35+ and pregnant

[Anonymous]

I was wondering how many women are out there who are/were 35+ when they had their baby and did not to the early screen test.....

If you decided not to go ahead and do it, how did it make you feel?

[Anonymous]

Just to clarify - do you mean the nuchal test?

[Anonymous]

I was 38 when pregnant for the first time. I had all the non-invasive tests I could. I wanted as much information about everything as I could get. If I hadn't done it, I probably would have felt anxious the entire pregnancy.

[Anonymous]

OP here. I mean the CVS test. I just realized that early screen tests are suggested for women UNDER 35 and that those over should go straight for the CVS.
I'm a little clueless about all of this. From my understanding the CVS is invasive. To the PP, did you do the CVS??
When I was pregnant at 33 I didn't do the test for down-syndrome at the 5 month stage because I didn't think I'd be able to go through an abortion. I had my first child outside the U.S (I'm new here), so the whole prenatal care system here is kinda strange to me.
Regarding the nuchal test, I'm also confused about that. Where I had my child before they did the nuchal test at the 12/13 week stage (and told me that was the crucial time to do it in), but here they have scheduled my visits for 11 weeks and then 15 weeks, which suggests to me that it is either too early or too late to do the nuchal test--anyone have any idea?

[Anonymous]

You can do the nuchal test as early as 11 weeks and as late as 13 weeks. Most people do it at 12 weeks, but the advantage of doing the nuchal test at 11 weeks is that if the results are bad, you can still do the CVS (CVS can be done until 13 weeks, after that, it is too late to do the CVS). I don't know what your 15 week appt might be for.

[Anonymous]

PP here -- I did the nuchal fold test -- which told me I had a 1 in 2,500 chance of having a child with Downs, and I think that other alpha feta protein test ruled out spina bifida -- so no, I never had CVS or amnio.

You have the nuchal done between 11 and 14 weeks. I think mine was done at 12 weeks. Give your doc a call now and ask about it, just in case they need to set you up for it.

[Anonymous]

37 and my first pregnancy. I did amnio rather than the earlier tests, mostly because I was fairly sure my insurance paid for amnio and not sure about the others.

From reading pregnancy books I was surprised to discover that the risk of Down Syndrome is a lot lower than all the talk about "older mothers" had led me to fear (don't know the statistics on other conditions, sorry). At 35, there's still only a 1-in-400 chance that the baby will have Down Syndrome. Put another way, 99.975% of babies born to age-35 mothers *won't* have Down Syndrome.

[Anonymous]

Yes, I was closer to 40 when I delivered, and my risk for Downs was closer to 1 in 100 (before I did the test). Honestly, though, while there are some physical challenges for kids with Downs, I personally was much more terrified of spina bifida, which runs in my family, and can cause devastating disabilities. I think most Americans get enough folic acid, but some people, like my relatives, don't absorb it well from food/supplements.

[Anonymous]

Op, this is info that might be useful to you:

Should maternal serum screening be offered to mothers 35 or older at time of delivery?
In women 35 years or older, maternal serum screening detects 75% or more of all Down syndrome cases. However, false-positive rate increases with maternal age. Amniocentesis should be offered to women who will be age 35 years or older at delivery because at this age the incidence of trisomy starts to increase rapidly and because the midtrimester risk of Down Syndrome roughly equals the most often quoted risk of procedure-related pregnancy loss (1/200).

[Anonymous]

OP here, just want to thank everyone for sharing their thoughts and experiences.

[Anonymous]

Anonymous wrote:You can do the nuchal test as early as 11 weeks and as late as 13 weeks. Most people do it at 12 weeks, but the advantage of doing the nuchal test at 11 weeks is that if the results are bad, you can still do the CVS (CVS can be done until 13 weeks, after that, it is too late to do the CVS). I don't know what your 15 week appt might be for.

The 15-week test is most likely the sequential screen -- they do more blood work, which screens for other proteins/hormones, and then combine those results with the results of the 11-week first-trimester screen to give you a combined, more accurate score. Then you still have time to do amnio if you are not happy with your results.

Before getting CVS, decide what you would do with the results -- if you find out your baby has a chromosomal anomaly, will you terminate? If you would not terminate, you may not want to risk having a miscarriage from the test -- especially when the first trimester and sequential screens may put you at ease. But if you don't do CVS, you may be in for a month+ of genetic uncertainty -- my first trimester screen results were not great, and now I'm waiting on the sequential screen (and AFP, which is a blood test that tests for neural tube defects at 15 weeks) and after that may have to decide on amnio. It's been a rough month, and CVS would have cleared it all up right away and let me make a decision over a month ago...

Good luck!

[Anonymous]

Hi there OP,

I may have a different perspective than those offered, so i'll throw it in here FWIW.

I think whether or not you get any tests (invasive or non) probably depends on a number of things, most significantly, your personality and your own value on reassurance vs. risks, and finally, your willingness to terminate if there are problems.

I'm a pro-choice 35 year old first time mom. If I knew with 100 percent certainty that I was going to have a Trisomy child (read: child that will not survive more than a day or two) I would terminate. (I would not terminate a Down syndrome child or child with other defects that are still compatible with life) Unfortunately, as you note, the only truly diagnostic tests are CVS and amnio. I was not comfortable with amnio risks and even less comfortable with CVS risks. While I know that the risk factor for an experienced practitioner is probably closer to 1 / 500 - 600 than the 1 / 200 risks you see associated with amnio, it was more than I was prepared to accept. With that in mind, I also skipped the early NT and quad screen tests. To me, the false positives they raise can be high, and since I wasn't willing to resort to amnio or CVS in case of finding soft markers, it wasn't worth getting upset over potential false positives.

On the other hand, a woman on another board I visit gave birth to a Trisomy baby. She found out in advance that this was case and, while she chose not to terminate, she found that knowing ahead of time that her baby would only have a few days to live saved her a lot of the agony. With this in mind, she didn't have a shower, told everyone ahead of time that there was a life-incompatible problem with baby (which saved her from well-meaning inquiries about the child after it passed away) and finally, just felt that she was able to emotionally and mentally prepare herself for this. However, I do believe she was able to get the info she needed from a the more detailed 20 week u/s and not only via early testing.

Again, it comes down to your personality and how reassured you would be with good test results vs. how worried you are now about your risks. You also have to come to terms with the fact that the diagnostic tests do come with risks, although they are lower now in the hands of a talented practitioner.

Hope this helps. Good luck with your pregnancy and whatever you decide to do!

[Anonymous]

17:11 here again. I forgot to address part of your question.

I didn't get any of those tests done. For me, although I'm 35 (and will be 36 when I deliver) birth defects are just not ranking high on the things I am worried about. My chances are higher than someone 10 years younger, sure, but they are still pretty darn good. I read somewhere (either on another board or a blog) someone describing an analogy their husband used.

If someone told me that in order to have our baby, I had to go out to a pumpkin patch, and underneath the pumpkins I would find 300 babies, one of which had down syndrome, I would still go out and pick us a baby.

I thought that pretty well resonated with my feelings about my risks, and why I haven't missed a moment of sleep since making my decision to skip them.

[Anonymous]

I was 35 with 1st pregnancy and did not do CVS or amnio b/c my nuchal test results were very good (much better than for my age) so I felt pretty confident with those (had a healthy baby girl). I am now 37 with my 2nd pregnancy and although my nuchal test results were also very good (much better than for my age) I did opt for an amnio around 16+ weeks b/c of some soft markers for Trisomy 18. The amnio results came back fine and the baby is healthy. Its a very personal decision and many women end up making based on whether they would "do anything" with the results (e.g. terminate).

best of luck to you.

[Anonymous]

Anonymous wrote:Hi there OP,

I may have a different perspective than those offered, so i'll throw it in here FWIW.

I think whether or not you get any tests (invasive or non) probably depends on a number of things, most significantly, your personality and your own value on reassurance vs. risks, and finally, your willingness to terminate if there are problems.

I'm not this poster, but one more reason I can offer as to why I personally wanted as many non-invasive tests as possible is that I wanted to educate myself if I was having a baby with downs, SB, etc. I would want to be as prepared as possible with what it was going to require to have a child with a disability. I'm sure you can never prepare yourself competely for something of this magnitude, but I'm an information junky and would like to feel I had some knowledge going in.