Would you have a CVS if your risk was...

[Persnickety]

overall risk: 1/1200
Nuchal Translucency: 2.8mm
Everything else (nasal bone present, heart valve, etc.) normal.
Age: 40 (40 now, 41 at EDD~)

DH and I are worried about the 2.8mm. But everything else looks okay.

What would you do?

no.

There is a greater risk of having a miscarriage (approx 1 in 100) than having a baby with downs.

I would be happy with my results, 2.8 is , from what I have heard, not a worrying figure. But some people need to know for sure no matter what the result, so it depends how much you worry!

I have also posted on the over 40's thread.

No, not at 1/1200. Those are fantastic odds for a 40yo (I only had odds of 1/1200 with DD when I was 35).

I am leaning more now towards not ruling out CVS if I have a third child (mind you, leaning more now towards not having a third child) if I were having the CVS somewhere that is really good and has a very low m/c rate, much lower than 1 in 100. But with odds of 1 in 1200 I'd be cracking out the non-alcoholic champagne rather than contemplating a CVS.

It depends how strongly you feel about what you would be likely to do if you found your baby did have DS. If you wouldn't terminate (and do research what it means these days to have a child with DS - it's quite a differnt prospect fom a generation or two ago), then there is little point in taking the v small risk of a m/c (which is lower than 1:100 nowadays, I think). If you would rather risk a m/c than have a 1:1200 chance of a child with a chromosomal condition then that's another consideration.

I guess you would also want to take into consideration the chances of conceiving again.

I had a baby at 43, and was terrified at the 20 wk scan by all sorts of talk of soft markers, and thought then that if I had had my time again I would have had CVS earlier - but now, I think I wouldn't bother at all!

"If you would rather risk a m/c than have a 1:1200 chance of a child with a chromosomal condition then that's another consideration. "

That is pretty much my question really. I would rather miscarry than have a child who absolutely certainly without a shadow of a doubt has DS. But, is 1/1200 such a low probability that I have lost sight of the whole picture because I am obsessing on my 2.8mm reading.

I am so stressed out over this. I don't want to take a decision later in the pregnancy. If anything is to be done, it has to be done now. But, of course, I don't want to risk a miscarriage for a baby that is almost certainly healthy.

Jeez... I should have asked more questions while I was there. But, Iokay with 1200 until DH made it clear he was not happy with 2.8mm... and now I don't know if 2.8mm is bad enough that it alone warrants the risk of CVS.

BUGGER!

Call your midwife and talk to her - ask her all the questions you need. Speak to the sonographer if you can.

Thanks, Lilred. I will do that. I have the name and number of the screening co-ordinator, with whom I would need to book the CVS. But, I am hoping to get a wider sample of opinions here before I call her.

But, I will do that when I feel I have a clearer idea of how I feel about my level of risk.

No I wouldn't - great results. Good luck with whatever you decide.

Can you get to the Fetal Medicine Centre in London? Prof Nicolaides will probably be able to tell you if your baby has DS or not from an ultrasound. He did with mine. I was v high risk with all 3 of mine (1:30 iirc). As others have said though, 1:1200 is extremely low for 40 year old and I personally would not have CVS.

really good advice from castles - have had many recommendations for the FMC and Mr Guru in particular.

In terms of picking out individual factors, being 40 is far worse than having a NF measurement of 2.8mm. Your DH presumably knew you were 40 going into this, and isn't saying "yes, everything else is great, but you are 40 so I think you should have a CVS" so why is he now focusing in on the 2.8mm measurement? The whole point of doing all the measurements checks and tests is to come up with a more realistic risk figure than just looking at the NF measurement. Years ago they just looked at the NF measurement (and even then 2.8mm wouldn't be considered a bad result) but the various soft markers have been gradually incorporated into the test, with statistically justified measures of risk, to make the results more accurate. Yet your DH seems to want to throw away all those advances and go back to the older, cruder and less reliable approach.

I don't mean to rant; it just sounds to me as though you are actually perfectly happy with your results, but your DH is raising objections for no real justified reason.

Persnikety - these are great results 1:1200 is brilliant and 2.8 is within normal range.

But you are clearly rattled here. You need to establish what it will take to give you back the peace of mind that you may have had in this pregnancy up until now. My last, recent pregnancy was blighted by the most terrible anxiety and I learnt from it the necessity of meeting worries head on, dealing with them and then allowing yourself to move on.

But rather than talking to us, I would suggest talking to the experts - ARC are superb at this and have helped clarify many a woman's angst. Also your screening co-ordinator/consultant may be able to set your mind at rest. It's a good start.

And if it doesn't allay your fears, then either thorough scanning or invasive testing may be your next stages - purely as a means of setting your mind at rest, not because your results indicate a need. In pregnancy, we all need different levels of reassurance, as these threads illustrate. You need to go with whatever works for you to make this time as easy on you as is possible.

Have already said this but NO wouldn't have CVS or Amnio. Some NHS Trusts have their cut off as Riven has said at 1 in 150/200, some have slightly different ones but they used to just say high risk or low risk and not give the odds. I don't think knowing the exact fiqure is very helpful tbh.

Don't focus so much on the nuchal measurement which is still 'normal' anyway. It's the overall risk factor that's important and yours is the same as a 25 year olds!

If you really must know then go ahead but honestly .....you can't guarantee anything with a baby.

BTW ARC may have been mentioned. Ring them for advice. They are really really helpful and will put everything into context for you.

I actually had 2 nuchal tests yesterday. The first one was at FMC. They measured 2.8 mm. Then I had one at C&W, and they measured 2.1. I don't understand how the measurement could change so much in 6 hours. So am still very .

I think I was happy with the 1200 overall figure when we left the FMC. But now I'm worried about the 2.8 so it's not just DH. He might be overreacting based on only one aspect of the risk (as might I), but he is doing so because he is worried about the baby and I can't really fault him for that.

I have been to the FMC three times now (once for each baby) and never even seen a picture of Nikolaides.

I think ours was 2.8mm and risk was 1/302 (reduced to 1/604 after anomaly). My consultant did a detailed anomoly scan with markers at 18weeks and then we decided against an amnio.
The consultant was very against us having an amnio even with our results, so no with yours I wouldnt risk it.

ARC are very good with advice about testing I can recommend them

But surely the 1:1200 is your adjusted risk, taking everything - including the 2.8 - into consideration. 1:1200 is amazing at 40 - I had a much higher risk at 37 and higher again at 42.

Measurements change because they aren't exactly accurate, it isn't helpful to have 2 scans IMO but that's not a criticism just an observation.

You are not even high risk of Downs - nowhere near. I think you should definately talk to ARC. I bet most obstetricians would also advise against an amnio on that basis.

If you both talk to ARC maybe it will help you get some perspective on this. You appear to be driving yourself mad with worry over something that shouldn't really be of concern IMO.

Some women on here have odds of 1 in 40 etc and go on to have totally healthy babies.

I'm not driving myself mad. I'm just hope to gather lots of opinions today which will help me work through what to do next - a decisione I want to make quite quickly. If everyone comes on here and tells me I'm bonkers and my risk is really fantastic (as some already have) then that's great, and probably just what I would really like to hear. Probably tomorrow I will talk to FMC and to C&W and to DH and decide.

For now, any and all opinions most wellcome.

And thaks very much to everyone who has already contributed. Much appreciated!

That's an interesting point, Riven. I wonder what the accuracy is of the measurement. I see a lot about the accuracy of the test in predicting downs. But not how accurate the NT measurement is.

I think DH is just worried about the one marker being a sign that something is wrong with the baby. But, we do need to remember to look at the whole picture. I have scoured the internet in the last 24 hours and can't find anywhere that 1/1200 would be considered high risk. So, that is reassuring.

I had a 1:105 risk with ds. I actually considered that quite a low risk - it mean that if I gave birth in the same circumstances 105 times, 104 of the babies would not have Downs.

Can't see anyone backing a horse at 105 to !!

I had exactly the same 'risk' factor as yourself, 1 in 1200. I did go on to have an amnio, mainly because of my age at the time (38) and the big jump from my risk at 35 which was 1 in 50,000. I am a 'need to know' type, for us it was the right thing to do but an agonising decision to make. Think if were in that situation again (we won't be, but if we could do things again) I would go to see Nikolaides for a detailed scan, rather than having amnio. Sorry, can't recall where he practices, but I know from other posts he is rated highly.

Good luck, whatever you decide.

Good luck

No, fair enough I was before the time of nuchal scans with dd, but my risk I think was much less than yours, I was 21 at the time.

1:1200 is damn good odds, much, much less than the risk of miscarriage with intervention.

With my further 2 children I declined testing, I thought that if you were the one, then you were the one. Wether you have a risk of 1:15000 or 1:3, it doesn't change the fact that your child will either have a genetic abnormality or not. I wouldn't have had an amnio etc so decided to save myself the heartache.

If you really do not want a child with any kind of abnormalities I would advise that you donotconceive have the amnio.