning.

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#15 of 40 Old 12-15-2014, 03:38 PM - Thread Starter
 
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I'm supposed to schedule this for 2 weeks from now and I'm so torn!

Has anyone seen this article about how inaccurate the chromosomal screenings are?

I almost feel like I'm asking for trouble by doing this screening (and the nuchal translucency screening.) The lab I go to uses MaterniT21 Plus, the same screening the woman in the article used.

It was simpler when we didn't have all of these options.

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#16 of 40 Old 12-16-2014, 03:56 PM
 
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Originally Posted by Metasequoia View Post
I'm supposed to schedule this for 2 weeks from now and I'm so torn!

Has anyone seen this article about how inaccurate the chromosomal screenings are?

I almost feel like I'm asking for trouble by doing this screening (and the nuchal translucency screening.) The lab I go to uses MaterniT21 Plus, the same screening the woman in the article used.

It was simpler when we didn't have all of these options.
I did see that, and talked to my midwife about it at my first appointment today. She said that in her opinion it's true that if you get a negative it's about 99% accurate but if you get a positive about half of those are false and worry parents unnecessarily, so while she's happy to refer me if I decide I want it (they don't do it in-house) she doesn't push it and a majority of her clients decide not to. After speaking with her about some of the implications if we did have a baby with a trisomy I've decided to only do the 18-20 week anatomy scan, and I'm feeling comfortable with that. It would be a relief if we got the test back with a negative but at least in my mind it's not worth the risk of a pregnancy's worth of worry if we got a (potentially false) positive because in any case I wouldn't be willing to risk the pregnancy to confirm with an amnio.

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#17 of 40 Old 12-18-2014, 07:31 AM
 
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MaternT21 and Panorama aren't covered here and cost a lot out of pocket. We're doing the blood screening + NT scan, which I know has a fairly high false positive rate of flagging elevated risk. I'm not sure what we'll do if we come back as positive on that.
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I've already scheduled the NT and blood screening. I'm pretty worried about false positives.

I only did the 20 week level 2 scan with my son. So this is new for me. I know what ever happens I'm not willing to risk amino.

I am just hoping for good news and will just deal with everything else as it comes.
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#19 of 40 Old 12-22-2014, 06:06 AM - Thread Starter
 
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Just scheduled my nuchal screening + MaterniT21 Plus for January 2nd. Gulp.

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#20 of 40 Old 12-22-2014, 06:19 AM
 
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Just scheduled my nuchal screening + MaterniT21 Plus for January 2nd. Gulp.
Can I ask what made you decide to do it?

I have my kit sitting here waiting for me.

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I'm only able to do the blood /ultrasound nuchal fold thingy, around now (blood test done, ultrasound measurements coming in a week), but I wish they had the materniT21 in the country I live in!
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#22 of 40 Old 12-22-2014, 01:01 PM - Thread Starter
 
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Can I ask what made you decide to do it?

I have my kit sitting here waiting for me.
I don't know. I'm still second-guessing my decision, like I'm inviting trouble. I guess I'm hoping for a good result so I can relax and enjoy and if I didn't do it, I feel like I'd wonder the whole pregnancy if there's something wrong. If there's something wrong, I'd want to know sooner rather than later. My concern is the false-positives. On the sheet they gave me, it says false-positives occur less than .1% of the time for MaterniT21 Plus. I feel like from what I've read here on MDC, it's higher than that.

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#23 of 40 Old 12-22-2014, 02:12 PM
 
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I don't know. I'm still second-guessing my decision, like I'm inviting trouble. I guess I'm hoping for a good result so I can relax and enjoy and if I didn't do it, I feel like I'd wonder the whole pregnancy if there's something wrong. If there's something wrong, I'd want to know sooner rather than later. My concern is the false-positives. On the sheet they gave me, it says false-positives occur less than .1% of the time for MaterniT21 Plus. I feel like from what I've read here on MDC, it's higher than that.
I totally understand what you mean.... will you relax and trust it with a negative? Please forgive my questions... I amin the same emotional, undecided boat.
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#24 of 40 Old 12-22-2014, 02:20 PM - Thread Starter
 
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I totally understand what you mean.... will you relax and trust it with a negative? Please forgive my questions... I amin the same emotional, undecided boat.
Yes, I think I would.

And I know that just because I'm 37 (will be 38 next month) that I'm not magically unable to create a healthy baby...but I guess it's the medical pressure that leaves me with the what-ifs.

I really want as much info as possible before I tell my kids but I don't know how much longer I'll be able to "hide" it (I use quotes because I look like I swallowed a cantaloupe right now...)

Would you mind sharing what's on your mind in regards to the screenings?

Mama
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#25 of 40 Old 12-22-2014, 02:30 PM
 
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I think just false positives and having to wait to find out? Or a false neg. I don't know... I wonder if the "knowing" is really worth the stress. ..it seem odds of a false neg are pretty slim. And I will be doing the 20week sono. I like to see where the placenta is and just see everything... I don't know. Midwife is out of town for Christmas. I could wait and call her for a long chat... I bet she would say skip it. I am 40, had a baby at 38, 36 and 34. All great pregnancies and very healthy babies. I don't know. Lol
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#26 of 40 Old 12-23-2014, 04:56 AM - Thread Starter
 
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I've scheduled the nuchal scan for the same time as the MaterniT21+ which includes a u/s. I'm not entirely comfortable with a u/s and if the baby is clearly trying to get away from it, I'll ask the tech to stop.

Between the nuchal and theMaterniT21, I think I'd feel secure in a negative.

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#27 of 40 Old 12-23-2014, 05:50 PM
 
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I don't know. I'm still second-guessing my decision, like I'm inviting trouble. I guess I'm hoping for a good result so I can relax and enjoy and if I didn't do it, I feel like I'd wonder the whole pregnancy if there's something wrong. If there's something wrong, I'd want to know sooner rather than later. My concern is the false-positives. On the sheet they gave me, it says false-positives occur less than .1% of the time for MaterniT21 Plus. I feel like from what I've read here on MDC, it's higher than that.
I read an article about these tests that basically said that when independent testing was done, the actual false positive rate was much higher than the companies who offer the tests claim it is. In the independent testing it also didn't catch a couple samples they sent in from non-pregnant women (gave them negative results and said they were having girls.) The 1% rate was about right for false NEGATIVES, but if you got a positive result then about 50% of those were false. So basically you can reasonably trust a negative result, but you can't trust a positive result at all which is why it's considered a "screening" test and not a diagnostic test, and that's why we ultimately decided not to do it.

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#28 of 40 Old 12-24-2014, 06:52 AM - Thread Starter
 
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I read an article about these tests that basically said that when independent testing was done, the actual false positive rate was much higher than the companies who offer the tests claim it is. In the independent testing it also didn't catch a couple samples they sent in from non-pregnant women (gave them negative results and said they were having girls.) The 1% rate was about right for false NEGATIVES, but if you got a positive result then about 50% of those were false. So basically you can reasonably trust a negative result, but you can't trust a positive result at all which is why it's considered a "screening" test and not a diagnostic test, and that's why we ultimately decided not to do it.
Right, right, I read that article too. I remember the part about them sending in the samples from non-pregnant women - yikes.

I'm really on the fence the most about the u/s. There's so much conflicting information out there (or really, not enough to really make an informed decision) and to add one more seems a bit much.

I do feel like with the nuchal + MaterniT21+ that the combined results will be more telling.

I just want to know as much as I can, that everything is okay before I tell anyone - mainly my children.

Mama
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#29 of 40 Old 12-27-2014, 05:43 AM
 
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None. Like always. I am 'ama' too, at 40. Not gonna get on the treadmill.

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#30 of 40 Old 12-28-2014, 09:38 AM
 
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I am not advanced maternal age but my midwife suggested the harmony screening test. However, my insurance doesn't cover it unless you are 35 plus or have another compelling risk factor, so I will just be doing the NT scan and associated blood work. Then, if that comes back abnormal , my insurance will pay for the harmony test.
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BBardott , Boodah'smama , Deborah , eastbaymama , hillymum , jamesmorrow , JElaineB , Lady49 , legitd , lisak1234 , MarylandMommy , moominmamma , MountainMamaGC , olive&pimiento , redsally , Riostpaloma , RollerCoasterMama , rubelin , sarrahlnorris , zannster , zoeyzoo
Most users ever online was 449,755, 06-25-2014 at 12:21 PM.