To amnio or not to amnio....that is the question.

I need some advice from an experienced group of girls like you. I went for my 12 week ultrascreen and the sono went well. The tech. said everything looked great and that the Dr. didn't even need to see me. She said not to think twice about the bloodwork and enjoy the good news.

Well, 3 days later, I get a call from my OBGYN and he says that my numbers for downs came back as 1 in 264 (where he said the cut off is 296). He suggested I do the amnio to not worry about anything, but that those numbers indicated a minimal possibility.

My fear is that I'll be the statistic that does the amnio. and miscarries a perfectly healthy baby. Would I be wrong to opt out of not doing it?

TIA

Re: To amnio or not to amnio....that is the question.

I don't think you would be wrong at all to opt out of not doing it. There are a lot of risks that come with an amnio, and I would be just as scared to get one. Many girls on here have gotten amnios, and everything has been OK, so it might be a good idea to search for them, and see what led them to their decision. Some people get it so they can educate themselves and prepare properly, if something is wrong. My doctor strongly pointed out to me, though, that none of those numbers from the blood test, no matter how good, or how bad, are definite. I am sure everything in your case is fine! Good luck with your decision

Re: To amnio or not to amnio....that is the question.

I wouldn't do it. If she's saying to do it for peace of mind, I don't think that's reason enough. She said the chances are slim. So I wouldn't risk it.

Re: To amnio or not to amnio....that is the question.

Re: To amnio or not to amnio....that is the question.

This is a very personal choice that you will have to make and no one will be able to make for you.

Yes the test can be risky, but some feel they would rather just know and yet some women say "It is what it is" and deal with whatever god gives you.

I think either way, you are not making a wrong decision and don't feel guilty whatever your choice may be.

I am sure everything is fine, but again for peace of mind or not, that is your call.

Re: To amnio or not to amnio....that is the question.

I am in a similar situation. In fact, simply because of my age (which is over 35, but not THAT much over ), my OB scheduled me for an amnio at my very first visit. She told me I could cancel it, based upon the 1st trimester screening, etc. but she seemed to think I should do it. I think the incidence of Downs for my age is around your "elevated risk" without any other variables.

Let me put that in perspective for you: with those numbers, the chance that your baby (and mine) will NOT have a chromosomal abnormality is 99.96% or thereabout.

I had my ultrascreen this week too. The tech and doctor said the baby looked wonderful; the nuchal measurement was perfect and we saw all the structures as they should be. I'll get the results from the blood around Monday. I know my DH wants me to have the amnio regardless, but unless the numbers dramatically increase (or decrease, whatever the case is...) to like 1:150 or something like that I don't see me having the amnio.

A last thought...my friend--who has been a sonographer for over 10 years--told me that the nuchal measurement/ultrasound is typically the most important "piece of the puzzle" 1st trimester testing-wise.

Good luck with your decision!

Re: To amnio or not to amnio....that is the question.

I was not able to get a conclusive reading at 17 weeks, but when I went back a 20+ weeks for the second set of test, I was told that there was a little too much fluid in kidney, the doctor was extremely pushy about me getting doing the Amino. DH and I had already agreed that it was not worth it the risk no matter how minimal. Our thoughts were whatever we get is what GOD wanted for us. In my opinion have an additional few weeks to research downs won't have helped us any, (when life happens you just have to roll with it). Keep the FAITH, I'll SURE your baby is perfectly HEALTHY.

Re: To amnio or not to amnio....that is the question.

When we went for genetic counseling around the time of the NT test, she informed us that being 35 automatically put you at 1 in 350 for Downs. She also said that 35 is a number that insurance companies needed to come up with as a cut-off for coverage (although there are studies that show a correlation. I just don't think the day you turn 35 is a HUGE indicator of anything). She said the NT test is not indicative of anything other than you are recommended for further tests.

Personally, your number is not so low that I'd be alarmed. Also....your level II will show signs of downs if that's the case.

I'd ask yourself this......would it make a difference for you if your dc did have downs?

This is a very personal decision and I wish you well

Re: To amnio or not to amnio....that is the question.

It's totally a personal decision and I know it's a hard one to make.

So I can only tell you MY reasoning for doing the amnio.
I'm a worrier- a HUGE one. I feel like if I didn't do the test I'd be on pins and needles the whole pregnancy- wondering what if. Wonder if she was ok in there. I wouldn't be able to relax and enjoy anything. (As it is now, I STILL have a hard time relaxing- and I got perfect amnio results back. Let's face it, there are 100 million other things that can go wrong still- even WITH a perfect amnio result)

All the ultrascreen tests give percentages- but we want 100% yes or no. We needed to know 100%- not a percentage.
The peace of mind the amnio results have given us these past months is worth the tiny risk IMO. But again- that is for ME. For others- ANY risk- no matter how small - is too much.

You really need to sit down with DH and decide what level of risk you are comfortable with.
Go for the genetic counseling too- I found it very informative. She went over all the things the amnio tests for- so much more than just downs-. She also went over the risks for their practice- not the national numbers. Which I found even more comforting.
A place like Madonna- who has only perinatologists performing the procedures with constant amnio guidance -has a lot smaller risk of miscarriage than the national average.

In the end it will come down to what you and your DH are comfortable with in terms of risk vs peace of mind.

Good luck in your decision and you can always FM if you have any questions about the procedure itself etc.

Re: To amnio or not to amnio....that is the question.

i'm going for my NT scan next week...i can tell you now, there is no way im getting an amnio - no matter what the NT scan results are...that was just our decision from day one

the baby is coming home with us no matter what (obvi) and maybe its b/c i work in the field so i am already very educated on services and whatnot, but im 100% fine with not doing the amnio

but like all the other ladies said, its a very personal choice so good luck!

Message edited 4/22/2010 8:58:27 AM.

Re: To amnio or not to amnio....that is the question.

You have another choice.

I had a similar thing happen to me... I had a high risk for Trisomy 13/18 on my 12 week screen. It was close to the cut- off (but similar to that of a person 15 yrs older than my age).

I was devastated. I have had (work) experience with those syndromes & would terminate if my child would be affected.

MY OB said that he would not recommend CVS unless I needed it for mental sanity. He thought risk of miscarriage would be higher for that procedure than amnio. It was hard for us to get pregnant: we did IVF, which I thought would actually confuse the risk (because I've been on so many meds to force my body to keep the baby).

He said he would recommend a repeat screen that would go to the same lab. The lab would then use the two tests together to determine risk. The test was a little over 1 month later.

Thank goodness, the repeat screen came back with chances of 1 in 70,000 (from about 1/200) for Trisomy 13/18. I was a LOT happier with those odds. I had no need in my mind to go through an amnio (which if the risk was higher, I would have done & then terminated if the amnio was positive). I'm glad I didn't go through a CVS. I found out later that I have an anterior placenta, which would have made an amnio technically difficult... maybe ? have increased my risk for amnio.

A point though: personally, I would be OK doing a late abortion for this disorder (as kids usually live about 2 weeks)... I don't know about Downs. It's a tough one.

It's a tough decision... and I know a personal one. I remember how upset I was. I stopped looking at all baby stuff and acted like I wasn't pregnant anymore. In my mind... the child died.

BTW: at my 20 week ultrasound, everything looked perfect.

Good luck. My prayers are with you.

Re: To amnio or not to amnio....that is the question.

You wouldn't be wrong. Any decision you make in the best interest of your child is not wrong. It's such a personal decision.

If you base it solely on numbers:

Your risk = 1 is 264 = 0.3% chance
Plus about 5% of the ultrascreen results are wrong.

risk of miscarrying due to amnio = 1 in 200 = 0.5% chance

Good luck in your decision.

Re: To amnio or not to amnio....that is the question.

I went through this with my first pregnancy.

My Ultrascreen came back normal, but that coupled with the results of my AFP/Quad Triple Screen made my numbers go to 1:90 for Downs.

We also did not want to do an amnio for many reasons. I was scared because of the miscarriage aspect especially since we went through so much to get pregnant to begin with.

So, we talked to my OB and instead of doing my Level II at 20 weeks, we moved it up to 18 weeks so they can look for any markers on the baby that could signify a problem. Based on those findings we would then decide whether or not to do the amnio.

Well, as our luck would have it, DD showed 3 soft markers for Downs which further increased the odds. Based on that alone we opted to do the Amnio for peace of mind. I did not want to go through the rest of my pregnancy wondering and worrying. The risk of miscarriage is less than 1%

We did ask for the FISH results (expidited results) because I knew I couldn't wait the 2 weeks to find out.

In the end, everything came back 100% perfect. For us it was worth the peace of mind.

With that said, it's a personal decision and only one that you and your DH can make.

Good luck!

Re: To amnio or not to amnio....that is the question.

Of course you would not be wrong. Like the others said it is a very personal decision and you have to decide what is right for you.

What you REALLY need to think about is why you would be having the amnio done. If you are not considering terminating the pregnancy if it comes up abnormal, it doesn't really matter then one way or another.

Good luck to you - I hope everything works out for the best no matter what you decide

Re: To amnio or not to amnio....that is the question.

A last thought...my friend--who has been a sonographer for over 10 years--told me that the nuchal measurement/ultrasound is typically the most important "piece of the puzzle" 1st trimester testing-wise.




That's what was told at my nuchal screening. I was really really nervous and wasn't sure what I should do regarding an amnio because I'm 36 and carrying fraternal twins, so there would be two needles, etc.

The Dr. told me the nuchal sono is the most important thing they look at.

Re: To amnio or not to amnio....that is the question.

Re: To amnio or not to amnio....that is the question.

If it were me I personally would opt out of the amnio. I know everyone has different beliefs though so it is a decision you need to make for yourself. I myself wouldn't do anything with the results from an amnio - would never terminate a pregnancy from results I got from a test...it would only make me worry more.
But again...totally up to you and your DH. Sending lots of your way!

Re: To amnio or not to amnio....that is the question.

I REALLY appreciate all your feedback. I will speak with my OBGYN about it more on Monday.....until then...many sleepless nights!

Re: To amnio or not to amnio....that is the question.

A friend of mine was just recently in this situation...mostly because of her age. She decided not to do the amnio because she tried for so long to get pg and just couldn't do it, given the risk.
I would probably make the same decision, but it really is such a personal choice.

I think you need to weigh how important it is for you to know more and what you would do with that info, in order to determine if it is worth the risk for you.

GL with your decision and I am praying that all is well with your LO!

Re: To amnio or not to amnio....that is the question.

My numbers were very close to yours and I didnt do it (actually scheduled it, showed up and walked out after talking to my doctor). Those #s indicate a .38% of having it. That's VERY low. Depending on what stats you look at, the MC rate isnt much different. I have a history of MC and didnt feel it was worth the risk. And when I told the doctor we wouldnt terminate anyway she said she herself wouldnt do it. I'm a total worrier so I thought that I'd worry about it throughout my PG and at 34 wks, I can honestly say it really never crosses my mind that it's a possibility.

It's a hard choice though