Sequential Screening Vs. Amnio

P.,
I had baby number 3 at 35 years old and baby number 4 at 37 years old. The DR made me go for special ultrasounds (level 2)and blood tests but I refused an amnio unless one of the tests came back questionable. Which none of them did. All because of my 'advanced maternal age' (coined by the DR). Don't let them scare you into doing something your not comfortable with. I am sure if one of your tests came back and the results were not normal, then you would approve an amnio but why go to that measure before other options are explored?
I am happy to say baby number 4 born 3 months ago is doing wonderfully and so is baby number 3, who's almost 2 y.o.
DO what your comfortable with. Your the patient and you say whats going to happen to your body, not them.

First, you need to ask yourself "why you want to do these tests" and WHAT IF...your results are not what you expect. I had an amnio with both of my pregnancies. I was only 28 with my first and 40 with my second. I "ALWAYS KNEW" that I didnt want to take the risk of bringing a child with special needs to this world. I was always positive of what to do with the outcomes. At the same time, this is something you also need to discuss with the father of your child.

TRUE, the amnio is invasive (I would not say painful, just cramps like premenstrual) and there are other alternative tests, but this is the only one (to my knowledge) that has 100% accuracy and I didnt want to take any chances.

I always had faith on what God wanted for us and prayed that everything would be ok, HE gave us two wonderful healthy children (14 and 2).

I know a little about this, as a doctor and a patient! I'm an anesthesiologist, not an obstetrician, but amnio is relatively safe. As a patient I had it done NINETEEN times!! My second pregnancy I had twins with complications, and they needed to take off the extra fluid. Your procedure is much simpler; they only need to get a little bit of fluid to make a diagnosis.

That having been said, if I were in your situation....I mean I'm 45 now, and if I got pregnant tomorrow, I'm not sure I would want to take ANY risk. My question would be, what would you do with the information you received? If you would absolutely continue the pregnancy no matter what the results of the amnio, (as I would), then I would just do the sequential screening and get as much information as I could to educate myself without posing any risk to my unborn child. If you are making a life-or-death decision, then you want to be 100% sure....if this is the case I would choose the amnio.

Let me know if you have any other questions....also I can recommend a good perinatologist if you need one.

Hi P.,
I am currently in the same position but is comfortable just doing the screening. 35 is a number they just picked out of a hat. it doesn't matter if you are 30 or 38. My specialist made me feel comfortable picking the option of doing the screening unless my numbers were bad but I just got a call and he said my numbers are great. I go for my second screening and thats the last.
I can't tell you what to do or how you feel but if you would terminate a pregnancy because of Down syndrone then get the amnio.
I don't know who you are seeing but I am seeing Dr. Gary Cohen. I trust him he calls me with my test results and he does the ultrasounds. He is in Wellington.
Good Luck

I'd say avoid those tests. They can cause miscarriages. Trust that your child will be born healthy with the non-invasive tests available.
S.
www.CreateWealth.myarbonne.com

Hi P.,
I turned 35 a month before I delivered and did the blood test with the sequential, and NOT the amnio. I chose this for 2 reasons: I had heard horror stories about amnios going wrong and I was turning 35 not 45! If you are healthy and there is no other reason to believe anything might be wrong, I think 91% is pretty high.
Just my 2 cents :-)
I have a beautiful and healthy 8 1/2 months old girl.

Unless you or the baby's father has a family history of any problems, here's what my Dr. recommended I do with my 2nd baby.
First have the meeting with the genetic counselor to determine if you are at increased risk for any conditions that an amnio can detect. Then have the sequential screening. It's non-invasive and has a pretty high accuracy rate. If it shows you're at an elevated risk for any of the conditions that an amnio can detect, then go ahead and decide whether or not to do the amnio. One step at a time. Don't get overwhelmed with a decision (amnio) that you may not have to make.
Good luck.

Hi P., first off congratulations on the baby! I had the sequential screening (blood test plus a looong ultrasound) because I'm carrying twins and am considered high risk due to complications with my first pregnancy. My doctor assured me that although the screening is not 100%, it IS highly accurate and is considered the preferred method in Europe. My results came back negative, and it was extremely reassuring to see in writing that my babies had a 1 in 3000 (or something like that!) chance of being born with a defect or congenital disease. So, I guess the short version of my story is that the screening is a non-invasive and accurate method, at least it was for me! Good Luck!!
A.

Does the doctor have any other reason for the screening besides that you are what they consider an older mom? If not, I would tell him you want to wait if and until they detect any abnormality on your ultrasounds. There are less invasive ways to detect problems before he goes ahead and subjects you and the baby to an amnio. Ask him about those first. I can't remember what the test was called but they did something when I was pregnant, it was standard procedure, I think a blood test or something.

P.:

I had the blood test with my first baby...it was the BIGGEST stress of my life because it came back low numbers twice...which means probably downs syndrome. I did the amnio and all was perfect. I would never do that blood test again, personally. I was 35 years old when I got pregnant with my son...didn't do the test...he is perfect too. If you must do something for whatever reason I feel tp do the amnio and follow ALL of the after care instructions. Have someone come over and help you for the day or two.
I am the last one to do anything but natural. I had both my babies in a Jacuzzi:)

L.

I am a Jupiter mom who had an amnio 7 years ago during my pregnancy. I was 36. I would never do it again.
The local (here) doctor was horrible and as we watched on screen the Dr. actually stabbed my child while trying to collect fluid. My child was born with a puncture divet where this occurred. The Dr.'s ofc. tries to scare you with "you are high risk possible" after a certain age. Don't fall for it and let your instinct be your guide. I wish I had.

Hi P.. I can speak from personal experience. I delivered my baby at age 37. I decided to have an amnio instead of the triple screen (sequential screening). Before I delivered my daughter, I worked in genetics though I'm not a physician. The triple screen is accurate, however, it is not diagnostic, only predictive. If you want complete certainty, the amnio is the only way for you to proceed. The amnio carries a very low risk of miscarriage and is not very painful. The perinatologist group in the area which my OB referred me to is extremely experienced. You might want to consider speaking to a genetic counselor to help you make your decision. Good luck with your decision and your new baby!

It depends on your family history. I had the screening done at age 37 with my third child. I say go with the screening if your family history is good, you're still very young.

I was going to turn 35 when I gave birth to my daughter. She was small for her gestational age and when the doctor gave me a blood test, the doctor told me she was going to have down's syndrome and to take an amnio for confirmation. I chose not to have an amnio for the same reason as you. They gave me another blood test that day and the blood test came back normal.
Before I decided I read alot about the procedures and the possible risks. One article by Dr. Sears really convinced me not to undergo the procedure.
A friend of mine had two amnio's and both babies were carried to term. She was on bed rest after procedure for 1-2 days.
In the end it's your decision, make one that you can live with and know that's right for both of you.
Good luck,
B.
PS let me know how everything goes.

Dear P.:

Do the sequential screening test first and if numbers are real bad then decide about the amnio. I did the screening and since the numbers were ok I decided not to go with the amnio. Also, it's an opportunity to have more ultrasounds and see your baby!!!!
Good Luck and enjoy your pregnancy!!!

It's so hard to make these decisions!
I suppose the important question to ask yourself is
"what will I do with the test results?"
meaning, if it's 'only' to prepare yourself mentally, then perhaps the screening is all you *need*...

however, if someone in your position (not saying you!)might want to terminate the pregnancy due to results of the amnio, OR even has a tiny little bit of *thought* in that direction (PLEASE NO ONE 'FLAME ME!' I'M BEING HONEST HERE!), then she should consider CVS (chlorianic villae sampling) that is done at about 13 weeks (a person would have to call the dr.to be sure!)- it is a *bit* more invasive than the amnio, but it's so much EARLIER that, God Forbid, it was medically necessary to terminate then it's not so far along as the amnio!

Dr. Lai's office (miami)is the way (*only* way in my opinion) to go if one is considering a CVS or even an amnio (I say this because regular OBGYNs regularly do amnios, but personally I like to go to a SPECIALIST for these kinds of (risky!)things- someone who does them day in and day out- not a 'general' doctor like an OBGYN...agian, MY opinion...

good luck w/ whatever you decide!
feel free to send me a private message if you'd like to
continue this off-postings :-)
~L.

I know this is late, and I know that alot has changed since i had my daughter 7 years ago. However, just wanted to share my POSITIVE experience hoping it will help someone in mamasourceland. I was almost 44 years old when I delivered my one and only child. My doctor educated me on the tests and left the decision up to me. I decided that because I had no intention of terminating the pregnancy regardless of the results, I did not want to put both myself and my child through the stress of it as well as the risks.

AFTER I informed my doctor of my decision, he confided in me that his wife had had a miscarriage as a result of an amnio. I don't know for sure who did her amnio, however, I would imagine that an OBGYN would have a specialist doing an amnio on his wife!

My daughter was 10 Lbs 3.8 Ounces and 21 1/2 inches. There was NO diabetes,NO morning sickness, NO stretch marks and I carried to term and delivered with a "scheduled" C-Section at almost 44 years of age.
She is now a happy, healthy, intelligent 7 1/2 yrs old and was evaluated for gifted in Kindergarten!

The BEST advise I received from my OBGYM at the beginning of my pregnancy was this:
"You are going to receive alot of "unsolicited" advise, and MOST of it will most likely be negative, mostly because negative is more interesting, just like in the news. I am the doctor, however, you know your own body better than ANYONE! LISTEN TO YOUR BODY! YOU are the expert when it comes to your own body". I was very determined to do this and have a positive experience and I did!

My suggestion for anyone currently pregnant is to
Keep positive thoughts and people around you and don't get caught up in listening to or reading "horror stories", especially on the Internet.

HI.. I'm a 34 year old mom to a beautiful, healthy 4 month old little girl! I had the sequential screenings. I decided that 91% accuracy rating was better than putting my baby at risk or having a miscarriage. It was a wonderful process because you get to have more ultrsounds and you can see your little baby a lot more than normal! IF there were to be something wrong (God Forbid..) the probability of you finding out during your screenings is VERY high. They can tell with the bloodwork, and by a fluid filled sac behind the baby's neck. It's pretty amazing. Also, if they even suspect something is wrong during the screening, you can still have the amnio because they do the have to do the screenings during the 1st and 2nd trimester.(the baby wouldnt be too big yet) I think you would need to do it soon if you were going to do the screening!
It's up to you.. but I was very happy and comfortable with the whole process.
Good luck!

I also will have my second child after turning 36. I chose to have the sequential screening. My pregnancy has been going along fine and so my doctor didn't even suggest the amnio. I think as long as you haven't had any complications up until the time for this testing the sequential screening will provide enough information. I have had multiple sonograms until they felt comfortable with the results shown.Everything has turned out fine for me. I agree that the amnio is riskier and if your doctor isn't pushing it then stick with the screening.
Good luck!

My thoughts about the screening may or may not help you but the only test I agreed to was the triple test. Any other tests I would not have agreed to because of the risks for one thing and for another, no matter what the result of any test, I would not have terminated my pregnancy. I know that for most women knowing if there are any defects before the baby is born is important but no matter what the result, it would have not changed my mind about keeping my baby. I have a friend who's doctor told her that all the tests they did said that something was wrong with her baby. Her baby was born without anything wrong with him. If you have a strong faith in God, then know that He is in control and trust in Him that He will take care of everything.

Hi P.,
Yes, I had an amnio done for my first pregnancy as my afp (alpha feta protein) levels were off. I then ended up developing pre-eclampsia and had to deliver early at 28 weeks. He was premature....long story short I always regretted having that test done. My feeling is that the most important part of being pregnant is proper nutrition and being stress free. I would always go the non-invasive route. My second pregnancy I was 35 and refused all tests and exams EXCEPT I did allow blood and urine work to be done to monitor things. I made sure to eat well, relax, taking Omega 3, 6 & healthy oils. I had a perfect pregnancy and a healthy baby boy! I think the main point to consider is WHAT are you going to do with the information that you get from the amnio? IF it shows something "negative" (which there are no 100% anything) would you terminate the pregnancy? There have been many mistakes with amnio results and come to find out later that the baby was totally healthy....These are the important considerations so it isn't black and white. And the risks are there..........I wish you a healthy pregnancy and healthy, happy, baby! Please don't let the doctors "scare" you into a test. You are the only one that can make that decision and you not your doctor will have to endure the consequences of that decision.
All the best! M.

Hi P.....I did the sequential screening and not that scary thinking amnio...I actually enjoyed doing the sequential because you could hear the heart beat and see the baby eventually. I decided upon the former because I had wanted to keep my baby no matter what. My baby came when I was also 35 years old and he's a lot (smile).

Go with your gut feeling but just the thought of that needle in my stomach scared me a lot. What's a 9% difference gonna tell the docs anyway.

God bless!

Hi P.,
I was in my late 20's and then 31 when I had my two children so it was not an age factor that the amnio was brought up but it was put in front of us because of a test that showed a "chance" of our son having down syndrome. We decided that there was a greater risk of losing him due to the invasiveness of the amnio than there was of him being born with Down Syndrome and furthermore we were not going to terminate the pregancy if it did come back that he had it. You really need to weigh what exactly is the point of the Amnio and further more what will you do with the results. I hope this helps a bit.

***After reading everyone else's responses I see that the test I referred to that they considered us have the amino for was the sequential screening you are referring to. When I was pregnant is was called a triple screen and I didn't connect the two. Talk over with your doctor about that test. They didn't tell me until the results came back and stressed us out that the test has a high number of false positives. In other words, as at least one other person wrote, the test comes back worrying you that something may be wrong with your child and then there is not. Keep this in mind if you are definately going ahead with the sequential screening if anything comes back on it. Don't let them stress you out.

I was 35 when I was pregnant with my daughter. I had a miscarriage about 6 months before I became pregnant with her and I knew I didn't want the amnio or the triple screen because, like you, I was reading everything I could on the internet about pregnancy and tests for birth defects (bad idea). I read that the triple screen factors in my age and that there was a great risk of false positives. However, I did choose to have the level II ultrasound. Make sure it's the level II. This test is also very accurate at determining birth defects. With the blood test and the ultrasound, you'll be fine. But, just so you know, the amnio miscarriage rate is not as high as people would have you believe. And please, try not to read about pregnancy on the internet because you will read more negative than positive and you don't need that. Enjoy your pregnancy! Everything will be fine.

Dear P.;

I am not for all this testing. If it will put your mind at ease, then really think about it. I had my son at 40 and I did not have any testing on him. I did some genetic testing on myself. This is a very tough decision; one that I have talked with other mothers about. A lot of mothers I have found did the sequential screening. I heard that a lot of mothers were quite upset over it. They calculate your age and some other things together. I decided not to do that as I didn't want to worry.

Also, an amnio is not 100%. I have heard where people were told that their babies were going to be born with something and they weren't. Imagine if they were to abort those babies.

To me, even with an amnio, some women still worry. For a doctor to tell you that an amnio is 100% is wrong and not good medical advice.

How do you feel about this baby? Do you feel that it's going to be healthy. Having a baby can be scary at any age. You need to have faith.

If I were you, I would look up on the internet about amnios and see what they say. I recently read some where that mistakes can be made by the tech. My counselor told me what they did with the information once it was taken from the mother. That right then and there made me decide not to do it. I can not imagine if one of these techs had a bad day or a binger the night before and then do my test. No thanks. This probably doesn't happen often but my counselor said that she could never do the problem solving and separating of chromosomes correctly. Needless to say, she is a counselor.

Again, if you want to do research, it's up to you. I stopped researching when I was pregnant. I just wanted to enjoy my pregnancy. To me it's the most beautiful thing.