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Advice/support needed
Hello,
I have a very good friend who is due in November (as am I), who had something called the "First Look" testing done a couple weeks ago. The u/s looks for a skin flap in the back of the neck, and it detected nothing. The blood work looks for blood protein levels, which came back low- apparently anything below 240 is not good and hers is 160. The nurse did not do a very good job explaining exactly what it all meant, and she was in shock, so couldn't ask questions well at the time. She is still waiting to talk to the doctor. Does anyone here know what the blood protein levels indicate? And is 160 really bad, or can it be normal? Could it just be because of her age (37)? TIA for any clarification. Erin |
#2
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Advice/support needed
Steve & Erin wrote:
Hello, I have a very good friend who is due in November (as am I), who had something called the "First Look" testing done a couple weeks ago. The u/s looks for a skin flap in the back of the neck, and it detected nothing. This is a nuchal translucency test, which is used to screen for Downs Syndrome. It is not a diagnostic test (you can only diagnose DS with an amnio or CVS), but it does help identify a population at higher risk who might benefit from more invasive testing. The blood work looks for blood protein levels, which came back low- apparently anything below 240 is not good and hers is 160. The nurse did not do a very good job explaining exactly what it all meant, and she was in shock, so couldn't ask questions well at the time. She is still waiting to talk to the doctor. Does anyone here know what the blood protein levels indicate? And is 160 really bad, or can it be normal? Could it just be because of her age (37)? This was probably the triple screen, which does not look at blood protein levels. It looks at maternal serum AFP (alphfetoprotein), estriol, and hCG levels. These are screening tests for Downs Syndrome and neural tube defects. When the AFP is low, that means she is at increased risk for Downs Syndrome. The 240 and 160 are likely odds. They define a "positive" screen as anything less than a 1 in 240 chance of having DS. This number is almost *completely* arbitrary. The only reason they chose it is that it's roughly the same as the risk of having a miscarriage from having the amnio done to see for sure if the baby has DS. A result of 160 means that the screen indicates a 1 in 160 chance of the baby having DS. If you turn that around, that's a 99.4 percent chance that the baby is PERFECTLY HEALTHY. In addition, the triple screen (because it is just a screening test) has a very high rate of false "positives." The vast majority of babies who screen positive do not have DS. Given her age, it was almost guaranteed that she would screen positive on the triple screen. In other words, she absolutely should not worry. The odds are very, very high that her baby is completely healthy. At this point, she can do one of three things: 1) Decide the odds look good enough to her that she does not want to follow through with invasive testing. This makes sense especially if she would not consider terminating the pregnancy if the baby had DS. While having an amnio would tell her for sure if the baby had DS and would give her time to prepare, odds are that it wouldn't improve the health of the baby significantly and the amnio does bring about a 1 in 200 chance of miscarriage. 2) Decide that she wants further non-invasive testing. They can do a more detailed ultrasound that can spot some other soft markers for DS. This is not definitive. You can't diagnose DS for sure or eliminate it for sure with an ultrasound; however, if the u/s showed no markers, the odds would tip in favor of no DS, and if the u/s detected markers, the odds would tip more towards the baby having DS. After knowing that, she might decide to skip the amnio or go ahead with it. 3) Decide that she wants an amnio to know for sure. Amnio is the only way to know for sure whether the baby has DS, but you also have to take into consideration the risks and what you would do with the knowledge once you have it. If you wouldn't do anything different, then the information may not be worth the risk to the baby. Best wishes, Ericka |
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