To do the 1st Tri screening or not

chicky1231 · August 2012

I have the NT scan schedule for next Friday but now I'm wondering if I should even do it. I wouldn't do any further testing b/c I'd be to worried about the risks.

I've read up as much as I could on it and it seems it doesn't diagnose anything but gives you odds. I'm a worrier at heart and I'm scared that I will get a false positive that will lead to a stressful pregnancy.

The other part of me wants to do it so get results so I know if there is anything wrong. We have no risk factors and no reason to think there would be anything wrong.

What are you doing?

Lisa1183 · August 2012

We decided to do it. At the end of the day, we discussed that we would rather know so we could prepare ourselves. It's a completely personal choice and see why you would be leery of doing it. I hope you make whatever decision you feel the most comfortable with. Best of luck:)

KMac570 · August 2012

The way I see it is, it won't affect anything I do - there is nothing in this world that could make me terminate this pregnancy. Knowing the odds would then just make me worry, and I am doing enough of that already. Plus, I think the fact that I lost a twin early on might mess with some of the tests? Not sure about that last part. But anyway, no testing for me.

Happy2BPregnant · August 2012

Honestly, the choice is up to you. I am doing it so that I can just know. I am a planner by nature. Also, I want to see my baby again on the ultrasound!

oliversmom03 · August 2012

I worry all the time, but hubby and I have decided to go ahead and do it.

ann_jeremiah · August 2012

We chose not to do the scan last time and won't do it this time either. Our risk is so low and we wouldn't do anything differently. I have a friend who was told her first baby had downs and was born without...

MrsNiner · August 2012

We did it with our DS and will be doing it with this LO as well. We mostly wanted it the first time so we could have another peek at the baby, and insurance covered it all. I wouldn't terminate if anything were wrong, but if there were something... it would be nice to be able to prepare before LO's arrival.

46 · August 2012

We didn't do it with our first and we will be skipping it this time as well. I don't see any reason for us to do it. I know it's the right choice for some people, but we would do nothing differently no matter the results.

BabyRN2006 · August 2012

I'm honestly not sure if we will be doing it or not. We are kind of in a tough area with out appointments because we just graduated from the RE and are meeting with my OB next week, and I will be 12 weeks already at that appointment. So we are tight on time if we want it. No one has talked to us about it but as far as I know we have no risk factors.

I am a worrier by nature, and I don't know if I will worry more if they find increased odds of something with the testing (I also probably won't do further testing due to the risks) or if I will worry more not knowing. Another ultrasound would be nice though. I just don't know what to do yet!

myszko · August 2012

ann_jeremiah:
We chose not to do the scan last time and won't do it this time either. Our risk is so low and we wouldn't do anything differently. I have a friend who was told her first baby had downs and was born without...

Same here. We didn't last time and won't this time.

alber2am · August 2012

Knowing the odds would make me worry constantly, if you would not terminate based on the test results then I don't see the point in doing the test.

kac831 · August 2012

I did it. I wanted as much information as possible to be prepared. Sometimes risk factors can lead you to explore things that need special medical intervention at birth, or a special hospital or nicu you need. It does not hurt to be prepared and have as much information as possible.

Plus I loved seeing the baby on the u/s , so fun to see how much it had changed since we last saw it at 9 weeks.

wittyschaffy · August 2012

We aren't. The test only gives you a degree of risk of certain conditions and they can still be wrong. I'm a total planner but I decided that the results wouldn't change anything for me, and I don't need to stress myself out about it in the meanwhile. That isn't good for me and it isn't good for baby-nugget. If they are born with some syndrome or condition, we'll figure it out. I also know I wouldn't want more invasive testing like amnio or CV sampling so why bother.

I do want to know about something that would require a special type of delivery (spina bifida for instance) but that should be visible on the 20 week anatomy scan.

kellyrn9956 · August 2012

The test does not have good enough sensitivity and specificity for my tastes. Only around 80% of babies with Down's or Trisomy are even caught on the test, so 20% are still either surprises or caught other ways. And the VAST majority of positive screens are false, leading to unnecessary risk with amnio or CVS. So we chose no. In fact, once we read the brochure, it took us about 5 minutes to make that decision.

I'm not saying that others should not do the test. I am just explaining why we have chosen not to.

philfemgal · August 2012

We will not getting the 1st trimester screen. We will most likely get the 2nd trimester screen. And given my history of second trimester loss, we will be getting a good amount of ultrasounds. And if I were able, I would get the MaterniT21 test, but my OB says without a prior risk factor I cannot get that test.

Our reasoning for not getting the 1st trimester screen is that it CANNOT tell you that everything is okay and it CANNOT tell you that your baby has a trisomy. It can only give you an odds ratio which is meant to then help you decide whether to undergo more invasive (i.e. risky) testing like an amnio or a cvs. The false positive rate for the test is 5%, which is much higher than the actual chance of a trisomy (for me, given my age).

So we asked ourselves what would we do with a positive result or a negative result. If we got low odds for trisomies, we might feel a little relief. But not much given we are anxious about every aspect of pregnancy anyway given my loss history. In addition, as PP said plenty of babies with a trisomy are missed in the screening anyway. So getting a low odds ratio is far from a guarantee.

If we got a high odds ratio result, we would have to decide either to do a cvs/amnio which each have a risk of causing a miscarriage or to do nothing in which case, what was the point of getting the screening in the first place? (Another possibility might be to do the MaternityT21 test after a positive on the 1st trimester screen. I am not sure if that is a possibility.) The idea of a cvs/amnio is especially scary to me given my history of loss and the fact that most positives on the 1st trimester screen are false positives. I would absolutely refuse an amnio/cvs simply to determine whether the baby has down syndrome. We would not terminate for down syndrome and while it would be nice to "be prepared" there is nothing to be done at 12 or 14 or 16 weeks in particular. A heart defect related to down syndrome would be my biggest fear, but I assume such a defect would be very likely to show up on the a/s or later ultrasounds. We would absolutely terminate for a fatal trisomy. But according to my OB, such fatal trisomies have lots of markers which will show up on ultrasounds. So again, if our odds were high for a fatal trisomy, there is still the 5% false positive rate and so I would fear risking an amnio/cvs when quite likely it is a false positive, and if it is not we will likely get some information about it by ultrasound (a/s will be at 16 weeks) anyway.

The second trimester screening is an entirely different story for us because it looks at far more than just trisomies but also markers for spina bifida, preterm labor, and preeclampsia. These are things were there are possible interventions that can change the outcome which go beyond merely just our ability to terminate earlier rather than later or our ability to be prepared early on for a child with down syndrome.

At least that is *our* reasoning which works for *us*.

aeb20 · August 2012

philfemgal:
We will not getting the 1st trimester screen. We will most likely get the 2nd trimester screen. And given my history of second trimester loss, we will be getting a good amount of ultrasounds. And if I were able, I would get the MaterniT21 test, but my OB says without a prior risk factor I cannot get that test.
Our reasoning for not getting the 1st trimester screen is that it CANNOT tell you that everything is okay and it CANNOT tell you that your baby has a trisomy. It can only give you an odds ratio which is meant to then help you decide whether to undergo more invasive (i.e. risky) testing like an amnio or a cvs. The false positive rate for the test is 5%, which is much higher than the actual chance of a trisomy (for me, given my age).
So we asked ourselves what would we do with a positive result or a negative result. If we got low odds for trisomies, we might feel a little relief. But not much given we are anxious about every aspect of pregnancy anyway given my loss history. In addition, as PP said plenty of babies with a trisomy are missed in the screening anyway. So getting a low odds ratio is far from a guarantee.
If we got a high odds ratio result, we would have to decide either to do a cvs/amnio which each have a risk of causing a miscarriage or to do nothing in which case, what was the point of getting the screening in the first place? (Another possibility might be to do the MaternityT21 test after a positive on the 1st trimester screen. I am not sure if that is a possibility.) The idea of a cvs/amnio is especially scary to me given my history of loss and the fact that most positives on the 1st trimester screen are false positives. I would absolutely refuse an amnio/cvs simply to determine whether the baby has down syndrome. We would not terminate for down syndrome and while it would be nice to "be prepared" there is nothing to be done at 12 or 14 or 16 weeks in particular. A heart defect related to down syndrome would be my biggest fear, but I assume such a defect would be very likely to show up on the a/s or later ultrasounds. We would absolutely terminate for a fatal trisomy. But according to my OB, such fatal trisomies have lots of markers which will show up on ultrasounds. So again, if our odds were high for a fatal trisomy, there is still the 5% false positive rate and so I would fear risking an amnio/cvs when quite likely it is a false positive, and if it is not we will likely get some information about it by ultrasound (a/s will be at 16 weeks) anyway.
The second trimester screening is an entirely different story for us because it looks at far more than just trisomies but also markers for spina bifida, preterm labor, and preeclampsia. These are things were there are possible interventions that can change the outcome which go beyond merely just our ability to terminate earlier rather than later or our ability to be prepared early on for a child with down syndrome.
At least that is *our* reasoning which works for *us*.

This is my first baby and I am so confused with all of the different screenings.

Is the second trimester screening just a blood test? Is it the quad?

I am getting the sequential bloodwork done which is a blood test in the first tri and blood work in the second tri. You can also get the NT scan to go along with it if you choose, but we are still debating.

PippaLee33 · August 2012

kellyrn9956:
The test does not have good enough sensitivity and specificity for my tastes. Only around 80% of babies with Down's or Trisomy are even caught on the test, so 20% are still either surprises or caught other ways. And the VAST majority of positive screens are false, leading to unnecessary risk with amnio or CVS. So we chose no. In fact, once we read the brochure, it took us about 5 minutes to make that decision.
I'm not saying that others should not do the test. I am just explaining why we have chosen not to.

This. The screening is just that, a screening. It gives odds and probabilities, not definitive answers or diagnosis. They can tell you much more information at your A/S, so since I'm not planning to do more invasive testing and wouldn't consider termination it doesn't make sense.

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