Great NT scan - struggling with decision on CVS..

LucyP2013 · December 2012

Hi older mamas - I am actually not new to the Bump but had to re-join today as my old username/PW would not work when I tried to sign in.

Anyway - I am 41 and pregnant with twins - due June 22, 2013. I also have a 4 year old little boy, Jack (had him at age 37.) I will be 42 when I give birth to the twins (HOPEFULLY - my birthday is May 12.)

I had CVS scheduled for this past Tuesday when I was 11w3d. The day before, my husband and I both got cold feet. We went in for genetics consult anyway - and a very good discussion with very nice counselor - decided to have NT scan followed by CVS ONLY if NT looked not so great. Measurements for both twins came back at 1.1 mm - so - we opted not to have CVS that day. (U/S tech was a total sourpuss - and I could tell she visibly disapproved of our decision to skip CVS. Whatever.)

We then went to lab for first trimester blood draw (which will be even less accurate for me with twins - but genetics counselor said they still offer it - and basically split the difference as far as the HCG and PAPP-A meaurements - and come up with a risk number that way.)

MaterniT21 is not a good option for me - because I originally started out with triplets. One of them did not make it past 6.5 weeks. Sac is still visible on u/s (but very small.) However - if that trip had a trisomy - which is very possible - my M21 test could come back positive even if both twins are fine - which would mean I'd have to get amnio down the road (wouldn't get results back in time for CVS - my providers will do CVS up until 12w6d - so for me - that's one week from today.)

Even with great NT scan - I am still struggling with decision not to have CVS. DH is too. Neither of us want to do it (well, who really *wants* to have something like that done?!) but we aren't sure, and need to make decision soon. It's almost certain I'd have to have both cervical and abdominal poke (with twins) - and it's also scary that there are two chances for something to go wrong, instead of one. Plus - although the person who would do test has done a million of them and is known to be very good - what if no matter how good he is - my body, my uterus just has a bad reaction to getting poked - and we lose everything - possibly two very healthy babies? This is it for us - we did fertility treatments to get pregnant with our son and these babies - and we're done. I won't go through any of this again - so these babies - are it.

Meantime, I wait for bloodwork results and an overall risk number based on NT and bloods - if it's awful (even with great NT number we got back) - that would likely prompt me to schedule CVS. If it's not awful - I think we might just skip it - and I have to find a way to be peaceful with that - and let things progress however they are going to. We will do level 2 u/s and anatomy scan at 18 weeks - so that will provide more info as well.

This is more of a vent than anything else but I imagine there are some older moms here who have also struggled with this decision - just wanted to share this with people who get it. Thanks for letting me!

ShellBear+ · December 2012

I totally understand not wanting to do the cvs and I don't think I would in your case either. I hope your bloodwork comes back great and you don't have to struggle with the decision any longer. Before I got pregnant I thought I would want to have a cvs but then I had 3 miscarriages and I decided that I just couldn't risk it no matter how small the risk. I decided to just do the nt scan and quad screen which was great and made me feel better.

Good luck with your pregnancy and please keep us updated

dhreczuck · December 2012

It's definately a personal decision, but due to my own misfortune with the CVS test, (see siggy) I obviously chose not to do it this time. I would do anything to go back in time and have chosen to do exactly what you did and back out at the last minute... I'm happy with the good NT results I received this time, that being said we had a back up plan to do the Matern21 if those results were on the bad side.

You should also be aware your NT results are already somewhat skewed to the bad side because of age. That doesn't mean you won't get a good result, it just means that you're already starting off at more of a disadvantage than someone younger just based on age risk alone. My OB advised me that she doesn't feel these screenings are super effective for over 40 because of that. Good luck with whatever you choose!

lovelyday39 · December 2012

I would say, if you don't want to- don't do it! It's not mandatory! I hate that the medical community treats it like it is or tries to pressure people into doing it!. Fact of the matter is that it introduces risk, so you have to decide if the risk is worth it.

letzgoracing81 · December 2012

This is a rough decision. I was carrying twins (up until 14 weeks) I was told the blood test would not yield accurate results because I was carrying twins so we decided to skip that and go right into the NT scan.. The NT scan showed possible Genetic abnormalities on my baby girl (twin A) and we decided to go ahead with the CVS. For Twin B the doctor could not go through my cervix so it was a direct shot through my stomach. (quite painful)

I was a bit angry with my boyfriend for wanting to get the testing done on Twin B. His U/S came back with excellent results and I didn't feel like we should do any further testing. But I ended up getting testing done on both twins.

My baby girl came back T-18. Before we could make a decision on whether or not to terminate--we lost her. Her loss was not due to any complication from the CVS...it was simply a result of the T-18.

The doctors who are checking those ultra-sound images know there stuff...if they are not seeing any indicators of genetic issues...I say leave well enough alone. If you opt for further testing...I think the CVS is less invasive then the Amnio, and less risky to the baby.

kat1221 · December 2012

lovelyday39:
I would say, if you don't want to- don't do it! It's not mandatory! I hate that the medical community treats it like it is or tries to pressure people into doing it!. Fact of the matter is that it introduces risk, so you have to decide if the risk is worth it.

All of this. It's def a personal decision that only you and your husband can make. The NT scan came back "normal" for both of my pregnancies and I declined further testing.

WeAreSmalls · December 2012

I am 38 with twins - hopefully 39 at delivery. We skipped blood work and CVS and are having an amnio at 16 weeks. My dr said CVS is more difficult with twins and there's always a higher chance of miscarriage w/CVS than with amnio. We didn't do the blood work because it's not as reliable with twins. I know there is a risk of complications with amnio but I was more comfortable with those odds than with CVS. Good luck to you in your decison.

jkzinck · December 2012

I did not have any testing with dd and I had her when I was 38. My steph sister had a bad experience with testing and it stressed he out her whole pregnancy. Having a previous mc I didnt think the testing would change what I would do

ocho2002 · December 2012

I am PG with twins and had the CVS last week only because the ultrasound on one was really bad. They tested both babies, but I am still waiting on results for the one they are concerned about. I had both tested through the abdomen and I thought it was very painful. I was/am also a ball of nerves so that probably didn't help. If my scan had been good, I would not have done it. Good luck with whatever you choose.

LucyP2013 · December 2012

Thank you ladies SO MUCH for the support and encouragement. dhreczuck I relayed your story to DH and couldn't stop crying - I am so, so sorry for your loss and wish you so much happiness in the future. Again, I just really appreciate the support today - it helps to know others have been in your shoes (or are in your shoes now) and to hear about how others dealt with these decisions. Thanks again ladies.

mrsjami · December 2012

I had CVS done on twins, both abdominally. Previous pg ended due to T18 at 17 weeks so we felt we needed a straight answer. I was terrified and almost backed out, but I am glad we did it. It's really a difficult decision.

GalLaura · December 2012

Good luck to you. It is such a big decision. Wishing you all the best. I go for my nt on Monday and I'm so nervous.

NicoleWI · December 2012

I would not do it. I would go with the NT results, do quad screen, do the 20 week scan, etc. You could always still do amnio down the line if any serious markers popped up.

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