Please or to access all these features

Add post

Watch this thread

Save thread

Start a new thread

Flip thread

Hide thread

My feed

Active Unanswered threads

Getting started FAQ's

Unanswered threads Acronyms Talk guidelines

Hide shortcut buttons

Talk

Antenatal tests

Get updates on how your baby develops, your body changes, and what you can expect during each week of your pregnancy by signing up to the Mumsnet Pregnancy Newsletters.

Flip

1 2

Original poster

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

44 replies

Persnickety · 15/06/2010 11:03

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?

OP posts:

Original poster

Persnickety · 17/06/2010 10:44

The Nikolaides clinicn is Fetal Medicine Centre (FMC) and that is where I got the 2.8mm measurement. They have now offered to rescan me today to double check this measurement. And if still high, will also scan heart.

And I will ask all the questions I should have asked last time but didn't think of until after I had left.

It is quite possible we are freaking out of something not worthy of all this attention. But, we need to know. And I need to make sure my DH is also happy with out choice.

Thanks for listening. And, of course, any and all advice is most welcome. So please feel free to tell me if you think I am acting wisely a complete loon.

OP posts:

fifitot · 17/06/2010 11:30

You are being a complete loon! (No offence you did ask!) If you go for CVS you are accepting a risk of miscarriage at 1 in 100 apx against the chances of a problem at 1 in 1200.

Hopefully you will be reassured after your next scan.

Scrumdiddlyumptious · 17/06/2010 14:02

Hi There

I don't want to be flippant as if you are worried about something then that is a very real feeling for you. However, having said that you have such good results for a 40 year old. At my clinic going into the room at this age (my age) you have a 1:81 risk so a 1:1200 risk is very good indeed. Also, any nuchal measurement under 3.0 is good, with some clinics having 3.5 as their cut off. So, in terms of your original question in terms of what you would do? I would honestly celebrate such good news with non-alcoholica champagne and enjoy the rest of your pregnancy.

However, its up to you so good luck with whatever you decide.

Original poster

Persnickety · 26/06/2010 12:17

I just want to come back to this thread for the benfit of anyone who may read it in the future because they are in the position of making a similar decision. I did go ahead with CVS at 13+6 (yesterday) at the FMC. The procedure was a bit uncomfortable (and bloody nerve racking), but it went quite quickly. They checked for a heart beat at the end, which was just as it should be. AH RELIEF...

Now my risk is just that of infection, which is unlikely but I will of course be on the loout for fever or pain, in which case I need to get to the GP or local hospital proto for antibiotics.

Apparently a large number (sorry, don't know exactly what number) of babies who miscarry do so because the needle going into the placenta causes the heart to stop right there and then. This is why the check the heart beat after they take the sample. And, of those, it is more likely for this to happen to a baby who already has a heart problem.

These are the things I learned yesterday and just want to post them while they are still fresh in my memory in case anyone else should find this information helpful in making a CVS decision.

I decided to have the CVS because, while my overall number was pretty good, we felt we really had to know for sure with a NT reading at about the 97th percentile.

OP posts:

Gi1da · 26/06/2010 13:21

Hello, I hadn't been worrying about my results as the scan gave a fold measurement of 1.3mm so I wasn't that concerned about the blood test results / combined result. Went on holidays, just came back to a letter saying low risk - 1:800. To which my logical brain says hoorah bloody good news at 38 (39 at edd). However, now it doesn't seem so good - 800 is a lot lower than 1200.

I also noticed that my results say:
Weight: 100kg. But I (only) weigh 68kgs.

Will this have made a difference? Should I ring them and ask? Partly I want to be told the weight is a mistake and be given an improved stat, and partly I think I should throw the bloody letter away and try to forget all about it. I think if I rang and they re-figured my weight and the stats got worse I'd be in a right state.

Oh bloody hell, I really don't think any of this information helps at all. I feel really stressed out now. Can someone please tell me it will all be ok and not to worry? Sorry for being such a wuss!

Gi1da · 26/06/2010 15:08

Apologies, just done more reading and realise that I should be very grateful for 1:800 result.

Original poster

Persnickety · 26/06/2010 17:20

It wasn't the 1200 which worried us. It was ather the 2.8mm nuchal translucency at 12+2 in spite of the rather good 1200 reading.

The more we thought about it the more we felt we needed to know for sure. I was not prepared to have a 20+ week termination but was prepared to have one at 14/15 weeks.

Again, it was the 2.8mm reading and not the overall score that concerned us. Ironically, the NT reading yesterday after the CVS was 2.1mm.

OP posts:

Original poster

Persnickety · 26/06/2010 17:21

Oh, and as far as I know, maternal weight has nothing to do with the nuchal calculation.

OP posts:

FabIsGettingFit · 26/06/2010 17:26

My advice would have been to have the CVS as you so obviously don't want a child with DS. I thought an amnio was the only way you coud know for sure though?

When will you get the results?

Original poster

Persnickety · 26/06/2010 17:44

CVS and amnio are both invasive diagnostic test which will teel you "for sure" (although nothing is really 100.000000% accurate). The advantage to CVS is that it can be done earlier then amnio (from 11 0r 12 weeks) and I think Amnio is from 16 weeks then the results take two weeks. With CVS the initial results take 3 days, then more come in 2 weeks. I am, however, not sure about the time on the results for amnio.

OP posts:

HappySeven · 26/06/2010 18:08

I just wanted to say that really there isn't much difference between 2.1mm and 2.8mm. It would be very difficult for a sonographer to get consistent results when it involves clicking on two points which in reality are just over half a millimetre apart.

I wish you well with your results and a good pregnancy.

Original poster

Persnickety · 26/06/2010 18:39

I think if you look at the scale of what is normal you will find 2.1 is normal on most anyone's scale and 2.8 is about at the 97th percentile. And that was the number that scared us. The chances are the baby is fine, but 2.8 is not really a good sign.

2.8 is 133% of 2.1 which is a significant increase and the doctor at FMC told me that the nuchal translucency should not fluctuate this much on the same day. Whose reading was correct I will never know. I have lost a lot of faith in the accuracy of the nuchal scan in the last couple of weeks. In the end I was confused by whose numbers were correct and were the risks of going with the wrong ones and weighed heavily on my decision to proceed with the CVS to just find out for sure. Having 2 muchal tests was definitely a bad idea. And I can now understand why one might choose not to have one at all.

Also, in case anyone is interested there is a deviation of +/- .3mm in the NT measurement. So 2.8 could be 2.5 and it could be 3.1.

OP posts:

HappySeven · 26/06/2010 22:19

I can see what you are saying, it's just that it's not really that easy to measure to 10ths of a mm using an image created by bouncing sound of interfaces between different materials. The angle the image was taken at would make a large difference in itself.

Will keep my fingers crossed for you.

HappySeven · 26/06/2010 22:26

PS 2.8mm normal at 13 weeks. Chances are that the 2.1mm is more accurate and the 2.8 was taken at an angle. The accuracy of the measurement is dependant upon the skill of the sonographer. I'm not trying to worry you further, just let you see that it is probably insignificant.

Original poster

Persnickety · 28/06/2010 09:01

Why do you say the angle could be a factor?

Surely the doctors (not sonographers) at the FMC know what they are doing. And I have every faith that their reading are accurate within the limits of the machine (+/- .3mm)... not least becaue he took the measurement literally 20 times. And I'm sure he did this because he was not happy with the 2.8mm reading. I also went back 2 days later for them to verify their findings when the NHS came up with a different reading six hours after the first nuchal at FMC. FMC verified their own reading (on a different machine).

Anyway, we have now had a cvs so am awaiting clear diagnostic results, which I expect to be good news.

I just wanted to post this in case someone else gets similar results in the future and is looking for what someone else might have done in their shoes.

2.8mm is a high reading at 12 +2 (or even at 13+6), but on it's own is not necessarily a clear reason to take on the risk of diagnostic testing, which is what made this a very difficult decision. Some NHS trusts will say that 3.0 or even 3.5 is still normal, but their numbers take into account the budgets of the trust and how much diagnostic testing they want to pay for. And are not necesarily in the best interests of the individual patient.

I am not comfortable calling anything over 95th percentile "normal".

OP posts:

HappySeven · 28/06/2010 14:12

Sorry, I don't mean to upset you, I was trying to say not to worry about 0.7mm (although I can understand why you would worry). The machine may be accurate to 0.3mm I was just saying that the whoever is doing the scan only needs to be reading across the neck at a slight angle (baby is moving and I'm talking less than a degree change) to make the reading change. Sorry, I can't really explain without drawing it out.

As you say, your CVS will give you a clear answer and it highly likely to come back as normal. I wish you well.

Original poster

Persnickety · 28/06/2010 14:39

It's okay. It appears I didn't have much to worry about after all. FMC just called and everything is normal for the initial 3 day result. I believe there are more results in a couple of weeks but can't remember what they are. Definitely don't have Dows, Edwards, Patau.

OP posts:

HappySeven · 28/06/2010 20:57

Congratulations!

Deux · 06/07/2010 20:47

Someone asked about one's weight and whether it is used in the calculations. It is used in some way in conjunction with the blood chemistry. I remember having to stand on the scales at the FMC when I was having mine. I wasn't sure what my weight was and they insisted I be weighed.

What influence it has on the readings, I don't know. Worth checking it out though.

Flip

1 2