Pregnant after 35

No NT scan if 35+?

I just went to the OB last week for my annual and she asked about plans for more children.  I said *maybe*  next year, but I'll be 35 then.  She went through the whole explanation about how 35 doesn't drastically raise any concerns, but that they don't do an NT after 35 because it almost always comes back positive.  This concerns me.  She said the results are a combo of scan, blood test and age.  I mean, if something were wrong, that's at least 8 less weeks you have to prepare.  Did anyone else get an NT scan post 35?
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Re: No NT scan if 35+?

  • I just turned 37 and am 10 weeks pregnant today with twins. Am not sure I know what an NT scan is. What is that? My GYN never even mentioned it.

    Currently, my OB has me schedule for a ton of test. I mean a ton of test all prescreening as precaution. Before I got pregnant my GYN (different from my OB) just kept reminding me about the "magic number" as they like to call it. I think as long as you are fertile, than all is good and it is something you can test on your own.

    good luck 

  • I turned down the NT since we're doing CVS but my RE was all about me doing it - until we decided on the CVS.  Not really getting your OB saying it always comes back positive after 35 so not to do it.
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  • I had NT scans with both of my pregnancies (over 35 for both) and in my case, the doctor indicated that it was my option but that the insurance will actually pay for the NT scan if you are over 35, while it is considered optional if you are younger than 35.  My doctor encouraged me to have whatever testing I wanted to feel comfortable and prepared but did remind me that the NT scan is a screening test only and that for any definitive diagnosis I would need a CVS or amnio. 

    With my DD, I was 36 and we did the NT scan and the sequential screening and because the results were good (i.e. my odds were lower than my pure age-based risk) we opted against anything more invasive.  This time I am 38 and for whatever reason I felt more unsure and more concerned about issues so we were pretty certain we were going to do a CVS or amnio regardless, however we did the NT scan and first trimester screening just to see if it changed our minds and also because the NT scan offers another chance for an ultrasound.  As it turned out, I wasn't happy with my screening results so we did go ahead with the amnio.

    I also don't understand your doctor's unwillingness to perform the NT scan; I think your doctor should present your options to you neutrally and with full disclosure of any risks and allow you to make the decision about what you want to do.  I know some women prefer not to get certain tests for fear of false positives;  I guess it depends on whether you are the type of person who needs to know as much as possible or not.  Either way I'd say if you would like to have the test you should explain that to your doctor and should be permitted to have it.

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  • I have had two 2 NT scans after 35 (one at 38 and one at 40) and they both came back negative - which is good news.  Not sure why your doctor says they always come back positive.  Also, many of my friends over 35 have had the NT scan and none of them came back positive.  
  • You should have him explain ALL of your test options in plain facts without his opinion and let you decide what you want to do.

    I went with the NT scan in the first trimester with the sequential blood work in the second. All numbers came back fine with no reason for concern. I wanted to do those test first and not just jump into test that carry a high risk of complications (CVS and amnio).

     Do some more research and ask your Dr. more questions. Good luck. 

  • I have had an NT scan with this pg and I am 35 and I had a neg result and my numbers came out great.

    I am not sure why your Dr does not want to do it. I would ask more questions.

    Erin

  • I haven't heard of not giving an NT scan to women over 35. My doctor discussed it as an option, but I knew I wanted the CVS, so I skipped all of the screening tests.
     
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  • imagechemmom:

    I have had an NT scan with this pg and I am 35 and I had a neg result and my numbers came out great.

    I am not sure why your Dr does not want to do it. I would ask more questions.

    Erin

    Yes
  • I had a NT scan with my 1st at 35 and sequential bloodwork follow-up in the 2nd tri.  Had great results from the test so did not opt for further testing.  Will be doing the NT scan and sequential again this time... at 37!
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  • When I went to the OB for my first visit, they gave me the info for all the screening and testing offered. The NT screen is offered to all pregnant women in the office.  I am 37 and will be 38 when our Baby Boy gets here.  I chose to do the NT screen and and no other testing.  All the statisitcs given to me were within normal limits. This is still no gurantee that there are no problems.  I also see a perinatologist monthly for other health issues.  My OB told be that pregnancy over 35 does not mean you are high risk. 
  • I'm 38 and had one at a large University Hospital.  It came back negative.  So did my AFP and all the ultrasounds so far.
  • NT scan is still optional, but OBs will recommend it more after 35. I had one done because of family history and we were fine at 32 years of age with DD#1. We had a really bad result with DD#2 at 35 that turned out to be a false positive. I opted for all the additional testing because I need to know and I know that the outcome could have changed the course of my pregnancy.

    I think it's totally personal preference on whether you want to get it done. There are a lot of false positives with that test, but it is much less invasive than the CVS or amnio.

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  • I had the NT scan with this pregnancy.  I'm 37.  It came back extremely good and I'm very glad I did it.  Saved me the trouble of CVS or amino.  Also, you really don't get a definitive positive/negative result, you get a number like 1 in 600 chance. As long as you go into it realizing that low numbers aren't the end of the world and just mean you might want to get the CVS or amino, then you're fine.  
  • I did not get it at 37, but did at 40. I have never heard they come back positive, in fact my numbers were 3 times lower for my age. They are optional, and if you want to get it I would ask for it. It's just a risk factor, not a yes or no answer, so her mention they come back positive is false, there is no "positive" its your risk, nothing more.
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  • imageRubygirl:
    I just went to the OB last week for my annual and she asked about plans for more children.  I said *maybe*  next year, but I'll be 35 then.  She went through the whole explanation about how 35 doesn't drastically raise any concerns, but that they don't do an NT after 35 because it almost always comes back positive.  This concerns me.  She said the results are a combo of scan, blood test and age.  I mean, if something were wrong, that's at least 8 less weeks you have to prepare.  Did anyone else get an NT scan post 35?

    Huh?  That's really weird that she would say that.  I had one done at 12 weeks.  My results were normal (I'm 37).  The place where I had mine done only has a 2% false positive rate, so I felt really good about having it done there.

  • Of course NT scan is offered to anyone regardless of the age. I had it done at 37 and now at 40 even though I also did amnio at 37 and CVS now. (The NT results were excellent both times btw).

    Looks like you either misunderstood your OB, or she misinformed you and she doesn't know what she is doing. I would double-check that she meant exactly what you told us, and if she did I would imediately find another OB.

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  • I have never heard of a doctor who refused to offer the NT scan. I had one and I'm 39, although I could have declined it. My OB did say that higher than typical results are expected 35+. He gave us the choice of skipping the NT and going straight to the amnio/CVS. But it was a decision DH and I got to make, not the doctor.
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  • as you can see it is very much offered to woman over 35, so it's kinda odd he said that. However, I am in a military medical system and when we asked about it I was informed that they don't do it and I would then need to get a referral to get it done, unfortunatly the timing was an issue and I did not have the time to wait for a referral.

     

    Perhapse you should call tomorrow and ask to have an appointment ASAP with there genetic counselor.

     

  • Wow, lots of responses!  Thanks everyone!  A few things to clarify:

    Yes, I know the NT doesn't give you a "positive" or "negative" result.  My poor use of terms, sorry.  I know it's just a ratio of risk, nothing more, and certainly not a definitive result of anything.  However, even doctors bandy about the "false positives" with this screen.  I'm pretty sure my OB even used the words "it almost always comes back positive" when telling me the reason they don't do the screen post-35.

    Perhaps they don't do it because they were getting a lot of 'bad' results for women >35?  I didn't ask because frankly this is all a big maybe for me right now.

    FWIW, my results at 32 were amazing.  For DS it was 1/10,000+.  I liked this screen because it gave me enough reassurance to break the news that I was pg and not go any further with testing.

    I like this Dr. in every other respect. 

    If / when I do get pregnant again, I'll bring it up then.  I might be able to request it even if it's not the office protocol.  Even if it were to come back with numbers that weren't great, isn't the first step a deeper-level US?  I'd rather avoid an amnio or CVS if possible.

     

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  • I had the 1st tri screening done (NT scan + bloodwork) and I am 37.  my results did not come back positive (at a higher risk for Downs or Trisomy 18).

    i don't understand how your dr. could say it mostly comes back positive.  That just isn't true.

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  • From what I've read on these boards a lot of NT scans come back positive for women of all ages.  The thing to keep in mind is its not really a "positive" result.  The scan can find "soft" markers for some chromosomal anomalies.  If these markers are present they give you "odds" that your LO might have DS or other issues.  LO could still be perfectly healthy.  A 1 in 500 chance for DS is considered a "positive" result.  The only way to know for sure is to get an amnio or CVS. 
    I give up trying to get a ticker.  I have a DD that is 2.5 years old and is awesome.  Maybe I'll add a quote to distinguish myself.  Hmmm.  How about...

    "It is more fun to talk with someone who doesn't use long, difficult words but rather short, easy words like "What about lunch?" - A.A. Milne, Winnie-the-Pooh
  • imagechemmom:

    I have had an NT scan with this pg and I am 35 and I had a neg result and my numbers came out great.

    I am not sure why your Dr does not want to do it. I would ask more questions.

    Erin

    This but also my doctor made it sound like an NT scan after 35 was the norm... I didn't really feel like I had an option - not that I didn't want it!

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