NT combined test result - is it ok?

[onebyoneNOTfourbyfour]

Hi

I'm new to this site and have just phoned to get the results of the combined NT Scan and blood test that I had on Tuesday.

I'm 42 and slim and healthy and this is my first PG. They've given me an adjusted risk factor of 1:170 which they say is low risk. The base one on my age alone is 1:60, and they say the cut off is 1:150 so anything less than that would be offered a diagnostic test.

I don't feel that 1:170 is a low enough risk and actually want an amnio of CVS to be completely certain but they won't offer me one.

Am I being silly not accepting this risk factor?

Amino or CVS usually carries a risk of around 1:100 of miscarriage

You can get the test done privately if you wish

At 42 your risk is going to be high anyway
Being slim doesn't affect your risk

It's a difficult decision - I don't think you are at all silly. Your combined risk is certainly much better than you age risk. Do you feel uncomfortable about your risk because it is so close to the cut off figure or is it any level of uncertainty that bothers you?
It might be helpful to discuss your situation and options with Antenatal Results & Choices (ARC), not sure if they are open at weekends though - might have to wait until Monday.

Hi

My risk was 1:160 and I was 39, the Midwife said it wasn't too bad but I needed to know for sure so went for an amnio. Results came back positive for downs and I terminated. If you are the type of person who needs to know I would recommend having the test even if it means going private. One piece of advice, if you can have a CVS, it can be done a lot earlier than an amnio.

As a previous poster said, it all depends on whether you can accept a figure for what it is - a 'risk' factor, or if you are a 'need to know' type of person.

I was 38 when I was pregnant with dd2. I went to the Wolfson Institute for the integrated test, my risk factor was 1 in 1200. I then went on to have an amnio, as for me, that risk has risen dramatically in just 2 years from 1 in 50,000. My consultant said I certainly wasn't the first woman he'd met with a risk factor like that who had still gone on to have an amnio. I am a need to know type, a risk factor alone didn't really help.

That said, I did struggle mentally having the amnio, but glad to say all went ok. Good luck, whatever you decide.

Different areas have different figures for high/low risk. Here where i am, high risk is below 250...so when we got 1:230 it was considered high risk.
I echo the thoughts of those above who say it all depends on what type of person you are (can you live with the uncertainty) and also what you would do if problems were found. And how you'd feel if a CVS or amnio caused the loss of a healthy baby. CVS can be done usually from 13 weeks +3.
ARC is a very good place to start your decision making (and yes you'd need to call on Monday). You should also talk it all through with your partner.
I had a 1:80 once and had a CVS and was the 'one' - our baby had very severe chromosomal problems, and we decided to let her go.
I am currently pregnant and this was the 1:230...but after very thorough scans at Kings in London, and another blood test our odds were reduced to lovely big numbers. So we opted not to have a CVS, and subsequent scans have shown all well so far. (27 weeks pg and counting). I also have a healthy 3yr old Dd.
It is a very hard choice and you have my full sympathies with the whole 'worrying what to do' business.
Best wishes. xxxx

Thank you everyone for your responses. At the moment I'm still undecided what to do. Haven't been able to get through to ARC yet (always engaged) and I'm at work so difficult to find a private place to phone.

Has anyone any experience of a CVS or Amnio at the FMC? Are their MC risk factors lower than the usual 1:100? What's the cost?
Am seriously considering this as my local PCT won't offer one.

Thanks

I feel for you, I'm worried too (even though my risk is lower at 1:800). You just wanna know for sure don't ya! If you feel you couldn't cope with a Down's child I would have the CVS. And hopefully it will be negative and you can relax! I've read on other threads that FMC is very good and they've never had a miscarriage because of CVS/amnio, perhaps someone else can confirm this... Good luck.

I don't think you're silly at all. I had an amnio four weeks ago after I got my integrated test results back as 1 in 410. I explained to the Consultant (at my Consultant booking appointment at the ante-natal clinic) that I was really very concerned about the result as I am 30, and my bloods were way off, and they booked me in for the amnio. On the day, the Consultants doing the amnio tried to talk me out of it, but I was adamant, and they went ahead and did it.

Afterwards I wished I hadn't had it done (I was petrified that I would lose the baby after two earlier MCs) but the results came back clear and I was glad to know that all was ok.

If I was in your shoes I would find out for sure whether the Hospital will give you the amnio (have they definitely said no? Have you spoken to a Consultant?) before investigating the FMC, particularly if it might mean travelling some distance to get there. Good luck x

Just a quick update. Managed to get through to the ARC when I got home from work. The lady I spoke to was fabulous and managed to give me some more reassurance. She also told me that the new national cut-off of high:low risk is 1:150, rather than the previous one of 1:250. This is due to research etc, so it's not just my PCT that have a lower threshold.

Anyway, I'm going to phone FMC today to enquire about an amnio. I'm either 13+1 (according to original EDD) or 13+6 (according to last weeks Nuchal scan) so may be out of time for a CVS. Will keep you posted. I know it's a risk but I really cannot rest or enjoy this without knowing for sure.

Thought I'd add an update from my private scan yesterday at FMC.

They tested my blood again and this time I had a much more thorough scan, 45mins compared with 10 mins NHS one. They also checked lots more markers, including nasal bone and heart valves and Dr Laura who did the scan and Prof Nicolaides who checked it could find nothing to worry about. My combined risk, considering my age, has now come out at 1:891 for Downs and 1:1700 for Patau's/Edwards so I am hugely relieved and happy. Can't recommend the FMC enough and was happy to spend the £150. I was prepared to go for a CVS too if the odds didn't improve but as they did I'm not risking a 1:100 MC rate versus my new odds.

Hurrah, thanks for the update and that's very good news. The same happened to us - once we'd had the scan checking all the other markers and new blood tests, we got good odds.
So very pleased for you and hope you can relax a bit now. Best wishes, lins. xx

Congratulations! (is "congratulations" quite right? General warm and fuzzy good vibey emotions, at any rate). I have already decided that if we have a DC3 (I'd probably be 39 by then) I'd go for a FMC nuchal scan rather than an NHS one; glad to hear that your experience has borne that out and that you're reassured.

I've just had a combined scan with nt test and blood test and have been given a high risk of 1 in 94. I am so scared, i have booked an amnio test in but have to wait 2 weeks for that and then 2 for results. Have been advised it's safer than CVS test. Don't think I can cope with a baby with problems but don't know if I can deal with a termination. Has anyone else been through this?

Dear Rie30

Am sorry your results put you into a high risk category. However until you have definite diagnosis, it's just that - a risk. There are still 93 chances in 94 that your baby is fine. I had a CVS as our baby had definite abnormailities that were visible at my booking in scan (scan at 13wks, CVS done the same day and results confirmed the obvious). I think CVS and amnio risks can be found out for your particular hospital, I think there may be a thread of that name in this section of Mumsnet. However, depending on where you are, some centres are able to give a scan that takes into account 'soft markers' eg whether the nasal bone is present, valves and blood flow in the heart, from around 14wks I think (the FMC in London is often quoted on this board), and give you a revised risk.

It is something no-one really wants to think about, pregnancy not going as you hope. But you can get support through this from ARC (Antenatal Tests and Choices) and from others who will post on this board. I hope you gain some strength from them, and do remember that nothing is certain yet. xx

Hi Rie - I check in on this board from time to time because it helped me alot when I had a NT scan and test and had to debate an amnio. Everyone was so helpful.

As NUmptymum says - try ARC for advice, they are great.

Also wondering who did your NT scan? Was it FMC accredited? If so it will be a good thorough one hopefully. I think where it's done on NHS may not take all the markers into account so maybe worth thinking about a private scan, if you haven't had one.

BTW - with an amnio I think you can get the initial test results back in 48 hours. The full analysis takes up to 2 weeks but they test for the more common genetic issues quite quickly. Maybe you could enquire about that?