Help with NT results

[mlk]

Hi I had my NT scan and bloods today. I am 12 weeks.

Due to my retroverted uterus and an uncooperative baby, they struggled to get clear pictures of the baby and were unable to detect a nasal bone due to its position. The Nt measurement came back at 1.5 and is within range. The bloods also came back with a low Papp-A of 0.5. They gave me a risk of DS of 1:600.

The genetic counsellor said it is likely the low Papp-A is more an indicator of pre-e which I had with my son but it was up to me whether or not I get the harmony test. It will cost me $500 out of pocket as I am not in the US. I asked about them giving me another ultrasound in a week or so to check the nasal bone but she said they wouldn't do that.

Anyway not sure what to think, I'm sure it was just hard for them to get decent images, but surely I should be able to get a quick follow up scan just to check the nasal bone.

Would love to hear some thoughts. Thanks

 

[SMC]

I don't think you have to worry (easier said than done, I know). I had a 1:3000 chance of DS after my first scan in which they detected a nasal bone, and after having a freakout because it was not 1:10000 like other people's, I sucked it up and paid $815 for the Harmony test. My second trimester screen results came back a week before my Harmony test and I had a 1:10000 chance of DS with the combined results. My Harmony results came back negative too. The only benefit I really got from the test was the gender (girl!!!), something that I could have found out had I waited 2 more weeks.

I think the first tri screen result is based on NT scan and blood work alone. The presence of a nasal bone isn't factored into that measurement.

A 1/600 equates to a 0.1% chance which is still really low. You can get your 2nd tri bloodwork done at 15 weeks. If those results aren't to your liking, you can opt for a Harmony / MaterniT21 test then (and it might be covered by insurance at that point). I believe even with those tests, you will still need an amnio for a definitive diagnosis if the test comes back positive for DS.

So, I guess what I'm trying to say is that you have plenty of time to decide whether or not you want to spend $500. You don't need to decide right away.

 

[mia1181]

Aw MLK I'm sorry! What a bummer they won't check again! My friend's baby was uncooperative and they could not detect the nasal bone and she went back and it was there and everything was fine. It's very possible that the same would happen to you. Is there any way to pay out of pocket for another ultrasound?

 

[mlk]

Thanks SMC and Mia. I spoke with my OB's office where I asked if I could come in there for a scan and was told that if I was in any doubt to get the harmony test.

I don't think we have the second tri screening here, I was certainly not given it with DS in 2012 and no one has mentioned it this time.

The thing was I paid $375 out of pocket for this scan so I think them not offering me another scan is a bit rich.

I was looking through the pics from today though and I'm sure I see something which looks like a nasal bone in 2 of the 3 pics?

 

[pancake]

mlk with all due respect I think that you are asking the wrong forum - obviously everyone here is really supportive but short of being a obstetric ultrasonographer or obstetrician I don't think you're going to get better advice than what you've already received. Is the 1:600 result from the combined blood screening, age-related risk, and scan?

Personally if I were in your position I would accept 1:600 as being low enough risk for me not to go ahead with the blood test, but we all have our own lines in the sand. It sounds like it would be worth you sitting down with your obstetrician - or at least having a detailed phone conversation again - before making a decision.

 

[mlk]

You are right Pancake, I shouldn't have posted. I guess I was just wanting to sound out somewhere as no one knows I am pregnant and was hoping someone may have had a similar experience and could share rather than looking for actual medical advice. Maybe I just phrased it completely wrong.

Anyway the scan place has done a complete turnaround and has agreed for me to come back for a second scan tomorrow to see if bub and my uterus are more cooperative , if not then I will get them to do the harmony test then and there

 

[pancake]

Oh hon I hope you didn't take my post to be callous - I didn't mean to come across that way! Of course you want solidarity, I totally get that.

The plan sounds like a good one, though. I think you have to do whatever you feel comfortable with, with the counselling that you've received.

 

[monkeyprincess]

MLK, I'm glad you are getting a second ultrasound. That certainly sounds like the most sensible step. I'm hoping the baby will cooperate and give you a nice picture of his/her nasal bone and give you peace of mind. I completely understand the worry!

 

[amc80]

MLK- Over on babycenter.com there is an Ultrasound board (http://community.babycenter.com/groups/a6925/ultrasounds) headed by an actual u/s tech. You could always post your pics over there to get another opinion.

BTW- Your name and DOB are on the u/s pics you posted, so you might want to edit

 

[Laila619]

I honestly wouldn't worry about it. With my son, I was given 1:800 odds for Down syndrome due to very high free beta HCG levels. It was something like 2.42 MoM. Even worse, the tech NEVER checked for a nasal bone; I remember my doctor saying she wasn't trained to do so. So we didn't even have that for reassurance. Then at the 20 week ultrasound, they found a soft marker (spot on baby's heart) and my odds were even worse. And he turned out fine, completely healthy and he does not have Down syndrome. I don't put much stock in those screening tests anymore. Even with my subsequent two pregnancies, I've never gotten great odds even though I'm fairly young. With my daughter it was 1:1,500 and with my twins, it was 1:3,000. I never get the <1:10,000 that everyone else seems to get. Oh well, it is what it is. I think the nuchal fold measurement is more important, and your baby's is normal. I know it's hard, but try not to worry!

 

[mlk]

Pancake, I didn't take you that way at all! Hopefully the new plan gives me some comfort.

Thanks MP. I'll be hoping the same for you at your ultrasound tomorrow x

I didn't know that amc about baby centre. Will go and check it out. I totally didn't think about my personal details. Problem is I now don't have a clue how to remove them. Anyone got any tips?

Laila, thanks for sharing your story. I too never got the 10,000s with my son either, I think it was 1;2,000 or something but at least they found the nasal bone with him.

It's about 6 hours to the scan so I am just trying not to worry. Any hints on how to get the baby moving? I have hear eating/drinking something sugary may help.

 

[amc80]

It's about 6 hours to the scan so I am just trying not to worry. Any hints on how to get the baby moving? I have hear eating/drinking something sugary may help.

It can help, but most techs would rather you didn't do that. A baby moving too much will make it just as hard to get good pictures.

 

[mlk]

I was thinking that could be a problem. Bub must be another boy considering how uncooperative it already is!

 

[TooPatient]

Is that your full name at the top of each scan?

Hope it all turns out okay and you are able to get some clear information soon so you don't have to worry

 

[mlk]

It is my full name, I have no idea how to get rid of it now that it is posted.

Good news they were able to find a nasal bone this time and my risk has dropped to 1:2200.

The genetic counsellor said to me that they thought they saw a nasal bone the first time but couldn't get a good picture. It would've helped with reducing my stress if you had've told me that rather than steering me towards the harmony test and mother $500 out of pocket. Also would've caused me less stress if you said I could have a quick second scan to check when I first asked! Anyway great news and I am so relieved.

 

[pancake]

That's terrific, mlk - what a relief!!!

 

[TooPatient]

Great news! Sorry they scared you though. They should give you that information to start with!

You could message the moderators and ask them for help.

 

[amc80]

It is my full name, I have no idea how to get rid of it now that it is posted.

Good news they were able to find a nasal bone this time and my risk has dropped to 1:2200.

The genetic counsellor said to me that they thought they saw a nasal bone the first time but couldn't get a good picture. It would've helped with reducing my stress if you had've told me that rather than steering me towards the harmony test and mother $500 out of pocket. Also would've caused me less stress if you said I could have a quick second scan to check when I first asked! Anyway great news and I am so relieved.

Awesome, what great news!

As for the pictures, just flag the post and it will prompt you to write a message.

 

[mlk]

Thanks Pancake,Too Patient and amc!