Prenatal Diagnostic Testing Anxiety

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QUESTION

Dear Experts,
My wife and I just got our triple blood screen back and we were told the test for Downs came back positive. The doctor set up an appointment for tomorrow for an ultrasound and possible amniocentesis. My wife and I have had two, very early miscarriages (fist month or so) and are scared to have the amnio. If it is healthy or not, we will go forward.

Are there any real benefits to knowing? We think being 17 weeks pregnant is a miracle after losing two and don't want to chance losing it. I've read that about 1 in 100 amnios result a miscarriage. Do you know the approximate odds that the blood test could be a false positive? We are terrified and could really use some information and maybe some hope that all may turn out normal.

Kindest Regards,
Tommy

ANSWER

Dear Tommy,
It's very scary to get back results from a screening measure that indicate a possible problem with your baby. Unfortunately, the triple blood screen has quite a high rate of false positives-research indicates that more than half the time, results indicate a problem where none exists.

A positive result does not mean that you must do invasive testing -- often the triple screen will be run again. That's why the triple blood screen is a screening measure, a way to decide whether further testing is indicated, and often, further testing shows that the baby is normal.

Even if you get another positive result, you can choose to do a high-level ultrasound (which provides quite a bit of diagnostic information) and decline the amniocentesis because you prefer to avoid the risk of complications from the amnio.

Sometimes, gathering more information gives families the opportunity to make a decision about how to proceed. If you intend to continue the pregnancy regardless of testing results, you can decide to forego any further testing, since results would not affect your decision.

Instead, think about what sorts of information would be helpful to you for the duration of the pregnancy. If having more specific information about your baby's condition will help reduce some of the uncertainties during the rest of the pregnancy, or help you plan for the future, then a more invasive test has value.

But no matter what, there will still be uncertainty -- no test can rule out every condition, syndrome, or birth defect. And even if your baby has Down's Syndrome, testing cannot tell exactly how serious that condition is for your child.

In general, it is important to keep in mind that prenatal diagnostic testing or heavy monitoring of an otherwise low-risk pregnancy can create unnecessary and undue stress in parents. Instead of constantly looking to uncover problems in the baby or pregnancy, focus on having the healthiest pregnancy possible, to give your baby the best start in life.

It can also help to take a wondering attitude about the outcome, and have faith that whatever happens, you'll find much to treasure, even if you meet with adversity.

We wish you the best,
-- Debbie and Mara
The Childbirth Complication Expert Team