High risk combined test, low risk NIPT - WWYD?

[nc14]

I got 60/150 for down syndrome on the combined test (NT normal, PAPP-A a little low, HCG a little high, and I’m nearly 40), so I had NIPT on the NHS which came back as low risk.

I didn’t have the combined test with my last DC and happily relied on the NIPT, but the combined test results this time around have made me nervous. In my situation would you get amniocentesis? I’m also needle phobic so the thought terrifies me.

I haven’t had my anomaly scan yet as I’m 16 weeks.

I was told that NIPT is more accurate than the combined test so you could happily rely on it. How low is your Papp-A and how high is your HCG? I have done NIPT which didn't detect anything and have to redo my 12 week scan next Monday as baby was not in the right position to take a good NT measurement.

The letter I received says bHCG 2.85 Corr MoM and PAPP-A 0.47 Corr MoM. I have no idea what that means so am relying on what the midwife told me!

Your NT is normal and I read on the NHS that anything under 0.4 for Papp-A is considered as low so you're at the limit.
If the amnio really scares you (and rightly so), then you could rely on the NIPT which is superior to the combined test anyway.

I'd rely on the Nipt, sounds like it's your age that's pushing your risk up (no offence, my twins were born when I was 38).

But it depends if you would Def choose a TFMR if T21 was highly likely? You could also wait for the anomaly scan and reconsider the amnio if it shows issues?

@SleepingStandingUp Waiting for the anomaly scan is my current thinking and they’ve offered to bring the anomaly scan forward to 19 weeks and have a consultant do it to ease my anxiety. (I’m prone to anxiety anyway, so this is not helping!).

@TTCbaby2023 I think it’s my age too, no offence taken!

@SleepingStandingUp @nc14 Yes age is a big factor. The midwife advised me to do an NIPT anyway as she said that my age (42) would most probably put me at a fairly high risk anyway.

I was high risk following combined screening and had NIPT which came back low risk and I was happy with that. I didn't want amniocentesis due to the small risk of miscarriage due to how long it had taken to conceive. I was told that it would be my age (40 at the time) which made me high risk due to the way the calculation works