Talk to me about what prenatal testing you had

happywifemomofone · May 2013

I have my second OB appointment next week, and will be just over 11 weeks. At my first appointment my OB said to look over brochures he was providing and decide what kind of testing we would like. My OB offers that Maternity 21 test. This will cost me $200 OOP, I think that this gives me 100% gender confirmation. I got a brochure for "First Screen by Integrated Genetics" it is written in hand writing on brochure that this is done between 11 1/2 and 13 weeks. The brochure says it is a blood draw that tests for Down's Syndrome and Trisomy 18. The nuchal translucency is measured at the back of the fetus's neck. Is this the NT scan? It only tests for 2 things? This will cost me $301 and the rest will be billed to insurance. I am thinking about doing only Maternity 21 test, but they did not give me a brochure about it. I feel that we are low risk for many abnormalities because our donor was only 29yo. Then there's a brochure for birth defects between weeks 16-18, second trimester screening. I think that this might be the Quad screening but, I'm confused because it doesn't call it that. This will also cost me about $300. Would any of these birth defects likely be picked up by anatomy scan at 20 weeks? We have spent a lot of $$$ to conceive and will continue to the PG regardless of results. Anyone do Maternity 21 and skip both first and second tri screening tests? Are these same tests offered to younger ladies?

mlamping · May 2013

With my first child, I had the test for down syndrom and something else and that is all. I was not offered anything else.

Sorry, Best of luck

supersarah77 · May 2013

It can be overwhelming with the decisions of which screenings to do, can't it? I did a lot of them because I'm of the mind that I'd rather know than not know. I'm not a worrier by nature so it didn't make me worry more.

We did not do the Mat21 test, we did the regular 1st tri test looking for likelihood of chromosomal abnormalities including Down Syndrome and Trisomy 13 and 18 (I think those were the two). We also did the Nuchal Translucency (NT) scan shortly after around 13w, and in combination with the blood test, we got our odds of Down and the Trisomies, which for us gave us peace of mind. The testing doesn't diagnose the chromosomal disorders, just gives you a likelihood with 87-89% accuracy. Our likelihood was waaaaay less than the likelihood just based on my age. Because of those very low odds we didn't do chorionic villus sampling (CVS) nor an amniocentesis.

In second tri we did the quad testing around 16w which I think is usually just offered to women >35. In that test I found out I have abnormally high levels of Inhibin, which is linked with pre-e, preterm birth, and delayed growth. Unfortunately, it's a more recent medical advancement and not a lot is known about Inhibin. It could be something, it could be nothing. It has just resulted in closer monitoring for me (growth ultrasounds and non-stress tests) but baby has been absolutely healthy. Again, I'm not a worrier, so for me it was an opportunity to see LO on u/s more frequently. :-) In second tri at 19w we also got the anatomy scan ultrasound where they measure all the body parts, look for all the organs and make sure they're working, heart is pumping, etc. That's when we found out we were having a girl.

In third tri at 28w I took the gestational diabetes 1-hour test, which I failed, so I took the 3-hour test and passed. That's when you drink a sugary drink and they draw your blood to see how your body is processing glucose.

Then I've had a few smaller tests along the way - HCG in the beginning, a couple complete blood counts, and starting at 20w my OB's office does urine samples at every visit as a quick screener for pre-e and GD.

Under my insurance all prenatal visits are free, lab work is $10, and ultrasounds are $10, so fortunately cost was not a barrier. It's hard to say if I would have made different decisions with a higher cost. I might not have bought into the frequent ultrasounds and NSTs since growth is monitored by fundal height at prenatal visits and so is BP.

GL!

MrsJillian · May 2013

I have high co-pays for my prenatal testing, too. It was going to cost me $368 for the NT test, in addition to about $200 for the blood screening tests that are done in the first and 2nd trimesters (I was told you need the blood screening tests if you opt for the NT test b/c the results of the blood tests are combined with the thickness of the neck fold that is measured during the NT test to determine the risk of Down's and other abnormalities). I opted to have an amnio instead b/c it was going to be a lot cheaper at $200, plus, it is a diagnostic test instead of a screening test. It is 99% accurate. Due to my age and family history, I want to know for sure.

QOTR · May 2013

That's a lot of good info Superzuber - thanks! May I ask, is there a reason why you chose the 1st tri screening + NT scan over the Mat 21 test?

Abeille · May 2013

I had the Harmony test (same as MaterniT21), which both screen for Trisomies 13, 18 and 21 (down's). I skippped the NT scan b/c it is less accurate than Harmony/MT21 and only tests for 2 trisomies.

I did the 2nd trimester screening b/c that one also screens for neural tube defects, some of which can be treated in utero. I felt the sooner we knew of a problem, the sooner we could evaluate possibilties for treatment.

10-4LilBuddy · May 2013

We did the NT scan as it was covered by insurance and the Mat21 which we should pay 250. Since both came back negative, that's it for us besides the main ultrasounds.

ELF4321 · May 2013

I did the NT, which is the one that has to be done between 11 and 14 weeks. Because our results were so good, we did not do the full quad screen in 2nd tri, but DID do just the AFP part of the bloodwork then, because that looks for spina bifida too, which the NT doesn't cover. The NT can also spot early issues with heart and brain development, in addition to the NT measurement, but is usually too early to give an accurate sex prediction. The anatomy scan in 2nd tri is, of course, much more detailed on organ development issues. If I had to choose between the NT, which has like 95 accuracy and covers more tham the Mat21, I would probably go with the NT and then decide based on the results if I felt further testing would be beneficial.

Tigger & pooh · May 2013

We just did a nt scan yesterday and maternti21. We will also do another scan at 16 and 20 wks to look for abnormalities, especially neural tube defects. I am not sure if our MFM will recommend the AFP blood test again or if they will be able to see enough at 16 wks.

happywifemomofone · May 2013

Thanks for the input ladies!! I really appreciate all the combinations of testings done by others and hope to be able to sort out what is the best combination for us.

supersarah77 · May 2013

QOTR:
lt;lurking againgt;nbsp;That's a lot of good info Superzuber thanks! nbsp;nbsp; May I ask, is there a reason why you chose the 1st tri screening NT scan over the Mat 21 test? nbsp;nbsp;

Because my insurance doesn't cover Mat21. Blood work and NT scan are high enough accuracy that we didn't even look into Mat21 out of pocket.

miracleat47 · June 2013

I had the Harmony Prenatal Test as recommended by my doctor because of my age. Also, this test is much cheaper than the one where they insert the needle and does not have the risk of miscarriage. This is a new test, but seems to be pretty accurate. You can look them up on the web under LabCorp for more information. I am thinking that the test you are describing may be the same one.

I hope this helps you.

sloturtle · June 2013

I am 39, DH and I decided to skip all prenatal testing. Our insurance didn't cover it. We agreed that we would accept what God has given us. So far our little girl is doing well and everything looked good with her development. When we had our 20 week u/s done, we were referred to the hospital to have it done because there machine were able to see a lot more than the doctor office machine. We did pay a little more for this but it gave us a good piece of mind about her development (only $60 more compared to a lot more for prenatal testing). Good Luck with what you decide

livy625 · June 2013

I had the NT scan which was good and then the Verifi test (like Mat21) which was not covered by my insurance. Luckily they cap off the price at 200. My test were all negative and we found out we're having a boy! I'm 43 and just wanted to be prepared. Our genetic counselor said the only risk that was higher at my age was the chromosome defects so that's why we went with the Verifi test. I'm almost 16 weeks now.

I will probably have the Quad screen though it has a high false positive rate. I had a false positive with my first son for downs and he was perfectly normal. The ultrasound at 20 weeks should also show if there are any defects so I have mixed feelings about the Quad screen. I guess it will depend if the test is covered by my insurance or not, if so I'll probably get it. We also had the cystic fibrosis test which was neg.

Good luck with your pregnancy!

cynthia071173 · June 2013

I am 36 weeks pregnant and we had to do in vitro and we knew that this was our one and only chance (could not afford to do another cycle and we are both older) so we chose not to do any of the testing. We knew that we would not terminate the pregnancy no matter the birth defects and the 18 week ultrasound could show some defects. If there was anything shown there to be concerned about then we would consider doing other tests but everything has looked good.

Carnation77 · June 2013

We also didn't do any screening because it wouldn't change anything and I don't deal well with percentages. We did get the 20 week anatomy scan (ultrasound).

MT-Head · June 2013

Back in 2010 when I was 36 and pregnant with #1, I did the amnio b/c there was no MaterniT21 and the risk of miscarriage was greater with CVS than amnio. With this one, I did MaterniT21 and the NT scan, but my insurance covered both so price was not a consideration at all.

The NT scan was done the day of the blood draw for MT21, and the tech commented that my scan looked better than the one they were currently using as a teaching tool for a good result, and she was going to submit my scan to be used as a sample going forward. That really reassured me, like, 80%, but I wanted, or rather needed, that extra bit of certainty, so I got the MT21 too.

MrsClaus8 · June 2013

We did the MaterniT21 this time. We have 2 children already and, more than anything, I wanted to be able to prepare THEM if there were any abnormalities. It's basically 100 accurate even though they are required to say 99.4. There have been zero cases of false results either way as it tests your actual blood. Our insurance covered it but I'd be willing to pay the 200 if it hadn't. It was a nice bonus finding out we're having another boy, too.
Good luck in your decisions!

synergy_gd · June 2013

I didn't get any options. I was just given a blood test that was 250 and the scan was 300. Then they combined those results for risk of downs and two others. I think I get a bit back from the government though

StephanieLove10 · June 2013

Late to the party, but maybe this information might be helpful to someone:

I had the Integrated Test and the Harmony test. I also had the NT ultrasound at the same time they drew the blood for Integrated and Harmony. I opted not to have the CVS or Amnio, although both were offered. They didn't get enough fetal DNA the first time they drew Harmony, so I had to go back a week later. All of those tests were done between 11 and 13 weeks. Everything came back in the normal range.

At 20 weeks I had the anatomy ultrasound. Baby wasn't cooperating and there is a family history of congenital heart defects, so we referred for a fetal echocardiogram at 24 weeks, which came back normal.

I'm going to have to have ultrasounds every 6 - 8 weeks due to large fibroids. The next one is scheduled for Monday.

I have my glucose tolerance test this Friday.

Other than that, I have a urine screen at every OB visit. My visits are now every three weeks instead of every four weeks.

That's about it.

Oh, and I'm 41 with three prior miscarriages, all due to fetal abnormalities that were detected with post-loss testing.

ocho2002 · June 2013

I was scheduled for the quad screen and Materni21. At the NT scan they found a cystic hygroma so I had an immediate CVS.

ABC7282 · June 2013

I'm 35 and pregnant with our first. We debated a lot about these early tests and here's what we did: We tested for cystic fibrosis and nothing else. Our doctor said what SHE did was to make an appointment at 20 weeks with the Maternal Fetal Medicine department (those fancy high-risk specialists) for an ultrasound with a physician (not just the tech).

At 20-ish weeks, they can look for physical signs in your baby of Downs, spina bifida and other anomalies. We opted for this since some of the other early blood tests (QUAD, etc) just gave us probabilities (and my MFM doc was questionable about my insurance paying for Maternity21 at all). If things looked "questionable" at the ultrasound, we would have done more testing to confirm, but if things looked good and normal, we were happy with that.

I think all the genetic testing comes down to what you would do with the information -- if a certain diagnosis is a game-changer, then you may want to get tested. I wanted to know about cystic fibrosis. The measurements at 20 weeks revealed everything's normal and right on schedule for his growth rate (which rules out the Trisomys pretty much, I think), and the doc said there's nothing to indicate everything's not normal. So we're going with that! Hope that helps!

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