talk me through an amnio please, experiences?

[kittyonthebeam]

I am 11 weeks pregnant and live abroad. I am looking at flying to London to have an amnio in my 17th week at the Fetal Medicine Centre under Nikolaides.

I am nearly 30 and have one healthy dd already but my Dh and I have agreed to undergo the procedure to make sure the baby is healthy as we would not continue with the pregnancy if that wasn't the case as we have to think of our older child.

What can I expect from the procedure? I know how it works, I understand that some women were traumatised by it? Is it that bad? Do you get results instantly?

We would then rest in London for 2 days before flying out to holiday for 2 weeks where I can recuerate? Is this unwise?

Please let me know your thoughts. TIA!

[escondida]

I don't know about traumatised. In fact they were very positive at FMC, making me get loads of pix of the fetus (which could have been awful in retrospect, but we were both fine after all). It did hurt, though, both during the procedure itself and for several days thereafter.
I had my amnio with Nikolaides, too (2003), also 17 weeks I think. I had prelim. results back in 3 days, and definite results well within 3 weeks. They are very keen on customer care there.

I would have been okay to fly after 2 days, in spite of the tenderness. But otherwise I just wanted to take it very easy.

I hope you don't mind me saying this, esp., seeing as I had amnio myself, but I suppose you might want to think more carefully about your reasons and the risks. What I mean is, amnio is not a guarantee, it's more like an inadequate insurance policy. And the things you're afraid of for your older child might not be as bad as you think. I'm just saying, I think it's important to make sure you've fully researched the basis for your undergoing amnio.

[GrimmaTheNome]

I had an amnio when I was expecting DD because I was 37 (so at statistically significantly higher risk of chromosomal abnormalities than you are at 30) and 11 years ago there were not the same non-intrusive methods which are available now (I believe, don't know details)

I didn't find it at all traumatic - just rather suprisingly like being punched in the stomach. I think it is one of those procedures where it does help to have a doctor who is very experienced ie does them a lot, but I would imagine that ought to be the case at the clinic you mention.

[didoreth]

Hello,
I had an amnio on the nhs at 17 weeks.
It was slightly painful but not awful, I felt a bit shaky afterwards but not really ill, was told to rest completely for the rest of the day. The results took about 8 days, though I believe you can get them faster (about 2 days) if you have FISH (think thats what its called). My baby was fine, he's now 22 months old.
I am puzzled why you are considering amnio at your age though - are you known to be at high risk of a genetic problem?
I had it it done because at 46 I was at high risk of a chromosomal problem (higher than 1 in 20) so that justified the risk of the amnio (about 1 in 100 of miscarriage).

[tartyhighheels]

I cannot understand why someone would have an amnio when the miscarriage rate is 1 in 100 and the rate of abnormality in someone under 30 is a lot less than that. I have had my last three pregnancies checked via nuchal scan and the latest two with the additional blood test too - but unless i received signicant result i would never risk an amnio for sake of it.

I am 40 now and I think my natural risk level was 1 in 80?? but after the nuchal and blood test 1 in 1820 - good enough for me.

[kittyonthebeam]

This will be our last child hence I am prepared to do this check-up. Having met Prof. Nicolaides before I have to say he is wonderful, truly right escondida.

I have read threads on here where women were afraid of and shaken by the procedure so I just wondered if this was something that commonly occurred or if it is a very personal experience. I am not afraid, I have spoken to my consultant and due to family history on both our sides and various other factors we have decided to go for an amnio which gives the closest results to a 100% check that can be had.

Thank you grimma, I feel a bit more at ease now.

Didoreth, what is FISH? I am not sure what that means..

Tarty, that's a really good result for you. I'm glad it went well.

[fifitot]

Have you had blood tests which indicate you are a high risk? Your age risk is about 1 in 1000! Your amnio risk of miscarriage is about 1 in 100 apx.

I am not judging you but find it strange you would put your pregnancy at risk when in all likelihood there is nothing at all wrong with your baby.

There are alot of things you just can't test for. We can't eliminate every risk of something being wrong with babies. I suppose it's up to you but my odds were nowhere near as good as yours will be and I agonised over putting my pregnancy at risk.

[escondida]

I was given a 1/400 risk by nuchal, and when Nikolaides looked at my notes he pronounced "Ah, I see you have fourth baby syndrome!" -- as in I suppose, I was prepared to take a bigger risk because I had so many DC already.

I wasn't at all afraid, Kitty, but it did jolly hurt! I wish that I had known that pain doesn't mean it's necessarily infected; infection is the main cause of m/c after amnio, if I understand rightly.

Good luck.

[fifitot]

When I was researching it I found out that the main risk is up to 48 hours later, hence while you are told to rest but there is still a risk of m/c up to 3 weeks later. I think that's where an infection can set in.

[kittyonthebeam]

Thank you escondida, we are awaiting the next Sunday to have the 12 week scan but are still considering the amnio. I appreciate your answer. We are prepared to live with the risk that an amnio entails, otherwise we wouldn't consider it. As mentioned we have abnormalities on both sides, also not sufficiently picked up at antenatal scans that make us look into this option.

Thank you fifitot, we would stay in London for 2-3 days before flying on towards the West.

[kittens]

I had amnios with both my DDs as they were categorised as high downs risk from the nuchal scan (1 in 50). The procedure was not painful and we did read that the risk of m/c was very dependant on the skill and experience of the consultant. Luckily the hospital we went to and the consultant we saw was very experienced. They suggest resting for the nest few days which I did and everything was fine. It was done on the NHS so the results took around 1 week.

I also read that if you are going to m/c no amount of rest will stop it happening and there really is little you can do as most of the m/c are due to birth defects anyway.

The real worry is waiting for the results, even if you know what you plan to do if you get a bad result actually doing it is another thing.

Have you thought about going for a Nuchal scan which is not invasive and then the amnio or a CVS if you really need one?

If its downs you are worried about there are other measurements they can do such as Nasal bone and I understand they are blood tests too.

[PacificDogwood]

I had CVS x3 @ 10 weeks each time, and amnio x1 @ 16 week, all in NHS care (in Scotland).

I found the amnio physically speaking an absolute doddle, skinprick through the abdominal wall hurts like when you have blood taken and you feel another stabbing sensation when they penetrate the uterine wall. You do not feel fluid being taken off. I was not tender on the outside afterwards but felt a bit bruised on the inside.

We flew to a wedding the following day (my choice, I am big on denial ), got a preliminary result within 24 hrs (direct test, FISH is an acronym for the lab test used, not every hospital offers this) and culture result after about 2 weeks.

FWIW, CVS was much much sorer, risk of MC is higher but obviously you can have result earlier in pregnancy which was our main reason to favour it.

Advice to rest is mainly to give you peace of mind, there is no evidence that it makes any difference. There is of course no evidence that it does NOT .

Risk of MC is including background risk of MC at whatever gestation you are when the test is performed.
It is v worthwhile asking what the statistics are for the person preforming your amnio (I presume must be v v good for Prof Nikolaides ).

V best of luck, hope you get the answer we all wish for

[kittyonthebeam]

How did your pregnancies go kittens? I can imagine you must have been very worried. I tend to agree with you in regards to the rest. If an infection happens, then there is little one can do to prevent it.

I am very unsure as to what other non-invasive checks are out there that give me the same high % of knowledge as an amnio at the hands of one of the world's most experienced specialists would. We are in the UAE and the state of medical care here is shocking. All the gear, no idea springs to mind...though sometimes they don't even have the right qualifications. Awful, just awful.

[didoreth]

FISH stands for fluorescence in situ hybridization, its the test that gives you quick but provisional results (in 48 hours).

[kittyonthebeam]

Thank you Pacific. Very helpful answer to understand how it feels and what you did.

Thank you didoreth, I didn't know that.

[PacificDogwood]

CVS/amnio are diagnostic tests but they can only test for karyotype abnormalities, ie trisomies, deleted arms of chromosomes etc. They do not test for multigene problems, say significant heart defects (which are sometimes part of a chromosomal syndroms) or any number of other things that can go wrong with a child's or any person's health even if they are born perfectly healthy, say diabetes/epilepsy.

All other tests (nuchal scans, triple blood tests, detailed scans @ 20 weeks) can give you odds.
I think it does get forgotten v easily that odds of say 1:10 for something being wrong (which we would all consider fairly bad odds, I think) still mean there is a 9:10 chance of everything being fine.

Just be sure that you know what a chromosomal analysis can and cannot answer for you. They do give you definete answers but only to a finite number of questions IYKWIM. They do NOT guarantee a healthy child.
Sorry if I am teaching you to suck eggs

I would imagine that the counselling before the test at the FMC will be rather extensive.

[Linnet]

I had an amnio with dd2 in November 2003. When we'd gone for our first scan they thought there was something wrong but didn't know quite what so I had an amnio.

I don't remember it hurting at all. A bit nippy when the needle went in, like getting blood taken, then there was a strange tingly sensation like pins and needles,then it was all done.
I could watch on the the screen to see what was happening and dd moved her hand towards the needle but didn't touch it.

To be honest the most painful bit for me was when they gave me an anti-d shot afterwards in my hip, now that really hurt plus the fact that I didn't actually need that jag made it an unecessary pain as well.

We got major results back within about 2 days, I think those were for downs,trisomy 13 and there was another one I can't remember now and the rest came back after about 2 weeks. My consultant did mention heart conditions and that the amnio would pick that up if there were any but that came back clear and Dd2 is fine, we did have to go to Glasgow for an extra heart scan but we got the all clear.

[kittyonthebeam]

Thank you Pacific. I completely understand what you are trying to say . It is to those few questions that we seek an answer on the babis of family history. I was prepared to wing it for my dd as she was my first, but for this child I have to think of the family I already have [if that makes sense].

I am very aware that nothing on earth guarantees you a healthy child and I don't for a second think that I can achieve that through the amnio. After all, there are alsways risks, at the actual birth, on the way home from hospital, in the play ground, etc. The list goes on and I have a healthy faith in life righting itself, however this is my family we're talking about and my DH and I have made this decision together and it is right for us.

I will see how things go next Sunday at the 12 week scan and then speak to my old consultant to see what he advises.

Thank you for describing your experience Linnet, interesting to hear about the rhesus shot. I gather your dd is totally fine

[PacificDogwood]

I totally understand where you are coming from. And clearly I am not at all against diagnostic tests having had them repeatedly myself...

Very best of luck !!

[kittyonthebeam]

I guess I'm just nervous and a bit scared of it all looking bleak again. I hope to sound a bit less tense after Sunday.

No place like MN to get good POVs and a bit of support. Most appreciated Pacific and others.

Good night.

[Linnet]

Yes Kitty,dd2 is fine,all test results came back negative and the heart scan was fine.

Best of luck