Is it better to pay for tests? I'm 38 and first pregnancy

[usernamein]

My family have all had healthy pregnancies - mum was having babies until her 40s.

I'm having my first one at 38. I'm overweight/obese but no other health complaints.

I'm going for my first hospital appointment and Ive accidentally had to tell some family. I'm 10 weeks this week.

My anxiety over having a baby that it's viable etc is high. I really want this baby. Would it be wise to get a test done? I'm a bit confused what tests to do.

I'll be speaking to hospital midwife (if that's what I'm seeing) and ask for more information.

I know most pregnancies run smooth but when it's something you want it's hard :(

What sort of tests do you mean?
There will be routine tests they will offer

Will you have a scan at that appointment or just see a midwife?

Most tests are routinely done at 12 weeks.

You will be offered tests routinely as part of the NHS service you receive. However some women, generally those age 35 plus also pay for the NIPT test which tests for Downs, Edwards and one other syndrome earlier than the NHS tests.

It's basically the test they send you for if you NHS test flags as high risk. It can be done from 10 weeks. Totally personal choice I know lots of people who chose to have it myself included and those who chose not to. It is expensive at £400 x

Not sure

Why did you choose to have it? Was it because of your age?

@usernamein yes I am 36. I didn't have it during first pregnancy when I was 32. Just had standard NHS tests then c

At the 12 week scan you will be offered a test to check for risk of Down syndrome, edwards and pataus. If they come back as high risk you’ll be offered a nipt test on the nhs so I wouldn’t pay for anything

On thanks.

I'm just worried.

Congratulations on your pregnancy. I was 41 when I had my dd. The first weeks are a bit nerve wracking but you should be able to access tests on NHS from 12 weeks if not sooner

Thanks.

I wish I didn't tell anyone as I'm so worried

Are there any reliable stats I can look at?

I didn’t have the NIPT test with my first pregnancy (at 31) but did with my second (at 33).

Personally, my decision to have the tests second time was based around what I would do if the tests showed a problem. With my first, I think I would have carried on with the pregnancy even if the tests had shown a problem, unless that problem was severely life limiting/likely to be painful for the child.

However, with my second I think I would have terminated the pregnancy if the results had been bad - I struggled with motherhood and don’t think I could have coped with a child with significant additional needs and it would potentially have had a negative impact on my first child.

I am totally on board with a woman’s right to have an abortion. However, I think it’s significantly preferable to have it as early as possible if you do have to have one - before the foetus can feel pain or really have thoughts if possible and the NIPT would give results several weeks before the NHS so we went with it.

I don’t really see a point in paying for the NIPT tests if you wouldn’t actually change what you’d do if the results were bad but if you would I think it’s worth knowing that little bit earlier.

Is that NIPT test the extra one that they do if the first one doesn't go well?

I'm a primigravida too - had my babies at 36 and 39, I worried myself silly but everything was fine. You can get a private scan if it helps. Fingers crossed for you x

Hi guys, is there any other tests bar NIPT, I am pregnant at moment, 13 weeks, was twins and one sadly didn't make it which makes NIPT unreliable and not advised. I'm also 38 and worried about the baby so would like as much info as possible, have my 12 weeks scan Thursday at 13w+3 but don't mind paying for extra private tests

It's about reassurance. Yes you get the NHS test and you might get a low risk result ie less than 1 in 250 chance. However for some people they want more certainty so they pay to get it privately. The NIPT is still a screening test but it's 99% accurate which is much higher than the nhs combined screening test.

You can get the nipt test from 10 weeks. With my first I got it before my nhs tests as I knew I wanted it anyway. With my second I had to have it after for a variety of reasons.

I had a low risk result both times with the nhs but was happy to pay £500 for extra reassurance due to my age.

Is sounds like NIPT test is the option? The results are more certain?

Can you confirm the test will only pick up 82% of downs, 49% Pataus and 37% edwards?

The Warwick Evidence Systematic Review of the performance of NIPT found that the negative predictive value (NPV) of NIPT was 99.9%. The NPV tells you how likely it is that a low probability NIPT result is correct. This means that if you get a result that shows a low probability of the chromosomal conditions you can be fairly certain you do not have a fetus with any of the conditions.
The positive predictive value (PPV), which shows how likely it is that a high probably NIPT result is correct, varies for each condition tested:
• 82% for Down’s Syndrome (known as Trisomy 21)
• 49% for Patau’s Syndrome (known as Trisomy 13)
• 37% for Edwards' Syndrome (known as Trisomy 18)
A high probability result does not definitively confirm the presence of one of the conditions and further testing is required.
The NIPT test will detect 99% of pregnancies where a high probability of Down's Syndrome, Edward’s Syndrome or Patau’s Syndrome is present.
Results can also be inconclusive, which happens in less than 1% of cases. This is usually because the proportion of fetal DNA present in the sample is not high enough to give an accurate result. The test may be repeated with the hope that the fetal DNA levels will have increased due to the increased gestation. In some rare cases however, the fetal DNA is naturally low and in these instances a result cannot be yielded.
The NIPT is more accurate than the first trimester combined test or second trimester quadruple test for estimating the chance that the baby has Down's Syndrome. The false positive rates are 0.01% for Downs Syndrome, 0.01% for Edwards' Syndrome and 0.01% for Patau's Syndrome. Conventional screening tests can miss 15% or more of Down’s Syndrome pregnancies.

www.ultrasound-direct.com/services/pregnancy/nipt-scan

I'm sorry, I was in the exact same situation as you. You can still have the NIPT but you need to have the SAFE test rather than the harmony test. The SAFE test was developed by St George's hospital in London and can be used with a vanishing twin. It is slightly less accurate than with a singleton pregnancy but still much higher than the nhs combined test. You do however have to wait until later in the pregnancy eg 16 weeks, to ensure it doesn't pick up the fetal DNA from the vanishing twin. As far as I know the only other option with a vanishing twin pregnancy is an amniocentesis, which is diagnostic but comes with a risk of miscarriage.

No, you are reading it wrongly sorry. It is 99.9% accurate if you get a low risk result. The figures you have quoted are if you get a high risk result. i.e. if you get told it is high risk for downs then in 82% of cases this is correct. However if you get a high risk result you would likely want to get a diagnostic test (cvs or amniocentesis) which would confirm it. In other words especially with edwards and Patau there is a high risk of a false positive. But if you get a low risk result it's very very reliable

Ok thanks.

This had made me feel better knowing in just over a week I will be able to get the tests and get the results a week later.

@Whentwobecomesthree is this something can be done privately or nhs? Is it only available in that spefific hospital? I wonder how I go about getting it done, I live in the North of Ireland

@38andtrying you get it done privately. I got it done privately in London. St George's created it but you definitely don't need to go there to get it.

Here is some info about it www.stgeorges.nhs.uk/service/maternity-services/your-pregnancy/fetal-medicine-unit/the-safe-test/

There is an email address on that page [email protected] if you can't find a supplier then you could email and ask

I think so - I think you would normally have the NIPT test as a next step if the NHS checks showed a potential issue as it would give you more certainty. So by having the NIPT test first you speed things up.

@Anonymouslyposting thanks £400 😞 but anyway I'm overweight so I don't think I can test at 10 weeks....