help- dodgy nuchal result - how to get a private scan?

[alondonmum]

Hi, just had my 12 wk scan today and would really appreciate some advice. I'm 40 and my scan nuchal result only reduced my risk to 1 in 202 of downs. The hospital said anything under 1 in 250 is higher risk and did I want to consider amnio/csv? In the meantime they've taken bloods to add that as a factor which may of course increase or reduce my risk factor. But the thought of a 1 in 50 miscarriage rate for csv is a bit worrying and I can't bear thought of waiting 4 wks for amnio.
My nuchal scan didn't include the nasal bone, heart valve element. So I was wondering if a private scan would maybe give me a bit more to go on - has anyone done this/know how to go about it/how much it costs? I'm in London. Sorry for length of this, but I'm just a bit worried about it all.

The risk factor for CVS is 1-2% and the risk of an amnio is 1%. It can depend where you have the test done, those risks can alter very slightly depending. The fetal medicine centre in Harley St is one the best places anywhere in the UK.

Just before you do anything, stop for a moment and think about what you'd do with the results. If the CVS or the amnio say your child has Down's syndrome, or posibly another chromosome abnormality, think about whether you would definilty terminate or not.

If you want this baby, regardless of any SN's then do some research, make yourself familiar with what it actually means to have a child with DS, and I can help you with that one.

Yes, a private scan would most defintely give more insight into these other areas and combine your blood work into the entire assesment and give you your own personal risk factor then and there, no waiting. They look at the nasal bone, the heart, internal organs, blow flow in and out of the umbilical cord, etc. so it is indeed very detailed. It's been mentioned loads on threads here and I'm always plugging the Fetal Medicine Centre (they should put me on commission!) so I'll go ahead and recommend them very highly again. It costs £150 and they are located on Harley Street. Google them, they have a website. They are really wonderful and the counselling and advice they offer if you are a higher risk (or not for that matter) is really wonderful, very clear and informative. Plus their own statistical risk rate if you do need to or decide to have CVS or amnio is much better than the national average and they are specialists in this area of medicine. Keep in mind though that the rare times a miscarriage tragically follows a CVS or amnio procedure is almost always a result of chromosonal problems with the unborn baby which would have resulted in miscarriage anyway, it's not the procedure itself. Whilst it is an invasive test it is still quite safe to have done, providing the doctor performing it is experienced and well trained, which is the case at the FMC. They will talk you through this all though and help you decide. Good luck with all this, I hope all goes well!

Thank you so much for that recommendation - I've called them and they're booked up, but might see if they can squeeze me in - fingers crossed. I think it's definitely the way forward as more info can only be a good thing? Just in case they can't fit me in - is there anywhere else that's highly recommended (although FMC on Harley seems to be top of everyone's list!)?

Don't know where in London you are, but if you're east, then Holly House in Buckhurst Hill (on central line) were very good. I wasn't offered a nuchal on NHS so had to go private and my GP recommended there or the Fetal Medical Centre - went for Holly House purely because they had Saturday appointments and FCM didn't - all very straightforward and got the results on the following Monday (by phone, by post on the Weds). Sure they'd be happy to talk through with you.

Try to see if the FMC can squeeze you in, very likley they will get cancellations and you can be fitted in. The Create Health Clinic is also located on Harley Street and has a great reputation as well. They also cost £150 so maybe call them as well and book a back up appointment in case you can't get into the FMC? They are another medical centre that specialises in fetal medicine so I'm sure they are also very thorough and reliable, they come highly recommended although I've no personal experience there myself.

I can't help with recommendations but some say that CVS only has a higher risk rating than amnio because its done earlier and therefore the natural risk of mis-carriage is a wee bit higher anyway the earlier on you are. Wherever you end up going definately ask them what their miscarriage rate is, if its a good place, the chances are they may say 'none'. I had two CVS tests done at my local NHS hospital and the consultant who did mine had never been aware of a miscarriage from the ones she had done.

FMC have managed to squeeze me in - which I'm really pleased about. Fingers crossed for Tuesday!!

OOh manners - sorry forgot to say thank you so much for all your help. It's amazing how quickly you can get good advice on here - I'd have been aimlessly trawling websites for ages...

Great! So pleased they managed to fit you in Best of luck with it, I hope everything goes well!

Hi Alondonmum.
According to
www.wolfson.qmul.ac.uk/epm/screening/calcrisk.shtml
the risk for a 40 yr old is 1:110, so your risk is only hwlf that of a women in your age group.
The 1:250 is averaged over all age groups and an arbitrary cutoff. (Am on the older side myself...)
I would definitely wait for the bloods to come back because they can change the overall risk quite a bit. All the best

good risk for a mum of 40 - especially as this doesn't include the blood tests. It's only a risk factor though - a detailed scan would be good - but this doesn't see everything. The amnio will give you an absolute result.

The risk should be calulated from your age, blood test & nuchal result.

what was your nuchal measurement?

Londonmum I had the combined Nuchal & bloods done (CUBS), albeit in Glasgow, privately & I'm a bit older than you but my risk with the combined test came back at more than 1 in 7500, considering my triple test with DD 5 years ago came back at 1 in 169 it's amazing what a more complete test can tell you. I almost went for an amnio the first time but decided against it & had a detailed scan at 18 weeks, thankfully she was fine.
My clinic don't look at the nasal bone but do look at the bloodflow etc, the scan where they did that bit was amazing when you consider how tiny the little guys are. My nuchal measurement was 1mm at 13+3 if that helps you at all.

Hi there,
Upstairs from the fetal medical centre is the Birth Company where you can have a private scan done by Dr Gibbs (obstetrican) who is lovely. They do very thorough scans and have the absolute latest and greatest equipment. I can highly recommend. Google them - they have a great website. Similar pricing I think.

Dr Gibb does not do nuchal scans, he sends you to the Fetal Medicine Centre for these anyway. He also sends you to the FMC for CVS or amnio, he does not do these either. Just wanted to mention this.

I had the nucal with Gibb - well, he took the blood but then results were processed downstairs. This was in 2004 though at 12 wks.

I had my nuchal scan with Doctor Gibb.
Don't know what you're on about. Why would he send you elsewhere when he has all the equipment in his consulting room???

Mine was only a couple of months ago too, so I'm not out of date.

Okay - sound a little hostile there but all I can say is that bloods were taken at the 12wk testing and processed downstairs, not in his office, for part of the test. This is what happened to me.

Thanks again for all the info here. I can't really work out what my nuchal measurement was - on the report they gave me I hve the measurements: CRL 67.7mm, NT 2.0mm, BPD 23.2 mm. They didn't actually tell me in person what the measurement was - just the risk factor. Anyone know if NT the Nuchal bit?? And what does the measurement mean? This was at 12+2 wks.

Sorry 45Days. Pregnant and clearly having a moody day . Didn't mean to sound so harsh!

SD - don't worry about it. I overreacted!!

Londonmum NT is the nuchal bit at about 13 weeks I was told average NT would be 1.4 millimetres so yours was a little more but that doesn't mean baby has DS, some babies have a thickened fold at this stage then it decreases. the combined tests where they include your age, bloodwork etc calculate an overall risk. I was convinced my NT was good so my bloods must be rubbish from what had happened to me previously when I'd only had the blood tests. It's all quite confusing & a little worrying but try & get as much info as you can & then deal with things as they come, don't second guess when you don't have all the info that is available if you're going for a private scan anyway. Good luck.

I was told this by Dr Gibb and this was in January when I went for an initial consultation. I didn't actually end up using him as my consulant for a number or reasons but regardless, he could have changed his policy regarding nuchal scans, CVS and amnio but his website also still says he doesn't do these but sends you to the FMC, I just checked. Only one way to find out for anyone interested, and that's to call his office. I'm just telling you what I was told.

dr gibb did my nuchal scan with this pregnancy - i#m 30 weeks now so this would have been in january i think

agree he's fab

Hmm.. maybe he meant he just doesn't do the CVS and amnio? Did anyone go to him for these procedures? I was sure he said he sends you to the FMC for the nuchal scan and these procedures but maybe I'm talking rubbish and imagined the whole conversation? Either that or I was singled out and you all were able to have your nuchal scan! I'm very curious now!