2 part test for down syndrome — The Bump
June 2016 Moms

2 part test for down syndrome

Has anyone had the 2 part test for Down syndrome? It's a blood test they take blood in first trimester then again in the second trimester. The results came back normal for the first part now I'm waiting for the results for the second part. I'm not worried about the results I'm young, only 25 and have no family history. I'm seen on a military base because my husband is military and we see midwives and so far both midwives are not very good and are giving me outdated information. I'm just wondering how common this test is and accurate? I tried researching it online and couldn't find much about a 2 part test. The midwife couldn't explain any of the test or anything to me she just told me the results came back normal.

She also was upset that I went in town to find out the gender(girl). She told me it's still a 50% chance because a males boy parts do not show until 18 weeks so they are all girls until then. We don't care whether it's a boy or girl and haven't bought anything and are waiting for our 20 week scan it just bothered me how rude she was about it. Then I looked that up and read that what she said was wrong too male parts start developing in first trimester.

The last midwife at my first appointment told me when I excercise to keep my heart rate under 140 then I looked it up and from what I read that is outdated information. Which I have been following just to be safe and I switched from running to walking because when I run my heart rate does right over 140. I use my Apple Watch to monitor it.

Being military I have the option of switching to Tricare standard and being seen off base it just costs more out of pocket. Which is what I am thinking about doing because I'm not happy with the care on base so far. Sorry for the lengthy post and rant I'm just so upset with the care I've been receiving.
Daisypath - nBGk

Lilypie - GQnA

Re: 2 part test for down syndrome

  • I had never heard of the two part test until recently. A friend of mine is pregnant with twins and they performed it on her.

    The comment about all being girls until 18 weeks is very odd. I don't know why she would tell you that. It's harder to tell early on, but they still can before 18 weeks.

    As for switching that's a decision only you can make. I will say however that it is important for you to be comfortable with and trust your provider. So you need to weigh out if the extra cost is really worth it for you. Good luck.

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  • Trust your gut. That information and service definitely don't sound great. I was raised in a military family and our doctors were hit or miss depending on which base my dad was at. If you're not happy and can swing the additional cost, switching might be the best bet. Will the midwives be delivering or will you be at a nearby hospital?
  • Yeah the midwives do the delivery and you get whoever is on that day/night. I'm at Camp Lejeune, NC and have always heard mixed things about the naval hospital here when it comes to having a baby some people loved it others said it was awful.
    Daisypath - nBGk

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  • The two part blood test is called the integrated screen I believe. I'm scheduled for the second part next Friday. As for the rest, if you are concerned about the care you're receiving, I'd looking into switching practices if you can.
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  • I had the 2 part test. My practice refers to it as a sequential screening. We had an NT ultrasound at 12 weeks to measure the nuchal fold and check for a nasal bone. I had four vials of blood taken that day and got normal results back a week later. I went back for a second blood draw of one vial at 16 weeks, those results also came back normal. I plan on asking my OB about what "normal" means at my next regular appointment but we were not recommended to pursue further testing.
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  • I also had the tests done. Kaiser calls it the Sequential Integrated Screening test. I took a blood test in the 1st trimester, then had the NT ultrasound done, then last Mon I had the 2nd blood test. The are looking for different things that could be wrong with the baby in these tests. I just emailed my doc this morning to see if my results are in so I can finally share with people that I am pregnant!!!!! Ugh!!! I would love to be able to tell people on New Years Eve.
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  • I'm getting the sequential screen done too, it was blood and the ultrasound in the first trimester and then the Tetrascreen (or quad screen, don't remember which its called) at 16 weeks. The Tetrascreen tests for levels of fetal proteins that, if in too low of a ratio, indicate a trisomy and if too high can indicate neural tube defects. Combined with the 1st tri screening it can get pretty good coverage to detect problems.

  • I couldn't get the first part of the two part screening because I missed the cut off date (my doctor told me I would be getting the MaterniT21 test but she got my birthday wrong...I turned 34 this year not 35...so I wasn't eligible).  I got the second part (the quad screen) done though.  That with the 20 week ultrasound should be pretty conclusive.  

    As to heart rate, if you are in decent shape the 140 bps is outdated.  My doctor told me I could do what I did before pregnancy just to stop if dizzy or out of breath (to the point where I can't speak a full sentence without taking a breath).  For me, that means a max heart rate of 160 bps but each person is different.  Listen to your body and stay hydrated though.

  • vulpinivulpini
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    edited December 2015
    The two part screen is called sequential or combined genetic screening. It is the most common type of testing done, though that might be changing in the next 5-10 years. There is usually an ultrasound that is included with it called the nuchal translucency (NT) scan. The test uses the combination of the ultrasound measurements of the baby's neck and limbs, the presence of certain proteins in your blood, and your age and other risk factors to calculate the likelyhood of baby having Trisomy 21 (Down sundrome) or Trisomy 18 (Edwards syndrome). It only gives the likelyhood (1 in 100, 1 in 10,000 etc), not a definite answer. If the likelyhood is high, the mom is advised to get CVS or amnio testing to find out for sure. If the likelyhood is low, the results are called "normal", but there is still a very tiny possibility that baby has one of the syndromes (is that 1 in whatever number).

    Boy and girl genetalia look the same until about 13ish weeks (and look more like boy parts, so your midwife has it backwards). By about 15-16 weeks, a trained ultrasound tech can definitly tell the difference with high certainty. Boys at that stage are obviously more easy to tell for sure than girls, since you're looking for the presence of a penis rather than absence of one, but mistakes by trained experienced techs after 16 weeks are very rare.
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  • vulpinivulpini
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    edited December 2015
    Also, I'm pretty sure that if your pregnancy is not high-risk, the current advice about exercise is that you can keep doing whatever exercise your body is already used to (keep running if you are a runner) except maybe where there is big risk of falling down (rock climbing and horseback and such). One of my friends ran marathons at 7 months pregnant with both her kids and doctors said that was fine because she was a runner before and all through her pregnancies.
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  • Military health care can be hit or miss. I know some people rave about it and others wouldn't let a military doctor touch them with a ten foot pole. Personally, I went Tricare Standard as much for the hospital facilities as the prenatal care (we're in San Diego and a friend was refused at the military hospital because they didn't have room for her and her twins).

    The only thing to consider is cost, which will be a little higher for your hospital stay, as well as other preventative maintenance like dentist and regular doctor appts, prescriptions, etc. Also, you generally will not be allowed to switch back to prime for 1 year. Baby should be prime eligible immediately.

    So far, I'm loving my civilian OB for their extended working hours and more frequent appointments, and I LOVE the hospital I will be giving birth in. Private recovery rooms? Yes please!

    Hope that helps.
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  • I'm a navy healthcare admin. If you are unhappy with your care fill out an ice complaint so higher ups can document and have suggestions on how to improve. If you are unhappy I'm sure there are others unhappy. As a supervisor is hard to talk to someone without an ice complaint or complaint in writing

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  • I switched from Prime to Standard the day I found out I was pregnant. I had a horrible experience with the clinic nurse when I found out I was pregnant and miscarrying last time. I didn't want to go through that again. When you're pregnant, Standard pays 100%. You might want to consider switching.
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  • I don't have experience with your healthcare (not military) but go with your gut! If you feel you aren't getting the right treatment or information, change providers!! And file a complaint about your experience. As far as boys not having parts til 18 weeks... Bogus! We are having a boy and saw clear as day at 13 weeks and 1 day! And every ultrasound since then confirmed boy for us also! Sorry you are going through this, I can't imagine how frustrating it must be for you!
  • Thanks it's good to know Tricare will cover pregnancy still when you are on standard. We are going to look into our options the only thing stopping us from switching is that we have heard the hospital in town is worse then the one on base so we would have to travel an hour for appointments and when I go into labor.
    Daisypath - nBGk

    Lilypie - GQnA

  • I had my first trimester screening and blood work at 12 weeks.  The bonus with that test is that there is an option to find out the sex which I totally did.  The results came back normal and it's a boy!!!  Amazing that there was enough of my growing son's blood in my own blood to pull out his chromosomal makeup! 

    I just had my second semester screening (blood taken) yesterday so am awaiting those results.  I wonder the likelihood of abnormalities showing up in the 1st trimester versus the 2nd?  Why is the sequential screening done if it appears normal in the 1st screening?  Seems like unnecessary worry to me!
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  • My obgyn didn't offer me to find out the gender of the baby for the two part test but I went and got an ultrasound done and it's a girl. My first one was normal and I never heard anything about my second they always tell me if I don't get a phone call then assume the results were normal.
    Daisypath - nBGk

    Lilypie - GQnA

  • mrsp2213 said:

    I had the 2 part test. My practice refers to it as a sequential screening. We had an NT ultrasound at 12 weeks to measure the nuchal fold and check for a nasal bone. I had four vials of blood taken that day and got normal results back a week later. I went back for a second blood draw of one vial at 16 weeks, those results also came back normal. I plan on asking my OB about what "normal" means at my next regular appointment but we were not recommended to pursue further testing.

    This is what I had done as well. The second vial at 16 weeks,looks for Alpha fetal protein, someone correct me if I'm wrong, which can detect things like spinabifida and other neural tube defects.

    My OB said to keep my HR under 130...he's old school with exercise. The OB at my old practice said about 85% of previous exercise rate. My normal exercise HR max is 175, I've been keeping it below 160, and monitoring how I feel.

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