PREGNANCY-BIRTH Messages for March, 1999: Re: amniocentesis 34 years old vs. 35

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Re: amniocentesis 34 years old vs. 35

From: R. (anonymous@obgyn.net)
Thu, 11 Mar 1999 05:31:39 -0600 (CST)

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Reply: Marcia: "Re: amniocentesis 34 years old vs. 35"

At Wed, 10 Mar 1999, Carolyn wrote: >
>Having been where you are, I can tell you exactly why 35 is the "magic"
>age. At 35, the chances of having a baby with DS is approximately the
>same as the chances of losing a baby due to an amnio...supposedly around
>1/200. However, different Drs have different "success" rates. My Dr
>had been doing amnios for 7 years and said that he had one
>miscarriage(but the amnio was done at 17 weeks and she miscarried at 22
>weeks). I acutally had two amnios, one at 16 weeks which, after two
>sticks, was unsuccessful (couldn't get a draw) and one at 21 weeks(which
>was successful).
>
>The triple screen, while being fairly reliable for determining neural
>tube defects, is less reliable for screening for DS, with a high rate of
>women put in a "higher than normal" risk category.
>
>I'm interested in hearing what the Drs say about the triple screen and a
>targeted level 2 as I was told at my level 2 that the 60% of the
>physical signs of Downs Syndrome are missed in an US. Also, what is
>thought to be a soft sign (like a shorter than expected femur) could
>just mean a shorter than expected baby, not a DS baby. So...I'm
>curious...as always.
>
>--
>Carolyn

The combination of Triple Screen and targeted ultrasound is usually pretty good at ruling out either neural tube defect or Down syndrome. It is not as accurate as Chromosome anaysis based on amniocentesis. There are several ultrasound findings of Down syndrome, but they are not usually seen on routine ultrasound. They should not be missed on a "targetted" Ultrasound which is done for the express purpose of looking for them. About 60-70% of all babies with Down syndrome will have one or more of those findings. That means that 30-40% will not have any of them. As was pointed out above, there is some risk to having an amniocentesis done. So it all boils down to what risk are you willing to accept in order to be 100% sure that your baby does not have Down syndrome.

--
R.Daniel Braun, MD  FACOG
Clinical Professor of Obstetrics and Gynecology
Indiana University School of Medicine
Indianapolis, IN
                                      "Heisenberg might have slept here."
                                          Unknown or maybe Indecisive                                               Unknown

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