NT Scan is not being offered to me

TXUltraRunner · June 2014

Should I push for it? I have a doctors appt on Monday which will be 13 weeks. It occurred to me that I should call and see if this is what we're doing on Monday. My OB's office doesnt have the equipment for the test. The nurse told me that I'm not eligible for that test. I called my insurance company to see if it's covered and it is. Should I push for my OB to send me to a specialist next week and have it? I fear it might be too late to get the appointment since next week is 13 weeks and you have to do it between 11 and 14. I'm 31 years old and DH is 34 so that's why the nurse says I don't need it.

kayham12 · June 2014

My doctor told me I don't need one either we are both in our mid 20s. I was told that I could if I wanted. Haven't decided yet. My appointment is also Monday.

luciddreamer106 · June 2014

I've never heard of anyone needing to be specifically eligible for the NT screen. It is my understanding that it's offered to everyone. I'm not having it done in my OB's office, but at the hospital system's radiology department. If you want it done, then I think you should ask again for it.

apolloslanding · June 2014

My doctor made it sound like the quad screen and the Nuchal are fairly interchangeable. He likes the Nuchal better, and it will be my first ultrasound, so that's a bonus. When I factor in false positives (I know the test isn't really positive/negative) of any of the screenings, I'm not entirely sure I've made the right choice, but more information, even skewed information, is better to me than no information. I don't think age really has anything to do with it. I've heard stats recently that the trisomy disorders are fairly equal-opportunity.

TXUltraRunner · June 2014

My doctor saw me 4 weeks ago and she never brought it up. I've of course been studying up on it since my 9 week appt and had decided I wanted it. It occurred to me today that her machine is too old to do it so that's why I called about it. I'm really annoyed that it was not brought up and I was not asked if I wanted it. This relatively small incident is making me consider finding another doctor but I think I'm being hormonal. I also think that I expect too much because of how well cared for I was with the RE.

apolloslanding · June 2014

I'm really annoyed that I wasn't tested for Cystic Fibrosis before we started trying. I had other bloodwork done once my doc knew we were going to start trying, why not that? I think it comes down to all the ob/gyns having their own opinion about what screenings are worthwhile to do. If you want it, definitely get it. I'm sure you've read there's a specific timeframe it has to be given in. Good luck!

Beauxbaton · June 2014

My first doc never mentioned anything with my last pregnancy. My current doc says you have to be eligible for the more invasive ones. But everyone can get the NT cause its an ultrasound and blood work. They told me you have to do it BEFORE 13 weeks. So...

WillCMyInk · June 2014

I also remember something about the NT scan needing to be done before 13 weeks...

Regardless, it's a personal decision and I think you should at least be offered it. I think it would be worth at least asking about.

TXUltraRunner · June 2014

CuppyCakes721 said:
My first doc never mentioned anything with my last pregnancy. My current doc says you have to be eligible for the more invasive ones. But everyone can get the NT cause its an ultrasound and blood work. They told me you have to do it BEFORE 13 weeks. So...

Exactly . It's just not gonna happen for me as my appt is 12 wk 6 d. It's partly my fault for not being more informed at my 9 week appt. I just feel like I shouldn't have to come up with questions to get answers, she should bring up some stuff. A conversation about standard tests just seem like it should be routine. I miss my RE he was so thorough and took so much the with me. My only other option is to find an OB two hours away and m not comfortable with that (small town and the other two doctors are assholes)

ktkoala · June 2014

I've been a little annoyed about how hands off my midwife has been about the NT test as well. She gave us a folder with a ton of information during our first visit and one of them referenced the genetics center that does the testing. If I hadn't proactively called the genetics center, it would have been too late for me as well. If it is covered by your insurance, I would push for it if you want it.

WillCMyInk · June 2014

@ktkoala - I'm pretty sure midwives are known for being hands off and expecting you to be as much a part of your pregnancy and delivery as they are. My midwife did something very similar and just said to call her if I wanted it done.

Beauxbaton · June 2014

@TXUltraRunner‌ I know the feeling. My first doc was like that. He was also a dick. That's why ultimately I switched OBs and I love my current one. They also may have not mentioned it because they may have not figured you needed it? But I'm 25 and my H is only 23 so its not like we are exactly the type of people who are at a major risk for birth defects.

Not that it can't happen, just we aren't high risk for it. You can ask them at your appointment if there is anyway you can do it that day.

UberBiz · June 2014

I have never been offered the NT scan for either of my pregnancies and it was not brought up this time either.

SKLH · June 2014

I just posted about this on another board.I wans't offered it either and I have NO idea why. It kinda bothers me.

TXUltraRunner · June 2014

It does make me feel a little better that others were not offered it either. Kinda makes me feel like maybe there are just two schools of thought on the scan

Jellybean707 · June 2014

I was offered the screen by my midwife and they are pretty hands off as well. She did tell me that the last day to do it is at 13 weeks 6 days so you still have a little time if you want it.

ETA I am 30 so I'm not sure why age would make you "ineligible"

mom2case · June 2014

I didn't have an NT scan with DD nor did I ever consider getting one. I was considered high risk during my last pregnancy because I have clotting disorders. That was the ONLY reason I got the NT scan. It's fun to see our babies but I think demanding an NT scan might be a bit much. Most people only get an anatomy scan.

LooneyLife · June 2014

TXUltraRunner said:

My first doc never mentioned anything with my last pregnancy. My current doc says you have to be eligible for the more invasive ones. But everyone can get the NT cause its an ultrasound and blood work. They told me you have to do it BEFORE 13 weeks. So...
Exactly . It's just not gonna happen for me as my appt is 12 wk 6 d. It's partly my fault for not being more informed at my 9 week appt. I just feel like I shouldn't have to come up with questions to get answers, she should bring up some stuff. A conversation about standard tests just seem like it should be routine. I miss my RE he was so thorough and took so much the with me. My only other option is to find an OB two hours away and m not comfortable with that (small town and the other two doctors are assholes)

It has to be done before 14w. I had my first appointment today with my OB at 13w1d. She gave me the order for it and said to call today to get them to fit me in next week for the screening (they also don't do them in my OB office).

ktkoala · June 2014

WillCMyInk said:

@ktkoala - I'm pretty sure midwives are known for being hands off and expecting you to be as much a part of your pregnancy and delivery as they are. My midwife did something very similar and just said to call her if I wanted it done.

Yeah, I agree with you and generally, I expect it and like the hands off approach. I guess I was just a little surprised that the words "genetic testing" or NT scan didn't even come out of her mouth. I guess they just expect you to be well-educated about the options and be pro-active in your care.

TXUltraRunner · June 2014

mom2case said:

I didn't have an NT scan with DD nor did I ever consider getting one. I was considered high risk during my last pregnancy because I have clotting disorders. That was the ONLY reason I got the NT scan. It's fun to see our babies but I think demanding an NT scan might be a bit much. Most people only get an anatomy scan.

I feel very strongly (as does DH) that if the NT scan and then further testing showed a high chance of abnormalities we are not certain that we would continue the pregnancy. If we did decide to continue the pregnancy, we would do so being well informed and knowing what we need for care. There is not a NICU unit in my local hospital so if the NT scan and more invasive testing (if the NT scan showed something) led us to believe that our child would be special needs, we would change doctors and hospitals. To me its more than just another ultrasound.

Sunflower9939 · June 2014

I had the NT done last pregnancy and was 24 at the time. I'm having it done this time again and am 26. There's no eligibility factor. My doc discusses all testing options at the first appointment and then again around 11 weeks. You just have to do it between 11w and 14w.

Sunflower9939 · June 2014

As a patient, she has a right to stand up for her options. An NT scan can provide good information, even if you don't want to terminate under any circumstances. It's important to know if your child may need special care or help when born and to ensure you deliver at a location with the proper facilities and staff to provide that care.

ETA: not to mention preparing yourself emotionally as a parent.

Stargirlb · June 2014

They aren't routine here. I've never had one or heard it even mentioned.

mom2case · June 2014

TXUltraRunner said:

mom2case said:

I didn't have an NT scan with DD nor did I ever consider getting one. I was considered high risk during my last pregnancy because I have clotting disorders. That was the ONLY reason I got the NT scan. It's fun to see our babies but I think demanding an NT scan might be a bit much. Most people only get an anatomy scan.

I feel very strongly (as does DH) that if the NT scan and then further testing showed a high chance of abnormalities we are not certain that we would continue the pregnancy. If we did decide to continue the pregnancy, we would do so being well informed and knowing what we need for care. There is not a NICU unit in my local hospital so if the NT scan and more invasive testing (if the NT scan showed something) led us to believe that our child would be special needs, we would change doctors and hospitals. To me its more than just another ultrasound.

I just feel differently I guess. And as far as NICU care, the things they would see that would make NICU care a necessity would be able to be diagnosed at the anatomy scan. In fact, the NT scan would just put a flag out there and it would be confirmed or denied at the a/s. If you're wanting to terminate due to certain abnormalities, the harmony test would suit you far better than an NT scan.

TXUltraRunner · June 2014

The Harmony test is not covered by my insurance while the other tests are.

LadyXaverian · June 2014

They aren't routine where I live, either. I wasn't offered one during my previous pregnancy. I asked about it and they told me it was unheard of unless you were in a high risk category. I get one this time since I'm over 35, but I have to go see a high risk OB at a different hospital to have it done.

ekbrick83 · June 2014

I had a similar experience to @ LadyXaverian
I had the NT scan with my first back in 2011 and it was just something that was scheduled and done. I'm on my second pregnancy now and living in another state that has different guidelines on testing. They offer them all, but my insurance doesn't cover them unless I'm considered high risk or over 35. Kind of annoying because I would rather have them done for some peace of mind before the 20 week anatomy scan. :-/

dragontears507 · June 2014

I was told that I didn't need it because we're in our 20s and have no family history of issues. That same week, a friend around the same age and with similar family history ended up getting horrible results from her NT scan and is in limbo waiting on an amnio to see what's wrong with their baby. That was enough for me. I called that same day and scheduled it.

If your insurance covers it, why not have it done just in case?

12chachacha · June 2014

My doctor (gp) was the first who told me about it and gave me the forms. I haven't been to see the midwife yet so not sure what they usually do. I'm 32.

bkmama · June 2014

Now I'm a little puzzled-- my OB didn't explain any of the testing options whatsoever, but during my recent ultrasound at 13 weeks 1 day, they automatically did a NT scan. I'm 25 so not high-risk at all. I didn't have any expectations of what types of scans to expect but when I laid down, the tech said "ok, today we'll be testing for Down's syndrome", and I was like "ok, sure!"

Now I'm slightly worried that they didn't have to do it but now I'll be billed extra? The tech did the full screen, including fluid at the back of the neck as well as presence of a nasal bone (it was there, so that's good). Sigh, stressful.

Eta: I have good insurance, so maybe it's not a concern. But still! I'm thinking I should change OBs to someone who will at least explain basic what to expects... Or I need to do a hell of a lot more research on my own.

goldengal72 · June 2014

I'm 20, first pregnancy, not high risk... and my doctor offered it to me, it's crazy that you're not offered it even though your insurance covers it!!

MaPetiteFamille · June 2014

Stargirlb said:

They aren't routine here. I've never had one or heard it even mentioned.

Apparently they are in Ontario. The only reason I know this is that there is an excellent guide to prenatal screening published by a Canadian agency. I'd recommend anyone weighing their options regarding prenatal screening read it. It's located here: https://www.nygh.on.ca/data/2/rec_docs/300_Prenatal_Screening_PatientInfo.pdf

The TL;DR version is that getting the NT scan plus triple/quad screen is more accurate than getting either the ultrasound or bloodwork alone.

Also, while being of advanced maternal age puts you at higher risk for carrying a fetus with Down syndrome, the majority of infants with Down syndrome are born to women under the age of 35. This is mostly because the majority of infants period are born to women under the age of 35, but still, I think it's good for patients and doctors alike to keep in mind.

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