Testing questions

DrillSergeantCat

This is my second pregnancy, but the last one I only 19 and healthy. This one I'm 38. I asked my doctor about genetic testing because of my age and the fact that I have limited family history from being adopted and she brushed it off. One of my questions is, does being AMA automatically make you high-risk? If so, what tests should I be expecting? 

PlainJane8350

I had a (genetic) loss my first pregnancy at 34, so we asked for a cell-free DNA (blood) test and my doctor's office offered Materna Plus. We had already done the one that included cycstic fibrosis, where you spit into a tube, with my first pregnancy so we didn't have to do it again (that tests you, not individual pregnancies).

DrillSergeantCat

I'm second-guessing my choice in OB, honestly. She's very sweet, but I get the feeling very anti-abortion. When I asked about the testing she asked, "Why? Would it change your mind or just help you be better prepared?" I just don't know if I'm being overly anxious for nothing, you know?

PlainJane8350

It's a personal choice, but you should have the choice nonetheless. Your OB may just not be knowledge about your testing options, I see a perinatologist. With my loss, I did see a regular OB who offered us that cystic fibrosis test, though. Not only do you have a right to know your background, it's a smart thing to do. The cystic fibrosis test tells you what you're a carrier for, not whether or not your baby is affected. No doctor should have a problem with you obtaining information about your own medical history. I wouldn't be afraid to switch, especially if you're feeling this way now. I switched just because I wanted someone more experienced with genetic abnormalities after my loss and, before I knew about Materna Plus, went into my first appointment with my perinatologist asking for CVS (because it could be done sooner than amnio). She introduced us to Materna Plus, we went with that based on her recommendation and she didn't feel the need to do CVS/amnio after that. Materna Plus can be done as early as ten weeks. My sister had doubts about her OB, too and ended up switching at 22 weeks. It's your pregnancy, I'd find a doctor who's on the same page as you are.

Erinka

I think in most doc and insurance circles 35 and over means you are entitled to expanded screenings and testing. My OB refers his patients to a Maternal Fetal Medicine office at the local hospital. I went there for my NT scan (got a good result) and then had a genetic counseling appt where the counselor presented the option of cell free DNA test that just requires a blood draw. Since I'm 35 my insurance completely covers it. You def have a right to go that direction if you want more info and peace of mind.

DrillSergeantCat

Thank you @PlainJane8350 and @erinka. I really do just want peace of mind. What's bothering me most is that I do feel like she's taken away my choice. I've got an appointment in 2 weeks and I'll bring it up with her again at that time. 

redfallon

KittyCatKCCO I delivered my DD when I was 35, so I was considered AMA. That is typically considered a sort of high-risk, I suppose. At least, there are a lot more things that you are at risk for being 35+ that someone younger may not be. We were automatically offered the MaterniT21 test with my last pregnancy, and the Panorama test this time. Both of them are the blood tests that determine risk factors. These are done before 14 weeks typically, since an amnio or CVS are then offered before 18 weeks, I think? You need time to decide if you want one of those. Since you are around 13 weeks (your ticker) I'd want to take one of those risk factor blood tests so you still have time to do either the amnio or CVS if you want to go through with one of those that will tell you for sure if there is anything you need to prepare for.

I hope that your OB isn't one of those who thinks that it's all about terminating a pregnancy. It's not. It's about your choice to either do that, or to be prepared if there is some abnormality found with your child.

Ellsmac

I was also told that over 35 = higher risk and the option for expanded testing. I have no family history of any issues but was still offered the materniT 21 testing. It wasn't guaranteed that insurance would pay for it but it was offered . My understanding Is that there is an increased risk of chromosomal abnormalities just because of age . I would be concerned if I felt my doc was blowing me off. Also what does that mean for other frank and open discussions with her going forward? My personal opinion ? I would find someone else. Quickly. Good luck!

DrillSergeantCat

Thank you ladies. I'm going to call my doctor's office about this this morning. @redfallon before 14 weeks or would during the 14 weeks be okay?

redfallon

KittyCatKCCO The FAQs on the Panorama site say: "The Panorama test is made for women of any age and ethnicity who are at least 9 weeks pregnant. It is not meant for women who are carrying more than one baby (twins or triplets), or for women who have used a donor egg, or have received a bone marrow transplant." https://www.panoramatest.com/en/expecting-parents/common-questions

CVS is done between 10 and 13 weeks: https://americanpregnancy.org/prenatal-testing/chorionic-villus-sampling/

Amnio is done between 14 and 20 weeks: https://americanpregnancy.org/prenatal-testing/amniocentesis/

The blood tests can be done whenever, it seems like, but you get them done earlier so that you have time to do either a CVS or an Amnio if you want to.

ETA: The blood tests are screening for your risk factors and levels, but cannot tell you for sure anything: they tell the risk level that you may have for something. The other two are diagnostic, so will tell you definitive answers.

DrillSergeantCat

Thank you so much for the info. I really appreciate it.