Help I'm 41 expecting twins and just received worrying nuchal results.

[ajpolkadot]

I'm 41 and expecting twins (for the third time) following 4 miscarriages in 5 years. I had my nuchal translucency scan and blood tests last week and received a phone call from the hospital this morning to say the risk based on my age etc was 1 in 63 and the cut off between high and low was 1 in 150 however one of the twins was high risk (1 in 143 the other low risk at 1 in 204). NT measurements where 1.8mm for high risk and 1.9 for low risk, bloods are obviously the same for both readings, so how can it be that the low risk baby has a higher NT measurement. Help i need to make a decision re CVS or amnio. I've had an amnio before and don't wish to repeat the experience, especially as i will need two with this pregnancy. Any advice/support would be appreciated.

I don't know about the measurements but this has happened to me twice with similar levels of risks (not with twins). Both times I opted for no further testing as both times the risk of the test causing miscarriage was greater than the risk of there being an issue with the baby.

When you think of your base risk due to your age (1:63) the results you have rececived should reassure you that your risk has been lowered from that base. Also a risk of 1 in 143 is just outside the cut-off. It is a 0.7% risk. Which is very small no?

I think that the nuchal fold might be looked at alongside the baby's length, which would explain why the baby with the 1.8mm nuchal fold is the one that is 'high risk'.

As for the overall risk, WizardofOs is right that your risk of a down syndrome pregnancy is lower than the average 41 year old - in other words, the results from the nuchal measurement and blood tests must have been better than that for the average 41 year old. Which is a good thing. Your age (no offence!) will be skewing the results anyway.

Were any soft markers identified on the scan? The nuchal fold measurements are great, so there are no worries there at all. And the scan is more reliable than the bloods, I believe.

What would you do if one / both babies were to be found following CVS/amnio to have a chromosome abnormality... would you terminate? If not, do you need to know in advance to prepare yourself? Or, can you not face the rest of the pregnancy without knowing? If you answer yes to any of these then you need to consider having the CVS or amnio. It's not an easy decision to make, I know, I made it in 2010 and had a CVS (1:15 risk, all clear).

Why did you previously need to have an amnio, if you don't mind me asking?

Thanks for your responses they have pretty much reinforced what i was thinking anyway, but its great to have such support.

I had an amnio previously as I had recieved a risk factor of 1 in 89ish just based on bloods, before NT was widely available. Although the pregnancy was initially a twin pregnancy I miscarried one of the twins at 10 weeks. Although the amnio wasn't the most enjoyable experience of my life the worst part was receiving the all clear after 2 days only to be told there was still a high risk of miscarriage for the next week. Thankfully the pregnancy continued without further complications.

I think those odds are pretty good for both, it's only a tiny bit higher than them offering extra testing or not
I had an amnio and didn't find it bad at all, maybe the technology has got better since then? Could always leave it a bit and see what soft markers come out on extra scans? We waited til 20 week scan showed more markers before agreeing to an amnio
We are expecting DS baby but risk was 1:5