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Pregnancy

triple test and Fetal Medical Centre

45 replies

geranium · 12/12/2005 10:34

I know this has been raised before but I would be grateful for help in reviewing my options. My triple test result has come back as 1 in 780 (for Down's or Spina Bifida). That seems very high to me since last time the probability was 1 in 7700 (I'm 36 now and was 33 last time). I would like to carry out further tests and would be grateful if I could just be reminded of the options.

I am starting week 18 today. Can I still have a nuchal fold test and, if so, where in London do you go for a private test (hospital does not offer this). Also, would nuchal fold test tell me much more.

If I go for an amnio, it sounds like the London Fetal Medical Centre (?) is more used to carry these out than the hospital is likely to be and with a better chance of not harming the baby - is that true and, if so, should i ask for a particular doctor at the FMC or would any do? How quickly do I need to have this done?

Any other options at this stage (other than hope and pray).

Many thanks in advance for your help. Sorry to be asking again such a common question. I have tried to read the previous threads on this but somehow when it happens to you it rather focuses the mind!

OP posts:
hub2dee · 12/12/2005 16:06

Actually, I think it's CVS that can be more position-sensitive, but I am a layperson, so do check with your docs ! I think CVS is also only up to about 13 weeks, so for 'certainty', at 18 weeks, I think it'd have to be an amnio.

Re: consultation - I'd guess this was only because they want to explain EXACTLY what this test would achieve and to properly explain to you the pros and cons of doing it, and to advise on whether your risk profile would tend to indicate whether this was advisable IYSWIM.

FWIW, if you were my wife, with our second baby at 36 (which is actually probably close to how things will work out for us, if we go for a second and conceive within a year), and there was no specific medical complication to our familial backgrounds and pregnancy histories, I would be very happy and reassured by your 1 in 780 result. (And I am a research nut / investigating / querying PITA hub, LOL).

Best wait for the anomaly scan results and, like you say, take it from there.

geranium · 12/12/2005 16:24

thanks again. Hope it is pregnancy that's making me slow on the uptake but just realised hub2dee may mean you're a hubbie (probably to Dee) rather than the female member of the partnership. That would explain your suggestion of the scenario of "if you were my wife". I was a little taken aback 'coz in the same circumstances I would probably have said "if you were my sister/best friend" (not that I want to be judgemental) but all is clear now

OP posts:
hub2dee · 12/12/2005 16:37

LOL, g, yep, a hairy-handed, truck drivin' mean-talkin' bear grapplin' bloke. My dw's name is Dee.

Our photos and stuff can be found here .

geranium · 12/12/2005 17:01

very sweet! how old is your daughter now?

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hub2dee · 12/12/2005 17:12

23 weeks I think. Or 22 and a bit, LOL. (oh, re ages - I'm 35, dw just turned 34 a few days ago)

hub2dee · 12/12/2005 17:13

(re shoebox - she was 4 weeks prem)

pacinoFanOfBrusselsSprouts · 12/12/2005 17:42

Geranium, have been in a similar situation a few weeks ago and I can sympathise with you.

I echo what a previous poster has said, i.e there is a difference from 'risk assesment' and 'certainty' and it really depends what type of person you and your hubby/partner are as to what route to take.

Personally, I am a need to know type. We opted for an amnio with odds that others would consider really quite good - 1 in 1200 - but given that my previous odds (same test) had odds of 1 in 50,000 the risk increase was significant and we opted for amnio.

It's a tough call, and only you and your other half can make this decision. It sounds to me like you are doing an excellent job informing yourselves of your options, best of luck to you whatever you decide.x

Oh, and FWIW, had I lived nearer the London area I would have opted to have an amnio at the Fetal Medicine Centre. Having read previous threads here, this centre seems to come out tops for testing. In the end I had mine done at my local hosptial, glad to report results all fine and baby doing well.

geranium · 12/12/2005 18:00

do you mind telling me a bit more about your amnio? was the age element significant in your test results? did they give you counselling? what was the procedure like? how long did it take? how did it feel afterwards? did you check your hospital's rate of miscarriages for amnios or just go for it once you had decided? I take it you didn't bother last time round (what amazing odds - I thought 7000+ was good!)?

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pacinoFanOfBrusselsSprouts · 12/12/2005 19:03

Not all all, geranium. Yes, it was age related (am 38) so didn't expect 1 in 50,000 result again. I spoke with the administrator at Bart's where I had my screening tests done and he said that of the 5 markers they looked at, 2 had raised levels, though not enough to give a screen positive result.

I must stress, it was never recommended by anybody to go ahead and have an amnio - this was purely the decision me and dh arrived at as, like I said, we are 'need to know' types and the unknowns were just too worrying for us. The actual amnio - yes, I had some counselling provided by the consultant performing it and he was more than happy to answer my questions. I found the acutual procedure pretty unpleasant, partly because my dh was unable to be there due work commitments and also it did take a while for baby to be in the right place so the fluid could safely be extracted. However, I have read of others who found the experience actually ok and not too unpleasant, I suppose it must be different for everyone. In reality, it probably didn't take too long, about 5 mins total. Was a bit shaky afterwards, consultant said it was normal as there was bound to be plenty of adrenaline running around my body. I rested (I mean really rested) about 3 days, and did no lifting or manual stuff for over 2 weeks. I also booked dd1 in for extra nursery sessions so I could get some rest. Yes, I did question the consultant's miscarriage rate. Inititally I found the thought of asking questions like this quite difficult but it has to be done, and he was quite ok about it. His risks were 1 in 300 and I felt confident in his ability to go ahead and have it done. You are right in assuming I didn't have one done first time round, we were happy with the results of the screening tests we had done.

Hope that helps, geranium. There have been plenty of threads on this subject, and a real variety of views. Take your time in deciding what to do - it really is a toughie but I did find that once we had reached a decision, we felt somehow calmer and a bit more in control, if that makes sense? Best of luck to you and your dh,

Imafairygetmeoutofhere · 13/12/2005 09:05

Geranium,

when I had my nuchal I was given a 1:63 risk of Downs (it was on my 35th birthday!) so I decided to go for the Triple (I think maybe we're calling different things the triple - triple for me was two bloods and nasal bone). Before I went for the test DH and I agreed that if the risk came back as higher than 1:300 I'd go for a CVS (like you I have another child to consider)- it came in as 1:235. That came back negative for Downs and all the other tests they do.
HTH and good luck

geranium · 13/12/2005 20:11

So just as a matter of interest did you go for CVS given that result? The triple test I had was just a blood test. I wish I'd known more. I've now got my Mum worrying which is bad since she is unwell. She mentioned this to her doctor this morning (as one possible cause of stress aggrevating her high bp) and her doctor said cheerily that not to worry as I could alternatively have nuchal scan or CVS. Grrr doesn't he realise my main concern is that I am too late for those!

will tell you how the scan goes tomorrow. May not take us any further but at least I'm doing something.

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Imafairygetmeoutofhere · 14/12/2005 09:03

Geranium - yes, when he gave me the test result I said I'd like a CVS, and he said "we can do it now if you want" which was great. The worst part was waiting for the results (take 2-3 working days, but there was a weekend in between). FYI, my nuchal measurement was 3.2 (at 13 weeks) which is huuuge, , but as I say it all turned out well.
Hope the scan goes well for you today - let us know once you're back.
x

geranium · 14/12/2005 16:52

just to warn other people using the FMC, they work to 3 or more hour delays. Still haven't been called in and they tell me people with 1230 appointments still haven't been seen . By the time I get there the person doing the scan plus prof. himself are likely to be exhausted at the end of a long day. Goodness knows what shape they will be in to give me a proper scan or any good advice. Feeling cheesed off. NHS is one thing but can't believe I'm paying several hundred pounds for this.

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tonton · 14/12/2005 16:55

I had to wait AGES too genranium! Had planned to have a CVS whatever my 'score' but in the end couldn't bothered to hang around any longer than I had to.

geranium · 14/12/2005 17:35

Useful to know though, isn't it? If I was going for an amnio I'd be absolutely beside myself by now given that one would be anxious, trying to stay calm and focused but at the same time was having to ring on an hourly basis to find out when to come in. Anyway, so long as they know their stuff and are still able to do it by the time I'm seen then it will have been worth the wait.

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blueshoes · 14/12/2005 19:48

I am the queen of anomaly scans at Kings/FMC, having been obsessively scanned from 13 weeks until term for anomalies picked up at the 12 week scan. Yes, be prepared to spend a morning or an afternoon. Geranium, I know you have already booked the scan, but morning scans tend to be slightly better in that cumulative delay is less severe. I am not sure about your scan, which you are paying for, but my hospital-recommended scans were always done by someone other than the prof, with his whearabouts being discussed by the other doctors, to see if they could pull him in to see mine. So it is hit and miss whether I got the prof.

Hope your scan goes well and it allays your concerns. They are v. good at FMC

blueshoes · 14/12/2005 19:49

Oh and also, FMC have the best clearest machines.

geranium · 14/12/2005 23:37

Thank you blueshoes. It was well worth the more than 6 hour wait (). By the time they saw me, the scanner and the Prof. had been working for 12 hours, apparently non-stop so hope they were still awake. Scanner said 17 weeks would be a bit early to tell much except in terms of development according to dates but prof. breezed in during the scan, took over and after a very very short scan (1-2 minutes if that) said it all looked fine and no markers were present. So hope he really had checked everything but he was very reassuring so delighted we went to FMC. Despite the fact that they were running 7 hours late by the time we left, I would certainly recommend the place.

Oh, and we just resisted temptation and chose not to find out the sex of the baby.

Thanks for all the help and support received on this thread. Much appreciated. Can't say I'll stop worrying (about this or any other point) given my personality but hope at least to have a good night's sleep tonight. Night all .

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Imafairygetmeoutofhere · 15/12/2005 11:25

Glad to hear it went well Geranium. I think worrying excessively is an occuaptional hazard of motherhood and pregnancy, so I'm right there with you!!!!
xx

blueshoes · 15/12/2005 11:38

Geranium, just wanted to say I'm glad the scan went well and you had a very positive experience notwithstanding the wait . Your description of the prof breezing in and taking control is absolutely spot on. 1-2 min scan by him is par for the course - I don't need to say but he is v.v. experienced. Better a short (normal) scan than one where they pore over this structure and that!

Although a 17 week scan won't pick up everything, their machines are very advanced and give a clear image. They can still see the main organs like the brain, heart (right down to the heart vessels), spine, abdomen clearly and some chromosomal and genetic defects would present markers in those areas - which the prof has cleared.

Hope you got the reassurance you were looking for.

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