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Re: amniocentesis 34 years old vs. 35
From: Marcia (anonymous@obgyn.net)
Thu, 11 Mar 1999 12:25:47 -0600 (CST)
I was also in this position a couple of years ago. At that time,
several of the doctors on the WHF told me, "The ultrasound is only as
good as the technician..." My triple screen indicated a 1 in 248 chance
of defects (don't have the exact numbers right with me), but after
having a targeted ultrasound, the odds dropped to 1 in 4000. I had had
two miscarriages previously and was scared of the risk that an
amniocentesis posed.
In addition to looking at long bones (this is interesting to me because
I am short and my husband is as well, so chances were we would have a
shorter than average baby anyway), the
major organs: heart, lungs, bladder, etc. I don't have the figures, but
many Down syndrome babies have heart defects that would most likely be
visible on a good targeted ultrasound.
In the end, it comes down to *your* comfort level. If you want to know
specifically (and absolutely) about Down syndrome, an amniocentesis is
probably the better choice for you.
At Thu, 11 Mar 1999, R. wrote:
>
>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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