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Greater than 1 in 2 chance of Downs Syndrome - Experience - Good Outcome

58 replies

Royal23 · 12/12/2023 09:35

After reading a really informative and comforting post on mumsnet after looking all over online for some reassurance I felt compelled to share my husband and I’s experience in the hope it can offer someone else the same. It’s our first pregnancy.

I (32F) am currently 17 weeks pregnant and have just received the all clear after 5 weeks of hell.

I quite naively believed if I made it to 12 weeks then everything would be fine - my main concern being a 1st trimester miscarriage. At the 12 week scan we had an awful experience with an ultrasound technician who seemed unable to form full sentences, make eye contact or give us any information beyond ‘raised NT measurement’ and ‘4mm’. When we asked what that meant he said it could indicate Down’s syndrome but that someone would be in touch as he just did the scans. He sent me off to give blood where a totally disinterested woman told me to expect results in 2 weeks! We left our 12 week scan feeling scared and totally out of our depth. After spending all afternoon down a rabbit hole researching ‘raised NT measurement and downs’ I booked a private NIPT test for the same night. I just couldn’t face waiting two weeks for information.

At the private NIPT test the technician measured the NT at wildly varying amounts. The lowest being 3.3mm and the highest being 4.6mm. He recorded 3.3mm as the official and took my blood to test the foetal DNA.

This was a Thursday and I went home feeling reassured by nothing else other than the fact that these NT measurements seemed to vary quite a bit depending on who’s taking the measurement and the position of the baby etc. as all the measurements were taken on the same day! The NIPT results were due in 5-7 working days.

The following Monday (not two weeks later!) we got a call from the hospital, asking us to come it. We both knew that couldn’t be good. Once we arrived we were taken into a consultation room and presented with our Combined screening results. This was when reality really hit us. Seeing greater than 1 in 2 chance of Down’s syndrome was heartbreaking. Our chance of Edward’s and Pataus was 1 in 5000 so not at increased risk. But to find out that anything greater than 1 in 150 is higher risk and we had greater than 1 in 2 was devastating. We were talked through our options and as we had already paid for the private NIPT and the fact that a ‘lower risk result’ on an NHS NIPT meant you wouldn’t then qualify for the diagnostic testing (CVS or Amniocentesis) made our decision easier and we booked in for CVS two days later (13 weeks pregnant).

The combined screening looks at various factors (Age, ethnicity, diabetic status, smoking status, NT measurement and pregnancy hormones in your blood). I was advised the raised NT score of 4mm (anything above 3.5mm is worrying but below 3mm is ideal) and the fact my free beta hCG hormone was 2.25 MoM (above 2) is what had driven this result.

The CVS was unpleasant and I was devastated to hear that due to how my placenta had grown (down the back, parallel to my spine) they couldn’t get a sample. They booked me in for two weeks time for Amniocentesis which can be performed at 15 weeks onwards. Physically, I was sore for a few days afterwards but mentally I was totally drained. I felt like I was in limbo and trying not to get too attached to my baby while looking and feeling more pregnant by the day. Life went on hold and I didn’t want to make any plans because I suddenly didn’t know what the future looked like.

10 painfully long days after the 12 week scan and private NIPT test (I was now 14 weeks pregnant) we got the NIPT results back - which came back as ‘lower risk’. I tried not to let this give me hope as the NHS guidance says that where you have a very increased risk of Downs (between 1 in 2 and 1 in 10) then the NIPT is less reliable and can produce false negatives. I just didn’t know what to think and spent hours online trying to reassure myself.

The week after I went in for my amniocentesis (15 weeks pregnant) , which was less painful than the CVS and after two attempts they were able to get the sample. I took this opportunity to ask our consultant whether she could see any physical indications of Downs though it was early (ossified nasal bone, femur length, heart and kidney function, shape of the head etc. here is the most informative link I found - https://zayacare.com/blog/can-ultrasound-detect-down-syndrome/) which she confirmed there was no sign. She did however seem surprised when I told her the results of our private NIPT - as if she had expected the result to be higher risk which was worrying. Amnio Results take 3-4 working days for downs, Edward’s and Pataus with a more in depth screening taking a further 7 days. I was also booked in for a foetal cardio scan at great Ormond st. as a raised NT can also be a sign of a cardiac anomaly.

The odds of having a healthy baby felt slim to none with these obstacles to navigate and such bleak odds.

That weekend I spent more time researching combined screening and found the mumsnet post that inspired my own and the OP had linked an online cloud based version for free. https://www.prenatalscreeningcloud.com/ 

After putting my information in, it came back with a 1 in 11 chance of Down’s syndrome - which I admit isn’t great but definitely better than 1 in 2! I was questioning how accurate the combined screening truly is or whether our result was down to human error?

The following Monday (the 4th working day) we got the call. No downs was detected from the amniocentesis. We were clear for Edward’s and Pataus too. On the Wednesday we went off to great ormond st. And had the heart scan - after a tense 15 mins we again were told that everything is as expected but that we would need to come back at 22 weeks (in Jan 2024) to check that everything was developing normally. And finally yesterday - we recieved the final results for the full screening results of the amnio - and that was also clear.

To be perfectly honest, while I feel elated and relieved there is a part of me that questions how we came out so high risk in the combined screening and yet all results have come back clear so far. I almost don’t want to believe it. And I don’t think that fear will leave me until our baby arrives. I just hope I can help someone else going through a similar experience, even if it’s just to feel less alone and to know it may not always be the worst outcome!

Prenatal Screening Cloud Software

Low cost prenatal screening software targered to small labs and doctors. Screening types: First trimester screening, Second Trimester Screening and Preeclampsia screening

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OP posts:
MrsScotland · 12/12/2023 14:58

Wow, thank you for sharing your story. What a worrying time you have had but I am glad everything is on track for you now.

I remember those worrying weeks in limbo, we had to wait two weeks for a referral to Fetal Medicine, and got a NHS NIPT in the meantime. Our NT was 8mm so to be honest, we didn't expect a good outcome. Our NIPT came back high risk for T18 so we didn't even have the CVS.

It is great to have both outcomes on here, I am sure your post will be useful for people.

sunshinesupermum · 12/12/2023 15:15

Thank you for sharing. It's a long time since I had my children and at that time there was more chance of miscarriage with having an amnio ( I was 35) so I never had one. DD2 is pregnant now (8 weeks unplanned age 38) and naturally I'm worried for her.

NorthCliffs · 12/12/2023 15:23

My third pregnancy came back as high risk. I was told my age alone (43) would've automatically pushed up the chances. The baby was genetically okay.

So it was quite the shock when my fourth pregnancy came back as low risk ... I was 47 🤷‍♂️

Royal23 · 12/12/2023 18:31

@MrsScotland - Thank you and I totally agree. The more people that share their experiences (both good and bad outcomes) the better. It can feel like an extraordinarily lonely time. I’m so sorry you didn’t get the all clear.

OP posts:
Stressed2024 · 22/03/2024 08:07

I’m reading your post and can’t hold my tears back. I’m currently in the exact same situation waiting for the NIPT results after having received a 1 in 2 chance of Down syndrome and really worrying blood results.
You have put in words my thoughts and feelings about this week of wait. I just can’t think positively most of the time and I’m worried that even if I get a good NIPT result these numbers will indicate something else.
Yours is the first post I see with a positive outcome and I truly thank you for giving me a little hope.
Can I ask how your 22 week scan was, if you don’t mind?

CB1209 · 24/03/2024 11:19

@Stressed2024 sorry you’re going through this. I posted on this forum before but I had a positive outcome after greater than 1 in 2 chance, high risk nipt, abnormal cvs… finally a normal amnio and a miracle of a healthy baby boy who is now 11 weeks old. I had really high hcg in the combined screen and low Papp an although nt was fine. Wishing you all the best for the NIPT, it’s such a horrible time waiting xx

Royal23 · 25/03/2024 23:15

@Stressed2024 I’m truly so sorry that you’re going through this at the moment and I have everything crossed for a good outcome for you. It’s truly a horrible, scary and lonely time.

I would say regardless of the NIPT result I would opt for diagnostic testing. The NHS leaflet says that where you have a high chance (greater than 1 in 10) of downs the NIPT can produce false results. I would always opt for CVS or amnio for a definitive answer. In my experience Amnio was less painful than CVS but waiting the extra week till I was 15 weeks was agony.

Im now 32 weeks and everything is progressing normally! We were discharged from GOSH after the second foetal cardiac scan (22 weeks follow up was normal) and the NHS 20 week scan was normal. We had a 4D scan a couple of weeks ago where it was much clearer to see all 4 chambers of the heart, and that baby’s features, fingers and toes were all developing normally.

I know it’s hard to stay positive but please do know sometimes it does work out. And whatever the outcome there is nothing you could have done to change it. Wishing you all the best!

OP posts:
Stressed2024 · 26/03/2024 07:35

Hi @Royal23
Im so happy to hear everything goes well for you so far and I wish it continue like this until you hold your bundle of joy in a few weeks.
I got my NIPT results yesterday and it came back as low chance. I was still restless all day so I went for a private scan last night just to see that the baby still had a beating heart. We found out we are having a boy.
Im scared to let myself feel relieved and I think I’m going to do the Amnio in a few weeks when I’m 15 weeks. You said the NHS guidance is that when the screening shows a very high chance of a syndrome then the NIPT can produce false negatives. Can you remember where you read this?
Thanks for your encouraging words and for taking the time to answer.

Royal23 · 26/03/2024 08:36

@Stressed2024 thats fantastic news! Congratulations on your baby boy.

the leaflet I was given was this one: https://www.gov.uk/government/publications/downs-syndrome-edwards-syndrome-and-pataus-syndrome-options-after-a-higher-chance-screening-result/your-choices-after-a-higher-chance-screening-result#nipt-results

And the bit I’m referring to is under NIPT Choices:
“In particular, if you had a very high chance result (‘1 in 2’ to ‘1 in 10’) from the first screening test (the combined or quadruple test), the benefits of NIPT are less clear.”

Though I distinctly remember mine saying it increases chance of a false negative - perhaps I was given an older version. But I threw mine out so can’t double check!

Your choices after a higher-chance screening result

https://www.gov.uk/government/publications/downs-syndrome-edwards-syndrome-and-pataus-syndrome-options-after-a-higher-chance-screening-result/your-choices-after-a-higher-chance-screening-result#nipt-results

OP posts:
PurpleRayne89 · 08/12/2024 13:58

@CB1209 I read your post and I wanted to ask whether there were any soft markers on your scan? We have some soft markers, intermediate risk of DS with NHS combined, high risk NIPT, currently awaiting CVS result which I should get this week. Do you think it’s worth having an amino? For some reason I don’t think they’d let me as they seem dead cert on T21.

CB1209 · 08/12/2024 15:37

@PurpleRayne89 sorry you’re going through all these tests - it’s so stressful. No my scans were normal throughout so in the cvs result it said they couldn’t exclude it only being in the placenta because of that. I asked for the amnio but they were fine with doing it because the scans were normal, although they never expected it to contradict the CVS like it did. if you need it for peace of mind then you could ask although I keep my fingers crossed for the cvs in the meantime x

PurpleRayne89 · 08/12/2024 15:41

@CB1209 Thank you for responding. I know you posted this some time ago. I take it you had a happily ever after? I think I’m clutching at straws at the minute.

CB1209 · 08/12/2024 17:00

@PurpleRayne89 i did yes, he’ll be one in Jan and I will honestly never forget the rollercoaster I went through in the pregnancy or stop being grateful that it turned out the way it did. they would have let me make a decision on not proceeding based on the cvs which is a completely terrifying thought. What are the soft markers they have seen if you don’t mind me asking? I should say my case is apparently super rare so I wouldn’t want to give false hope but at the same time I hope they would be receptive to any patient who needed an amnio for confirmation of a cvs diagnosis. Feel free to message me if you want to chat more about it x

PurpleRayne89 · 08/12/2024 17:04

@CB1209 No, ask away! Congratulations on your outcome. You must have been so relieved!

12 week scan showed soft markers for Downs Syndrome which were no nasal bone, tricuspid regurgitation) my NT was 2.5, bloods within normal range. I’m 35. I came out as intermediate risk for DS 1:250. I was then offered a NIPT (Harmony) test which was completed there and then. I received a call 8 days later to say it has returned a high risk result for T21 which is DS. I was asked to come in the following day for a further scan and possible CVS if I consented. My scan at 13+2 showed no nasal bone and a reserve a-wave ductus venosus. No further mention of the tricuspid regurgitation. However, still soft markers were present so I agreed to the CVS.

CB1209 · 11/12/2024 09:22

@PurpleRayne89 sorry for the slow reply, hope you’re doing ok, such a horrible stressful time waiting for results x

PurpleRayne89 · 11/12/2024 12:33

@CB1209 No worries. It’s a busy time of year 😊 I received my result yesterday which retiene abnormal. So T21 has been confirmed.

Lulumamabear · 11/12/2024 14:02

Thanks so much for sharing your strong, such a journey to go through for you, pregnancy can be such a hard time when there is uncertainty.

I had a similar experience in my early pregnancy 3 years ago, I would really recommend the private FB group Great Expectations, it's for mums to be with a high chance or confirmed diagnosis, it was a lifeline for me. Small group so only a hundred or so mums, but many in similar positions to me, and it was such a relief to find others in the same boat.

DSUK PADS Great Expectations For Pregnant mums expecting LO w Down syndrome

I didn't have the invasive tests as I was too afraid of the risk of miscarriage, but that's a very individual thing. I was high chance for all three trisomies, and also waited until 15 weeks for an answer, which was truly agonising and the hardest 3 weeks of my life without doubt.

Sending tons of love and support for anyone struggling right now xx

Lulumamabear · 11/12/2024 14:04

I'm sorry just for some reason my link didn't work, but if you search DSUK great expectations on FB you'll find the group.

Lulumamabear · 11/12/2024 14:07

PurpleRayne89 · 11/12/2024 12:33

@CB1209 No worries. It’s a busy time of year 😊 I received my result yesterday which retiene abnormal. So T21 has been confirmed.

So sorry you're having a stressful time, I hope you've got support around you. Always happy to chat as I've been in your shoes. Do have a look at the group I've suggested above, it's a really lovely place where you can ask any questions you have and get whatever support you need. It's a very pro-choice environment, and your feelings will always be respected. Sending you hugs xxx

PurpleRayne89 · 11/12/2024 14:12

@Lulumamabear Thank you for your compassion. Can I ask what decision you made in the end? Also, what influenced it? I will check out the group, thank you so much ☺️

Lulumamabear · 11/12/2024 14:25

PurpleRayne89 · 11/12/2024 14:12

@Lulumamabear Thank you for your compassion. Can I ask what decision you made in the end? Also, what influenced it? I will check out the group, thank you so much ☺️

Honestly I want to reach out and hug you, I know how this feels. It's frightening and heartbreaking, and it felt like such a huge weight on me to "do the right thing". I don't think I've ever been so afraid or lost. The group really helped, some mums went ahead, some chose not to, but just seeing others go through the same journey and hearing their stories was a real help to me.

If you're open, have a look at positiveaboutdownsyndrome.co.uk/nobodytoldme/

I did go ahead with my pregnancy, I didn't want to go into that because I didn't want to make things harder for you, but I'm more than happy to fill you in on the rest of our journey if you'd like to hear it. Totally up to you though lovely, whatever you need xx

PurpleRayne89 · 11/12/2024 14:29

@Lulumamabear Thank you 😌 I would love to hear your story if you’re ok to share. X

Lulumamabear · 11/12/2024 14:59

PurpleRayne89 · 11/12/2024 14:29

@Lulumamabear Thank you 😌 I would love to hear your story if you’re ok to share. X

I'm very happy to share, I've seen the other side of all of this and the short answer is it's really not what anyone ever expects I don't think!

So as i mentioned we had high chance for all three trisomies at 12wks. I was too scared of the miscarriage risk to go ahead with the invasive testing - I'm very much a "trust your gut" person and ironically we did book in for the CVS, it didn't sit right with me but I booked it under advice, but on the day the consultant didn't want to do it, he said due to the position of the baby and the cord he couldn't guarantee a valid sample (meaning we'd have to wait for the amnio at 16wks) and if he did it he would have to increase our risk of miscarriage. So I took that as a sign, and booked the NIPT instead! This ruled out Edwards and Patau, and gave 99% likelihood of DS. Our son never had any soft markers for DS during pregnancy so we wouldn't have known unless we had the NIPT. We decided to continue at that point, I do believe in trusting my gut, and I felt strongly that if baby wasn't meant to survive then they wouldn't.

We were very well looked after from that point - I know a lot of mums who felt pressured to terminate by medical professionals, some right up to before birth, but I never had that experience. We had regular scans and checks with a consultant and they kept a close eye on us both. Leo was born at 36 weeks by planned section (I had vasa Praevia), he came into the world with a red face and plenty of air in his lungs 😆. He had the usual heart scan within 24hrs as all babies with DS do (we hadn't had the confirmation by then but I could see that he had DS, I am sure the docs could too!) and his heart had a slightly narrowed left artery. This didn't mean anything for him health wise, although it will have gone done on the records as a "heart defect" - it's well known that around 50% of babies with DS have a heart defect, what no-one tells you is that only around 12% of those babies need any form of surgery! Also there's no comparison with typical babies as they don't get scanned at birth, so it's one of those stats which slightly annoys me now! Leo was signed off by cardiology at 4 months because his heart was fine, they put the narrowing down to him being 4wks prem and not fully developed. Other than that he was a bit cold for the first few days and had jaundice, both very common in prem babies, and he failed his newborn hearing test - again very common. We stayed in for about 9 days because Leo had to have phototherapy for his jaundice, and then we came home. He had an Ng tube for about 48hrs before I asked them to remove it (he didn't need it, he was breastfeeding fine, it seems like something they do with babies with DS!). His growth and weight gain were slightly slower than my previous baby, but we had a different red book insert for babies with DS so we didn't panic about that too much.

Fast forward to today, he's a happy and healthy 5yo boy, he's off to school in September next year (we deferred him for a year) and he's currently living life at nursery 3 days a week! He's walking, running, climbing, potty trained (barring the odd accident 😅), loves his food, is a massive Bluey fan and adores people and dogs! He can also be stroppy, cranky, grumpy and stubborn - I think it runs in the family, I blame my husband..... 🫣😜

For sure there are a few things which are different for us, he does have delayed development, so he's at around age 4 in most areas. His speech is a little slower to come, we understand him but others not so much just yet - apart from a few words, NO! is a favourite at the moment 🙄😆 but we use makaton with him and he's a brilliant signer.

I honestly look back and wonder what worried about, but it's easy from my perspective because I've travelled the road already. I worried so much about how I would "cope", and whether I could parent a "disabled child". Society has in the past shown us a pretty grim view of DS in some areas and I'm sure that sticks with us. But the reality these days is so different, our kids are welcomed into mainstream schools, medical treatment is available if needed, therapies etc are available. Our experience has without doubt been a positive one, and we wouldn't be without our little man, he's bloody awesome!

Anyway sorry I rambled a bit!! I hope this is helpful, obviously whatever choice you make will be right for you - I'm 100% pro choice, I just like to share our story if it's wanted, because I find that the narrative can be very one-sided at times. Wishing you all the luck going forward, and please don't hesitate to contact me if you have any questions or want to chat at all xxxx

PurpleRayne89 · 11/12/2024 18:16

@Lulumamabear Thank you for sharing. Why would you say the hardest and most rewarding things have been so far? Also, is there a treatment pathway given upon discharge from the hospital? I’m concerned about potentially having a child who requires a lot of care to the point of me having to give up my job. Are you still able to work or have there been some changes there?

Lulumamabear · 11/12/2024 21:12

PurpleRayne89 · 11/12/2024 18:16

@Lulumamabear Thank you for sharing. Why would you say the hardest and most rewarding things have been so far? Also, is there a treatment pathway given upon discharge from the hospital? I’m concerned about potentially having a child who requires a lot of care to the point of me having to give up my job. Are you still able to work or have there been some changes there?

Always welcome lovely. The hardest thing for me hasn't been Leo at all, the thing which I've found stressful is dealing with the local authority!! As I mentioned we deferred his school start by a year, just to give him a more level footing with his peers when he starts and to give him an extra year to develop his speech a bit more. I had to do a lot of back and forth with the LA to get this agreed, and they were a bit of a pain in the arse to be honest. But we got there eventually and he'll start with the appropriate peer group in September next year. Having Leo himself isn't hard at all - well no more so than having any child in terms of parental challenges 😆😆 I mean his favourite word is NO and I have to be very creative if I want him to follow my schedule, but that applies to both my kids for sure 😅

The most rewarding thing is being Leo's parent, he's such a smashing little human, he loves people and makes friends wherever he goes! I'm proud of both my kids and I wouldn't change either of them for the world.

In terms of work, my situation was a bit different, because I was made redundant while on mat leave with my eldest 🤬 and as I had no family to care for my then 8wk old baby there was no way I could go back to work, so I stayed at home until she was 3, with the encouragement of my husband - luckily we were able to get by on his salary - by which time I was pregnant with Leo. Then when he was 9mths old Covid hit! Hubby and I had sort of agreed that I would do with him as I did with our eldest anyway and stay home for a longer time, I didn't initially plan to be a SAHM at all but fate threw that my way and actually I'm glad I was able to spend their early years with them. I did get itchy feet though and did some volunteering, became a qualified breastfeeding supporter, did some charity work and became a school governor (thinking ahead!!) so I have kept myself busy for sure!! Now I have a part time job doing some contracted work for a charity, I only do about 12hrs a week which is enough for me right now, but I definitely want to go back to work properly once Leo starts school.

i guess you can never predict what needs your child will have - usually any issues with gut or heart can be picked up in utero, so that may give you more of an idea of what to expect. The thing is I suppose that any child can be born poorly, it's always a gamble to some extent. But I do think there's a narrative around all babies with DS being poorly, and that's just not the case. Yes SOME babies are born with complications, but many are not, as we have found.

Some hospitals have adopted a DS Care Pathway, it's being rolled out to all hospitals but they haven't all got it in place yet. There's a great book for new parents from Down Syndrome U.K. called The Little Orange Book of Knowledge, it's kind of a step by step of anything and everything you may need to know! There's a link somewhere which I will try to find for you. And the community is incredibly supportive if you choose to get involved, I've made lifelong friends along the way! I guess the way I'd think of it is it won't maybe be what you expected, there will of course be things that are different, but different isn't necessarily a negative thing, in some ways it's just a change of mindset.

I've rambled again, sorry!! But if I've missed anything you wanted to know just let me know xxx