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Old November 16th 05, 06:30 PM
Circe
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Default nuchal fold in 20 week ultrasound causing distress

"k_raps73" wrote in message
lkaboutparenting.com...
I recently had my ultrasound at 19 weeks and 6 days. The baby's
maeasurements indicated that he was bigger than the gestational estimated
date that was calculted. My doctor told me the baby was measuring at 20
weeks and 5 days. Everything was normal, i.e. his limbs, spine, brain and
heart. My quad test which was done at 16 and a half weeks came back
negative as well (normal). However the doctor noted that there was one
abnormality in the ultrasound and that was a nuchal fold found at the back
of my baby's head which measured much bigger than it should for a 19 week
and 6 day old baby! She said this could be a marker for a downs baby.


It has always been my understanding that nuchal fold thickness has no
correlation to Downs after the end of the 14th week. I would question your
doctor very closely on this, since I believe she is incorrect.

She
offered us the option of an amniosynthesis and even abortion at a later
part if we choose to. I was apalled and very much distressed.


I understand. Of course you're distressed. While I question the accuracy of
her finding based on nuchal fold thickness at mid-pregnancy (when I believe
it is no longer of diagnostic value), you should know that what she was
offering you is pretty much "standard" when there is a suspicion of Down
Syndrome. Because amnio is the only definitive diagnostic tool, it's
appropriate to offer. And most people whose fetuses are prenatally diagnosed
with Downs ultimately choose to terminate the pregnancy.

I told her
that my quad test results were good and that there was no history of downs
in my or my husband's family.


Down Syndrome does not, as a general rule, run in families. (I think there
is one type that does, but it is an exceedingly rare form.) Down Syndrome is
a congenital replication error that results in the fetus having three copies
of chromosome 21 instead of the standard two. Therefore, the fact that there
is no familial history of Downs in your families does not affect the
likelihood of its occuring in your own child.

She told me that chances of me having a
downs baby was 1 out of 47. They want me to come back for an ECG of my
baby's heart in 5 weeks which I am going to do. I even asked the doctor if
the measurement of the nuchal fold was bigger because the baby was much
bigger than the calculated due date.She said that the measuremnt would
have not mattered had the baby been 20 weeks or more (as per his
measurements and not the previously calculated date of 19 weeks and 6
days).I cried when I came out of that doctor's office and having been
trying to stay positive. I console myself with the fact that the
ultrasound images look normal and my quad tests were negative. However I
am still so worried, I can't sleep and need advice on this topic.

Well, first of all, I'm incredibly suspicious of the risk calculation
provided by your doctor based solely on a nuchal scan at 19w6d. The face
that your quad screen was good makes me even more suspicious (since your
negative quad should be factored into any risk assessment). As Elle has
already suggested, I think you should seek a second opinion regarding the
nuchal scan measurement.

Even if the 1 in 47 number is correct (which I doubt) and sounds quite dire,
try to keep in mind that it still means there is nearly a 98% likelihood
that your baby does NOT have Downs.

Good luck and HTH!
--
Be well, Barbara