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hcg too high, nuchal fold fine - what to do????

(24 Posts)
nummymummy Tue 24-Mar-09 12:23:20

Have spent past week worrying myself sick over combined test result - 1 in 202, cut off is 1 in 250. Nuchal fold was good but blood test showed hcg hormone too high - haven't been given numbers but risk was 1 in 38, age risk was 1 in 162.

I'm 38 and have healthy 21 month old dd. We declined all screening on that pregnancy and wish we'd done the same this time - have been offered CVS but risk of miscarriage at 1 in 50 higher than abnormalities. Terrified of needle in belly and damaging baby but don't know what would do if baby had abnormalities...

Can hcg be high due to my age? Can't seem to find info. Have appointment tomorrow for another scan and they'll do CVS if we decide to go ahead but still don't know what to do. Can anyone help/advice? Much appreciated.

jeanjeannie Tue 24-Mar-09 13:38:49

Well, I had a 1 in 2 odds - and a high nuchal fold and after a CVS all was fond to be fine - and I'm 42. DD2 arrived 9 mnths ago and she's pefect.

My bloods were shocking - much more worring that the 'soft markers' they look for. According to Prof Nikolidies (sp?) who I saw, it can just be an a blip and no one knows why. He did say that severe bleeding in the first few weeks can affect the bloods - and this is what happened with me. Not sure if you had any bleeding in the early stages but it does seem that it can throw the bloods off course slightly. No one mentioned age being a factor though. Hope all goes well tomorrow smile

alittleteapot Tue 24-Mar-09 14:09:09

sorry you're going through this. I'm 38 too and have my nuchal scan and bloods tomorrow so feeling a bit nervous.

If you didn't do screening last time, does that mean you would proceed with the pregnancy whatever?

That might affect your decision about whether to have CVS.

Additionally you should ask what the miscarriage rates are for specific practitioners. For example at my local hosp it's 1 in 200 because they do so many!

If I were you I would write a careful list of questions and have a thorough chat with obstetrician tomorrow.

Good luck whatever you decide.

I think there's a helpline about all this, I've read about it on Mumsnet before, but can't remember the name, sorry, maybe someone else will come along who knows, or you could post a new thread asking for the helpline on antenatal screening.

alittleteapot Wed 25-Mar-09 15:23:31

hi nummymummy, so had my scan etc today. nuchal fine, hcg fine but PAPP-A low so they've given me risk factor of 1 in 86. Can't quite get my head round it and now busy googling.

I found the number of the antenatal screening helpline - it's 020 7631 0285. Haven't called yet but it's on my list.

Good luck to you - what did you decide?

babyblue3 Thu 26-Mar-09 13:01:28

Hi everyone... I posted my story on another thread as well... but if it helps settle someone's mind, I will tell it again. After all... when I was going through this, every positive outcome was a Godsend!

My story is very similar. My 12 week nuchal was fine, but my HCG was a little high and my PAPP-A was very low.. 0.21. With my age, my risk for DS went down from 1:250 to 1:35. We decided to go for an amnio at 17 weeks. The baby is just fine and I am now 23 weeks. My 20 week scan put the baby a little big for his age, but he looks great! When we went to see the genetics counsellor before the amnio, she told me that PAPP-A is related to placental function. Because mine was low, I would need to do a growth scan between 32-36 weeks to make sure baby is growing. My OB will also keep closer watch on his growth throughout the pg. She also told me that some women just metabolize the protein quicker, and that I may not have any issues whatsoever. (this is baby #4 and I have never delivered early). The high HCG, I was told, could just be due to my body not ridding itself of it quick enough... with no impact on the pg at all.

To all you ladies going through this right now... I know its scary, but try to think positively. The amnio was painless and the chances of m/c are really low. I have never had CVS, so I can't speak of them. Just make sure the doc performing the procedure has a good many of them under his belt.

Good luck to everyone, and hope you have wonderful pregnancies and healthy babies!

katendmom Thu 26-Mar-09 14:03:17

Hi, I had CVS on Tue. For us it wasn't a choice - our first-born was a stillborn with DS. I guess people tend to think of DS babies always surviving... not always. We can't go through the same experience again. Plus we now have a 3 year old and we cannot get him excited if things do not work out. But my post isn't about us. It is about CVS. I was nervous as heck - my hands were shaking. They did the scan first and my uterus wasn't in the best position (so they said - GULP). They told me to empty my bladder (pee, in normal people's language). It actually made things worse - my uterus moved into a more wrong position sad. BUT the doctor who did the procedure had a lot of experience and said that he had 2 plans - A and B. Well, we did not have to go to plan B. He numbed me first (a tiny pinch) and then (I wasn't looking) they inserted a needle through my belly. I did not feel a thing! Just a feeling like somebody was pushing with a finger, that is it! The needle was in me for 10 seconds (I counted!) and it was over with. I was on bed rest for the next 24 hours with some VERY mild cramping. All cramps are gone. Now the hardest part - we should get the results in about 10 days. God, give us strength! Good luck to you all!!! smile

I had a 1in5 chance after nuchal and bloods.
Had a CVS and all fine.
DD3 is 2.6 rs now.
I am 45!

CVS was uncomfortable because they had to push my uterus up with the scanning thing but otherwise really not bad at all.

Good luck, best wishes. smile

Yanka Thu 26-Mar-09 15:57:34

I had a very high HCG (5MoM) while nuchal + scan were completely fine. Combined result gave me 1 in 16 chance (I am 36). I had a CVS and all came back fine. Once more, I was told that it could be nothing (this is my 2nd pregancy and in my first I also had high HCG, although not quite as high as this time round). I think these hormonal 'blips' are quite common.

Good luck - hope all turns out well!

nummymummy Thu 26-Mar-09 22:25:16

Thanks so much for all your messages.

We decided not to go for the CVS. The scan looked good, everything developing as it should be - and I cried all the way through. It just seemed to clarify my gut feeling that I couldn't go through with a termination. Although if it had been suggested/likely that baby would have horrific agonising problems then... it's such a difficult thing to think about.

The scanning doc was pushing us to do CVS but the very kind specialist midwife gave us time, support and more information and we eventually decided to go home, try to put this scare behind us and enjoy the rest of the pregnancy. 1 in 202 aren't bad odds. Still don't know what my exact hormone results were but much appreciated everyone's information on hormonal issues and "blips" - and that these are quite common. Fingers crossed all will be well for all of us going through this.

Good luck everyone and a big thank you.

Lionstar Thu 26-Mar-09 22:39:35

Seem to be a lot of CVS-type threads about at the moment - or maybe because I'm going through exactly the same as nummymummy I just notice them more? Also had a nuchal scan fine (including visible nasal bone), but beta-HCG a bit high. Put me in a 1:230 risk, which doesn't seem high compared to many on here. We have declined the CVS - the 1:50 miscarriage risk just far outweighs the risk of abnormality. We may still opt for an amnio, but are discussing having the quadruple test. We may also opt for the anomaly scan at FMC as they are experts.

There is no way I'm going to relax in this pregnancy!

Best of luck nummymummy (and everyone else)

alittleteapot Fri 27-Mar-09 08:47:50

we're going to the FMC on Tues for a scan. I just felt a load of numbers were typed into a computer and the stat 1 in 86 churned out. I want more info and a more thoughtful evaluation. I think they will be able to say more and change our stat. If we're higher risk I think I will go for CVS at FMC where miscarriage rates are VERY low. If they're lower we'll feel even better about our decision to hang fire for now.

Best of luck to all as well and well done to nummymummy for your decision. Your odds are actually very good. I worked out that even at 1 in 86 for me - that's 98.8% likely all is well.

VictorVictoria Fri 27-Mar-09 09:33:51

I am 40 and pregnant with DC3. I have always had very good nuchal score in the past. On wednesday I had a nuchal scan and blood tests at the FEtal MEdicine Centre and my score came back at 1.35, mainly because my HCG was way too high. We opted to has a CVS straightaway which Professor Nicholaides did. IT was uncomfortable but not painful and I was absolutely fine afterwards. We got the results back in just over 24 hours and everything was fine. I don't think the FMC have had a miscarriage as a result of a CVS in the recent past and I am so,pleased we went down the route we did.

alittleteapot Fri 27-Mar-09 14:03:34

Hi VictorVictoria, glad to hear all is fine and htat your CVS was ok. Was it just your HCG or are there other factors? Interested because my result is based just on low PAPP-A - HCG normal, nuchal fold etc normal, and it's made a massive difference to my odds.

gits Sun 05-Apr-09 08:51:43

I did the first trimester blood screening at 12 weeks all the other parameters came normal except for beta HCG which is 5 MoM. They put me under increased risk for down syndrome 1 : 35, I am now 40 years old. I have a daughter who is 12 years old. I have been advised to do amniocentesis, quite worried and scared of the outcome. Anyone in similar situation and their amnio results came out normal.

alittleteapot Sun 05-Apr-09 09:09:51

gits, after my low papp-a result gave me a 1 in 86 risk i went to the fetal medicine centre where they do a more advanced scan accounting for more markers. the baby looked fine, it was still just my papp-a that was low, and based on this they recalculated my risk at 1 in 1619. it might be worth you considering visiting the centre. it's on harley street and the scan costs £150. it just means they're factoring in more markers and can give you a more realistic assessment of where things are at. your age will be swinging your risk hugely, but age as a marker is itself only 30% accurate. Good luck, it's a worrying time I know.

gits Sun 05-Apr-09 10:33:17

alittleteapot, thanks for the suggestion & support, I will probably do a more advanced scan, to check the real risk factor. By the way I live in Dubai,UAE. I was also taking Duphaston, prior to this during my ovulation time the Dr. had given pregnyl shot of 10,000 ml. May be this could have increased my beta HCG. With all this dilemma's I think finally I might have to do amnio at 16 weeks now I am 13 weeks. where are you now in your pregnancy, I mean which week?

alittleteapot Sun 05-Apr-09 10:36:35

Hi, I am also 13 weeks, just had fmc scan this week. As we were 1 in 86 the risk factors of invasive testing were perversely as bad or worse than current risk to baby so i was keen to get a clearer result either way. big relief I don't have to consider amnio or cvs now, though of course i will worry and will want detailed scan at 20 weeks.

good luck, the odds are still very much in your favour that all is well. if there is somewhere in dubai that can scan for other markers such as nasal bone and heart valve then you can have that scan till 13 + 6. Otherwise amnio sounds good idea.

gits Sun 05-Apr-09 12:16:54

Hi, I am happy for you, I am sure everything will go well for you as all the detailed results are clear for you. Ofcourse it is big relief you dont have to go for amnio or CVS.
With lots of prayers!

christypoo Thu 06-Aug-09 13:54:22

I've just got back from a CVS appointment and as I was nervously scanning these pages before I went I thought I'd share my experience.

I'm 40, so have a 1:90 risk of having a DS baby. The nuchal translucency was well within 'normal' at 1.4mm, but my HCG was apparently way beyond the high end of the normal range, and my PAPP-A was only just within normal - giving me a corrected risk factor of 1:85. Not much different from where we started, but we discussed it and decided to go for a CVS.

Arrived at the hospital (C&W, London) this morning, consultant did a new scan and was not willing to perform the CVS as my placenta is at the back instead of the front, and therefore difficult to get to - apparently if they had attempted it, it could put the baby at unnecessary risk.

During the discussion with the consultant, he said that the nuchal measurement is the key one of all the markers, and that with the scan looking good (nasal bone evident, good spine development) he'd be very surprised if anything was wrong.

He also said that the risk of miscarriage there (at C&W) was much lower than 1:100 - so again, if you're going somewhere where they do them routinely, take heart!

We've decided to go ahead with the amnio at 16 weeks anyway, but I'm feeling much less worried now I have some decent information about my particular case.

pea1 Thu 06-Aug-09 18:48:43

I am a Mumsnet virgin, so here goes..............I am 41, first pregnancy, 14 weeks. Have just had the 13 week scan - nuchal fold ok, nasal bone present...but bad blood test results (low PAPP-A, high Hcg) giving me a 1 in 35 risk of DS. Have made the mistake of too much internet research - some things I have read suggest that low PAPP-A is virtuallly diagnostic of DS. For various reasons we have decided not to go down the CVS/amnio route, but obviously I am anxious. 1 in 35 sounds high, but the equivalent percentage, i.e. 2.8%, doesn't sound half so scary. How much should I be panicking?! Any words of reassurance, or experience of higher risk factors but healthy babies?

pea1 Thu 06-Aug-09 18:49:52

I am a Mumsnet virgin, so here goes..............I am 41, first pregnancy, 14 weeks. Have just had the 13 week scan - nuchal fold ok, nasal bone present...but bad blood test results (low PAPP-A, high Hcg) giving me a 1 in 35 risk of DS. Have made the mistake of too much internet research - some things I have read suggest that low PAPP-A is virtuallly diagnostic of DS. For various reasons we have decided not to go down the CVS/amnio route, but obviously I am anxious. 1 in 35 sounds high, but the equivalent percentage, i.e. 2.8%, doesn't sound half so scary. How much should I be panicking?! Any words of reassurance, or experience of higher risk factors but healthy babies?

echops Sun 23-Aug-09 22:49:59

Hello ladies - I was so relieved to find this thread. I've had a normal Nuchal scan but raised HCG (1.67MoM) and low PAPP-A (0.36 MoM) - get me, knowing the lingo!!

I'm due a CVS on Wednesday and am terrified of the risks of miscarriage. Having read some of your comments I'm now thinking of having Amnio in a few weeks time instead.

Have any of you experience of having either test at the MOMs centre in Solihull?

KTMama Sat 17-Oct-09 00:26:51

HiYa! We have IDENTICAL resuts! Where are you at with test and things? I am getting amnio in 5 days. Its all pretty worrying! My Dr seems to think its IUGR, so im googling my ass off to find things to help prevent this!! Take care and goodluck!!

KTMama Sat 17-Oct-09 00:28:52

pea1, i meant to adress that post to you! Oops! Soz, im agoose sometimes! Id love to talk to you further, just because your results are the same!!

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