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Screening test for neural tube defects - to have it or not?

(5 Posts)
MrsMcJnr Fri 27-Jul-07 12:26:46

I’m looking for some advice – if you were me, would you have the AFP screening tests for neural tube defects?

I am a bit nervous about my pregnancy; I lost a baby at 10 weeks in March and am trying to avoid things that would bring me stress. I also have a medical condition which means I am under close observation and will have lots of scans throughout my pregnancy. I am 33, this is my first baby and I am nearly 16 weeks.

After careful consideration, DH and I decided to pay for a private nuchal fold scan and associated blood tests because our consultant advised us that they were 90% accurate as opposed to the Down’s element of the Double Test which is only 60% accurate. You are only offered a Double Test here. We were lucky; our Downs risk was low at 1:7881 (or near there) so we did not have to think about an amnio (which we didn’t want because of the fear of loss). We had already decided that whatever the risk, we’d continue with the pregnancy and we’d feel the same about a neural tube defect.

I have a MW appointment on Weds and I know it will include the test if we decide to go for it. I’ll be 16+1. We are already booked in for a foetal anomaly scan at 21 weeks in any event due to my condition.

So, do I do the AFP test and risk getting a high result and having to wait until the 21 week scan for clarity or do I go to that scan blind?

I know that certain things can elevate the AFP levels and that elevation of those levels in themselves can mean more careful scrutiny for pre-eclampsia etc aside from the neural tube implications.

Can anyone add anything else to my decision pot or help me decide? Many, many thanks in advance

cornflakegirl Fri 27-Jul-07 13:04:44

I had the AFP test when I was pregnant with DS - we also knew that we'd continue with the pregnancy whatever. It came back that I had raised levels, so they brought my 20 week scan forward (to Christmas Eve). The wait for the scan was awful, the scan itself was awful - and in the end, they couldn't find anything to explain the raised level.

I was told by a friend down south afterwards that her health authority didn't offer the test, because it was seen as too unreliable.

Given that the test is only screening, not diagnostic, and that you've already got a diagnostic scan booked, personally I wouldn't get the test.

BetsyBoop Fri 27-Jul-07 13:39:56

my hospital have stopped offering the AFP test (they did it when I was pg with DD born Dec 05) as it is too unreliable. They just use the 20wk scan now

If you did have a high result you'd be waiting for the 20wk scan anyway to tell you if they could see any problems, so I can't see the point in the test myself TBH (we didn't have it done with DD & wouldn't have had it this time if it had still been an option)

wannaBe Fri 27-Jul-07 13:47:01

hello mrsmc

I guess the question you have to ask yourself is what would be achieved by having the test? If you would continue with the pregnancy anyway, the only outcome could be that it would cause you more anguish until your 20 week scan, when a nural tube defect would be picked up anyway. So in reality you have nothing to gain by having the test, apart from potentially a lot of stress.

MrsMcJnr Fri 27-Jul-07 15:23:33

Sorry you went through all that Cornflakegirl – there are some really good points in there to add to my “against” list, I do remember reading that in some places they are scrapping this test because it is so unreliable.

Betsyboop – thanks

Thanks wannabe – I guess part of me is thinking that it would be worse to go into the scan expecting all to be ok and at least forewarned is forearmed but as you all so rightly say, is it worth those weeks of stress, potentially for nothing?

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