First trimester screenings - Twins

jordangilliam · August 2014

Hey Mommies! Just wanted to get pros/cons of doing to the first trimester screenings? They want me to do the screenings in 2-3 weeks and I just want to know what your guys think...

absolutelymaybe · August 2014

Do you mean the NT scan? Are you AMA?

dal2aus · August 2014

It's been a long pregnancy, but I can't believe I remember any screenings in the 1st trimester other than the first ultrasound. In early 2nd trimester, you're given the option of doing an NT scan, which is non-invasive, so the risk is minimal. If it's offered and covered by insurance, it's not a bad idea.

carrotcake06 · August 2014

There are a couple different tests out there, so I can only speak to what I did. Around 11-13w (I think it was 12w w the twins and 13w for my singleton), I did a combo blood test and u/s to assess risk of certain chromosomal abnormalities, namely the trisomies: 18, 21 and one other one? I forget. I did not do Harmony, Maternit21, or any other "new-ish" named test.

When I met w the geneticist, she told me that the test has a lower accuracy for multiples - I think it's somewhere in the 85% range. My twins were di/di, so if the test came back w an elevated risk, we wouldn't know which one without more invasive testing.

There is also an option for bloodwork at 16w and I forget exactly what it tests for, but it's generally referred to as the quad screen. I think, but not positive, that it has the same accuracy as the NT scan / first trimester screening.

Whether to do it is a personal choice. Some people get worried, or freaked out, or don't want to know. Other people like the information. I'm a big fan of knowing everything there is to know as early as I can know it, so I did the testing. If the tests I could had come back w elevated risk, then I could plan more testing and prepare more effectively for my child/children's needs after birth and create support networks.

zazu13 · August 2014

Since the tests are not conclusive and I would never choose to terminate, I opted to skip all screenings. I would rather not know.

jkayb123 · August 2014

I agree with @zazu13, I wanted to enjoy the pregnancy and not worry myself the whole time and I would never have terminated. Plus there's a high degree of false positives

4legsRbest · August 2014

I don't think it is fair to say you would never terminate. If they told you your baby would be born and would suffer unimaginable pain for hours before passing, would you allow that suffering? Just have to get that out. I honestly don't know how I would react if I were faced with a choice like that.

Anyway, our first tri scan was like PP say, a high level scan to look for anatomical abnormalities combined with a blood scan. You do get back risk numbers, but the geneticist will hopefully do a good job of explaining what it all means. I don't suggestions trying to interpret them yourself unless you are a statistician - these numbers don't read like most people think. It is not invasive at all. I am in the group who wants to be armed with information. There are some abnormalities that need to be identified before birth which can be caught here or at you a/s. There are also some that aren't conducive to life and the baby will pass before the a/s due to these (read up on the trisomies they test for if you are curious as to which will get the baby out of first tri but not second). Having had a previous loss I would rather know sooner than later that something is wrong. Information is power.

carrotcake06 · August 2014

One of my biggest gripes w these screenings is the giving of results as "positive" or "negative". You are given a statistic of risk. Nothing is 100% definitive based on these tests alone.

A "positive" result just means that your risk factor is higher than some threshold someone set. And that could be something like less than half of one percent to get a "positive". I really prefer calling it "elevated risk".

Like I said, that's my own personal gripe with these things.

I also agree w @4legsRbest‌. I don't know what I'd do if faced w a prognosis that my baby would be in pain, suffering, and or have issues incompatible w life. But I do know that I'd want to know those things as early as possible so I would have time to think/reflect, understand my options, and plan.

diz1313 · August 2014

We opted to not do the first trimester screening. I've known too many people who were given false positives on certain conditions and such that I just didn't see it as being worth the possible stress. Also, I wouldn't terminate regardless.... so I figured we would just wait until the anatomy scan to get a good look in there.

kefttsc · August 2014

Due to being AMA, we had the Harmony testing done at around 10 weeks and were given results of low risk for all three Trisomies. We had an NT scan and were told the measurements were great. We are having the AFP drawn tomorrow to round out the genetic testing just to be confident the risks are as low as possible.

I agree with PP that it isn't fair to say you WON'T terminate. I don't think I ever would, considering it took me 5 years to get these babies, but if they were to have a painful condition that would only cause them misery for a few short days/months of life, I don't know what I'd choose. IMO we only know what we would do when we are put in certain situations.....

zazu13 · August 2014

4legsRbest said:
I don't think it is fair to say you would never terminate. If they told you your baby would be born and would suffer unimaginable pain for hours before passing, would you allow that suffering? Just have to get that out. I honestly don't know how I would react if I were faced with a choice like that.

Based on what I believe about the purpose of life, I would never terminate a pregnancy of a child who had any of the defects that are tested for in the screenings or a condition incompatible with life. I leave those things in God's hands. I would hope modern medicine could help with pain, etc. It's OK if others feel differently and would make another choice.

I actually did have to terminate a non-viable / ectopic pregnancy at 5 weeks. It was the worst time of my life. I was told I could die if I didnt. I did not want to. My family begged me to. I had reservations. What ifs. I was finally pregnant after years of trying and wanted so badly to believe my baby had a chance, that the doctors were wrong. I finally went ahead with the methotrexate and ended the pregnancy with no consequence to my health. Ironically it was on mothers day. Probably the right decision, but So hard...

But that's not the topic of this thread

. If the testing gives you peace of mind, do it.

Edited for redundancy

PinkinProvence · August 2014

What screenings are you talking about? DH& I had the Counsyl genetic testing done during 1st trimester. I guess our NT scan was also 1st tri,

I wanted to be prepared for anything and everything, especially with twins. I hate when people make it sound like only those who would terminate a pregnancy should have testing! What? Termination is not the goal of screening. Even if you think you would not terminate for any reason, it would be a great disservice to your child if you were not prepared for a diagnosis that you could act on immediately at birth. As a parent, I want to arm myself with knowledge and do the research if I knew he was going to be born with a particular disorder or disease (no matter how mild or severe).

ksgsmu · August 2014

zazu13) but I would want to be prepared. My best friend has a little boy with downs and she didn't know until after birth. It was super hard on her as she felt ill prepared and overwhelmed. He is adorable and they are now doing well, but it was hard.

auntjessy · August 2014

I originally wasn't planning on doing the screening for reasons already mentioned here (I'm pro-life, didn't want to worry, etc.) and told my OB. He is a very experienced doc and told me that with multiples, it's even more important and gave me a scenario that happened to one of his patients earlier that year to prove his point:

A mother was pg with twins. She had the normal scans/tests done, found out one of the babies sadly had either Trisomy 13 or 18, can't remember which. When the twin with the genetic defect started having issues in the womb, it would have been so early to deliver the second, healthy, twin that it would have compromised its life. Knowing the (almost always fatal) diagnosis of the twin with the defect allowed the mother and OB to make the decision to carry the pregnancy to term for the healthy baby. Armed with this knowledge, I chose to do the screenings.

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