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HCG

This forum seemingly answers more questions that most doctors out there. My wife is 21 weeks pregnant. The first two ultrasounds came out fine, the AFP was negative. However, the Doc informed us that her HCG was 2.07 (the normal level's 2.0), and the risk of down syndrome is 1 in 260.

We are scheduled to see a genetic counsellor in a week. Expectedly, we both are scared, and sad. If anyone has had a similar experience or if you know a bit more than my 3 days of internet research - please express your thoughts.

Thank you!!!
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23 Comments Post a Comment
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Avatar_n_tn
What do you mean 2.07?  2 million?  200,000?  A level of 2 is a nonpregnant level.

HCG is not the only factor for Downs Syndrome.  Just because it's high, doesn't mean the child has Downs.  In fact that AFP test is usually done as a triple test, looking at 3 key blood levels - just one of them is hcg.  An amniocentisis is pretty reliable in testing for Downs - I'll have one in a few weeks.  A friend of mine who's wife is 43 and pregnant chose against amnio and got what's called a Level 11 ultrasound - they will look for markers of Downs syndrome.  The problem with getting an amnio is that is takes several weeks to hear results and that can lead to several weeks of anxiety.  

At 4 weeks pregnant, my hcg was 2,028.  At six weeks pregnant it was 109,000.  Now THOSE are high levels. But in the absence of other markers or abnormal tests, hcg levels alone doesn't signify Downs.

Your wife can't be very old.  That figure you quoted mean she has pretty slim chances of having a child with Downs.  The older you get, the greater chance you have of having a Downs syndrome child.
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Avatar_n_tn
Just noticed you said your wife is 21 weeks pregnant - too late I think for the amnio.  You can be reassured through a level 2 ultrasound.
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Avatar_n_tn
Thanks, Suze-ee.

My wife's 32 years old, and I'm trying to find out how to interpret this "2.07" number or maybe its a percentage. So, will be too late for the amnio at 22+ weeks?
How accurate is the Level II Ultrasound? Thanks again.

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Also, my wife is on a thyroid medication for hydpothyroidism. She's been on the medicine for over 1 1/2 yrs, and her thyroid levels have been normal since then.
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Avatar_n_tn
Maybe this will help...did a bit of searching for you.  The number you indicated is a Multiple of Median. (MoM)

MoM

"The important numbers on your test results are the Multiple of Median (MoM), or how much your level differs from the middle of the normal baby population. A MoM of 1.0 means you're exactly in the middle and most likely have a normal baby. A MoM of 0.5 means your level is half the middle of the normal population and a MoM of 2.0 means your level is twice the middle.
A low or high level does not mean you have a problem, it just means you're at higher risk of having one. The farther your MoM is away from the norm, the greater the risk. For example, an MS-AFP MoM of 5.0 would put you at serious risk for a neural tube defect.

There are several things that can cause false positives. One of the most common is incorrect age of the pregnancy. The median value of the levels in the Triple Screen test change with fetal age. This makes the value used to determine your MoM different depending on how far along you are. If your fetal age is overestimated, the value used to compare your HCG level to the median will be too small. That makes the MoM incorrectly high and cause a false positive for Down Syndrome.

Another critical error, especially for IVF pregnancies, is caused by a vanishing twin. Having two gestational sacs dramatically raises your initial HCG level and, even though one of the sacs is re-absorbed, it takes a long time for your level to return to that of a normal singleton pregnancy. This high initial HCG will trigger a false positive for Down Syndrome. If you initially had two or more sacs, you should ignore the increased Down Syndrome risk on your Triple Screen."

Here are some a link for you:

http://www.ivfer.com/tests.htm

Hope this info helps!
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Avatar_n_tn
Hi Went through the same thing as you and opted for the level II sonogram rather than amnio. Sono showed a perfectly NORMAL baby. My results prior to the levelII said I had a 1 in 100?(or close to it) chance of a down's child. If the previous sono's showed nothing I am sure all is fine. Go for the level II and put your mind at ease!!!Good luck.
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Avatar_n_tn
All I know is what my friend was telling me about the level 2 ultrasound.  He said it's amazing how detailed they get.  They look for "markers" of Downs - he said something about them measuring the fingers and toes because certain lengths of bones are common in Downs babies.  My doctor never told me about that option.  I'm considering it now myself.  Lots of other ladies on this forum have had the level 2.
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Avatar_n_tn
hello
The same thing happened to my sister and it scared her too death.
She had a healthy baby boy and I have a great nephew. I don't know much about the percentage thing but sometimes the DRs make us worry more than we have to.
Hope that helps a little.
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Avatar_n_tn
Ladies,

Thank you for your comments. Amongst other things my wife and I were looking for was support, and familiarity. We found both. Our genetic counselling's on 10/22, and hopefully the Ultrasound will be reassuring as well. I can tell you this, I have aged more in the last 5 days than the last 5 years put together. I'm glad I came across this site. Thank you.
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Avatar_n_tn
I don't know a whole lot about the prenatal side as I am a labor nurse, but I can tell you that the tests are often very misleading and alarming.  In my experience I've seen more people think something is wrong and out comes a perfectly healthy baby.  You are not alone.

Jen
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Avatar_n_tn
And, the level 2 ultrasound will likely set your mind at ease.  The triple screen test is often falsely elevated.

It is not too late for an amnio--but what would you do with the info is the big question.  Many families WANT to be prepared for the birth of a child with special needs, and would like the amnio simply so they can be prepared.  Others want an amnio b/c they would choose to abort.  So, yes, 22 weeks would be too late for that, but not to late for an amnio done to diagnose a problem.

Hopefully the level 2 ultrasound will set your mind at ease.  Let us know.
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Avatar_n_tn
Hi,
One point that has been overlooked is that you run a risk of miscarriage having an amnio.  I was NOT going to have the AFP test done because of the false/positive rate and during my level 2 u/s the doc found 2 soft markers for Downs a few weeks ago.  (I'm 33).  They were white spots in the baby's bowels and heart so I went ahead and had the AFP which came back normal.  LAter I found out that those white spots often disappear on their own.  I had another u/s last week and indeed the spots were disappearing.  My doc said at that time I had a greater chance of losing the baby to the amnio than to genetic anomolies. At 22 weeks you wouldn't receive the results from the amnio back til she was around 24 weeks.  That's when the baby is viable.  As someone else mentioned, what would you do with this information?  If you plan on keeping the baby regardless why even chance a miscarriage with an amnio?  Just my thought. I know this is very stressful for you and your wife but truly, the odds are in your favor for a healthy baby. Try to have faith. Good luck to you both.
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Avatar_n_tn
I went through the same thing and had amnio Oct 1st. My AFP test results showed 1 in 150 and we also got our level 2 u/s. We were told level 2 is also only 50% accurate. we wanted to be well prepared and of course thats a personal choice. Our level 2 u/s showed perfectly normal and amnio results came back yesterday which was great. My point is that AFP is a total nuisance... if we want to know we should just go for amnio or not go for any tests at all. Due to AFP I had lost my sleep, have nightmares etc etc.. which was total unnecessary thing. Now I am doing great and enjoying my pregnancy. Wish you all the best. and hope you have pass this time with no worries. I did a lot of research on AFP and found out that they re only possibilities.. so it doesnt really say much..
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Avatar_f_tn
Hi all, I hope I'm nopt too late in responding - i was on vacation.  I too was worried because I thought my hcgs were a tad hight (30000 at approx 6 weeks) but at age 26, I didn't want to chance the u/s and I didn't have a triple screen cause of the high false positive rate so I had a level II and all looked great.  My doc said hcg doesn't tell you anything alone, you need to measure other things along with it.  Also, my cousin had a triple screen, came out normal and sadly her baby was seen as deformed severely at the level II.  I suggest getting that level II, I think that will put your mind at ease....
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I just got a call that my AFP test came back that I have a 1 - 233 chance of downs baby - I am very nervous and very scared.  Of course people around me tell me the chances are low and not to worry - but how can you not.  My first pregnancy went smooth as can be and we were blessed with a beautiful baby girl.  And today this happens -
I am not doing the Amnio - instead we are having an Ultrasound down on 12/12 to measure the arms legs - eyes - ears etc.
Any women out there that were told they had 1 - 250 chance or under of a downs baby and what were the reults of your tests.
Any advise or stories will help.  Thank you
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Avatar_n_tn
I realize this forum took place in 2003....I just found it while doing a search for myself, however I hope I can get some information to ease my mind.
I am 22 weeks.....and my quad screen came back 1 - 24,000.
However, I had an ultrasound on 8/24 and they found a calcium deposit on the heart, so my doctor sent me for a level 2 ultrasound this past Tuesday.The results were good...all measurements showed a healthy baby.
I just can't stop worrying about Down Syndrome!! The only way to be sure is the Amnio...which makes me very nervous.
Any advise or stories will help. Thanks!
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Avatar_n_tn
My son is 2 years old.  I was told I had a 1 in 150 chance of having a baby with Down's and I did not bat an eye.  I think that is pretty good.  I am 35, I just had an AFP that gave me a risk of 1 in 75 and the Level 2 ultrasound raised that risk to 1 in 50.  I opted for an amnio.  If they had not found a soft marker on the ultrasound, I would not have worried a bit.  I think 1 in 24000 is excellent and would not worry.  Your risk of complications with an amniocentesis are far greater than having a baby with Down's.
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Avatar_n_tn
Just wanted to add that I am 16 weeks with my second child.
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Avatar_n_tn
I'm 16 weeks as well. I'm scheduled for my amnio on 9/24. It's has been a hard 3 weeks. I opted to do the screening where they check the nuchal translucent and found that it measured 3.0 cm. When my blood work came back a few days later my chances of having a downs baby increased from 1/265 to 1/17. I still have at least another 3 weeks of the unknown. Has anyone come across a similar situation? Thanks for your help. I'm 35 but will deliver at 36. I have  a healthy 4 and 3 year old. I did not have any complications with either of my children.
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Hi,

I'm a 23 yr. old & 16 weeks pregnant. Doctor called me with an abnormal Quad screening result (1:177) for Downs. Should I be worried? I'm scheduling a 2nd level US for next week - would the results be accurate now that I'm 16 weeks? The amnio procedure is out of the question for me!

How accurate is the 2nd level US...What could make an abnormal screening result a false positive?

Please respond...
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Avatar_n_tn
Hi everyone....I received a 1 in 15 chance for Downs, when the positive cutoff is 1 in 270.  So, I think we can see that the number does not look too promising.  I, however, don't know too much on how to intrepret things.  I am 30 years old, this is my first pregnancy, and the ultrasound measurements are fine?  I had a level two, but before this and nothing "derogatory" was said?  The dr. performed a regular sonogram after we looked at the test results but as I said, the measurements were fine, and nothing else was said, except that there is/was a small cyst on top of the baby's head on the left side :(     It's the scariest thing in the world....he said he wasn't worried about the cyst, but recommended an amnio because of my results.  I am thinking it over.  The only reason for me to do it is to know and inform myself and being prepared in raising a child with special needs.  I am almost 18 weeks and although I cried like a baby yesterday when I saw my test results...today I am fine with whatever God has blessed me with.  I just don't want my child to struggle...it has nothing to do with me.  Anyway, I keep thinking was it possibly the vanishing twin/embryo (finally disappeared at 10 weeks..) that caused my AFP levels and numbers to be so extreme?  But the Dr. said, that it would have been the other way (my AFP levels would have been elevated???)  SO, I dont know what to think.   Anyone have such a scary number with the AFP screening and everything was ok with the baby?
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Avatar_f_tn
I am 30 years old 17 weeks pregnant with my first child and received an abnormal reading on my quad screen. I was WNL for AFP, estriodal and inhibin-A. My HcG levels were at 3.98. 4 multiples above the median (which is 1.0). Given my age and normal markings for the other indicators, my risk is low. But how does the elevated level fo HcG relate to an increased chance of having a child with down syndrome?
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