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Old November 18th 05, 01:33 PM posted to misc.kids.pregnancy
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Default nuchal fold in 20 week ultrasound causing distress

An ECG is not going to rule out Down syndrome if you're looking for signs of
heart defects because there are many that are too small to see. And an ECG
would not necessarily rule out esophageal atresia or some of the other
disorders associated with Down sydnrome. I guess my point was that an amnio
would probably be a better test to take to determine if the baby has Down
syndrome before doing an ECG.


Well, that is the same trade-off between diagnostic uncertainty (with
ultrasound) and risk of complications (with amnio) that is still the
crux of testing decisions in antenatal diagnosis. You're right that
ultrasound can never rule out trisomy 21, but ultrasound findings can
modify the odds for an individual and for some, that can be important
in deciding what to do next. From k_raps perspective, if the ECG
appears normal, you're right, that doesn't rule out Down syndrome. But
if a structural heart defect is detected, that plus the thickened
nuchal skin fold does demonstrate a higher risk which for some people
might be the difference between justifying an amnio or not. For others,
the diagnosis of aneuploidy itself would not affect their management
decisions and they might not want an amnio under any circumstances but
they might change their delivery plans (or place) if a structural heart
defect was detected. All of which is to say that even imperfect
technologies can be helpful depending on what the individual or
family's priorities are and what the landscape of their choices looks
like. There is no one forumla that is going to work for everybody.