Prenatal Screening - Amnio vs. CVS vs. non-invasive options

suzhan · Post by **suzhan** » Fri Jan 05, 2007 3:19 am

Does anyone know any good references for comparing the various screening options for we ladies over 35? I know there's pro's and con's between the various options and some must be done earlier than others. I don't get referred back to the regular OB until 10 weeks and my RE says he doesn't advise on this, they I need to talk with the OB. I don't want to miss any important timing windows waiting to get advice from my OB and my RE is pretty firm that amnio is the only way to go but I'm concerned about the potential m/c risks which I've seen really varying statistics - from 1% to 5%! So, I'm looking for web sites or other resources that really show the various options, how accurate they are, and any risks associated.

I'd also appreciate any advice and thoughts from ladies who have had various types of screening and why they chose what they did. No judgment from me here....just really trying to learn.

Thanks!

DolceVita · Post by **DolceVita** » Fri Jan 05, 2007 6:41 am

Suzhan,

Congratulation on your pregnancy! Unfortunately i dont have any advice on either one of these procedures as i am pregnant with triplets and its not adviced. But the one thing i would definitly recommend is to have any of these procedures done with really experienced doctors preferably perinatologists and specialists. If you are in the LA;CA region i can refer you to someone out of UCLA who is known to be famous for it. Just think about the reason why you would want the procedures. I always asked myself and please dont take this upon yourself, the only reason i would do the procedure is if i was willing to abort incase something was wrong with one of my babies.. since i was not willing to do that i refused the procedures. But everyone has their own way of thinking and nothing is wrong with doing with what ever you choose to do. I would just really emphasize the experience of a doctor. If you would like more info feel free to send me a PM.... goodluck with whatever you choose to do.

God Bless

teachertam · Post by **teachertam** » Fri Jan 05, 2007 2:24 pm

Suzhan,

Congrats on your pregnancy! I agree with Vita. DH and I just did not want to take the chance of a posible miscarriage. Therefore, I opted to have the non-invasive options. I had the 1st trimester screening which consisted of a blood test and a scan to measure the fluid accumulation in the back of the baby's neck. I believe it tells you the risks of having a baby with downs and a few other genetic abnormalities within an accuracy range of the high 80's. I then had the 2nd trimester screening test (blood test). It showed my risks of downs at 1:5700 with an accuracy of 92 - 93%. I then had a genetic ultrasound where the baby's heart is scanned and different measurements are taken. All of these tests were done by a Genetic Specialist. Most OB's will do the tests, but I agree with Vita that you should consult a specialist. Good luck with your decision!

Tammy

deepa100 · Post by **deepa100** » Fri Jan 05, 2007 2:43 pm

Suzhan,
My experience w/ my RE has been the same and I have similar concerns about genetic testing. I am waiting to hear from others on this forum.

Nance · Post by **Nance** » Fri Jan 05, 2007 5:43 pm

Good Afternoon Ladies,

I just went through making this decision and I found it very difficult. First of all the most important advice I can give you is that you and your DH have to make this decision on your own. Do not let anyone sway you one way or another. You should do what you both think is best for you and your baby. Saying that, I can tell you what my ultimate decision was. I will be 36 when I have the baby and I had the first trimester combined screening which is a Nuchal scan (a fancy ultrasound) combined with blood work. My results came back 1:4700 for downs and 1:8000 for Trisonomy 25. I compared those results with the 1 in 250-400 (depending upon what research you listen to) chance of an amnio causing a miscarriage and the 1 in 1000 chance of an amnio causing an infection and since the risk of amnio complications was so much more than my risk of a problem with the baby we decided against the amnio. It was not easy and I lost many nights sleeping and several crying afternoons making that decision but in the end I think it was the best thing for us to do in our circumstances. I do not think that there is a right and wrong decision when it comes to this, only what is best for you.

Good luck.
Nance

cinders101 · Post by **cinders101** » Fri Jan 05, 2007 7:52 pm

Hey Suzhan,

I actually met with my ob/gyn yesterday. If I were you, I would schedule an appt with her. Just because you are with the clinic for 10 weeks doesn't mean you can't see your OB earlier. I had ?s, just as yours and didn't want to wait. I really trust my OB and she's fabulous if you want her name...she's in Torrance. She confirmed and reassured me what to do with a lot of my ?'s/concerns. Good luck!!

cinders101 · Post by **cinders101** » Fri Jan 05, 2007 7:55 pm

P.S.: I have a name of a dr. who is infamous for amnions (he's a perinatologist) at UCLA if you are interested. Dr. S ref'd me, but I also asked my OB and she said he is excellent. In researching him on line, he is know as "Dr. Amnio".

LauraLou · Post by **LauraLou** » Sat Jan 06, 2007 1:51 pm

I had the cvs test done at 11 weeks. It is the most high risk option, but you get the results very early. If the babies had some terrible genetic defect, we wanted to know in the first trimester.

The procedure took about 5 minutes. I had no spotting or cramping afterwards. I got the results in one week, two genetically perfect baby boys!

I am an OB nurse at a large university hospital and see babies with truly awful genetic defects. It is a hard place to work when you are pregnant. For me, the piece of mind was worth the slight risk, but it is a very personal decision.

For most people, I would suggest doing the nuchal scan combined with the blood tests. Depending on the results, you can then decide whether to do an amino or not. With an experience doctor, the risk of miscarriage with an amino is less than 1%.

Good luck whatever you decide.

suzhan · Post by **suzhan** » Sat Jan 06, 2007 6:27 pm

Vita/Tammy - Thanks for your responses. I too am struggling with any screening that has risks, but I struggle with the potential of having a child with serious illness. I'm 38 so I know my risks are creeping up there. It's such a hard decision.

Laura - Thanks so much for your input. I thought I read that you can have CVS up to week 13. Does that sound correct to you? I'm going to try and have the nuchal/blood test at 11 weeks, which theoretically would allow us to have CVS if the nuchal didn't look good (which I very much hope doesn't happen!)

Cindy - I talked to Heidi yesterday and she talked w/ Dr. S. Looks like he's going to make the perinatology referral for me when I'm there on Wednesday, as well as my OB referral. My regular gyn doesn't do OB deliveries, was a GYN specialist only. So, I'm finding a new OB, but I know which one I want (he's delivered lots of babies for doctors I work with so I trust him.) Have you decided if you're doing any kind of screening?

This thread was a great help, thanks ladies.
- suzhan

cinders101 · Post by **cinders101** » Sat Jan 06, 2007 9:34 pm

Suzhan: Yes, I am doing an early amnio at 12 weeks. Dr. Tabsh from UCLA is doing it. He specializes in them. He doesn't do CVS with multiples because he can not honestly say he got a sample from each. So, I will take it from there. I think you live in the South Bay area. Dr. Latrice Allen is an AMAZING ob/gyn and she is in Torrance. She delivers either at Little Co or Torrance Memorial. She is around our age and is very easy to talk to, has a lot of experience, and has excellent bedside manner. She will deliver your baby for you too. Good luck...I'm glad you're seeing someone early I think that is smart. Let me know how it goes.

LauraLou · Post by **LauraLou** » Sat Jan 06, 2007 11:28 pm

Suzhan,

Yes, I believe you can have the cvs done up to 13 wks. So it would be possible to do the nuchal/blood tests and then have a cvs depending on the results.

Cinders is right, they don't normally do cvs with twins, but as mine are identical, there is only one placenta. So it was no different than doing it with one baby.

If you do decide to have the cvs test done, be sure you find a very experienced doctor. The m/c risk is directly linked to the experience of the doctor performing the procedure. You want someone who does 1 or 2 tests a week, not someone who does 1 or 2 a month.

It is such a hard decision to make. I really hope your nuchal/blood tests come back with a very low risk and you don't have to make that choice.

Laura

deepa100 · Post by **deepa100** » Sun Jan 07, 2007 5:23 pm

Is it ok to have my OBGYN do the NT/nuchal scan?
Thanks!

suzhan · Post by **suzhan** » Wed Jan 10, 2007 1:59 am

Does anyone know if the blood test portion of the early screening in conjunction with the nuchal translucency test have to be done by the beginning or the end of the 11th week?

deepa100 · Post by **deepa100** » Wed Jan 10, 2007 3:12 am

My doctor's (perinatologist) office asked me to come between 10-12 weeks. So, I had a 2 week window during which I could schedule the scan and blood test.

DolceVita · Post by **DolceVita** » Wed Jan 10, 2007 8:37 am

Cinders,

Suzhan, that is exactly who i would have refered for an amnio,... hes my dr right now He is INCREDIBLE..... JUST Google him if you wanna know more...

Dr. Khalil Tabsh...

Prenatal Screening - Amnio vs. CVS vs. non-invasive options

Prenatal Screening - Amnio vs. CVS vs. non-invasive options

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