Confused when Nuchal Test will occur

[BluegrassLass]

Being an American new to the UK (only been here 6mo), and newly pregnant, I'm confused when scans are supposed to happen. I'm not booked to see the midwife until 17 March. I had a miscarriage in early Jan. (was only about 3weeks along), and stopped bleeding around 10 Jan. This is the date they are basing my due date on. So according to this date, I will be 10 weeks pregnant when the MW sees me for the first time on 17 March. When I booked the first MW appt, I also booked the first scan - which isn't until 8 April when I will be approx. 13weeks pregnant. Since that will be my first scan, will this just be a dating scan, or will it also include a Nuchal test? If not, when can I expect to have that test done? Being 35, and my OH 39, we are pretty concerned about anomaly testing and don't want to miss the window. Tbh, we're seriously considering the Harmony test, since it seems so definitive. If it makes a difference, I'm in Edinburgh. Can anyone please shed some more light on this? Thanks!

[ChicaMomma]

The bad news is, the US is streets ahead in terms of genetic testing..
The Nuchal scan can take place between 11 and 13 weeks- the harmony blood test can take place from 10 weeks on.. The former is not diagnostic, it just gives you a risk assessment- so for eg my risk was 1 in 54,000 which is very low risk. Had it come back less than 1 in 100, i think i would have opted for the (more expensive) harmony test then.

Next time, i'll go straight for the Harmony for the reasons you outline! However, correct me if i'm wrong (anyone!) but i think you have to pay for it? NHS dont cover it?

[Expectingtwins1975]

It should be your nuchal scan. They normally do it all in the one scan.

[squizita]

If you're in week 13, they'll do the nuchal test then (the scan's part of it plus blood tests). Mine is next week (week 12) and they happen week 11-14.

Try not to worry too much about being 35: genetic problems are still pretty rare. The fact they do these tests is because they used to calculate by age and it was found to be unreliable.

[BluegrassLass]

ExpectingTwins, if it also my nuchal scan, should the booking letter I received in the post say this? The letter says the appointment type is "US Obstetric Booking".

There appears to only be 1 private clinic that does the Harmony test here, and they charge £650, so we are seriously looking at our budget to see if we can afford it. :-/

[ChicaMomma]

yeah that's what i thought re the cost of Harmony.

I would get the standard screening done- and if it comes up high risk (decide in your head what your definition of high risk is- is it 1 in 100, is it 1 in 1000??) then you could go for Harmony? I decided at 1 in 54,000 it was just not worth the money. 700 eur was what i was quoted (I'm in Dublin). I will be a good bit older on my second though (37 now on first) so will probably go directly for the Harmony next time.. it can also be done quite early, at 10 weeks, which gives you lots of time to explore your options.

[PenguinsEatSpinach]

If finances are an issue, I personally would wait and see what your nuchal comes back as. Particularly if they combine with bloods you could come back very low risk indeed, and I'm not sure that 1/3,000 is really that different conceptually to 1/10,000 (that's what the Harmony result gives isn't it?).

You would normally only have two scans in a low risk pregnancy - one around 12 weeks and one around 20. Therefore, if your area offers a nuchal scan, the appointment you have is likely to be it. Do just check you are being offered one though - I think some areas (Northern Ireland maybe?) don't do so? I'd ring the number on your appointment letter and just check.

[Dazedconfused]

I am in Edinburgh too. I had my first mw appointment yesterday at 9 weeks and I asked her and she said it would be done at my dating scan in 3 weeks.

sounds like I am a couple of weeks ahead of you so if you ever have any questions let me know (and if you want to meet for a coffee *decaff haha or anything I'd be happy to)

take care

[eurochick]

The nuchal and dating scans are usually done together at around 12 weeks.

The Fetal Medical Centre in London offers the Harmony for 400. Unusually it seems to be more expensive outside London, against the usual run of things!

[Expectingtwins1975]

Bluegrass depends on your nhs trust - I would be amazed if it wasn't a nuchal scan given your 13 weeks. They might just not call it that on their letter.

Wouldn't overly worry about being 35 ... I'm 38 and DP is 50 and our risk still came back low 1:2500. Our nhs trust was offering the harmony free as a clinical trial so we had it done anyway - but wouldn't have bothered paying for it with a risk factor as low as we had.

Good luck with your scan .... Is great seeing your little one moving around etc

[Dazedconfused]

hi again
just so you don't worry about wording we don't have nhs trusts in Scotland because snp oppose private sector partnerships with the nhs. we just have the health boards.

sorry just a wee thing and know slightly pedantic(sorry expectingtwins just know sometimes wording can be confusing )

[Expectingtwins1975]

No probs ... I didn't realise they weren't called nhs trusts and I'm actually from Edinburgh! Clearly been living down south for too long

[legoplayingmumsunite]

When I had DS 2 years ago (in my 40s) I had the combination test, they did the nuchal fold test plus took bloods. I live in England but that was free on the NHS because it was considered the most accurate screening test, that might be different in Scotland.

I don't know the details of the Harmony test but it's still just a blood test that gives you a probability not a certainty so if it give you high odds you still need to have either CVS or amniocentesis to confirm you have a child with Downs or another chromosomal abnormality. 'High odds' are greater than 1:150. That figure is chosen because the risk of miscarriage from having the invasive test is about 1-2% (depending on the hospital where it's carried out). It's not sensible to offer a woman will low odds of a genetic abnormality an invasive test that has a greater chance of causing a risk to her baby.

[Heatherbell1978]

Hi I'm in Edinburgh and 16 weeks pregnant. I actually had a m/c in November at 6 weeks and they never saw me as being any greater risk the second time around so I've not had any 'extra' scans. Had my first midwife appointment at 8 weeks where she went through family history, height/weight etc and took blood. Had my first scan at 12+4 weeks where they did the nuchal fold test plus took blood. Got a letter confirming I'm 1:2050 so low risk and nothing further to be done there. Had another midwife appt last week which was just a general check up and nothing now until 20 wk scan. Oh I'm 36 and this is my first:-)

[Armadale]

Hello, you are in the same position as me, having conceived after a MC so not having a last period date to use.

But dating a PG from a MC has some difficulties, as I am sure you are aware. My consultant says that they normally take the date of the miscarriage and add a week to it and use that as the LMP date, but this can be out by ten days or more.

The best practice in this situation is to do an earlier scan, when they expect you to be approx 10 weeks, for dating purposes only.

The reason for this is that you can miss the nuchal window if the date is out by a few days, especially in your situation when the date you have been given is towards the end of the window for testing. If you turn up for the scan and you are a week further than their estimate you would miss the test.

I declined the nuchal testing, so I didn't think I would need the extra scan to check, but the hospital still thought it was worth doing one at 10 weeks to know when to do the 12 week one, if that makes sense, because after 12 weeks babies grow at different rates and so it makes dating a pregnancy after this point less reliable, so they wanted to be sure I didnt' miss this window.

I don't know how things stand in Scotland, I'm in Southern England, but I would push for an earlier scan, so that you are more sure of your dates.

Good luck with your pregnancy

[Heatherbell1978]

Oh I meant to say that I too was in the same position, getting pregnant right after a m/c with no period in between. I had my due date as 17th Aug based on that and it is now 15th Aug after dating scan so almost bang on but I was using ovulation test sticks so I knew I ovulated exactly 2 wks after the m/c x