2nd pregnancy much higher screening result

[ab03]

Hiya,

My combined screening came back as 'low' but the actual figure is 1 in 207, which is not far above the low/high risk cut off, and is much higher than I would expect for my age (30).
NT was 1.9
PappA 0.45
Hcg 1.75

Has anyone had similar, particularly with a very different experience in another pregnancy?

My previous pregnancy two years ago had results of 1 in several thousands so this doesn't feel low risk! I feel like there must be something wrong this time as my bloods must have been very different last time (NT was 1.7, very similar). I'm not sure what I would do if I found out that the baby does have Downs, I can't stop thinking about how much it would affect my daughter for the rest of her life but my husband doesn't seem concerned at all.

Not sure if anyone can help at all, I think I might have to try and pay for an NIPT test to ease my mind - just wondered if anyone has had anything similar?

Hi there

This is a great post for info on the numbers
https://www.mumsnet.com/talk/antenatal_tests_choices/4939237-info-for-those-with-a-high-risk-screening-result

Looks like your PappA is borderline low (0.4), which they like to pick up so they can give you a bit of extra monitoring - it can be an indicator of your placenta health. They might tell you they are not worried and it would have to be lower than that but that's maybe somewhat of an explanation for you?

@MrsScotland thank you for your reply, that is a helpful thread. I am basically worried that my age is pulling me into a lower risk category when my bloods indicate there might be a problem, especially compared to my last pregnancy. It's frustrating that locally they don't test for any of the soft markers like nasal bone so there is nothing else to reassure me!

Have you heard of the NIPT? It costs £400-500 privately and would give you peace of mind if you could afford it?

I had a NIPT on the NHS as my results came back 1 in 5 for T13/18, the NT was 8mm so really we knew something was seriously wrong. My NIPT came back high risk for T18 and sadly that was confirmed.

Regarding your age, I don’t think it plays a huge part on the figures. I am now pregnant again, I’m 39 and my results this time came back in 1 in 5000 - I couldn’t quite wrap my mind round that as my age related risk should be a lot higher! I also had the NIPT again this time and it was low risk x

@MrsScotland thanks again. I am thinking about the NIPT, I just feel bad spending the money as my husband isn't worried at all. I just hate the thought of having to deal with a down syndrome diagnosis at birth rather than being prepared beforehand. Congratulations on your second pregnancy and the screening results, everything must look exceptionally healthy for your screening result to be lower than your age risk!

The initial screening is basically just various factors and measures and an algorithm is used to give you risk, I’ve recently been though a nightmare few weeks with high risk for all 3 fortunately the nipt came back low risk and the screening midwife explained that my Papp-a was low so that pushed my risk up and my age I’m 39 pushed it over the top I suspect it’s just the low Papp-a that’s increased your risk, you could have the harmony test which I believe is £300 if your really concerned but personally I’d take the low risk, they are pretty good at identifying those with problems x

You could also pay significantly less for a private scan, Down’s syndrome has physical abnormalities that can be picked up on so if there’s an issue they will be able to identify it plus if you wait a few weeks you could find out the gender as a bonus x

@Notimeforstupid thanks for replying. Is this your only pregnancy or have you had others with lower risk? I think it's odd that my blood would be very different this time to last time unless something is wrong. I did ask a midwife about whether they would check more at the 20 week scan and she said cases aren't always picked up there either, and I have heard that the majority of down syndrome babies born now are diagnosed after birth. So I think I will have to pay for the NIPT to get any certainty

This is my 5th viable pregnancy and the other 4 have been really low risk, my last pregnancy was only in 2021 so not a huge amount of time has passed. My screening midwife said the initial screening will pick up almost all people who it needs to but to make sure that happens they have to cast the net quite wide so even a few slight low hormone levels etc can put you in high risk. When it comes to downs symptoms in particular the nt levels are most telling and yours were absolutely fine so I think you can take some confidence from that, totally understand why your stressed though, my cousin has had very similar results to you with her second after a really low risk in her first. She’s opted to just wait after weeks of stress and research (she’s 26w now) x

I’ve had experience of both high and low risk pregnancies (3 total) and different blood levels each time. Personally I would pay for the nipt with the numbers you have - just for peace of mind - the NT being normal is very reassuring.