Did you do first trimester screening? - Mothering Forums

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#1 of 44 Old 10-26-2010, 11:42 AM - Thread Starter
 
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At my midwife appointment on Friday, she offered this--it included the NT scan and some bloodwork. She told me that the ONLY drawback to this screening was that if two of the things in the bloodwork (sorry, can't remember the technical terms) came back high--one saying you're higher risk for preeclampsia and one saying you're higher risk for IUGR--you can't deliver in the Birth Center of the hospital--you have to deliver in L&D. I opted against having it done. Even if, later in pregnancy, you still show no signs of pre-e or IUGR, you still can't deliver in the Birth Center based on those two tests from the first trimester. I wasn't comfortable with that because, on the off chance those tests DID come back abnormal... well, that would just really suck!

I know they are screening for Downs and some other things, but I figured it wasn't anything we absolutely HAD to know, since we won't terminate anyway.

Just wondering if others did or didn't choose to have this screening?

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#2 of 44 Old 10-26-2010, 11:47 AM
 
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i really struggled with whether or not to have it done considering i have no idea what i would do with the information.

i decided to do it. had my first blood draw two weeks ago and my NT scan is scheduled for this morning.

the screening was recommended due to my "advanced maternal age" and honestly, i had a really disturbing conversation with the midwife at my doctor's office who pretty much said if anything is wrong with the baby i should terminate. left that appt feeling pretty uncomfortable. like i said i don't know what i will do with the information. i guess i'm hoping everything will come back ok and i'll be able to relax.

i know that false positives are common and will likely just cause a lot of unnecessary worry. oh well, we'll see what happens.

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#3 of 44 Old 10-26-2010, 11:54 AM
 
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That's crazy that they would risk you out even if later on you weren't showing signs. Aren't these tests pretty fallible? I've read too many stories of false positives to put much stock in them. My mws don't push it, and I would decline even if they did. The stress is not worth it, and even if it came back normal I don't know that I'd trust it. Anyway, that's just me. Like you, I wouldn't terminate anyway. I do get an u/s somewhere around 20wks. They can check/rule out a lot of things with that, especially if you use someone highly trained.

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#4 of 44 Old 10-26-2010, 12:02 PM
 
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DDCC-

I had the NT done at 12 weeks and came back high-risk for Trisomy 18 and IUGR. The numbers for the trisomy were so high (about 1:4) that we felt compelled to have CVS testing, which did come back negative, but certainly caused us a lot of stress.

Since then, I've shown no signs of IUGR. In fact, my baby was measuring "2 weeks ahead" at my most recent ultrasound. My mws are not concerned. And, while I do plan on delivering in the hospital, they still feel I'm a perfect candidate for a homebirth.

I don't understand why they would use that criteria to risk you out of a birth center. While I don't regret having the testing done, and would likely chose to do it all over again, I have to admit I'd be very hesitant if it had the potential to risk me out of the birth I wanted. At the very least, I'd be asking many questions.
What if other "signs" pop up through routine care? Would they risk you out over the first trace of protein or glucose? Or a slightly off fundal measurement? Or would they just keep an eye on it, as most hcps would with an NT test?

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#5 of 44 Old 10-26-2010, 12:04 PM
 
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I've heard a lot of false positive stories too, and also declined the tests. They went over them at our first appointment and said we could think about it, do research on our own, and come back at our second appointment to let them know what we wanted to do. My husband and I had already discussed it and had decided the tests just weren't worth it for us, so we let them know then and there. I was definitely glad I didn't have to fight to opt out of the tests.

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#6 of 44 Old 10-26-2010, 12:34 PM - Thread Starter
 
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Originally Posted by ibusymomto5 View Post
That's crazy that they would risk you out even if later on you weren't showing signs. Aren't these tests pretty fallible? I've read too many stories of false positives to put much stock in them. My mws don't push it, and I would decline even if they did. The stress is not worth it, and even if it came back normal I don't know that I'd trust it. Anyway, that's just me. Like you, I wouldn't terminate anyway. I do get an u/s somewhere around 20wks. They can check/rule out a lot of things with that, especially if you use someone highly trained.
I'll have an ultrasound at 18-20 weeks as well, so I also felt like there are other opportunities to look for those things. Also, I know if the test for Downs, etc., comes back "positive" the next step is amniocentesis to check for sure, and I'm not sure I would do amniocentesis. One of my close friends had her test come back high, and she chose to do amniocentesis--and it took them like THREE attempts (couldn't penetrate the amniotic sac). When they were finally successful, she was nearly 24 weeks... and I know she would have terminated had it been positive. I just know I couldn't do that! And to risk miscarriage every time with the amniocentesis. Another friend of mine did the triple/quad screen, and it came back high for Downs and they saw other markers on ultrasound, but she opted against amniocentesis. Baby was also later diagnosed with a heart defect (in utero) and they knew he would have surgery when he was born... with all of this, they were pretty sure he had Downs, and this was confirmed at birth. He has been through a lot medically, but having the amniocentesis really wouldn't have changed anything for them. He is an absolute doll (I watched him every Sunday in the church nursery until I moved to San Diego) and is a blessing in the life of everyone he meets!!

So yeah, I kind of feel like it wouldn't really change anything for me, and it's not worth the possibility of "risking out." I opted against the triple/quad screen with both of my other kids too. I was 21 and 24 with them.. I'm 29 now.. I still don't think of 29 as old, right? LOL

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#7 of 44 Old 10-26-2010, 12:34 PM
 
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I did the blood tests yesterday and the ultrasound to measure the nasal passages and neck (which apparently are markers of issues). Aside from nearly passing out from the 8 containers of blood they needed, it was fine. It's my understanding that they use the two sets of blood tests, before and after the 1st trimester to make the determination. Then you can decide if you want to do further testing to be certain.

If you have no plan on terminating no matter what, then why bother with all the needles?

Personally, if I find out after both blood tests that I'm super high risk for something I'll choose to have a more invasive test and possibly terminate based on those results. So it's all a matter of your personal comfort level of raising a child with severe developmental issues, and your age risk level. I was really happy that my OB was not judgmental about it and is supportive either way. I couldn't imagine being swayed one way or another by someone who is supposed to be your impartial support. Seems odd that they wouldn't allow you to give birth where you wanted based on those results. I haven't read anywhere that the births themselves were any different.
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#8 of 44 Old 10-26-2010, 12:42 PM
 
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I'm not doing them and I certainly wouldn't if a (potentially false) positive could rule me out of a Birth Center birth.

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#9 of 44 Old 10-26-2010, 02:47 PM
 
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I will not have them done. I had to have it done due to state regulations on homebirth midwives with my first three kids, but I didn't have them done with my last pregnancy and I won't have them done this time around. The results would not change my mind about the pregnancy.

We may have the 18-20 week anatomy scan, but I'm not sure yet. We had it done with Galen, but more just to see the baby rather than due to any worries!

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#10 of 44 Old 10-26-2010, 02:59 PM
 
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I'm having my scan next week. We won't terminate, no matter what the circumstances are, but if we are up against a genetic issue, I want to know so I can study up as much as I can to feel as prepared as I can (if that makes sense.)

I'm really nervous about it, though -- and wasn't with my daughter. I think the main difference is we "tried" for her, and this baby is a surprise. And for some reason, I am more worried about this baby's health than I was with her's. I think I always felt that she was okay, but the surprise factor of this one has me a little more in the realm of the unknown. So... I'm on pins and needles until next Wednesday, and can't wait to see the baby and hear the heartbeat. I've really resisted the temptation to get a doppler, but it's stronger and stronger every day. I can't wait to start feeling movement.

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#11 of 44 Old 10-26-2010, 03:02 PM
 
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Being 46 years old with a precarious economic situation I had it done last week. Passed the physical scan with flying colors. Waiting for the results on the blood tests. Given our economic situation if it comes back negative we'd have the amnio and I know we would have to terminate. We simply can't afford a special needs child at this time.

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#12 of 44 Old 10-26-2010, 03:14 PM
 
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I don't know if I would terminate w/ a down's diagnosis (I know it would be a tough decision no matter what), but with something like trisomy 18 I am pretty sure I would. Either way I want as much info as I can, so we do the NT scan. If I had a high rating I'd hope to be able to do CVS rather than an amnio (so I could do it earlier) but the timing is pretty tight. I am 34, so the odds are higher for me as well for any of these issues.

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#13 of 44 Old 10-26-2010, 03:45 PM
 
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I'll be 36 when the baby is born, so my odds are higher than if I were 20, but really not too high.

** Warning - this is a highly emotional story **

There was a beautiful story in the Dallas Morning News about a year ago about a couple who welcomed their Trisomy-13 son into their lives. Their sweet little guy got to know his loving parents and snuggled in their arms for his few short days of life. It brings tears immediately, so be aware if you watch/read it, but reading and watching their story is what led me to my decision to not terminate if we ever have a similar test result: http://www.dallasnews.com/s/dws/phot...y/2009/thomas/

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#14 of 44 Old 10-26-2010, 04:04 PM
 
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Originally Posted by Crystalyn View Post
I'll be 36 when the baby is born, so my odds are higher than if I were 20, but really not too high.

** Warning - this is a highly emotional story **

There was a beautiful story in the Dallas Morning News about a year ago about a couple who welcomed their Trisomy-13 son into their lives. Their sweet little guy got to know his loving parents and snuggled in their arms for his few short days of life. It brings tears immediately, so be aware if you watch/read it, but reading and watching their story is what led me to my decision to not terminate if we ever have a similar test result: http://www.dallasnews.com/s/dws/phot...y/2009/thomas/
man, I shouldn't read/see these things when pregnant! A lovely story though. I do understand taking to term as well. I don't know if it would give me closure or prolong grief. With a child to take care of as well, I feel like going through that would be even harder. I guess I feel like a really hard part would be the third trimester - knowing something is wrong and yet everyone commenting on the pregnancy. I guess that's an argument for not finding out these things, but of course if it was something that could be helped right at birth I'd want that 20 wk ultrasound.

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#15 of 44 Old 10-26-2010, 04:05 PM
 
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I don't have any risk factors and I would not terminate so I have never done the tests.

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#16 of 44 Old 10-26-2010, 04:14 PM
 
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OMG, I was bawling after watching that video!!

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I start bawling as soon as the video starts... but it's really beautiful. And I'm so thankful to the family for sharing their story. It took great courage and grace to let the world into their lives at such a vulnerable time.

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#18 of 44 Old 10-26-2010, 04:48 PM - Thread Starter
 
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I start bawling as soon as the video starts... but it's really beautiful. And I'm so thankful to the family for sharing their story. It took great courage and grace to let the world into their lives at such a vulnerable time.
Thank you for sharing that. I am also thankful to the family for sharing that with the world. Yes, I am bawling, but it was SO worth watching.

Beth
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#19 of 44 Old 10-26-2010, 04:51 PM
 
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We did the NT test, if the results had come back positive it would have added so much more stress. Thankfully it came back normal, I really need that reassurance with this pregnancy.

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No tests. Not going to change anything anyway.

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OMG, I was bawling after watching that video!!

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#22 of 44 Old 10-26-2010, 05:50 PM
 
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We chose not to, because they're not accurate enough to be worthwhile (to us). We also wouldn't choose to do anything differently. I'm also not high-risk for any of the things tested for.

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#24 of 44 Old 10-26-2010, 06:16 PM
 
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I'll have an ultrasound at 18-20 weeks as well, so I also felt like there are other opportunities to look for those things. Also, I know if the test for Downs, etc., comes back "positive" the next step is amniocentesis to check for sure, and I'm not sure I would do amniocentesis. One of my close friends had her test come back high, and she chose to do amniocentesis--and it took them like THREE attempts (couldn't penetrate the amniotic sac). When they were finally successful, she was nearly 24 weeks... and I know she would have terminated had it been positive. I just know I couldn't do that! And to risk miscarriage every time with the amniocentesis. Another friend of mine did the triple/quad screen, and it came back high for Downs and they saw other markers on ultrasound, but she opted against amniocentesis. Baby was also later diagnosed with a heart defect (in utero) and they knew he would have surgery when he was born... with all of this, they were pretty sure he had Downs, and this was confirmed at birth. He has been through a lot medically, but having the amniocentesis really wouldn't have changed anything for them. He is an absolute doll (I watched him every Sunday in the church nursery until I moved to San Diego) and is a blessing in the life of everyone he meets!!

So yeah, I kind of feel like it wouldn't really change anything for me, and it's not worth the possibility of "risking out." I opted against the triple/quad screen with both of my other kids too. I was 21 and 24 with them.. I'm 29 now.. I still don't think of 29 as old, right? LOL

I definitely don't think 29 is old, but then I still feel pretty young at 40, lol.

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#25 of 44 Old 10-26-2010, 07:39 PM
 
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I didn't do any first trimester screenings. I am 29yo and have no risk factors. I don't recall the quad screen even being offered, though the NT was.

We will get the 20wk diagnostic/anatomy scan.

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#26 of 44 Old 10-26-2010, 09:11 PM
 
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There are too many false positives and negatives with the NT measurements. If a person is genuinely concerned about a poor prenatal diagnosis CVS or amnio will give you 99% certainty.
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#27 of 44 Old 10-26-2010, 09:16 PM
 
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DDCC-

I had the NT done at 12 weeks and came back high-risk for Trisomy 18 and IUGR. The numbers for the trisomy were so high (about 1:4) that we felt compelled to have CVS testing, which did come back negative, but certainly caused us a lot of stress.
I had a similar experience-- was given a "near certain" likelihood of trisomy. Chances greater than 1:2. I was advised to abort straight away, not even to bother with CVS or amnio. I insisted on CVS that came back normal to everyone's shock. DD is 2 yrs old now and her NT measurement was 6mm. Stress is an understatement! I will never go near the scan again. I *may* have an amnio but probably not-- at least that will give an accurate answer.
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#28 of 44 Old 10-26-2010, 09:30 PM
 
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I had a similar experience-- was given a "near certain" likelihood of trisomy. Chances greater than 1:2. I was advised to abort straight away, not even to bother with CVS or amnio. I insisted on CVS that came back normal to everyone's shock. DD is 2 yrs old now and her NT measurement was 6mm. Stress is an understatement! I will never go near the scan again. I *may* have an amnio but probably not-- at least that will give an accurate answer.
I can't believe that someone would advice terminating without CVS or amnio confirmation. That is absolutely insane.

I'm leaning toward doing the screenings since we would consider terminating if there is a major genetic abnormality. But we'd only do an amnio in case of a positive result due to the risk (albeit very small) of m/c.
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#29 of 44 Old 10-26-2010, 10:04 PM
 
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We don't do any of that testing.
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#30 of 44 Old 10-26-2010, 11:09 PM
 
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Nope. I'll be having 20w and 27w Level 2 ultrasounds with a perinatologist anyway (because of my MTHFR) so I'm confident that any major problems would likely be discovered then.

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