Thick nuchal fold at 12 weeks what are my chances for a positive 20 week scan?

[janski31]

Hi all

Had a nuchal fold reading of 4.6 at my dating scan, paid for a private nuchal fold scan combined with bloods the following day she measured the nuchal at 3.2 combined with my bloods gave me a 1:1128 chance baby had a nasal bone and normal tricuspid doppler.

Had a scan with nhs at 15+4 all ok nuchal fold had reduced to 4, then had my bloods done at 16+2 with nhs they have come back 1:5.

So now am not sure what to think as am getting so anxious for my anomly scan i will be 19+4.

Have chosen not to have any invasive testing due to personal reasons.

Just looking for reassurance really as my scan is a week on wednesday and getting so nervous!!!!

Thank you for listening x

I've posted on this topic before,

The NHS should NOT be using a nuchal scan done one week, and combining it with blood tests done a week (sometimes several weeks later), to give a combined risk (as they appear to have in your case, giving you a risk of 1:5 for down/other trisomies). The blood test and scan should only be used together if they have been done the same day - otherwise they 2 tests can't be combined in any meaningful way to give you an accurate risk profile.

Your private combined scan + bloods showed a nasal bone/normal tricuspid doppler reading (good) and gave you a combined risk of 1:1128, and this is the figure you should be going with. That's low risk.

No non-invasive test will tell you for sure that your child does not have one of the disorders the test screens for, but your private scan/test have give a low risk profile, so I wouldn't be worried in your position.

Make sure your NHS provider knows about, and gets a copy of your private test report, otherwise the "very high risk", 1:5 will be writ large on your notes - and will affect where they are willing to let you give birth (they are very likely to say consultant-led unit ONLY, as 1:5 chance of a sick baby requiring extra help at the time of birth).

I hope that helps!

Thanks again oldmum42 your very helpful!! Just trying to keep it togther as keep having moments of panic then moments of am sure it will all be ok.x

Is the 1:5 just from the bloods or did it include the nuchal measurement?

Just from the bloods I think as nhs nuchal was taken at 12+3 and bloods taken at 16+2 x

Janski, I think you may want to as your MW how they reached that figure of 1:5, as I think they have used the fold and either ignored the blood, or just lowered the risk (from the fold) a little when they got the bloods (maybe from 1:3 to 1:5, for example), as they know fine well you can't combine the 2 results in a meaningful way unless they have been taken at the same time (as with the private tests).
As far as they are concerned, the big fold= very high risk, but they are not looking at all the other information, as with the private tests.

It's difficult trying to negotiate the 2 systems (NHS/Private), I know, and sadly in many areas (and it does depend on where you live), the tests on offer are less than ideal, done in a less than ideal way and this can lead to an awful lot of worry that really doesn't need to happen - those of use who are lucky can pay for private tests to fill the gaps, but not everyone can afford to do that.

I would trust the methodology and the results
of the private tests over the NHS ones, anyway.

Hi janski,

Sorry your having a tough time. I found it all very confusing and stressful too. When we had our 12 week scan (NHS)the nuchal came out at 3.7 which I knew from mumsnet was on the big side. The songrapher didn't mention it until I asked (I'd seen the measurement pop up on screen). She clearly didn't want to talk about it and just said; it was big but she had seen worse and it didn't mean anything without the blood results, and at my age (28) I was low risk anyway.

So we felt a little deflated but decided it would probably be fine and went ahead and made our 'big announcement'

Then a few days later we got a call saying our combined results had come back at 1:6 and we panicked. After what the sonographer had said I assumed that my bloods were terrible but when we went in the midwife explained that the bloods had come back fairly normal and the risk was mainly due to the nuchal. We fealt very hard done by to have such a high risk considering my age and the bloods were ok.

Anyway, we opted for the CVS, though I wouldn't want to recommend it. I thought I was northern and tough but I found it very painful and traumatic as did my husband. (Lots of other posts saying its fine so clearly I'm soft). Thankfully we got the results the next day and all was well. So relieved. But I really feel that our NHS 'odds' were unduely high. I mean what do they give older women with nuchals of 5 and bloods that indicate a high chance???

Anyway, I agree with oldmum, the private odds seem to be based on much more reliable data. Trust in them, the NHS showed your nuchal was shrinking which is a good sign and its largely guess work anyway.

I really hope the scan goes well xxx

Hello readyornot2011

Thanks for replying I am also northern (so also trying to be tough about the whole thing) ha ha but not doing very well ha ha. As I said above keep having moments of panic.

Just been to midwife as think I have a water infection and she listened to heartbeat for me all sounded fine so thats another bit of loveliness to keep me going.

Just reading what you said about your combined result if your bloods were good that you were 1:6 cos of my nuchal alone they gave me 1:14 so it looks like they say different things at different hospitals, if that makes sense how could your odds be 1:6 when your nuchal was less than mine!!?? Its all very confusing, anyway hope all goes well for you also and congratulations on your pregancy!!x

Janski, 1 in 5 is still an 80% chance of everything being ok. Good luck - hope it all goes ok for u