QuestionDo yo know what are the normal ranges for all the bloodwork done in the sequential screening.?
I am 18 weeks and 3 days pregnant with twins and the results are as follows:
Baby A: NT 1.08 MoM / PAPP-A 1.17 / AFP 1.59 MoM / HCG 6.65 MoM / UE3 1.23 MoM / Inhibin 7.49 MoM
Baby B: only shows measures for NT 1.00 MoM , the rest ,as far as hormones go, are the same for both since it is my blood that is tested.
baby B has a Intracardiac Focus which is a condition found in babies with DS; however, has been found in normal babies as well and doesn't indicate DS if other markers are not present..so, i am wondering what other markers did they find that changed my chances of having a baby with Down Syndrome from 1:410 to 1:9??? After talking to the genetic councelor, she said that the numbers were triggered by the intracardiac echogenic focus found in baby B during the second trimester screening and the high hormone levels, which can be caused also by the twin pregnancy; however, she said that it could be also that one baby is producing more hormones than the other and for that my risk came this high!?! BUt from 1:410 found in the fist screening to 1:9 ?!?! that is a huge gap.
I have shceduled my amnio for tomorrow but DH and I are debating on if I should get it done..The results wont change the fact that i will have the babies at this point...however, I said to him that I needed to know so I could be prepared...
and he responded..for what? You are risking the chances of loosing both babies by doing so and then you would never forgive yourself...Even though we know that the risk of MC for a twin pregnancy is 1/100..,,then he said! That is why someone wins the lotto every week! :(
My question would be, waht is your interpretation for my results and what feedback can you give me according to your experience?
AnswerDear PM,
Sequential screening is actually a method of formulation in determining the level of risk for your pregnancy/babies.
NT (Nuchal translucency) screening is done during an ultrasound. It must be done between weeks 11 and 14 and a recent study found that NT scans done during week 11 were the most accurate of all because the fold is most translucent then. NT screening can be combined with blood tests for more definitive results. For example, your first trimester blood test measures free beta-hCG (a certain type of human chorionic gonadotropin hormone) and a zinc-building pregnancy protein called PAPP-A (pregnancy associated plasma protein A). Low levels of PAPP-A early in pregnancy indicate increased risk of genetic abnormalities, heart problems, and preterm birth. The results of these two blood tests plus the NT screening, known as the first trimester combined screening, can be combined into one number (likely your 1:410) that represents the likelihood of having a child with a genetic abnormality.
The results of an NT screen can also be combined with a second trimester blood test known as the quad screen, which tests for four entirely different markers present in the maternal bloodstream. Again, all the results can be entered into one formula, giving you ONE statistic. This option is called the fully integrated screen. Or you may be given the results of the first trimester screen and the quad screen separately (this is known as stepwise sequential screening). This has apparently been what has been given to you, as the new number has now changed to 1:9. The number changed because they plug in the results of those blood tests into the formula and an entirely new number is the result. This is not unusual.
The expected amount of the substances checked in the Quad Screen changes with each week of pregnancy. They determine the "normal" based on the week you are in when tested and use that amount when doing the formulating.
The amniocentesis is a personal decision for you and your husband/partner. One advantage to having the amniocentesis to help confirm a diagnosis is that it does help your doctor to have all the appropriate medical staff in place at the time of delivery if necessary.
I hope this information has helped you and answered your question. I wish you well and will have a good thought for you. Have a blessed Easter.
Brenda
