Sequential Screening - High Risk for Trisomy 18

Good morning... I am 19w5d with my third child - first was a graduate of a NICU in PA... labor started at 19w.. at 26 hard labor with mag to slow - daily shots of turb and she finally came after a nasty UTI I had went undetected as I was on bedrest the entire time at the hosptial and she devloped e-coli.. she only spent 10 days there... Son was full term with dialation and contractions starting at 20 weeks, but had a cerclage.  This pregnancy - clerclage in place at 12weeks.. but this time I did the bloodwork which for downs came back at 1/10000 trisomy 18 was 1/78.. PAPP-A and HCG were low and something else was high.  The company that does the test does not factor a good level2 US in to play or the fact I occasionally smoke ( I have cut back and am trying to quit.. did not smoke with the other two) - my question is those levels... can they be seen in a mother with a risk of preterm labor and or preeclampsia.. from medical journals that I have read I see a corrlation between those levels and preterm labor and preeclampsia occuring.... I understand taht Trisomy 18 is "not compatiable to life" and understand that if the baby has it and makes it to live birth I can expect a passing within the first week so I am opting not to get the amnio as with my history of preterm labor I see the amnio as an unneeded risk to the baby for my own knowledge... nothing to help her... The genetic counsler I was assigned is a paid employee of the company that conducts the testing so I feel her feedback/information is a little .... well lets just say a conflict of interest.  Thank you for your time...  Melanie

[Yao Sun, MD, PhD]

I do not have the obstetrical knowledge to answer your question about prenatal screen results and prematurity vs. Trisomy 18.  You should ask your Obstetrician or ask for a referral to a Perinatologist.  

Babies with Trisomy 18 that make it to delivery can live a variable period of time, from just a few days to several months.  It is, however, a uniformly fatal condition because of the multiple organ systems involved with this genetic condition.