Thursday, July 3, 2008

Triple Screen Query

Reader K writes:

I have a question. How do you all approach the prenatal testing that is available? I got a chill when a nurse suggested yesterday that I get testing done early so that I could "do something about it" before I'm out of the first trimester. I'm almost 37, and this is only my second pregnancy, but there wasn't this pressure with my first.

K, great question.

Just to give you some insight into my personal experiences, I have never opted to have the AFP (alphfetoprotein, triple screen, or quad screen) testing. It tests the mother's blood for the presence of AFP (and other serums), secreted by the baby's liver, which can indicate a host of anomalies, including neural tube defects, Down syndrome, kidney disorders, and others.  According to my midwife, of the AFP tests showing a positive reading, 90% are false positives, unnecessarily scaring the heck out of the poor parents! Positive AFP tests can (and usually are) followed up with an ultrasound and possibly an amniocentesis/chorionic villus sampling (CVS).  Many times an u/s is all that is necessary to confirm/discredit the AFP results.  Amnios and CVS carry risks (1-2%) of losing the baby.  

Most likely you are planning to have an u/s midway through the pregnancy anyway, so my opinion is--WAIT for the u/s and you'll have all the information you ever wanted without having to endure more tests and a potential scare!!  Present a firm "no" to your care providers and let that be the end of the story!

Now, as a disclaimer, some friends have recently been encouraged toward early testing with the promise of an additional second trimester u/s. Presented with such an option, I might go for it too! I can never see my little one too much during the pregnancy...

Additional thoughts?  Prayers, K, for a wonderful outcome and a blessed pregnancy!
For more information check out WebMD. 


Stephanie said...

I had both of my children in Germany, and friends in the U.S. were surprised that the German doctors don't recommend the triple test. Americans were given the option because the German doctors knew that American doctors tend to recommend it. When I asked my O.B. why they didn't recommend it, his answer was as posted in the original...that research shows most positives are false positives that unnecessarily worry the mother, and presents the needs for additional unnecessary tests.

Kat said...

Great question, K, and one that I think many moms are asking these days!

We opted out of the AFP test with our third child, simply because we knew that anything we wanted to know would be detected in the mid-pregnancy ultrasound. With our second daughter, Lucy Rose, who ended up having a neural tube defect and died at birth, I did get the AFP test at 16 weeks and the results were that I had elevated levels. My OB did not tell me that the AFP results were 7 times the normal level, so I thought that the results were probably just a false positive and did not worry about it too much. I had an ultrasound scheduled for 19 weeks, and I wasn't able to move up the date so we waited for 2-3 weeks before finding out that our daughter did indeed have anencephaly. In the case of our next child, Maria, I decided that I did not want to have the waiting period between the AFP test and the ultrasound if the results did happen to be abnormal. If the test were able to indicate something that an ultrasound technician wouldn't be able to pick up on, then I would have gotten it, but as B-Mama said, the birth defects that the AFP test screens for are very obvious in an ultrasound (anencephaly, spina bifida, etc.).

I will say that I am VERY glad that I knew about Lucy's condition before her birth, because our family was able to prepare for her arrival and really savor our time with her during my pregnancy. I think it would be even more devastating to lose a child at or close to birth when you have been expecting a healthy baby for 9 months...For me, this would have been much harder, even though I am a firm believer that it is devastating to lose a baby at any point, whether 6, 12, 20, or 40 weeks into a pregnancy.