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Antenatal tests

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Original poster

39 and pregnant - would you have an amnio as standard?

33 replies

NoNoNoMYDoIt · 16/04/2012 16:31

just found out i am (very very unexpectedly) pregnant with number 3. DS is 5 and DD is 3. Both normal pregnancies. Given my now (medically speaking) advanced age, would it be normal to have an amnio as standard? with my 2 DCs, i had the nuchal scan but given my risk of chromosomal abnormalities would now be much higher than it was a few years ago, the risk of miscarriage after amnio is now lower than the risk of having a baby with a chromosomal abnormality. any advice?

OP posts:

ragged · 16/04/2012 16:42

What do you mean by standard, do you mean what will the hospital advise?

Your hospital will have its own policy on what they think is standard treatment; 39 may be too young. My hospital only offered nuchal if you were going to be 40 on or before due date. They'd only offer amnio if nuchal or bloods came back as risky compared to your age. It's quite possible they won't advise amnio.

BulletProofMum · 16/04/2012 16:42

Depends if you are confident in what you would do with the outcome

lilbreeze · 16/04/2012 16:45

surely this is a decision to make after the nuchal result? If you get given very low odds, then miscarriage will still be more likely than a positive amnio.

I'm 38, pregnant, and got given a very low risk. Didn't even occur to me to consider amnio.

orangina · 16/04/2012 16:47

No. I had ds when I was 39 (ahem, very nearly 40....), and my nuchal result was better than dd 2 years previously (who knows how that is possible).... I had a really good scan, all possible soft markers were checked for that could be, and I didn't consider any further diagnostics.

As bulletproofmum says though, does depend on how you feel about any possible outcome.....

LunaticFringe · 16/04/2012 16:48

This reply has been deleted

Message withdrawn at poster's request.

Taffeta · 16/04/2012 16:49

I had DS at 36 and had CVS as there were some concerns raised re nasal bone and nuchal. All turned out fine.

I had DD at 39 and because nuchal and bloods were fine had no further testing.

I think wait and see what results you get from bloods and nuchal. I wouldn't choose invasive testing if there were no markers.

Taffeta · 16/04/2012 16:50

Oh and congratulations btw

lilbreeze · 16/04/2012 16:51

A friend of mine was high risk with DC1 at 40 (followed by negative amnio) then low risk with DC2 at 42. So as a couple of others have said, your risk could in fact turn out to be lower this time than last time.

ElephantsAreMadeOfElements · 16/04/2012 17:12

I was pregnant at 38 and had a nuchal scan and bloods privately at the Fetal Medicine Centre in London. They take the blood sample, you have the scan and by the time that's finished they have processed the blood results and can give you a combined risk factor. And had there been any cause for concern IIRC I could have had a CVS the same day.

The nuchal results were fine - much the same risk level as I'd had with the other two DC - so I never seriously considered a CVS or amnio.

Winnie81 · 16/04/2012 18:04

I would say the same as others, have the nuchal scan and see what they come up with.

I had an amnio on Thursday as we carry a rare genetic syndrome and have a 1 in 4 chance each preg of having a child with the syndrome. Although there are risks from the procedure, for us these risks were outweighed by the need for the results. We are currently waiting for a potential 2 weeks as the syndrome is rare. I'm 16 weeks tmrw.

batteryhen · 16/04/2012 19:48

I am 39, and 22 weeks pg. I had an amnio as my results came back 1:140. Before I had the amnio though I had a more detialed scan at the FMC in London. I thought if they gave me a better risk I wouldn't have had the amnio.However they gave me an even higher risk at 1:68. So I had the amnio. My hospital will only offer and amnio if your risk is higher than 1:150.

FWIW I don't believe in the thought that you should only have an amnio if you intend to do something with the results. I just wanted to be prepared that if there was something wrong then we could prepare and educate ourselves on any possible problems xx

Original poster

NoNoNoMYDoIt · 16/04/2012 21:12

Thanks all. I was thinking of just having an amnio and not having a nuchal. Nuchals aren't offered on NHS here and since I assume my risk could come out quite high and require me to have one anyway I guess I wondered if, on balance, I would be better off just not having the nuchal and going for the amnio.

OP posts:

Taffeta · 16/04/2012 21:13

All the best NoNoNo

wolvesarejustoldendaydogs · 16/04/2012 21:14

Depends how you feel about the miscarriage risk. I paid for a private nuchal/blood test with DD (aged 40) and came out with a 1:5000 Down's risk - to me, that risk was much better than the 1:100 miscarriage risk. If the test had shown a high Down's risk, I would have had an amnio.

Hpbp · 16/04/2012 22:35

Totally agree with Taffeta and Wolves. In France it is offered to all women above 38 and most of them think it is complusory ! I am glad here in the UK you are given the choice to go for NT or amnio or not.
Btw i am 41, 2nd pg, NT is low, risk of 1/1694. That is much better than 4 years ago with my first child which was 1/350 ! 2nd scan showed some areas of concerns so went for amnio ( i did rule it out after the good NT results) at 22 weeks, but so far it seems that baby is fine. Fingers crossed.
Good luck

PieMistress · 16/04/2012 22:47

I'm also 39. The offer the nuchal and blood test as standard at my local hospital irrespective of age. I wouldn't have had an amnio without having the nuchal first, especially as I had also miscarried last year and did not want to risk that again. I got a low risk result (doesn't stop me fretting tho') but had I received high risk would have considered an amnio.

Do you live near London? I would go to the FMC if so, have heard they are very good.

Original poster

NoNoNoMYDoIt · 17/04/2012 07:32

Thanks. Dont live near London but do live near fetal medicine centre so can have nuchal (at cost) easily. I guess this time I want to know absolutely whether this child has any chromosomal abnormalities. My risk on paper at this age seems so high (1/66) and as I have 2 beautiful children already and thought my family was complete, the idea of living for the rest of the pregnancy with a 'risk score' fills me with dread.

OP posts:

wolvesarejustoldendaydogs · 17/04/2012 07:42

Totally your choice. I would investigate where you have the amnio if you go that route though - I think that the miscarriage risk varies quite considerably between different hospitals and different doctors, so worth doing all you can to find out.

hazeyjane · 17/04/2012 07:57

I had dds at 37,38 and 42. My nuchal risk was very low with dd1, high with dd2 and very low with ds. Ds is currently having genetics tests because he is developmental delayed in all areas, has low muscle tone and feeding problems. It is very likely that he has a genetic condition - however it would not have shown up in an amniocentisis.

I don't know if I would be willing to risk miscarriage for a test that may not show up potential conditions.

Sometimes life throws you a curveball.

Jnice · 17/04/2012 08:01

I was pregnant with DS3 just before turning 39 so pregnant during my 39th year. I had the triple screen which showed a lower than average risk for my age and therefore was satisfied and no amino. I had more scans than in my previous pregnancies and everything looked fine. Indeed it was.

Afaik there is no need to have an amino unless screening turns something up. However the decision is yours in terms of your risk tolerance in this situation.

Good luck with whatever you decide!

hazeyjane · 17/04/2012 08:41

By the way I should add that 'something being wrong' was one of the things that made us cautious about having a third, and of course there is 'something wrong', but the reality is that I am so glad that we had a third, I can't imaging our family without ds, the 3 of them adore each other.

Good luck with whatever you decide.

Original poster

NoNoNoMYDoIt · 17/04/2012 08:55

I do know there is no guarantee of everything being 'normal' even if I have all the diagnostics in the world. That was my attitude on the previous two occasions. That there could be something far more significant wrong than a genetic condition. However in this instance the whole thing is more complicated because I am divorced from the DCs dad. So this baby would be born to me and my new partner. We dont even live together - yet. So this probably explains why I want to eliminate as much risk as possible. The impact to my DCs will be massive as it is.

OP posts:

hazeyjane · 17/04/2012 09:05

Ok, sorry, I hope I haven't upset you with my post.

I hope things work out ok.

PieMistress · 17/04/2012 09:42

nono I don't think the age related risk is as high as 1/66 at age 39? I think it's more like 1/150?

Good luck with whatever you decide, nothing in this baby game is easy is it, from TTC to pregnancy worries then even more worries when they arrive!

Original poster

NoNoNoMYDoIt · 17/04/2012 10:21

No offence at all hazeyjane. You make a very good point although your situation is different from mine. And what you say about other conditions is valid to me too.

Combined risk for all generic conditions is 1:66. Which is where my thinking re amnio came from as miscarriage risk is 1:100.

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