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Re: MSAFP vs triple screen From: Malcolm Griffiths (malcolm@mgriff22.demon.co.uk) Mon Jul 14 23:39:15 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Deborah Wage: "VBAC discussion (compliment)" Previous message: Deborah Wage: "obseity case results" In reply to: ATB28@aol.com: "Re: MSAFP vs triple screen" In message <970714080903_-1359968833@emout01.mail.aol.com>, ATB28@aol.com writes > >I didn't state that it was *inappropriate* ; rather, that it...screening >(using triple markers)... is our process of first choice. I may have misunderstood - if so sorry ! > >In addition, the risk you state (1%) for amniocentesis - while perhaps >accurate at your referral centers - is different than our experience (0.25% >over background) in > 25,000 procedures. Have you published this data ? If so I'd be pleased to have the reference. Alternatively get Roberta to put it one a web-page ! I met someone last year who claimed ( in a very large experience ) only to have had a single pregnancy loss after amnio/CVS. He even claimed that that was because someone else attempted sampling after he had failed. I don't beleive anyone has totally firm statistics on the amnio-relat4ed pregnancy loss risk. I do though counsell all my patietns that the loss encompasses late miscarriage, very early preterm ROM, +/_ preterm labour, etc. Personally my most memorable "amnio-related" loss occurred following 21 week amnio ( normal karyotype ) for CPCs. SROM occured at 23 weeks. Delivery was at 25 weeks. Baby died aged 9 weeks old ( LMP + 34 weeks ). Such anecdotes mean little except to the parents involved ! > However I think that it matters little what the actual figure is. This is one of very few issues on which Kypros Nicolaides and I totally agree !!! We may attempt to balance a (say) 1% risk of amnio-related pregnancy loss against a (say) 1% risk of trisomy-21. The numbers are equal, but the risks aren't. We are attempting to balance one foot on one hand with one pint on the other ! On one hand we are talking about a 1% risk of the loss of a potentially health child, whilst on the other hand we have the risk that not having an amnio may have a 1% risk that the option to prevent the birth of a handicapped child by late second trimester abortion will be lost. One woman who I counselled recently said: "it depends on which of the two options scares the hell out of you most". Yes it is all about informed choice ! Malcolm Griffiths MD,MRCOG,MFFP,Cert.Mgmnt Obstetrician & Gynaecologist Luton & Dunstable Hosp., LU6 2DT, UK. Tel: 01582-497459 (office) Fax: 01582-497376 01525-222849 (home) email: Malcolm@mgriff22.demon.co.uk http://www.obgyn.net/board/griffith.htm "It is dangerous to be right on a subject on which the established authorities are wrong." (Voltaire) "But sometimes it's fun :-)" (Griffiths) Next message: Deborah Wage: "VBAC discussion (compliment)" Previous message: Deborah Wage: "obseity case results" In reply to: ATB28@aol.com: "Re: MSAFP vs triple screen"

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