Procedures/Tests at Fetal Appts.

posted 2 years ago in Pregnancy
Post # 2
Member
7098 posts
Busy Beekeeper
  • Wedding: August 2012

Well, technically everything is optional. It’s your body. Are you talking about the additional genetic testing you can have done to test for downs and other chromosomal disorders?

Post # 4
Member
176 posts
Blushing bee

I’m no expert, but I think bare bones testing would include an initial dating ultrasound, routine bloodwork and prenatal exams, a 20 week anatomy scan, glucose screening around 28 weeks, rechecking RH (if initial result is neg), rechecking hemoglobin around 28 weeks, and testing for strep in 3rd trimester. I might be missing a few things though, and every doc will have their own prefrerred protocal. Unless there is a problem you I don’t think you need more ultrasounds or tests than this unless you want to check for genetic problems. 

Post # 6
Member
176 posts
Blushing bee

I think you are referring to the 12 week nuccal ligament scan. I believe it has a 5% false positve rate, (don’t quote me on that). We declined it. I’m 34 and a healthy FTM. The doctor found a soft marker for Downs on our 20 week anatomy scan, so now I really wish I HAD done the nuccal scan because it would give more info regarding whether or not this soft marker is anything to worry about. As it is, we just have to cross our fingers until baby is born. So keep in mind there are two sides to the coin… That being said, you and any significant other need to determine if you would change the course of your pregnancy if a genetic abnormality was detected. If you would NOT, then genetic testing *might* not be a priority for you. I hope that makes sense.

  • This reply was modified 2 years ago by  MrsZapatos. Reason: spelling
Post # 7
Member
7098 posts
Busy Beekeeper
  • Wedding: August 2012

You can definitely skip the NT scan (nuchal translucency). But there is a blood test that I believe is 99% accurate now that you can do at 10 weeks, which will test for genetic disorders and also tell you the gender. Obviously this is optional as well.

I do plan on doing it personally. I know it would be extremely stressful if something was wrong, but I’d also like time to prepare and we’d know ahead of time if we needed a NICU team standing by.

Post # 8
Member
2840 posts
Sugar bee
  • Wedding: June 2013

At 10 weeks, you might be offered a non-invasive genetic screening like MaterniT21, Verifi or Harmony. They will take your blood, separate out the fetal cells and screen them for genetic issues like trisomies 13, 18 and 21, and some sex chromosome abnormalities. The results of this won’t give you a definite answer – there are some false positives and some false negatives – but they are relatively accurate. 

At 12 weeks, you will be offered the Nuchal Translucency scan along with a blood test. They are looking for “markers” of those chromosomal problems – again, they won’t be able to tell you for sure whether your baby is healthy, but they will give you a likelihood ratio. 

Between 10 and 14 weeks, you can do CVS, which is an invasive procedure where the doctor will remove a small amount of chorionic villi from your uterus and send the sample for genetic testing. The risk of miscarriage as a result of the procedure is extremely low and the results are very reliable. 

Between 15 and 20 weeks, you might be offered an amniocentesis. Like CVS, it’s an invasive procedure but with a very low risk of complications. It should give you a definite “yes or no” answer. 

At 20 weeks, there’s an anatomy scan and the “triple screen.” http://americanpregnancy.org/prenatal-testing/triple-screen-test

I don’t think any of them are really “mandatory.” My doctor really wanted me to have a CVS or amnio, I said no and that was the end of it. They can’t tie you down and make you take them. But I definitely wanted all of the non-invasive tests that I could possibly take. I did the MaterniT21, the NT scan and bloodwork and the 20 week scan and triple screen. If our baby is likely to have a problem, I’d like to know about it ahead of time so we can research and prepare. 

Post # 10
Member
3756 posts
Honey bee
  • Wedding: April 2014

I’m 34 and I declined all genetic testing and the nuchal translucency scan. DH and I knew we would not terminate no matter the results, and at my age, I’m automatically going to get higher risk ratios. All of those tests including the NT scan have very high false positive rates and for me the stress was absolutely not worth it. I knew that any major issues would be able to be seen at the anatomy scan and if something came up we’d go from there. The only thing that did was that he had a little bit of fluid in his right kidney and just needs a follow up ultrasound to check on that but otherwise everything was fine. I don’t regret not doing the testing. 

Post # 11
Member
693 posts
Busy bee
  • Wedding: October 2011

newbabybee:  We’ve declined the NT scan, but are doing the first trimester blood screening.  I’ve already had the routine bloodwork, and RH was postive, so don’t have to worry about that later, and my urine culture already tested positive for GBS, so another test I don’t have to worry about later.  Not looking forward to the glucose screening, though 🙁  We also did not have a dating scan, since I know my dates.  We will have the 20 week anatomy scan, though.

Post # 12
Member
2609 posts
Sugar bee
  • Wedding: October 2011

newbabybee:  I was 32 when I got pregnant with and gave birth to my son. I live in the USand had all my prenatal care at a birth center with midwives. My first appointment was at 11.5 weeks where I had bloodwork done and we went over my family history and my husband’s. I had one ultrasound at 20 weeks and gestational diabetes testing (drinking the glucose solution) at 28 weeks. I was also concerned about false positives at the N/T scan at 13 weeks, so we opted out. However, for future pregnancies I plan on having the 13 week scan because 20 weeks was a long time to wonder if everything was ok!

Post # 13
Member
7098 posts
Busy Beekeeper
  • Wedding: August 2012

jny1179:  the genetic tests do not have the high false positive rates. According to the Harmony website, it’s less than 1 in 1000 compared to 1 in 20 with the traditional testing.

Post # 14
Member
4410 posts
Honey bee
  • Wedding: September 2010

Westwood:  that blood test does exist and is great. However, it’s my understanding that it’s only covered by insurance if you are 35 or older. I took it during this pregnancy (I’m 36), but not during my first (I was 34). 

Post # 15
Member
1185 posts
Bumble bee
  • Wedding: September 2016

The NT scan is a soft marker where the blood tests like Harmony, Verifi, and MaterniT21 are a lot more accurate. They also are generally only covered or offered to high risk patients.<br /><br />I wanted the NT scan because I wanted to be prepared if there was any chance our baby would have Downs. I got it his time also because now that we have our son I definitely wanted to be prepared.<br /><br />The thing about the NT scan is its a soft marker, and you will get follow up testing. Did your SIL not get this? I dont understand why she was worried about her pregnancy the entire time? She should have recieved further testing that likely would have given her a lot less worry and reassured her things were indeed normal. I’m sorry she worried so long.

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