Please help! Are combined tests offered on the NHS in Northern Ireland?

[minou03]

Hi,

I'm 12 weeks pregnant living (but not from) Northern Ireland. I don't understand the system here and I just can't seem to get any information about the combined test/nuchal scan. I read about it in my pregnancy book (published in the UK).

My scan is not until the 14th week so it would be too late to go private after that. I also don't have a lot of money...it seems the test costs £950.

I managed to speak to a midwife briefly and she said 'we don't do that anymore' and seemed quite annoyed. I'm not really sure what she meant. I just want to have the choice but I'm really confused as to how or what kind of tests are done here. Can anyone help me? I feel like I'm running out of time and now I can't get through to the antenatal clinic and my GP says he doesn't know. No-one knows I'm pregnant so I can't ask anyone I know either!! I'm so lost please help!

I've now booked a private scan for next week but I would really rather avoid it if I can get it on the NHS.

Thank you! Any help very appreciated!!!!!!!!!!

I think they don't offer Downs screening in Northern Ireland because terminations are illegal there so there is nothing they can offer you if it showed you were high risk. I would be surprised if a private clinic would do it as well, for the same reason, unless you were planning to travel to another part of the UK for a private scan?

You can get the nuchal translucency scan privately in NI
www.ultrasound-direct.com/mobile/ScanDetails.aspx?scanId=6&catId=4
Still nearly £200 but if you're set on it might be worth it.
If you are high risk for Down's I think they will do the triple (maybe quadruple not sure of exact name) test but it is not routine. HTH.

I was offered the quadruple test on NHS here but they don't do it until 16 wks.
Had nuchal fold test in first pregnancy (£200) and Harmony Test this time round (£400) at Dr Fogarty's clinic. I'm not sure what I would have done with the info but just needed to know if that makes sense? Other clinics offer the same but I found they were more expensive. Harmony test can be done from 10 wks, and gives a yes or no answer for trisomies. Really reassured me this time round as I'm an older mum.

I paid just over £200 for Nuchal scan at dr fogarty's clinic in crawfordsburn. They offered to combine it with blood test for an extra £40 or so.
The triple test (bloods only) is available on the nhs at 16 weeks, but not as reliable as nuchal, and obviously a good bit later on.

There is no such thing as "downs screening" the tests check for a range of trisomies and other conditions.

The nuchal is not generally done as it is not a diagnostic test - it does not give a definitive answer.

The quad blood tests are done as standard.

As a pp has pointed out, termination is illegal here so you really need to think about what you will do if your tests results are not what you want.

I'm not sure of the specific tests available in NI, but if you are potentially high risk, either from age or scan indications, they will offer a test.

wipsglitter, my local hospital (in England, not NI) certainly only give a risk of Down's syndrome and don't mention any other trisomies.

Thank you everyone!!!!!!

Its very hard to live somewhere where the system is so different. It amazes me because for me it is not about abortion or not, it is about information/reassurance/preparation and I assumed it would be the same across the UK, regardless of the difference in termination laws.

The babybond place in Belfast doesn't offer the nuchal scan either but I have an appointment (juuust in time) with Dr Fogarty so I'm feeling reassured already...I really appreciate all your help thank you so much!

dino if you got the triple test or the quad test (blood tests) then they were testing for other conditions, people are just fixated on Down's syndrome.

Here's a bit from wikipedia: they are also testing for two other trisomies as well as a whole range of other things.

"The most common abnormality the test can screen is trisomy 21 (Down syndrome). In addition to Down syndrome, the triple and quadruple tests screen for fetal trisomy 18 also known as Edward's syndrome, open neural tube defects, and may also detect an increased risk of Turner syndrome, triploidy, trisomy 16 mosaicism, fetal death, Smith-Lemli-Opitz syndrome, and steroid sulfatase deficiency."

The one I have booked is a 'nuchal scan and blood tests' is that the same thing?

minou that would be the combined test which is offered in most of England. It has to be done around 12 weeks. It takes the nuchal fold measurement plus two markers in blood to give you a probability of Down's syndrome. It also looks at other disabilities.

I believe they don't do it in NI because like others say you might want to terminate if the results aren't good. A follow up amino or cvs is offered in England if your results is high risk.

I'll find the NHS link that explains the different tests for you. It might be the same as what you are looking at already.

The triple and quad tests are less accurate then the combined nuchal and blood tests.

www.nhs.uk/conditions/pregnancy-and-baby/pages/screening-amniocentesis-downs-syndrome.aspx

It explains what you have booked vs the quad test. I guess that's the most commonly offered on the NHS? Harmony is a new test that's 99% accurate but only available in a couple of hospital in London (under NHS). I think someone gave you a contact if you wish to do it in NI. I'm glad you found Dr Forgaty who will give you a NT scan. It must be quite rare people request it in NI then!

wips, they really weren't. Down's screening is all you get in the local hospital as routine, although it can be used to detect other diseases.

(I am both a doctor and a mother of a baby of one of those other conditions. I am not "fixated", but do know what I am talking about.)

But the blood test is for those other conditions, not just Downs.

Right, I'll try again.

Those tests can be used for risk stratification of a number of diseases.

In my local hospital, the test is only used for risk stratification for Down's.

That is the only result given to patients and clinicians, even if, as in my case, you are being cared for by Fetal Medicine because of a previous baby with chromosomal abnormalities, so already high risk.

My local hospital, unless they are keeping it all a secret from me as a patient and from my Fetal Medicine consultant who might have a vested interest in knowing the results, do not tell you the risk of anything other than Down's following a triple test.

You can also get a CVS or amnio in Northern Ireland, if you get 'high' results back.

We're not a total backwater!

I know, my point is, the test can be used to find out about a range of problems not just Downs syndrome, however in your case it was apparently only used to test for DS.

No need for the sarcasm.

No, you told me several times that I was tested for other conditions, despite my saying otherwise.

"There is no such thing as "downs screening" the tests check for a range of trisomies and other conditions."

"dino if you got the triple test or the quad test (blood tests) then they were testing for other conditions, people are just fixated on Down's syndrome."

"But the blood test is for those other conditions, not just Downs."

My point, which you now concede, is that while those test CAN BE USED for other conditions, in some places, such as in my local hospital, it isn't.

I'm glad that we are finally in agreement!

I was unaware of your personal medical situation.

In general, people ARE obsessed with "downs screening" and frequently, through not in your case, they blood/quad/triple tests ARE checking for a range of conditions.

There are a few places in Belfast that do the Harmony test I think baby bind us about £500

I wouldn't recommend babybond, I had a private scan there a few weeks ago. The scan and sonographer were fine there was just this amateurish feel about it, you're barely in the waiting room 5 mins and the woman is over with a credit card machine, the waiting room is also a kitchen - very weird!

"I was unaware of your personal medical situation." - which I mentioned twice, wips, and even if I hadn't, your posts came across as being rather patronising. And yet, you are finally agreeing with me that, yes, the test CAN BE USED for testing other conditions but NOT ALWAYS, as in one of the largest teaching hospitals in the UK.

Anyway, minou, hope your scan goes well. I think time never goes as slowly as the wait in between having a positive pregnancy test and the first scan!

Calm down.

I was trying to help the OP.

And you are finally agreeing with me that the test CAN be used for testing other conditions not just Downs syndrome.

Aargh! Read my posts! That has been my point all along while you have been determined to tell me that I was tested for the other conditions.

Are you perhaps reading a completely different thread, wips??? You seem to have taken my local hospital's policy rather to heart.

Let me go over it again as it seems it has proved a little complex for you.

DinoSnores Tue 09-Sep-14 14:37:35
Down's screening is all you get in the local hospital as routine, although it can be used to detect other diseases.

DinoSnores Tue 09-Sep-14 15:05:14
Those tests can be used for risk stratification of a number of diseases.
In my local hospital, the test is only used for risk stratification for Down's.

DinoSnores Tue 09-Sep-14 20:49:16
My point, which you now concede, is that while those test CAN BE USED for other conditions, in some places, such as in my local hospital, it isn't.

DinoSnores Wed 10-Sep-14 14:33:48
And yet, you are finally agreeing with me that, yes, the test CAN BE USED for testing other conditions but NOT ALWAYS, as in one of the largest teaching hospitals in the UK.

Please, wips, stop replying and making yourself look daft, or read through the thread properly!