First Trimester Screening

Updated on March 23, 2008
D.P. asks from Carol Stream, IL
10 answers

Mamas, I need some advice. I was 38 years old when I had my first baby. I avoided all prenatal testing except the level II ultrasound and preferred to keep my head in the sand just hoping that I would have a healthy baby, and thankfully I did. Now I will be 40 at my due date for baby #2 and I'm tossing around the idea of the first trimester screening... partly because it is non-invasive -- just and ultrasound and a finger prick. Here's my dilemma... I am not scheduled for the test until my 13th week, which means if further testing is recommended based on the results, I would already be too late for the CVS but I would still be able to do the amnio. From what I've read, if you really want testing done for genetic abnormalities you should do the CVS. Should I skip the first trimester screening because it will cause unnecessary stress (and false positives/negatives, etc)? I'm not sure what I would do with any information that would come out of it. I'm already upset just thinking about it. Of course, I was already upset having to sit through my first doc appt when they go over all the risks that a 40 year old woman has as it is. My husband is hip to whatever I want to do. Any personal experiences and advice would be appreciated!!

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So What Happened?

After much thought and more conversation about this with my husband, we decided to go through with the testing. I think we would proceed with an amnio if results indicated a possible problem and worst case after the amnio we would consider termination of the pregnancy. I really appreciate everyone's input because it did make me think about everything a little differently. Update... the results are now back and look pretty good. I'm not going to get an amnio (based on this) and will proceed with the blood test for spina bifida and then the level II ultrasound at 20 weeks. The non-invasive tests are right for me for sure!

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answers from Springfield on

I would personally go through screenings for this reason. I have two friends who had babies with Down's Syndrome. Friend #1, who was in her 20's, had the screening and knew in advance her baby's condition. Related to advanced ultrasounds, they also knew she had a heart defect that would require special treatment at birth. She and her husband had several months to prepare for their daughter's birth, from finding a pediatric heart specialist, to finding an appropriate hospital to deliver at, establishing a support system, and gaining overall knowledge. I truly believe they had a more positive birth experience and parenting experience as a result. Things were calm, they knew what to expect and how to deal with it, and any grieving over their child not being perfect had been done before she entered the world. Friend #2 did not have the screenings and had a baby with Down's Syndrome as well. They had no idea until after she was born. In addition, she had a serious heart defect they were not prepared for, so while she was recuperating from birth her baby was being rushed across town to a different hospital! It was chaotic, unexpected and devastating, and it took weeks for them to accept and bond with the baby. You have to make the choice that is best for you, but I know what I would choose if it were me. Best of luck.

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answers from Chicago on


I debated this too. I had #4 at 33 and although I was not in the window for being at risk, I wanted to know. I had a false positive blood test result for my AFP - 1:119 chance my baby had downs syndrome. I went for the Amnio to find out for sure. they still use DNA to determine chromosomal abnormalities so I'm not sure if the CVS is any more or less accurate, but they told me it was over 99% accurate (amnio).

My thought process for going forward with the amnio, was that the statistics for miscarriage is seriously outdated and not truly accurate and secondly if our baby DID have downs, I didn't want to find out in the delivery room. It is hard enough dealing with hormones without having some form of grief along with it. And lets face it, giving birth to a special needs child is not what we dream of in our visions of our new little baby.

Not to mention, you'll want to do lots of research on whatever chromosomal anomoly your baby has (IF it's even positive for one) and you'll want to prepare your family and close friends as well...

I was really thankful that modern medicine gave me the opportunity to be completely prepared before the baby came. I know some mom's don't want to know... and I have a friend who refused the AFP test, and she said she worried anyway. At least once you have the AFP test and Amnio, you can stop worrying for the most part.

Good luck to you, and congrats on your pregnancy!


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answers from Chicago on

Hi D.,
I second what Jenn said - it all depends on how you would use the information. If you would choose to terminate the pregnancy if there was something wrong, then by all means, you would want to know as soon as possible. If it does not matter so much to you, then do not put yourself through the worry.

The first trimester screening not only looks for Downs, but also Trisomy 13 and 18 - both usually fatal - either fetal demise in utero or shortly after birth. In these cases, personally, I think it it would be best to know so that you can plan and/or make some very hard decisions right away. There is a chance of "false positives" (which is really a misleading term because the test is only a screening and not diagnostic) as well as a chance of "false negatives".

This type of decision is so personal, but hopefully you and your husband are on the same page no matter what you decide.

Best of luck to you and congratulations on the pregnancy!




answers from Chicago on

It all depends on what you would do with the information. If you would terminate the pregnancy if there was something wrong, you'd want to do that as soon as possible and not wait until the 20 week ultrasound. However, if you would raise the child no matter what, and you don't mind being surprised at the moment of birth with a baby that may have serious medical needs - then don't get the tests and just enjoy being pregnant. Best wishes to you & congratulations on baby #2!



answers from Chicago on

Hi D.,

I had false positives in prescreening with both my girls and immediately had the amnios to make sure everything was ok. Both girls were both genetically "normal" which means perfect to rest of us. I wish I never took the prescreening since they both caused me undue stress.

Good luck! T.



answers from Chicago on

Hey D.,

Congrats! I am 40 and pregnant with my 4th. I have ALWAYS refused 1st tri screening, too much worry, too much stress and undoubtedly a false positive. My first three are healthy - born when I was 35, almost 37, almost 39, now this one will be born when I am 40.5. My personal experience is that I like to keep my head in the sand too, and while your chances for problems at 40 are greater, blah, blah, blah, it not like all of the sudden they go from low to high. For me, if there was something weird, I figure it would be seen at the 20 week u/s(I never get level IIs either), and then we'd go from there. My husband and I are like, what's going to change? It's not like we would NOT bring the child into the world, and how can you prepare? It just seems like if there was something wrong, this child is still mine, and I love him no matter what, so I will deal when he's born.

Anyway, good luck and congrats again!



answers from Chicago on

Sounds like you two have already discussed and decided how to handle your children if something is abnormal, and sounds like you'd not terminate the pregnancy, or else you would be rip roaring ready to take the tests asap so you still have a choice. However considering your tests aren't scheduled till week 13, your options if something turns up are already diminished. I seriously researched CVS and decided I liked it a lot better than an amnio, and made sure to discuss this with my doctor as well as the lab, so that we would all beon the same page if I needed further testing after receiving the results of my 1st Tri-Screen. Thankfully everything was ok, though I was 25 at the time of baby #1. Since you have already decided that the testing is not going to change your mind about the pregnancy,then I say go ahead and skip the tests. Who needs the stress. You'll find out about most abnormalities at the ultrasound hopefully and then you can prepare if there is any need,but for now jus enjoy being pregnant



answers from Bloomington on

Before doing any testing, decide how far you will go with the information.
False negatives are always possible. I was 38 with our youngest and 36 with our second youngest child. I just did level 2 sonograms to determine if I needed to deliver at a neo-natal hospital (infant surgery). That was my decision. I knew I would stress over false negatives and went with the level 2 instead. Seeing is believing. Now, they say that neural tube defects are twice as likely with mothers over 35. At that, it is roughly 2.5% of moms compared to 1% of younger moms. Just take care of yourself and don't stress. That's the best thing you can do for you baby in any situation.



answers from Chicago on

I was 36 when I was pregnant with my twins . I asked my doctor if I needed and amnio . She said " would you do anything differently " ? I said "no". And there was my answer.



answers from Chicago on

Personally I choose to skip all the screening tests. I just feel the worry is unhealthy. I will have a 20-week ultrasound to screen for problems. At that point if they find evidence of other issues I will consider an amnio closer to term to see if there are any problems. I would not have an amnio now (I am 13 weeks) because of the miscarriage risk. I would not choose to terminate a pregnancy, just want to have a little preparation time.

Unlike another poster said, there's nothing they can do based on the results, only wait until baby is born. It can help to be more prepared, but it cannot change the diagnosis or outcome.

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