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Antenatal tests

When did you have an amniocentesis?

19 replies

lotsofcheese · 09/11/2012 19:34

I'm 40 & fairly likely to choose an amniocentesis.

My consultant has said that it can be performed from 16 weeks onwards, but for most of my friends who have had it, it was tied in with their 20 week scan.

I'm a bit concerned about leaving it that late, as we have already made the decision to terminate for chromosomal abnormalities.

Thanks in advanced

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lljkk · 09/11/2012 19:37

It can take up to 3 weeks to get full results confirmed back, so if you feel sure you want amnio I would get it done around 15-16 weeks. Then if they spot a problem at the 20 week scan they can place it in better context about what it means (and what it doesn't mean).

Later termination is usually considered that much more difficult, too.

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RTchoke · 09/11/2012 19:41

Would you consider a CVS? You could have that much earlier. This week I have had to do a lot of thinking about CVS or amnio and I spoke to quite a lot of doctors and the old idea that miscarriage is more likely with a CVS is outdated I think.

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lotsofcheese · 09/11/2012 19:44

Thanks for the quick response. I'm now 13 weeks & am realising that 20 weeks for me is over the Christmas/New Year period, so not the best time to have it done in terms of waiting times or results.

Is it any riskier to have it done at 15 weeks compared to 20, does anyone know?

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lljkk · 09/11/2012 19:58

I have vague memory that getting it done under 14 weeks is riskier, otherwise 15-25 weeks no difference in m/c risk. But please try to check that for yourself.

Would you get it done on NHS or privately? Either type of consultant should be able to advise about possible risk variations, too.

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lotsofcheese · 09/11/2012 20:07

Thanks RTchoke I'm unsure about CVS, for various reasons.

Firstly, I was hoping to wait for my neuchal screening then decide whether amnio or CVS was most appropriate. I should get them back next week, I hope. But I don't think the baby has Down's - based on the nasal bone being present at my 10.5 week scan - plus the neuchal fold was only 1.5mm. But of course, that doesn't rule out other chromosomal abnormalities....And my "theories" could be wrong too.

And secondly, I've had 2 miscarriages in the last year, so I feel apprehensive about both procedures, especially CVS.

Although 1-2% would seem a very reasonable risk level for most, it scares me as I've had some rarities: molar pregnancy (risk 1:1000) HELLP syndrome (1:500) missed miscarriage after seeing heartbeat at nearly 9 weeks (

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aimingtobeaperfectionist · 09/11/2012 20:09

We had ours done after 20 week scan which also fell over Christmas/New Year period. Not the best timing.

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RTchoke · 09/11/2012 20:26

Is it the full karyotype you want then? Are your concerns about a rare condition rather than one of the 3 main trisomys?

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lotsofcheese · 09/11/2012 20:48

I think I would prefer the full karotyping. There's no reason to suspect a specific genetic condition.

It's more that this is a high-risk pregnancy for me, medically. I had very severe, early PE with DS & we both nearly lost our lives - he was in NICU for over 3 months.

There is a reasonable chance (around 30%) that this will happen again. If my current pregnancy is non-viable eg trisomies, I will terminate rather than risking my life for a baby which cannot survive.

I know that sounds harsh & will probably offend some people - sorry if that's the case.

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kilmuir · 09/11/2012 20:53

I have had 4 amnios, earliest i had was 15 and a half weeks. Took less than 2 weeks for results. They used a fibreoptic ? End on needle which showed up better on scan

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eagleray · 10/11/2012 17:10

Congratulations Lotsofcheese - I remember you from the 40+ thread and so pleased for you that you are pregnant again.

I am 30 weeks pregnant and I decided to have further testing done after tests at the 12 week scan showed me to be high risk for down's (it was at the 'good' end of high though at 1:112)

Reason I am mentioning this is because I was first booked in for a CVS but the position of the placenta (posterior) meant that I was told that an amnio would be less risk, so opted for that instead (even though it meant waiting another 2 weeks or so). This isn't something I was aware of previously when reading information on invasive testing risks.

Also, with both appointments at the FMU, I was able to talk through risks, scans etc with the consultant before even considering whether to go ahead with the procedure, which was reassuring.

Good luck - I will keep my fingers crossed that everything works out for you.

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lotsofcheese · 10/11/2012 18:00

Thank you eagerlay I remember you too, 30 weeks is great - on the countdown!

Yes, my consultant had said that 30% of amnio's at 16 weeks were unable to go ahead for technical reasons, such as you have described.

I suspect that I'll need to wait a week or two after that. I'm expecting a ratio similar to yours as well.

I'm in Edinburgh, so a trip to London for testing isn't practical & there's not the same private services up here. I'd rather an experienced NHS consultant did it here (believe me, I'll be quizzing them about experience & failure rates!).

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lotsofcheese · 21/11/2012 18:34

Well. I got my neuchal screening results today & it's thrown me into a complete quandary. I don't know whether to have an amnio now.

My result is 1: 357. Average risk for my age is 1: 96, so it's a very good result for my age (40).

I spoke to Foetal Medicine today - the miscarriage risk within the hospital service is 1:150. So it would seem that the risk of miscarriage is higher than that of Downs.

I explained to the nurse on the phone that I was concerned about other chromosomal abnormalities. She feels that signs of the trisomies can be detected at the 12 week scan & these are rarer than Down's - so my chance of having these is even smaller & therefore an even riskier proportionately for m/c. She also told me that they only screen for the more common chromosomal abnormalities & not all, so it's not a guarantee having an amnio.

But on the other hand, I know I can't cope with another child with serious health issues (DS was born prematurely & has has issues related to this). DP & I have already decided that we would terminate for chromosomal abnormalities.

However I've also had 2 miscarriages & this is my last shot at things pregnancy-wise.

I'm 14+5 so have to decide soon.

Any thought/opinions welcome - thanks.

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mb2512cat · 22/11/2012 09:09

Here's what I think: go for a cvs if you are still within the time limit. Say if in the worst-case scenario you were faced with tfmr, if you are over 14wks on the nhs you will have to give birth rather than have an operation. Just something to bear in mind in terms of timings. Also, in terms of the test, as well as the normal test which looks for t21,t13 and 18 and possibly some others, there is another called array CGH which looks at the chromosomes in much more detail. For instance, with my second pg and my third pg I had a cvs and then an amino and both came back normal (both pgs had developed abnormalities). However they were not chromosomally normal. Only aCGH picked it up and that was after several years of heartache. ACGH seems to be quite routine in the US but not in the UK. Your PCT may tell you they don't have it, or won't want to give it to you without signs of abnormalities. You may be able to get it privately however. Hope that helps.

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lotsofcheese · 22/11/2012 20:30

Thanks for your response, cat I think I need to find out more about what chromosomal abnormalities are screened for in the amnio. I only had half a conversation with foetal medicine as a colleague walked into my office - so that will be tomorrows' task. Thanks again x

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lotsofcheese · 23/11/2012 13:10

Well, I've bitten the bullet & arranged an amnio for a week on Monday, when I will be 16 weeks.

I just need to know, definitively, that this baby is ok. I believe it is. But I just need peace of mind, and to be sure.

Thank you all for your responses & advice - I really appreciate them.

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snapple21 · 26/11/2012 15:30

Hi

I hope my story doesnt scare you - just to add my experience.

I got a risk of 1:330 for downs, I am 22. I debated with myself to have the amnio and was in such a quandry. I decided to go for it. If any bit of you feels you should go for it I would say definately do - you dont want to spend the rest of your pregnancy thinking "what if"

I had it done at 15+6 i think.

Unfortunately I was the 1:330. Biggest shock of my life. I hope things turn out more positively for you. My story indicates that no matter what your risk - 1:4, 1:330, you can still be the one so you have to do whats right for you in terms of further testing.

xx

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rosiesmartypants · 26/11/2012 15:40

lotsofcheese, I am living in the US, and going through my pg here - I had less invasive screening done at 12 and 16 weeks, by blood (working off the theory that I am already carrying foetal DNA in my blood supply right now).

I was chatting to my mum in Scotland a few weeks ago, who had just read an article saying the NHS were introducing this sort of testing in the UK...just in case you are interested.

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lotsofcheese · 26/11/2012 18:28

Thanks for the replies - I've heard of the foetal DNA test being trialled in private clinics in London, but not up here - plus I'm beyond that stage now.

snapple thanks for sharing - I guess someone has to be the statistic, but it still must have come as such a shock to you, especially at such a young age.

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lotsofcheese · 18/12/2012 21:06

Just a quick update to say that I had an amnio at 16 weeks - my usual consultant did it, which was reassuring. I now have the results & the all-clear. Plus I'm having a girl GrinGrinGrin

Looking back, I'm so glad I had the amnio; my fears about it were definitely worse than the reality!!

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