The mother of the child (my ex) is 43 and her blood tests indicate a risk of downs syndrome at 1 in 100, which is lower than the average risk for her age group which is at 1 in 40. She seemed ok about this yesterday when she had just found out, but she seems a bit more concerned today.
These statistics are doing my head in, her daughter’s age related risk (at 23 years old) is 1 in 250 which to me still seems astonishingly high. Her daughter’s personal risk is 1 in 1000 (or something similar) which seems like something I’d be happier with personally. The doctors seem to like throwing statistics around but never like to say “If it was me I would be happy/unhappy with this”
Is 1 in 100 quite high? Should I expect the worst? I’m going over to my ex’s this evening to talk about it, but I’d like to know if there’s any authoritative sourse I can read up on this and still understand the risks.
I’m really not sure what you’re after. No, 1 in 100 is not high, it’s 1%. It’s about double the chance of rolling 3 dice and getting 3 ones, or half the chance of picking a card in your head and drawing it at random from a well-shuffled deck.
Think of it this way: it’s a 99% chance of not having a Downs kid. I would have though any parent would be happy with those odds.
Well, it must seem high, but as you have indicated, it is lower than average for her age, so it is good news relatively. One question to ask is, “What are the better results possible with this test?” Could the results have been 1 in 1000 or 1 in 10,000 or is 1 in 100 as good as that test gets?
I hope that she takes this as good news. I have know parents that have had tests that indicated a much higher likelyhood of having a chromosonally abnormal child and they gave birth to a healthy normal baby.
Is she considering Amniocentesis? Personally, I would counsel against it, because the rate of miscarriage as a complication to Amniocentesis is stated as 1 in 200 and a study I read while pregnant indicated that some clinics have the complication rate of 1 in 38 in practice. To me both those numbers seem unacceptably high, but the 1 in 200 is called “vanishingly small” by many.
Ultrasound, which really has a complication rate that is truly “vanishingly small” may be able to detect Down’s syndrome in some cases by showing the physical abnormalities.
Definately no to amniocentesis, the only person we knew who had such a test was given odds of 1 in 4 and had a family history. The risk of miscarriage is way too high for it to be an option in our case.
You’re both right, its good news, especially since other unlikely matters have caused concern earlier in the pregnancy and they too have turned out to be of no consequence. My ex has (or had) what was called “erosion of the womb” which sounds frightening but in reality just meant there was a spot of bleeding a few weeks ago. It caused a scare but did nothing to the baby which was happily hiccuping on amniotic fluid
My ex was ok about it yesterday, then the internet and a tonne of sites giving a lot of technical info’ preyed on her mind which had a knock on effect. The SDMB was my first port of call before I see her later today
The best advice my micropremie’s doctors and nurses gave me was “Don’t go looking at preemie websites! You’ll scare the bejeesus out of yourself and it won’t help!”
They were right. I stayed, for the most part, right here on the SDMB for some moral support. Only when she had a reaction to some eyedrops did I go poking my nose around where I shouldn’t have and scared the pants off of myself. Which, considering that she was recieving excellent care in an unpredictable situation, did nothing for her, and only served to keep me from sleeping and therefore hindered my ability to relax and enjoy her.
I know it’s hard, but if you and mom feel she has good doctors who are willing to talk to you, try not to scare yourselves, especially if it’s stuff you can’t do anything about. (For example, with each of these tests, ask yourselves if it’s something you would abort over or something than can be best treated in-utero. If not, do you really need to know yet?)
When my mother was 42, she became pregnant with my brother. She had the AFP blood test, which is supposed to detect a variety of Bad Things like neural tube defects, Down syndrome, and various other things. Her results came back with the highest level the lab had ever seen, and the dire prediction that she was rather likely to have a malformed child.
It turns out that she had (at the time undiagnosed) lupus, and the lupus was causing problems in the uterine wall leading to placental infarcts. Placental infarcts release large amounts of AFP. While this is a serious condition, it did not indicate a fetal defect.
There are lots of other things that can cause high AFP levels, many of which are serious problems but which do not mean that the fetus is defective. Most doctors will want to do an amniocentesis to “rule out” a fetal defect, but an amnio will only diagnose some of those problems, and risks aborting the pregnancy. Modern ultrasound can diagnose many of the same problems (by looking for gross anatomical defects) as well as many more that amnio will miss (such as microcephaly). I’d skip the amnio and do the 3D ultrasound.
If you do the 3D ultrasound, make sure you do it through a hospital or obstetrician’s office, not one of those freestanding places that do it for the baby book. This way, if there are defects, there is a radiologist or OB who can interpret the images immediately, and who can offer guidance and information.
You mean an organisation outside of the hospital that will scan the mother? Never knew they existed, certainly not here in the UK. A 3D ultrasound is apparantly a special thing and cost £200 here in Northern Ireland over the free 2D scan of which the NHS provides at least three (all free) I’d rather spend the £200 on something the mother needs or save if for the baby’s arrival.
The big scan, the 22 week scan will be September 21st, that should let us know (and hopefully allay all fears) if anything is up. Scans so far have indicated nothing untoward, so fingers crossed for the baby to be.
The website the mother of my child looked up was probably factual, much of what it said corresponded with what the hospital had said. But there was an awful lot of it and it was quite technical. Apart from a rather un-communicative doctor at the last scan, hospital staff have all been very helpful and friendly and a much better source of help than the web
There are freestanding ultrasound centers that have no affiliation with doctors or hospitals. They do their scans as souvenirs, not for any medical reason. One center I found online (They’re called “Little Sprout Imaging”; I don’t want to run afoul of the mods for posting a commercial link.) requires proof of a normal midterm ultrasound and verification that the mother is under a doctor’s care before they’ll do a 3D scan. There have been other centers that don’t require such proof, and there have been reports of parents learning of anomalies or fetal death from these scans.
My own OB told me that he didn’t have a problem with these since I had had several normal scans.
No apologies necessary, I thought it was interesting they had such things. I only know you pay the NHS here about £200 (ish) for the privaledge of having one. The 2D scans I’ve seen so far have been astounding and all I need to keep me goggle eyed
3-D ultrasounds are amazing, and might help the uneducated (in radiology) to see a defect, but a plain ol’ 2D ultrasound is all a trained expert needs to see just about everything we’re talking about here.
A 3D would help to pinpoint extent of damage if gross abnormalities were found, or to better conceptualize a problem diagnosed by 2D, but it’s not usually a first-step diagnostic tool.
