Amniocentesis

[moakley]

I am wondering how everyone feels about having an amniocentesis.  I am 34 years old with my second pregnancy as the first ended i m/c.  I have researched all the information on having this procedure done.  My doctor feels that instead of having the triple screen that because of my age I should just have amniocentesis- of course he stresses that it is my choice to decide.  I am a need to know kind of person.  So that I may prepare if baby is born with special needs.  By the way doctor said he has performed over 2200 amnio's without any complications.  What do you all think?  Please share your experience.  Thanks.

[mommyoftwo65112]

I had the amnio to find out for downs and i think if your keeping him/her either way.. Dont do it. Its painful and alot of risks. Though i did get to find out i was having a daughter at 3 mnths

[Faby123]

I had an amniocentesis done a week ago because my AFP blood work was too high. It really didn't hurt I stayed off my feet and rested for 3 days I know it's longer than the dr said but I wanted to be sure my baby safe. I haven't had any issues yet and I'm glad I did the test I'm still waiting for the results but knowing everything for sure is more reassuring than waiting until the baby is born to know anything.

[1st_time_mommy91]

If it doesn't affect your decision on keeping the baby, I would opt out of it. Yes, it's nice to know, but your anxiety and stress levels could also increase and that's not healthy for you or baby. I trust God to know what He's doing and I'm leaving it in His hands. If my girl has Down's, she'll still be just as loved as if she didn't.

[1st_time_mommy91]

I'm a high risk pregnancy and was hospitalized at 30 weeks due to preterm labor. My husband and I moved to a new state and while waiting on insurance to go through, I missed the window to have the amniocentesis to check my little girl for Down's Syndrome. When I got to the hospital, they did an amniocentesis to see if my fluid was infected and it was more painful for me than all the contractions and dilation

[summero87]

Bump

[moakley]

Just got a call back from doctors office.  This is what I found out-  Genecare the lab who does testing for nucheal states in their brochure they do not suggest nucheal testing for pregnant women who will be age 35 at time of delivery- they suggest to go straight to amnio.  So I really think their is this huge gray area where doctors can make their own choices to either suggest amnio or nucheal blood test.  I feel better just knowing that my doctor wouldn't recommend the amnio for no reason.  Thanks everyone for getting me to think hard about my decision.  Also thanks mlb1234 for the abstract article.  I believe that I read in my research  that the risk of harm to baby is 1/400, which still isn't great, but is better than 1/200.  Thanks again everyone.

[Tanker Chic]

At 34 your risk is 1 in 465.  To me that is not that high BUT it is a personal choice.  No wrong or right, just whatever you decided.  I'm just surprised that your dr would push it so hard at 34.  

Good luck with whatever you decide.  

[mlb1234]

To do the first trimester screen you have to be less than 14 weeks along.  It is a blood draw and u/s measurement.  This screens for down's and trisomies.  Then at around 16-18 weeks you can have the triple(or quad) test done(another blood draw) or just a part of the screen which is what I did (only the AFP portion).  The AFP portion will tell you your risk for spina bifida while the others(hcg, estriol, etc.) again look at downs and trisomies (you wouldn't need this done if you already had the first trimester results).  In addition most everyone gets a level2 ultrasound around 19-20 weeks where they measure everything, count the vertebra, look at the heart, etc.  
The three of these tests are totally noninvasive and can give you a ton of information regarding the health of your baby.  If they had any indication at all that the baby was at risk for spina bifida they would tell you and would definitely have a specialist present at delivery.  There is no reason to jump to amnio yet since you can have one even at 22 weeks after the level 2 ultrasound.  In fact a 13 week amnio would be considered and "early amnio" and usually cvs is done at this time instead.  In the meantime, if you do the screens you could get good information on your risk factors to help determine if you really want the amnio.  Despite what your doctor says according to all the scientific literature there is a risk of m/c with amnio whether or not he has actually had this happen (perhaps he is just very good at it??), but of course you don't want to be his first to have this happen either.  Why not do the screens which will not harm your baby in any way while the option of amnio is still there after all the screens are done if you are still not comfortable with the results???

Here is an abstract from a review about these procedures....
Semin Perinatol. 2005 Aug;29(4):215-8.Click here to read Links
    Invasive prenatal diagnostic procedures 2005.
    Evans MI, Wapner RJ.

    Institute for Genetics, Mt. Sinai School of Medicine, New York, NY 10022, USA. ***@****

    Amniocentesis and Chorionic Villus Sampling have been the two most common prenatal diagnostic procedures for decades. There are wide variations in utilization, operator skills, quoted procedure risks, actual observed risks, and patient choices that come from highly variable counseling as to those risks. The compilation of published data suggests procedure risks of amniocentesis to be about 1/200 and in very skilled hands to be slightly lower. The risks of CVS in very experienced hands may also be about 1/200. Most studies comparing CVS to amniocentesis in skilled hands have found equivalency of risks. No well controlled studies support claims of amniocentesis risk at 1/1000 or lower. There is no increased risks of limb reduction defects following CVS at 10 weeks or greater, but there is an increase in Talipes from "Early Amniocentesis." In the first trimester CVS is the safer procedure.

[moakley]

Thanks  to all of you for your insight.  I get so much from this forum.  I realize that the amnio will not tell me all of the things that could be wrong with my baby, however I feel so strongly that if I were to have a baby with spina bifida (or downs syndrome) that to ensure great care I would need to have a specialist there at delivery time.  This is just one thing among many that I would feel the need to prepare for in advance.  I am thinking that I was 13 weeks pregnant  at the appt that we scheduled the amnio.  Maybe I would be too far  along to do the triple screen test- Not sure.  But I will call the office and ask without stepping on toes under what circumstance would the doctor just go straight to amnio and if this is common amongst the other doctors in the practice.  I really appreciate everyone taking the time to respond.

[stephie4]

i thought i'd jsut do the amnio (i'm 36)  but my dr. insisted on doing blood work first, becuase if the odds were from 1 in 500 to 1 in 10,000 he wouldn't bother.  he also reassured me that in his 12 years he's never had anyone miscarry from amnio.

[Atlanta Girl]

I agree with mlb1234 100%. Why skip the 1st trimester screening, considering you are only 34?  How far along are you? Is it too late to do a nuchal translucency? I'm 36 and did the nuchal, then the AFP (of which I don't know the result yet) and then II level ultrasound.  Considering the results of the nuchal and u/s, there is no need for an invasive test such the amnio. Ask more question to your doc regarding the early screening, look them up online first.  Then, I would see if the docs has good reasons for advising you that way.

Good luck to you!

[mlb1234]

p.s.  I am not against amnio at all - I just question why your doctor wants you to skip the screen when you are only 34y!  (If your results from the screen said you had a 1:8000 chance of down's or trisomy would you still do the amnio which has a 1:200 risk of miscarriage??  Just a thought...)

[mlb1234]

I am not sure if this doctor just wants to bill you for the amnio or what...but it sounds a little suspicious to me especially since you are ONLY 34!!!!!!!!!!!!! (you're not even in the AMA category yet "advanced maternal age"!!) Listen, even at my ripe old age of being 38y at delivery and having a sister who had a trisomy 18 baby, my overall risk for down's or trisomies was very small even BEFORE our first trimester screen (somewhere around 1%)!!!  The genetic counselor basically felt we didn't even need the screen but understood if we wanted it done (which we did).  Most physicians go by the rule that if the risk of a chromosomal abnormality is greater than the risk of m/c by amnio then go for the amnio but if the risk of miscarriage from amnio is higher than the risk of abnormalities then you would be putting your baby in harms way.  That is why these screens are nice - they kind of guide your decisions if you are on the fence about amnio.  Granted you have to make the decision for yourself and if you absolutely need a yes or no answer then amnio is the only solution.  BUT remember that amnio does not test for everything and does not GUARANTEE a healthy child - here are many childhood diseases and problems that are impossible to screen for (leukemia, epilepsy, metabolic disorders, adhd, autism etc.).  Best of luck and don't feel pressured by your doctor to have any test done if you are not comfortable with it - if needed get a 2nd opinion!

[Renogirl]

I am one of those people who need to know everything I possibly can - there is no way we would terminate, regardless, and we know that this child will be loved and will be made special and unique, just as God intended her to be made so we decided against it - plus it took sixteen years to get pregnant, if I had been that small percentage who had a problem, I couldn't have lived with myself.  From all that I have read though, they are safer now then ever.  Although amnio can tell you if a problem exists - some of them, not all things show up on an amnio -  it can't tell you the severity of the problem.  It's a hard decision to make but we decided against doing it and it felt like the right decision for us.

Rebecka
25 wks tomorrow

[moakley]

Thanks for your response.  I really don't think I would terminate.  I just feel the need to know what is happening so that I maybe can be a bit more prepared.  Congrats on your pregnancy.  I am just starting my 15 week.  Thanks again

[AshleysMom]

Hi  - I had an amnio with DD, no problem and will again with this preg (I'm 12w3d, 39 years old).  I'm going to skip the screening and go straight for the amnio.  I know this sounds terrible, but I'm not sure I'd go through with the preg if anything is wrong.  If you would not ever terminate, I wouldn't do the amnio.

Good luck to you.

P.S.  It didn't hurt one bit.