Should I pay for a private nuchal?

[datingscanonly]

I am regular but I have namechanged - with all the DM stuff at the moment forgive me for feeling a bit cautious.

I am 12 weeks pregnant with my third child. With my first two pregnancies I was offered nuchal scans at the local NHS hospital. Now I've been told these have been discontinued.

I had my dating scan last week and all was well. I've been told I can have a blood test for Down's at 14 weeks, but it is much less reliable than the CUBS test.

Here we don't get a 20 week scan. I didn't for my earlier pregnancies.

To be honest I don't know what I would do with the information if the odds were unfavourable from the CUBS test. As I've never had 20 week sans I've always been quite philosophical about so-called abnormality testing. I know there are many conditions a child could have for which there is no testing. I know many things could happen during a child's life. And I know how much anxiety these tests can cause to people having read a lot of threads here about it. But this time maybe because I'm older and it's my third pregnancy I feel more anxious. I could have coped with a child with more demanding needs maybe earlier in my life but things are more complicated now.

I and am considering having a private nuchal. It would cost me £230 which is quite steep - especially for something which was free to me before.

I would really appreciate any advice you can offer as I am a bit confused, and I'll have to make a decision soon as time is running out.

[Nettee]

Personally I would pay for both the nuchal and the anomaly scan. I think it is a scandalous postcode lottery. I did in fact do this with my first pregnancy where they offered a 16 week scan rather randomly but none of the others. It is expensive though - I seem to remember paying £100 for each in 2004 - I suppose inflation and all that. But I would prioritise the anomaly scan where they look at the heart and the spine and the position of the placenta and can see treatable things that would benifit from your baby being born in the right hospital. With the nuchal I suppose it depends on your age - if you are over 35 then definatley have it if you can afford it (and you want to know and would have the invasive tests if it came back high risk).

That is my opinion anyway - good luck with it all

[bubblesincambridge]

I had it, worth every penny.

[HeadFairy]

I would have it. Regardless of your opinion about the results, I'd want to know to allow myself some time to prepare if there was something that came up on the nuchal.

Postcode lottery is a ridiculous thing, makes me wonder how we can all pay the same NI and taxes when we don't all get the same service. We get nuchal and 20 week scan as routine.

[Mouette]

I had a private nuchal scan and blood test in both my pregnancies, at the Foetal Medicine Centre (which by the way only charge £150!) They were well worth it as it put my mind at rest. The scan they did was so much more detailed than on the NHS, we were even able to see the baby's brain, stomach, etc they did a scan of the heart and the second time were even able to tell us the sex with an 80% probability (they got it right). XX

[lazylion]

I would have the scan too. I have had both private and NHS and private seem to take their time and get more detail - it is worth it in my opinion whatever you do about the results.

[datingscanonly]

What do you think of the blood test you can have at 14 / 15 weeks? They will give me this on the NHS. I know it is much less reliable than CUBS but it still must be worth something? Or should I just try and find the money and go for the scan?

Again would really appreciate advice. It's very helpful.

[salvadory]

I'm 36 and pregnant with my first child. I'm in an area where nuchal fold tests are only available privately (grrr) and am so glad I took up this option. The scan equipment was newer, we got loads of pics, the sonographer took loads of time to explain what she was doing and what was on screen, there were 2 screens so I could see what was going on at all times the whole experience was really lovely.
Cut to the 2 rubbish NHS ones (12 weeks and 20 weeks) where there was only 1 screen and it was facing towards the sonographer (obviously)therefore I could only see when she bothered to stop and very briefly point out a couple of things, cue lots of tense quiet moments where the sonographer didn't explain what she was doing and my mind worked overtime thinking of all the things that could be going wrong.
I'm so thankful I paid for the private scan, initially I booked purely for the DS probability calculation but I'd recommend it purely for the scan experience.
However I do realise I'm probably being a bit precious first born about the whole thing and if I'd had more than one and wasn't in a high risk group I probably wouldn't bother paying for any subsequent pregnancies.

[Mouette]

I know the blood test at 14/15 weeks is a lot less reliable, from what I read it is only between 70 and 80% accurate depending on the type of test (there are several tests available - triple or quadruple). Meaning it will miss between 30% and 20% of Down's cases. The scan, combined with a blood test (they do both privately) is 95% accurate, some clinics claim a 98% accuracy rate. So if the result is very important to you, you would be better off with the scan. The other option would be to do the blood test on the NHS, then do a CVS or an amnio if the risk of Down's is high. Both procedures will give you a certain answer (100% accurate) however they both carry a risk of mc, about 1%.

[KatyS36]

Depends on your age, how comfortably you can afford it and what you would do.

I'm 36 and had it done privately. The experiance was fantastic and I very fortunatly came back with massively low odds.

If you would NOT have further testing (e.g. amnio, CVS) and the money would hurt then I'd suggest missing it, all you would have is a number which may or may not be reassuring.

If you would have further testing (not that you would necessarily want to do anything), and its not financially too painful I would have it done.

Hope this helps, and remember the most likely outcome is that the baby will be fine.

[datingscanonly]

Thanks it really does help, though I still can't make up my mind!

I guess I am missing what I had before - ie the nuchal, and the reassurance I got from that, however misplaced. And having never had a 20 week scan, I don't miss that. I hadn't thought about having that privately.

Would you really recommend I had both? And if just one of the two which?

I am 36 by the way, very healthy, no family history on either side to cause worry. The health board here take the view that it is not the best use of funds to scan an entire cohort of perfectly healthy women, and I guess I've been brainwashed in to agreeing!

[Chynah]

I had the combined test at the Fetal Medical Centre in Harley St a year ago and it was only £150. Would definitely recommend it.

[IsItMeOr]

Think I might be a weirdo, as we went for a private nuchal scan even though it was available on the NHS where we are. We went to the Birth Company on Harley Street (same building as Fetal Medicine Centre, and uses same techniques). They did an extra check on the nasal bone, which increases the accuracy of the test even further. The FMC guy is the one who invents a lot of these checks by the way, so you would have the reassurance of being seen by people trained by the leading person in this field in the country, and possibly the world. People do fly from overseas to see them.

But only you can decide how important it is to you to know what you can about whether your 3rd DC may have some health complications. Based purely on age, your odds for Downs are going to be fairly high (1 in 307, compared to 1 in 910 for a 30 year old mother).

We had the 20 week scan on the NHS here. Had the double screens as described by salvadory. The private scan didn't have that where we went. To be honest, I would have paid to have that one as well if it wasn't available on NHS.

If it might help you to read up on the available evidence, there's a long chapter (chapter 9) on screening in the NICE guidelines. They ultimately recommend that all women are offered both the scans you mention if I've read it correctly.

[Mouette]

Hi
The Foetal Medicine Centre itself advises women to have the anomaly scan at 20 weeks even if they've had the nuchal scan at 12 weeks, because there are things which aren't visible at 12 weeks which are visible at 20. Down's by the way can sometimes be picked up at the 20 week scan if it hasn't been picked up earlier. Can't recommend the FMC highly enough - both times I had a very good experience with them. It is wise to decide what you would do if the tests showed high odds of Down's before having them. Do note that there is a time limit for nuchal scans -I believe they can't be done after 14 weeks as the nuchal folds are no longer clearly visible. It is easier to detect Down's in the first trimester than later apparently.

[Mouette]

By the way how healthy a woman is normally has no bearing on the risk of Down's. the two factors are age (as someone mentions the risk at 36 is about 1 in 300, at 37 it's 1 in 187) and whether there is Down's in the family as some rare forms of Down's are hereditary. Trusts usually scan women based on age. You are a bit unlucky - my trust scans all women aged 36 and above. x