High risk for Down’s syndrome in combined test vs low risk harmony test.

[Sprakash]

Hi, I am 37 years old and pregnant with my second baby. I had a harmony test done privately and got a low risk result - less than 1/10,000 but had a nhs combined test - nuchal and blood and got high risk result 1 in 96. The scan was fine but my beta hcg is high and that combined with my age has given a high risk result. I was wondering if any one else has been in the same situation and what did you do? Did you go for any invasive testing? Thanks

[Megan2018]

I had the Harmony testing first and was told by the hospital that there was no point in doing the combined test as due to my age (I was 40 at conception, now 41) there would automatically be a high risk result and I already have a much more accurate result in the harmony, so we didn't bother
Which order did you have them in? If you had the harmony first what was the reason to have the Combined test done?

The Harmony result is the reliable one - I'd ignore the combined test as meaningless. What did your scan look like?

[Sipperskipper]

I haven’t been in this position, but the harmony test is far more accurate than the NHS combined test. What happens now in many NHS trusts is that if your NHS combined test shows high risk, you are then referred for the harmony test as it is much more accurate. If this is high risk then you are referred for invasive testing (if you wish).

I had my harmony and 12 week scan done privately, and they said not to even have the NHS combined test for this reason.

Wishing you all the best for the rest of your pregnancy.

[Sprakash]

I got the harmony test and scan privately first. The harmony test result was low probability, less than 1/10,000. From the scan they did, the background risk for trisomy 21 was 1:143 based on my age but after the scan and other parameters the adjusted risk is 1:2864. So they said result in low risk. I did the nhs combined test as I will have my baby in nhs so thought will do their tests. I was for a shock when combined test adjusted risk was 1:96. The background risk on the basis of age was 1:143 and I am scared that the adjusted risk is higher. The scan was fine, they said it was fine. From what I could understand the beta hcg in my bloods are high. Don’t know what to do

[Weathergirl1]

Combined test is not good if you're older as huge age component. I also understand that the bloods can be affected by things like sickness, which can skew the results. Someone posted on a similar thread a few weeks back and mentioned they'd been told that the same blood test two days on the trot would give a different risk factor.

I keep posting this link, but //www.ark-uk.org has some really good information on it about these tests. If you've had Harmony or similar go with that IMHO - the false negative is really really low.

[Sprakash]

Thanks, will check the link. I know i should try not to stress out but the combined test result has really stressed me out. I am planning to go back to the private consultant at the foetal medicine centre to get their opinion. My combined test was at Kings and since they are also supposed to be good it has really stressed me out. I wish I had been told not to go for combined if my harmony and private scan was low risk!

[Megan2018]

@Sprakash
I am sure they will tell you to ignore the combined test result - I am really surprised the NHS did it - when I went for my 12 week scan I took my Harmony results and they added them to my notes and said they wouldn't do the combined test now as no point in it as the result would be meaningless. I can't see why it would be different for you.
Please try not to worry, you genuinely have no need!

[Sprakash]

Thanks a lot of Megan. As soon as I reached for my appointment, they took my blood. As no one had mentioned to me I don’t need a combined test if I have already got a harmony test, I didn’t tell that to the doctor. I am trying not to worry, I had a miscarriage last year and I am blessed with a son but have been beating myself over not trying for a second baby sooner. I knew risks were slightly high after 35 but didn’t realise they could be so high. Holding on to the hope that harmony test is supposed to be very reliable.

[Megan2018]

@Sprakash
I'm 41 with my first - I don't think you have anything to worry about age wise, you are still young.

[Sprakash]

Yes, just that the adjusted risk is higher than the background(based on age) risk, Hoping to get some answers at my appointment tomorrow. X

[Sprakash]

Thanks for your replies and help ladies x

[peasando]

I got the harmony test done first (mostly because I'm 39), low risk result, and my consultant told me not to bother getting the combined test as well because it was likely to give a high risk result due to my age and stress me out, when we already know everything is probably ok. The harmony test results are significantly more accurate and he also said that the NHS will be moving to harmony in the future to replace the current combined testing which isn't really it for purpose - so there was no point in having a less reliable test after a more reliable one, iyswim. I'm sorry you are going through this, but a low risk result in the harmony is excellent and there's really very little risk at all of anything being wrong.

[Sprakash]

Thank you peasando, all of your experiences is giving me hope and am feeling a bit less stressed x

[csla]

I had harmony first and got low risk. I got my nhs results today which said 1 in 256. They said my age would be likely to increase the odds and the harmony was far more accurate. I was just interested to see the effect and also I have low Papp -a which can have other issues apparently

[Sprakash]

csla, did you get a scan done privately along with the harmony test? In my case the scan and the bloods that were done privately gave a much lower risk than the nhs. I went and had a consultation with the my private consultant and she put my mind at ease. Go back to your consultant esp if they are fetal medicine specialist and talk about your bloods. Best of luck x

[csla]

Thanks. No I just went to a Babybond clinic for harmony test so no consultant. There is an nhs consultant who runs a private clinic nearby who I can have a consultation and a scan with so I’m thinking of booking that to discuss the results. I suppose I could pay for private growth scans then as well if needs be x

[csla]

To clarify my above post, the low Papp a apparently comes with other issues (poor placental growth / risk of miscarriage). I’m happy that the harmony test is more accurate and I’m not overly concerned now about the chromosomal risks

[Bluebell9]

I had the quad test instead of the combined test as they couldn't get a measurement at the scan. It came back as 1 in 17 chance of downs syndrome. I was then given the NIPT (harmony) and my results were 1 in 50,000. Because the harmony is so much more accurate, I wasn't offered any more testing. The 20 week scan showed no issues.

[stucknoue]

What you decide to do really depends on what you would do if you found out your baby had downs, if you feel you would terminate then further testing makes sense but if you would continue with the pregnancy I would not risk invasive testing

[Mamabear12]

This is one of the reasons the songrapher was saying it doesn't make sense to do the test after harmony. She said harmony is the final answer...if you have a high risk on the NHS test, they would suggest harmony as next step, which would override NHS. She mentioned some women get the high risk result after doing the harmony and getting stressed etc. But she said if harmony test gave low risk, its low risk.

[PregnantSea]

The Harmony test is very accurate, much more so than the combined test. That's the result I would be focusing on.

[Yukka]

Like everyone else says if you’ve had harmony ignore nhs. Harmony is dna based - it’s gets baby’s dna from your blood. Nhs is numbers and probabilities, not accurate in comparison at all.

[SylvanianFrenemies]

The Harmony test is more accurate, @moonpeace. A high risk Harmony would override a low risk Combined test.

[LittleDoveLove]

I just did the harmony as more accurate than combined and hospital said no point in it if doing harmony.

[BagelDog]

In quite a few areas if you get a high risk in the combined test, the next step is the harmony or equivalent through the nhs, as it is more accurate, less skewed by age, but non invasive. Only if you are also high risk on the harmony are you offered amnio. Essentially the harmony is a more accurate test so I would try to relax.