CVS and amnio - balancing up the risks

[elkiedee]

I had my 1st baby last year at 37 (nearly 38), have just turned 39 and am 12+3 weeks pg. I had a scan/combined test on Tuesday (scan and bloods) and got a phone call this morning saying risk is 1:120 mainly based on age (39 at due date is 1:139, 40 is 1:112, I will be 39 and 7 months though I don't know if they take the months into account) and would I like to talk about further tests?

Not sure what to do at the moment, I want baby very much and my risk isn't going to get any better.

Any thoughts and experiences from other older mums?

Hi, I'm not an older mum but saw your thread. I have a feeling that, although your stats are low, they are not too bad (ie some come back 1 in 20). It's a really tough decision- risk of amnio or leave it to chance. You still have really good odds though that baby will be absolutely fine. Good luck with your decision. x

Only you know what you would do if the test was positive. You need to think how you would react to that before you can decide how to proceed.

Like you I'm an 'older' mum and I opted for the amnio. My local NHS hospital do not offer cvs as the risk (2%) is too high (ito). The experience was great as the staff were so reassuring, kind and gentle. Lots of tea, biscuits and rest for me & DH.....but the wait was agonising. 10 days, we didn't have the option of faster results that some hospitals offer. In our case the results were all ok. It is a tough decision, but I'm glad we went through with it. Good luck whatever you decide.

Just for your info the CVS miscarriage rate is 2% averaged over all the hospitals that do this test- BUT apparently the more experienced the person is who undertakes a CVS the lower the risk of miscarriage- so it your hospital do them very frequently the miscarriage risk should be similar to that of an amnio. The major bonus of CVS testing is the fact is can be done as early as 10.5 weeks, whereas amnio is usually done at the earliest at 16 weeks. This makes obviously a big difference if you think you would consider terminating the pregnancy if any positive results came through.

It might be worth asking for some advice from ARC (antenatal results and choices)- see: www.arc-uk.org/

BTW- many congrats on your pregnancy and I hope it all goes smoothly

If you would 'act on' an abnormal result then it may be worth looking into further tests. If however you would continue with the pregnancy regardless of the results then maybe it wouldnt be worth the (small) risk associated with amnios etc.
Its probably best that you speak to a professional before making any decisions.
Good luck.

Bump for Elkie

Hi I had a cvs this time at 13+ weeks - got the results in 2 days luckily. The procedure itself is very straightforward, but even a 2 day wait is not much fun.

I know most people take the view that if you aren't going to terminate the pregnancy there's no point having the tests, but I felt strongly I wouldn't know what I would do till it happened. My first pregnancy went badly wrong and I was offered a termination at 32 weeks. If you'd asked me beforehand what would you do in that situation, I'd have said I'd have had a termination no doubt about it. But when it came to it I felt strongly that I couldn't do it, so I didn't. This time round, I felt I could cope with anything as long as was prepared for it - I just wanted the test.

Also bear in mind the tests are designed for specific conditions, they can't give you any guarantees. And statistics can be misleading - when I had the cvs there was a lady there with a 1:5 chance of Downs, which sounds overwhelming yet realistically she had a 4:5 chance of having a non-Downs baby. On the other hand the midwife told me that they had recently delivered a Downs baby to a lady with a 1:30,000 risk on her nuchal scan.

There's no right or wrong decision but I wish you lots of luck whichever way you decide to go.

Fetal medicine centre on their website said they would offer a CVS if your results from the combined test was 1:300 or worse. In your position I would either have a cvs or an early amnio. Although I would first have another nuchal/blood test privately if you can quickly as the nuchal fold test is in the skill of the person who does it.

I'm 38 and will have my nuchal in a few weeks at the fetal medicine centre even my local NHS hospital offers it but at 14 weeks so that is too late for me. I am thinking about having an amnio anyway for peace of mind because they are only odds, you can be that one in whatever.

If you truly don't mind if you have a Downs baby (although my friends who don't refused nuchals) then don't have any invasive and wait to see if the 20 week scans shows any abnormalitiles.

Thanks all for responses so far. Still thinking but will talk to the hospital and see what they can offer in terms of further information and whether CVS is a possibility. CVS does indeed carry a risk which appears higher than amnio, but I wonder if that's partly because it's normally done earlier in pregnancy.

Another update, I have an appointment for CVS on Thursday. Even if the news is bad, I will at least know, I feel very much "on hold" at the moment. I haven't totally decided what I'd do in the event of bad news, but the uncertainty is hard for me to cope with.

Good luck for tomorrow Elkie. I am 36 and my risk was 1 in 96 (the nuchal scan showed an absence of nasal bone). The risks of having a CVS are much much less with an experienced person doing it. You'd go nuts waiting weeks for an amnio. Anyway, all was well for me and since (I am now 21 weeks) I have really appreciated the peace of mind it gave me. It's horrid waiting the couple of days for the results, really ghastly, but at least you'd know one way or the other. I 'treated' myself for going through this procedure by finding out the sex (as they are examining the chromosomes, obviously they can see for certain if it's a boy or a girl).

Thanks to everyone who offered advice, reassurance or even opinions, I found it helpful.

I went for CVS last Thursday (24th) - it was carried out by a very calm, confident female consultant. I felt very reassured that she does quite a lot because the hospital has a big early screening programme. It all went quite smoothly and quickly, I think the worst bit was the risks of miscarriage etc conversation and signing the consent form at the start. I also learned that apart from my age, the blood test results had been the issue in my case (nuchal fold was fairly normal). The consultant told me at the end that it had been quite straightforward and that the risk of miscarriage would already have dropped considerably. She also told us, checking we wanted to know, that it's a boy.

I had been told by phone that I'd get the results today but the letter I took away said 3-4 working days so I was on edge this morning wondering if I'd hear or not.

The phone rang at 11 am, and the woman from the clinic who does the phone calls about these tests/results said "I've got good news..." straight away so I knew I could start breathing again.

Full results will be two weeks but I'm ready now to think about maternity clothes and stuff.

Good news - I'm so pleased for you!