# Combined screening test result - high risk



## honeyhoney

Hi everyone, I'm new here - although have been reading the boards for a little while, this is my first post.

I'm almost 41 and this is my 4th pregnancy. I had the nuchal scan and blood tests on Monday, then yesterday received a phone call from the hospital to say that my result was high risk. My NT was 1.60 and my bloods were all in the normal range yet my result was 1:92. As far as I can work out from googling and from what the midwife said on the phone, it seems that my result must be purely age related. 

Would appreciated anyone's thoughts/experiences with this test as I'm not sure if my result is very worrying or not really - none of my other pregnancies were high risk (all pregnancies were in my 20's/early 30's).

I have decided not to go ahead with any further tests and I'm beginning to wish I hadn't had this test now!


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## Storm1jet2

No advice to offer I'm afraid - I'm still undecided as to whether to have the first set of tests!


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## honeyhoney

Storm1jet2 said:


> No advice to offer I'm afraid - I'm still undecided as to whether to have the first set of tests!

I'd decided not to have them at first but then changed my mind - not sure why now though and beginning to wish I hadn't.


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## Moti

Hi there. With my first pregnancy my results were close to yours. 1:100. After having an ultrasound where they looked at the soft markers for Downs, my risk was reduced to 1:200. We chose not to have any further testing done. I was 35 at the time. He did not have Downs.

Have you had a similar ultrasound where they would look for markers?


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## honeyhoney

Moti said:


> Hi there. With my first pregnancy my results were close to yours. 1:100. After having an ultrasound where they looked at the soft markers for Downs, my risk was reduced to 1:200. We chose not to have any further testing done. I was 35 at the time. He did not have Downs.
> 
> Have you had a similar ultrasound where they would look for markers?

Hi there. I will be having the usual 20 week anomaly scan and they have said that if anything of concern is seen then I will be offered an amnio. 

Glad everything went well for you and your little one.


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## ciarhwyfar

If your NT is 1.6 and your bloods are normal, I would honestly ignore it. I'm 42 but I am also in the US so I don't know if that has anything to do with it. Sounds like rubbish to me, all the same. However, I would never have an amnio or cvs anyway so take what I say with a grain of salt.


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## TiggerToo

So if age is going to skew the results anyway - why do they shove the "importance" of all this at us (because when you're our age TTC, they start preaching about it right away) to start with? And I'm asking because I sincerely don't understand.

I'm with ciarhwyfar on this one. I'll have one when I'm preggo just because they don't want to amino you without all that beforehand when you're the active duty military member - I'm the officer so I'm sort of instructed a bit differently than a dependent (and my own mom had an amino with me at 38 and I'm fine), but I'll take the initial results with a bit of skepticism.

This seems almost like a set up - especially given the results I'm reading here. I wish they tested everyone so we could "interpret" results alongside results from 25 year olds, since that might help these make more sense, or at least put them into perspective.

Very interesting thread for me and very helpful.


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## bbforme

Your NT scan measurement is 1.6 is awesome! And if your blood work is within range, you're only at higher risk because of your age. Basically, all of us over 35 are at higher risk. Keep in mind, high risk DOES NOT mean your baby will be affected. 

Congrats on your pregnancy!


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## bigmomma74

My NT measurement was much bigger than yours - 2.2 but my risk was only 1:2643 so I can't understand your result at all. I'm 37 so no spring chicken.


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## honeyhoney

bbforme said:


> Your NT scan measurement is 1.6 is awesome! And if your blood work is within range, you're only at higher risk because of your age. Basically, all of us over 35 are at higher risk. Keep in mind, high risk DOES NOT mean your baby will be affected.
> 
> *Congrats on your pregnancy!*

Thanks. I just need to try and enjoy the next 6 months now without letting this worry me too much!


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## honeyhoney

bigmomma74 said:


> My NT measurement was much bigger than yours - 2.2 but my risk was only 1:2643 so I can't understand your result at all. I'm 37 so no spring chicken.

I can't understand it either, it just doesn't seem to make sense. I'm going to ring the hospital again tomorrow to see if they explain further, although I've already spoken to them twice and all they've said about it is what I've written here.

They did give me a couple of age related risk numbers to compare mine to which I found quite interesting and I'll post here in case it helps someone else:

she said the maternal age (at full term) related risk at 40 is 1:87
the age related risk at 40 is 1:97
and the age related risk at 41 is 1:73

I'm not sure why the first two are different but going by these numbers my result of 1:92 ties in with my age of being between 40 and 41.

Does anybody know which factors are included in calculating someone's result? Do they include weight for example?


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## Amberyll23

I agree with the other ladies, your NT measurement of 1.6 is very good! This sounds to me like they gave you high risk due to your age, especially if your bloodwork also came back good.


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## kosh

honeyhoney said:


> she said the maternal age (at full term) related risk at 40 is 1:87
> the age related risk at 40 is 1:97
> and the age related risk at 41 is 1:73
> 
> I'm not sure why the first two are different but going by these numbers my result of 1:92 ties in with my age of being between 40 and 41.

i _think_ those two numbers should be the other way around, and that one is the risk at full term (lower risk) and the other one is the risk at 16 weeks or so (higher risk). the difference between the two is due to the spontaneous miscarriages of pregnancies with down syndrome between these times.



honeyhoney said:


> Does anybody know which factors are included in calculating someone's result? Do they include weight for example?

i've been doing quite a bit of research on this. the overall risk result takes into account the NT values, the blood values (measurements of hCG and PAPP-A in first trimestre, or another 4 in second tri) and what is called the backgroud risk, which is basically the maternal age. the calculation does *not* take into account your weight. 

because of the way the overall risk is calculated (probably too much weight to the maternal age?) there is a tendency to give false positives for women >40 (and false negatives to women <30). i read that for women above 44, for example, *all *tests come back as high risk, regardless of the NT and bloods!

for those of you that have had the tests done (i haven't yet) - how are the results reported? i noticed that most of you know exactly what your NT measurements were, but do they also give you the exact numbers for bloodwork? because the other thing to bear in mind is that blood values can be within the normal range but actually towards the higher end of 'normal', so when they take all into account the overall risk might be higher. 
or the other way around, say, a higher NT measurement with a very good blood value may give a better overall risk (like bigmomma). 

as if all this was not enough, i read that there are different ways of doing the calculations (using different models and databases), so that gives different results too!

i hope this did not sound too cold and technical....

did you call the hospital today? 
did they give you more info?
hope you feel better :hugs:


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## Eviesmum

Hi I am just 47 and have a 10 week old baby. I didn't have any of the tests but was told I was 1 in 6 of having a baby with downs syndrome. It was purely age related as the 20 week scan came back fine. Anyway she's here, absolutely beautiful and perfect in every way. So try not to worry too much, even though I know that's easier said than done. 
xx


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## honeyhoney

kosh said:


> honeyhoney said:
> 
> 
> she said the maternal age (at full term) related risk at 40 is 1:87
> the age related risk at 40 is 1:97
> and the age related risk at 41 is 1:73
> 
> I'm not sure why the first two are different but going by these numbers my result of 1:92 ties in with my age of being between 40 and 41.
> 
> i _think_ those two numbers should be the other way around, and that one is the risk at full term (lower risk) and the other one is the risk at 16 weeks or so (higher risk). the difference between the two is due to the spontaneous miscarriages of pregnancies with down syndrome between these times.
> 
> 
> 
> honeyhoney said:
> 
> 
> Does anybody know which factors are included in calculating someone's result? Do they include weight for example?Click to expand...
> 
> i've been doing quite a bit of research on this. the overall risk result takes into account the NT values, the blood values (measurements of hCG and PAPP-A in first trimestre, or another 4 in second tri) and what is called the backgroud risk, which is basically the maternal age. the calculation does *not* take into account your weight.
> 
> because of the way the overall risk is calculated (probably too much weight to the maternal age?) there is a tendency to give false positives for women >40 (and false negatives to women <30). i read that for women above 44, for example, *all *tests come back as high risk, regardless of the NT and bloods!
> 
> for those of you that have had the tests done (i haven't yet) - how are the results reported? i noticed that most of you know exactly what your NT measurements were, but do they also give you the exact numbers for bloodwork? because the other thing to bear in mind is that blood values can be within the normal range but actually towards the higher end of 'normal', so when they take all into account the overall risk might be higher.
> or the other way around, say, a higher NT measurement with a very good blood value may give a better overall risk (like bigmomma).
> 
> as if all this was not enough, i read that there are different ways of doing the calculations (using different models and databases), so that gives different results too!
> 
> i hope this did not sound too cold and technical....
> 
> did you call the hospital today?
> did they give you more info?
> hope you feel better :hugs:Click to expand...

Thanks for this. I'll be calling the hospital back on Monday to ask exactly what my blood results were. I have come across a couple of online calculators which seem reliable from what I've read, so I'll put my details in to compare the results once I know them all on Monday.

To answer your question, it seems different hospitals may do things differently, I wasn't told anything at all on the day of the tests, I was told the NT measurement and that my bloods were 'normal' during the phone call to tell me I was high risk.


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## honeyhoney

Eviesmum said:


> Hi I am just 47 and have a 10 week old baby. I didn't have any of the tests but was told I was 1 in 6 of having a baby with downs syndrome. It was purely age related as the 20 week scan came back fine. Anyway she's here, absolutely beautiful and perfect in every way. So try not to worry too much, even though I know that's easier said than done.
> xx


Thank you, I'm trying not to worry and as long as everything seems ok at the 20 week scan I think I'll be able to relax more. Congrats on your little one!


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## knitbit

At our age, I would look at the NT measurement and consider that your risk is lmuch lower than it should be for your age. I'm in a similar situaton, I'm 38 and pregnant with twins. I lost a pregnancy last year after a NT of 5.3 (chromosomes were normal) so I did a TON of research. After all the reading I did, I was going to be happy with any number <2.5. Mine had NTs of 1.4 and 2.1, which lowered the risk for my age, but it was still 1/89. I am not planning to do amnio this time because of my added risk. Even though the number isn't "good" I feel confident that the babies are fine.


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## Emx

I had a risk of 1-50 with DD at age 36... I declined further tests but had a very detailed scan at 20 weeks which reassured us as she showed no soft markers for DS etc.. She was born perfect.

I didnt have the testing done this time as I felt it completely ruined my last pregnancy, I wouldnt have a CVS or Amnio done and I feel (and so did the sonographer I had at 12 weeks) that the anomolly scan is sufficient to pick up any major problems xx


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## kellyb

I have my 20 week scan in 3 days, but I opted out of any testing for downs (I'm 35, by the way). Just a quick question: At the 20 week anatomy scan, can they tell for sure if the baby has downs or not?


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## hellywelly

Hi not sure if this would help - I am 37 will be 38 when LO arrives. To start off with due to my age weight and height my NT came in at 1: 167 - which is considered high risk. As soon as they measured the fluid that was 1.5mm - so my chances decreased dramatically basically 1 in some thousands I can't remember the figure - I then had the blood test and got a letter back saying that I was not a high risk person and the probability is that I do not have a downs baby.

I think that if someone is extremely prepared to have a baby with downs then I see no reason not to have the test. For me I want to have every test available to me so I can be prepared. 

I hope the maths has helped xx


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## bbforme

kellyb said:


> I have my 20 week scan in 3 days, but I opted out of any testing for downs (I'm 35, by the way). Just a quick question: *At the 20 week anatomy scan, can they tell for sure if the baby has downs or not?*

The short answer is No.

My genetic consoler told me soft markers are displayed on 50% of scanned babies with Downs. So one can have a Level II u/s which shows normal results, and still have a baby with Downs. 

The only way to know for sure (99%) is with invasive testing.


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## kellyb

Got it. Thanks bbforme.


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## honeyhoney

I spoke to the hospital again today and have now got my blood results. 

I asked which factors are used in calculating the 'background' risk and was told they use age, weight, ethnic origin and whether you are a smoker - just going by my age and weight I was always going to be high risk.

I think the important thing is, as others have said here, that my NT and bloods were good, so that is what I'm trying to concentrate on, rather than the 'statistical estimate' I've been given.


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## mafiamom

personally with all the good bw and scan results, i wouldnt give it another thought. just the fact that we are considered OLD skews the results in a bad way.


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## knitbit

My numbers are a lot like yours. My NTs were 1.4 and 2.1 (twins) and with the blood it came back 1/89. They did it based on 39 (age when the babies are due). After having a bad result last year after a NT of 5.3, I am thrilled with my numbers. I would just take the risk as a number to screen for having amnio. You and I fall into the "amnio is appropriate" bucket, which is where we were already. Essentially, the screening can only move you out of the bucket at our age if the numbers are phenominal.


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## mrngorickets

Hi,

Thanks very much for this comment. It help me to think about my ideals.

Tks again and pls keep posting.


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## knitbit

Are you doing the sequential screen, where they give you final results after a 2nd trimester blood test? My first trimester risk was 1/89 and it dropped to 1/4700 with the second trimester blood. I also opted not to do amnio. 

I would personally just look at if the result lowered or raised your age related risk. If it lowered it, odds are good everything is OK.


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## Animaniacs

knitbit said:


> Are you doing the sequential screen, where they give you final results after a 2nd trimester blood test? My first trimester risk was 1/89 and it dropped to 1/4700 with the second trimester blood. I also opted not to do amnio.
> 
> I would personally just look at if the result lowered or raised your age related risk. If it lowered it, odds are good everything is OK.

Thanks for your post. I went to talk about all of this testing with a nurse today and it's very overwhelming. I'm 34, but will be 35 when I deliver. So I'm considered "high risk". I have to get a blood test and ultrasound quite soon, then another blood test at 16-18 weeks. Anyway, I will be praying everything is OK for all of us; motherhood brings such worries both before and after birth.


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## FiNZ

deleted


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## Michieb

I received a 1:21 for downs. We did the level 2 us and had no markers so I declined the amnio. Did the baby's heart ekg 6 weeks later and also came out ok. Dr's still say w/ out amnio can't be 100% sure but I didn't think it was worth the risk. I hear these tests have a lot of false positives try not to worry.


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