Anyone recommend somewhere to get integrated test done privately in London?

[alittleteapot]

We've had a high risk result based on bloods in the combined test. We've decided to hold off invasive tests and want to have the integrated test (where they do further bloods at 15 weeks.) I'm trying to find somewhere i can get this done, any recommendations appreciated.

Sorry to hear about your result. That must be scary. I've heard the Fetal Medicine Centre recommended many times on mumsnet and in real life. All profits to charity and Kypros Nicolaides is pretty much the world's leading expert on fetal medicine, apparently. I would contact them to see if they can help if you definitely can't get further tests on the NHS.

Thanks. I've already rung them and strangely they don't do the integrated test but maybe i'll go there for a second opinion anyway as they do seem to have a golden reputation.

I had the combined test a few years ago at the Wolfson Institute, Charterhouse Square, London..They developed the test.

Here is a link to the Wolfson website
www.wolfson.qmul.ac.uk/epm/screening/leaflets.html

If you go the Questions and Answers about the Combined test leaflet the number to ring for an appointment is on the last page.

The integrated test was developed by the Fetal Medicine Centre at about the same time that the Combined test was being developed by the Wolfson - they don't offer each other's tests (well, they didn't a few years ago!)

Thanks Millarkie, I've just left them a message.

Is it the other way round? The fetal medicine centre doesn't offer integrated, the Wolfson seems to offer both!

The first part of the Combined (scan plus first trimester bloods) is the same as the integrated. When I went they would not tell you the result at that stage as they wanted to gather data on the full combined test (so they needed people to return for the second trimester bloods). I know there were some publications talking about giving the first trimester result to women if it was high risk, and then asking everyone else to come back for second trimester screening..at the bottom line it comes down to cost savings and whether it is better to do a few more invasive tests (amnio/cvs) by giving people a first trimester high risk result, or to do less invasive tests but make some people wait for what is inevitably going to be a high risk result.
From what I recall, the best use of the combined test is for 'older' mothers whose risk from age alone is high since even with a 'normal' nuchal scan and good first trimester bloods it is difficult to bring their risk down (the age risk is a big part of all of these tests). The combined test looks at more 'markers' so cuts down the number of people who fall into the high risk category.

Ooh, yes just noticed I've transposed integrated and combined - sorry. You know what I mean though

thanks, i'm booked in for tomorrow!

We are in exactly your position and I rang the FMC this morning to ask similar questions. Thing is our "high risk" was given as 1:230 - only just past the cut-off of 1:250. We have declined a CVS because the risk of miscarriage was quoted at 1:50 i.e. far outweighing the risk of abnormality. We haven't ruled out an amnio at 16 weeks, but I think our preference would be to have an anomaly scan at the earliest possible and if that gives any further cause for concern then have an amnio then.

The risk was tipped into the high category by one part of the blood test being slightly higher than expected (beta-HCG), plus my age (37), however the nuchal scan was fine. When I had my DD 2 years ago only the nuchal scan was offered so based on that we would have been happy. The FMC told me the blood hormones change all the time, so if I had the blood test again it would show completely different results - it only really makes sense in relation to all other tests at the same time. I'm not sure how much reliance to put on the blood screening results.

It's a minefield - I don't think I'm going to be able to relax in this pegnancy at all (had a previous miscarriage too which adds to the angst)

Good luck though, I'll have my fingers crossed for you.

Fingers crossed for you too. Maybe you should also go to the Wolfson for the integrated test. I had the integrated test with dd1 at UCH (I was 36) and the risk came back at 1 in 11,000. I realise that's nothing to do with it being the integrated test but it has added to the shock of this. Anyway, that's really interesting to hear that the blood hormones change all the time. I'm tempted to go to the FMC anyway and repeat the scan as they do nasal bone and everything (think I'm just on a retail therapy type trip).

The integrated is meant to be more reliable and for you it just might tip you into a more comfortable place.

The other thing is I think they might of got my age calculation wrong. I'm 38 which makes me around 1 in 200 risk when the baby comes but they've got me down as base risk of 1 in 100. Anyway, hopefully I'll get another angle on all this tomorrow.

Also, I was only seen by a fetal medicine midwife, and I'm sure they're wonderful but I'd quite like a doctor's opinion as all she was doing was typing some results into the computer and seeing what it said.

Well, good luck.

Hi again, been reading about the nasal bone test. No mention of this at my scan today yet seems to be a really useful marker. Anyho, must really go to bed! Night all.

I think the nasal bone should be one of the things they look out for at the nuchal fold scan, I think it is undeveloped in something like 75% of babies with Down's Syndrome. It was certainly mentioned at both my scans, and is visible in the printed pictures - so that is somewhat reassuring.

We're still undecided about the quadrule test, but it is looking like a good option if we want to avoid the diagnostic tests I might ask the antenatal clinic here if they will do one, otherwise the Wolfson looks like a good option. My DP is leaning towards having an anomaly scan as early as possible at the FMC - then let that guide whether we opt for an amnio.

So difficult to decide!

Good luck for today.

think i'm going to have the scan at FMC. If no nasal bone (actually i think i can see one on pic but what do i know?) then we know prob higher risk and i will prob do CVS at FMC which has v low risk of mc. If nasal bone and other things seem ok will stick to plan A.