Anyone here not do an NT scan? — The Bump
Pregnant after 35

Anyone here not do an NT scan?

First pregnancy I was 34 at conception (turned 35 very shortly after) and we opted not to do an NT scan.  It wouldn't change anything and I didn't want to needlessly worry.  This time I'm 38 and my Dr yesterday seemed to think that I absolutely should do an NT scan and strongly consider an amnio.  I don't like the idea of the invasiveness of an amnio so that's not likely to happen but we're really on the fence about doing the NT scan this time.  Did anyone here opt not to do the NT scan?  

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Re: Anyone here not do an NT scan?

  • I didn't do the NT scan.  This is my first pregnancy (36, 37 once the baby is born).  My Dr. said that as long as the Panorama test came back low risk, we didn't need to do the NT (or amnio) - unless something came up later in the a/s.  

    She said we didn't need the NT since the fetal DNA blood tests are more accurate than the NT - less chance of false positive too.  And since we came back low risk on all the tests, we did not do the NT (our a/s showed no issues as well, so an amnio is not needed for us)

    That being said - most people I know did the NT and Fetal DNA blood testing.  I would ask why he/she feels you need an amnio as well - that one seems odd - unless there is a reason to risk it.

    I would also ask your Dr. if they do the fetal DNA testing - I believe most if not all insurance companies will cover it if you are over 35.  Good luck!
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  • I am 36 and didn't do any testing. My doctor didn't act one way or the other about it either.
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  • I didn't do the NT or amino. I did the least invasive method with the panaroma test. Like you I wouldn't terminate but I wanted to be I the know.
    My DS has a chromosome abmormalty and we didn't know till he had to have open heart surgery at three weeks old. Being prepared would have made things a lot easier.
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  • My doctor's office for some reason isn't suggesting the blood tests yet (Materniti21, Panorama, etc). My stupid insurance doesn't cover "genetic testing" of any sort and therefore didn't cover the NT scan. Out of pocket costs were too high so I skipped it and just did the quad screen again (for which I paid most of the cost also).

    Personally, I would like to have all the info possible. I wouldn't terminate (why do people think it's just about that???) but I would like to know if something is wrong/be prepared. My last baby had single umbilical artery and I had high fluid, both of which can be markers for additional issues, and I would have loved to have had more test data to be less worried throughout the pregnancy. All turned out well. This time, all is well except that we have the bright spot on the heart, which is a soft marker for Down syndrome. I would have liked to have had the NT scan results also, again, to hopefully help put my mind at ease. Our risk is still super low, but when you have anything that is "abnormal" it's nice to have more data points to consider.

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  • Isn't the NT Testing included in the Materniti21? I feel like the Matreniti21 had so much to offer from all sorts of results.
  • I only had the Materni21 done.  The geneticist I spoke with didn't seem to think there was any added value to the NT scan, as, as mentioned, the NIPT tests are far more accurate.  I think these days most commonly for us over-35-ers, NIPT is done before amnio - amnio is not at all routine, and while it was tempting because it also tests for more issues, I decided it wasn't worth the (albeit pretty minisucle) risk. 

    amygirl78: I believe NT testing is done by ultrasound, while Materni21 is done just with a blood sample.  The NT test looks for physical abnormalities commonly (though certainly not always) associated with trisomies like Downs while Materni21 (and the other similar tests) look at free fetal DNA in the mother's blood, which is why it's a lot more accurate.
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  • thanks Tsuga76! It sounds like if all of the Materni21 results came back normal then an NT test might not be needed? I have an appointment tomorrow so I will be sure to ask this question to my Doc.
  • indianaalumindianaalum member
    edited September 2014
    I am 41 and did NT scan, but regret it now as it lead to a lot of unnecessary panic. 

    If I was to do it again, I would skip it and go straight to the NIPT tests (panorama, matern21, harmoney, etc) because they appear to be FAR more accurate. 

    I did NT scan which lead to 3 weeks of pure fear. I was given a high ratio for Down Syndrome which was basically just jacked up to my age.  When it came back "high risk", I was given a Panorama test and was then basically cleared of many genetic disorders. When I "googled", you see a TON of false positives with the NT scans. I predict (and hope I am right) that the new NIPT tests will make that NT scan outdated and it will go by the wayside in a few years.

    I am also suprised that "amnio" wold be mentioned PRIOR to the mention of a NON-invasive and SAFE test like one of the NIPT tests. Those have almost as much accuracy and zero risk to the baby as they test the mother's blood (like any other blood draw)

    Also, I agree I am sick of hearing "I wouldn't terminate, so why do the test". It is NOT about termination for some women. There are certain issues detected from these tests that can actually be addressed while pregnant. Not to mention, the mental and financial preparation for having a child with special needs can be extremely helpful to know ahead of time. 

    I know someone whose baby was born with a heart defect. They were blindsided mentally AND financially. It almost bankrupt them as they had no preparation for anything being wrong with the baby. sometimes knowledge is power in these circumstances. Had they known during her pregnancy, they could have preparred had nothing to do with termination and all to do with preparation

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  • Thank you Ladies for your insight.

    I guess that I should add that I am in Canada so an NT scan is covered by our health care but something non-invasive (and more accurate) like the NIPT tests are not.  There are some labs here that would do the blood draws for an NIPT test but the cost would be over $1000.  Definitely non-trivial but maybe worth it for the peace of mind.  The only way that our health care would cover an NIPT test is if the NT scan came out positive and then there would be weeks of waiting for an appointment to see a geneticist to have payment waiver forms filled out.  Unfortunately, here the routine seems to be an NT scan, a high positive result for someone over 35 and then straight to amnio.  The amnio rate in Canada is very high because of our health care system.

    I'm leaning towards paying for the NIPT test.  I just need to present a case to DH to convince him of this...

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  • I opted out of all of the early tests with my first (the non invasive)- I was 33.  We ended out with a high level u/s after the blood test that checks for spina bifida came back with an elevated risk.  We wouldn't have terminated, but being able to prepare was important to us.  We declined the amino b/c the peri doc was feeling pretty confident about her read of the scan and the risk of getting the amnio was higher than the risk that she misread our results.

    With our second, we did the Verifi test (I'm 36 now), which includes an u/s.  We also had the blood draw to check for spina bifida.  Everything came back normal so we didn't pursue any further testing.

    I agree with the other ladies that the amnio is pretty invasive and I'd only do it if I had a previous test show that there was a high chance of an abnormality.  We won't terminate, but would want to know so we could plan for the best possible care and delivery based on the situation.
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  • marijaa333marijaa333 member
    edited September 2014
    ahitiandreamin Wow, I had no idea you couldn't get NIPT in Canada! I'm a Torontonian living south of the border...  Depending on where you are, you could theoretically drive across the border and get Panorama, and have it adjusted down to $250 -- I have heard they will do that if you don't have insurance. 

    However, CVS (which you can do earlier than amnio) and amnio are diagnostic tests, while NIPT are screening tests only, so with CVS or amnio so you will know for sure about a large number of conditions, while NIPT will only give you odds with differing degrees of confidence (high but still not definitive). The miscarriage risks are tiny for CVS and amnio (closer to 1 in 2,000 than the various older/scarier stats floating around) and if amnio is a very common procedure where you go, i.e. you have a very experienced provider, the risk drops further. So, in a sense, going straight to the diagnostic may be a lot better overall.

    Sigh, I miss the turning maple leaves! Have a cup of Tim's and a Boston cream donut for me.
  • @marijaa333, the leaves are turning right now and it is gorgeous.  

    I'll definitely have a cup of Tim's (decaf) for you!  I'm pretty set on not bothering with the NT scan/IPS.  The likelihood of a false positive is too high for me and I am a worrier at the best of times.

    I'll be in DC later in October.  If the dates line up I might consider getting an NIPT while I'm down there.  That's a great idea!

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  • I did both Materniti21 and NT because my midwife recommended it, but, if I could do it over again, I would have just done the Materniti21.  The NT seemed redundant and the U/S was uncomfortable because of the way the tech had to push into my just beginning to stretch abdomen to get the right pic.  It didn't really seem to evaluate anything not covered by the Materniti21 from what I could tell.
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