NHS Combined Test limitations for older Mums(2 Posts)
Hi everyone. I am posting this as I am hoping it might save at least one mum to be from the stress I have just been through. I am 43 going through my first pregnancy and to be honest clueless. I blindly put myself in the hands of the NHS midwife who saw me for my first appointment who recommended the Combined Test. Having gone down that path, I have firmly come to the conclusion that if you are late 30's or early 40's the free combined test on the NHS is a total waste of time. I was scored high risk for Downs (1:18) on it but after asking a tonne of questions, I discovered that I was high risk before I even had a scan or blood test - 1:48 purely on age! My risk was increased because one of the 2 hormones they measure was elevated. The other hormone and NT were normal. Before going in to be told the bad news in person, I spent hours doing my own research and so thankfully was able to rejectCVS and Amnio - the only two options even offered to me. I asked about Non Invasive Pregnancy Testing (NIPT) options and was met with a blank look that that wasn't offered on NHS. As I knew NIPT has no harmful effect on the baby I pushed to find out where I might be able to do it privately. It's not free in most NHS hospitals sadly but well worth doing. There are 3 or 4 different makers of the same type of test all with roughly a 99% accuracy for detecting downs. I went with Verifi offered at Queen Charlottes and Chelsea (£400). Another more widely known one is the Harmony Test. I had 10 days of stress waiting, but boy am I glad I did - I have a low risk baby and avoided the risk of a miscarriage in the process of further testing. I cried so many tears over the stress of this - my advice is go straight to NIPT if you are over 38. I believe St Thomas and one other in London offer this testing on the NHS and from 2018 most will. Your midwife may or may not tell you this so hopefully this helps.
I'm sorry you have had a stressful time and I'm glad it has had a happy outcome.
What you have described is not how maths works. You didn't start with a 1:48 chance, that was only for the age part. And, unfortunately, increased age does bring with it increased risk of Down's syndrome. This is used in conjunction with the other risk factors, so someone without the elevated hormones you had could still have a low risk given and not 1:48 as a minimum.
The test is statistical not diagnostic, so there will always be limitations.
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