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alpha fetoprotein test - is this a crucial test?
My ob casually asked me as I was preparing to leave my last appt if I wanted
to have this test done. I had never heard of it before, and I asked her to explain. She mentioned it was to find out if the baby was at risk of spinal cord problems, but didn't really elaborate. She seemed busy and annoyed at the question. Is this something that everyone has done? Betsy |
#2
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"oregonchick" wrote in message
... My ob casually asked me as I was preparing to leave my last appt if I wanted to have this test done. I had never heard of it before, and I asked her to explain. She mentioned it was to find out if the baby was at risk of spinal cord problems, but didn't really elaborate. She seemed busy and annoyed at the question. Is this something that everyone has done? In a nutshell, the AFP is a blood test performed on the mother at around mid-pregnancy. The blood is analyzed and higher/lower concentrations of certain hormones *can* be indicative that the fetus is at a higher-than-expected risk of some types of defects, including spina bifida and trisomy (Down Syndrome, which is T21, being the most common). If the result of an AFP test is "positive" for any of these conditions, further testing can be done (amniocentesis in the case of a trisomy, high level ultrasound in the case of spina bifida) to determine whether or not there is actually a problem. It is important to understand that the AFP is only a screening test. A "positive" result on the test does not mean there is certainly something wrong, only that the amount of hormone in your blood stream suggests a higher-than-expected chance that there is something wrong. The AFP is generally recommended because it is a non-invasive test that poses no risks to the fetus or the mother, but tends to be fairly accurate in identifying women for whom further, more invasive testing (read amnio) might be warranted. That doesn't mean that most women who are referred for further testing due to AFP results wind up having babies with problems, but rather that most women who *do* have babies with these sorts of problems are identified by the AFP. Before consenting to taking the AFP, you need to decide whether or not you would consent to further testing if the result is positive. It's also worth noting that the results are considerably less accurate for women over about 37-38--the tendency is for almost all tests done on women above that age bracket to come back positive. Also, the usefulness of the AFP as a test for spina bifida is somewhat overrated, IMO. Unless you would not have a standard anomaly scan at 20ish weeks of pregnancy, it isn't likely to result in finding a problem you wouldn't otherwise have discovered. So what the AFP is *really* doing for you is screening for trisomies. I am sorry to hear that your practitioner did not explain all of this to you and that she seemed annoyed by the question. This is not appropriate behavior on the part of a physician, IMHO. In addition to evaluating whether or not you want the AFP, I would recommend evaluating whether or not you wish to continue in the care of a practitioner who does not answer your questions and treats you rudely. That does not seem like a particularly positive harbinger for her bedside manner or her ability to get informed consent before performing other procedures when you are giving birth. -- Be well, Barbara |
#3
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"Circe" wrote in message news:%pkwe.3632$Qo.2525@fed1read01... "oregonchick" wrote in message ... My ob casually asked me as I was preparing to leave my last appt if I wanted to have this test done. I had never heard of it before, and I asked her to explain. She mentioned it was to find out if the baby was at risk of spinal cord problems, but didn't really elaborate. She seemed busy and annoyed at the question. Is this something that everyone has done? In a nutshell, the AFP is a blood test performed on the mother at around mid-pregnancy. The blood is analyzed and higher/lower concentrations of certain hormones *can* be indicative that the fetus is at a higher-than-expected risk of some types of defects, including spina bifida and trisomy (Down Syndrome, which is T21, being the most common). If the result of an AFP test is "positive" for any of these conditions, further testing can be done (amniocentesis in the case of a trisomy, high level ultrasound in the case of spina bifida) to determine whether or not there is actually a problem. It is important to understand that the AFP is only a screening test. A "positive" result on the test does not mean there is certainly something wrong, only that the amount of hormone in your blood stream suggests a higher-than-expected chance that there is something wrong. The AFP is generally recommended because it is a non-invasive test that poses no risks to the fetus or the mother, but tends to be fairly accurate in identifying women for whom further, more invasive testing (read amnio) might be warranted. That doesn't mean that most women who are referred for further testing due to AFP results wind up having babies with problems, but rather that most women who *do* have babies with these sorts of problems are identified by the AFP. Before consenting to taking the AFP, you need to decide whether or not you would consent to further testing if the result is positive. It's also worth noting that the results are considerably less accurate for women over about 37-38--the tendency is for almost all tests done on women above that age bracket to come back positive. Also, the usefulness of the AFP as a test for spina bifida is somewhat overrated, IMO. Unless you would not have a standard anomaly scan at 20ish weeks of pregnancy, it isn't likely to result in finding a problem you wouldn't otherwise have discovered. So what the AFP is *really* doing for you is screening for trisomies. I am sorry to hear that your practitioner did not explain all of this to you and that she seemed annoyed by the question. This is not appropriate behavior on the part of a physician, IMHO. In addition to evaluating whether or not you want the AFP, I would recommend evaluating whether or not you wish to continue in the care of a practitioner who does not answer your questions and treats you rudely. That does not seem like a particularly positive harbinger for her bedside manner or her ability to get informed consent before performing other procedures when you are giving birth. -- Be well, Barbara Thank you so much for the clear explanation. It sounds like a worthwhile and noninvasive test, better safe than sorry! As for my practicioner, I feel a little helpless when it comes to that situation. I have an hmo, and I've seen a few different OB's through my plan. I'm really not impressed with any of them. I wish I could find a private birthing center in my area - I am willing to pay out of pocket. But how does one locate such services. I'm in Portland, OR, so there should be something like that here. Betsy |
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oregonchick wrote: I wish I could find a private birthing center in my area - I am willing to pay out of pocket. But how does one locate such services. I'm in Portland, OR, so there should be something like that here. Yellow pages. And when you contact them, ask if there's a discount if you pre-pay. The local hospital here offered one, and from what I understand, it's pretty common practice. Good luck, Amy |
#5
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"oregonchick" wrote in message ... I wish I could find a private birthing center in my area - I am willing to pay out of pocket. But how does one locate such services. I'm in Portland, OR, so there should be something like that here. Betsy www.birthcenters.org lists one in Eugene, OR if you were willing to travel. You can also check for midwives at www.acnm.org |
#6
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oregonchick wrote: My ob casually asked me as I was preparing to leave my last appt if I wanted to have this test done. I had never heard of it before, and I asked her to explain. She mentioned it was to find out if the baby was at risk of spinal cord problems, but didn't really elaborate. She seemed busy and annoyed at the question. Is this something that everyone has done? Instead of the AFP, I would consider the Triple Screen (or is it called the Quadruple Screen now?). It's done the same way - a simple blood test, and is considered to be more accurate, and I believe that it includes the AFP as one of the tests. But like Circe said, it's still just a screening test. Cathy Weeks |
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"Cathy Weeks" wrote in message
oups.com... oregonchick wrote: My ob casually asked me as I was preparing to leave my last appt if I wanted to have this test done. I had never heard of it before, and I asked her to explain. She mentioned it was to find out if the baby was at risk of spinal cord problems, but didn't really elaborate. She seemed busy and annoyed at the question. Is this something that everyone has done? Instead of the AFP, I would consider the Triple Screen (or is it called the Quadruple Screen now?). It's done the same way - a simple blood test, and is considered to be more accurate, and I believe that it includes the AFP as one of the tests. But like Circe said, it's still just a screening test. It seems to me that people use the terms AFP and Triple Screen pretty interchangeably. I know that when I had what was called the AFP, they also checked for HCG and estriol, which are the two other hormones tested in the Triple Screen. The Quad Screen tests for an additional hormone, but I'm not sure that it's become as common as the Triple Screen. -- Be well, Barbara |
#8
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Only one point to add to Circe's answer....
Maternal serum screening (with AFP and/or HCG) can also help to identify moms who are at risk for problems with the placenta, including preeclampsia and fetal growth restriction. If you do have a risk for these things, you will need to be monitored more closely in the third trimester. Early detection of these problems can be life-saving for mom and/or baby. |
#9
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On Tue, 28 Jun 2005 15:29:07 -0700, oregonchick wrote:
Is this something that everyone has done? No. IMO there are no crucial tests for a healthy pregnancy. Pregnancy is not a disease. Doing a lot of prenatal screening always makes me feel that I am at risk for the most terrible things, which is not true. If you are healthy and there is no history of perinatal problems in your immediate family, there is little reason to test, except for the doctors to assure they won't get sued if something is wrong at birth. Personally, I find many of the screenings that are offered result in more stress than necessary. If you decline, you get the feeling you are withholding your baby the best possible care. If you do get tested, you have the stress of waiting for the results and then dealing with them. Usually the results are not even a definite answer, like yes or no, but a number, e.g. you have a 1 in so many chance to have a baby with spinal cord defects. Either way, you have worries. Make sure you know *what* will be tested, and how reliable the results are before you agree to have testing done. Never get tested just because your ob/gyn thinks it's a good idea. Also consider what you will do should the test come back with a bad result. If the answer is nothing, why go through the ordeal? -- --I mommy to DS (July '02) mommy to four tiny angels (Oct '03 - Oct '04) guardian of DH (age classified) expecting twins (boy/girl) in August |
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