Screening Results

My ringing phone woke me up at 7:15 this morning (this after I’d already hit snooze twice).  I picked it up and heard a very cheery voice say, “Hellllllloooooo!”  I tried to sound awake as I said, “Who is this?”  It was Joanne, the nurse at my MFM’s.  She’d just gotten my lab results and didn’t want me to have to wait another moment, “but if you’re asleep you can always call me back later!”  Of course, I was awake in an instant, and ready to hear the news.  I was so relieved to learn that my risk of the 3 trisomies screened for has dropped from 1 in 100 to 1 in 1000!  Yay!  So the plan for now is to get my anatomy scan and second trimester screening labs at 16 weeks, and reevaluate the need for an amniocentesis then. 

A few posts on my discussion boards, things my patients have said to me about their pregnancies, and my own recent experience has me convinced that most doctors do a horrible job explaining what the first trimester screening really means.  What I hear most often is, “I don’t want to do it because it’ll just worry me for no reason.”  I think that is probably a reasonable thought process for women under 35 (though the one person I know who had a baby with Trisomy 18 was only 23 when she got pregnant, so it really can happen at any age).  But for older women, I think that thought process shows that their doctors just didn’t explain the screening the way they needed to explain it.

The first trimester screening looks at an individual’s risk for Trisomy 13, 18 and 21.  That much most everyone understands.  But what most women who are hesitant to do the screen don’t understand is that each of us already has a risk for those trisomies based on our age.  And for those of us over 34, that risk is higher than the risk of an amnio, even going by the old (and outdated) statistics of a risk of miscarriage being 1 in 250.  Here’s a link to one of the many risk tables that exist out there on the internet.  I have to admit, I never even looked at one until last night when I started wondering about my test results; even though I knew my risk was high at my age, I had no idea my risk was as high as 1 in 100, much less 1 in 87, as this chart indicates.

So my point is that for most of us pursuing choice motherhood, our risk is already really high, just because most of us (I know, not all!) are over 35.  Which means, that for most of us, the first trimester screening is going to either be reassuring (as in my case), or not really tell you anything more than what you already knew, based on your age.  It’s up to you what you do with that information once you have it.  And you’ll have another ultrasound to make it all worthwhile!

And now I’ve done what I feel is my PSA for the day, I’m going to go track the status of my fetal doppler that I ordered last night.  I never thought I’d turn into one of those crazy, overly worried pregnant ladies, but here I am, crazy and overly worried.  Thank goodness for doppler rentals!