QUAD SCAN

[stefanie1976]

WHAT IS A QUAD SCAN??  I am 15 weeks and all I have done is a NT SCAN.  Is my doctor missing something?

[JourneyJoJo]

There's additional and detailed information in the link that outlines the chromosomal abnormalities tested in each of the tests as well as the accuracy and false positive rate of each screen and confirms what wanting4#1 says in terms of what's tested.

It's also my understanding that once the initial genetic screening is completed, the next stage of testing is the Anatomic Scan/Level 2 u/s that looks at the skeleton and organs for abnormalities.

The only way to know with 100% accuracy if your fetus has a chromosomal abnormality is through CVS or amnio.

[JourneyJoJo]

Here's a link to prenatal genetics and screening that may be useful in understanding what screening is, why it is used, and what the tests are with additional links:

http://www.mountsinai.on.ca/care/family-medicine-genetics-program/prenatal

[wanting4#1]

Hmm....I think we're saying the same thing :)

They did all that b/w at my NT scan, as well. And the NT scan is a combined test of u/s and b/w that does test for Downs and Trisomy 13/18.  But I was told (and my sheet says) that the Quad Screen is ANOTHER set of b/w that tests for different markers (since the pregnancy is further along) for the same chromosomal defects.

I guess I just would be cautious in advising that someone doesn't "need" the additional testing.  For me, it was a piece of mind aspect and I wanted the more accurate testing, in addition to the NT scan.  And even though, everything is going wonderfully, we are still getting the Level 2 u/s which is the NEXT step in the testing process for us. Also, various regions of the country do different things as part of the protocol...I'm in the Midwest and my cousin is in the West and we have completely different recommendations!

I guess I just wanted to clarify to stefanie1976 that the NT and the Quad screen are not the same thing and if she wants the additional testing, she should ask for it.

:) Good luck and wishing all a healthy and happy pregnancy!

[JourneyJoJo]

My OBs office gave me an excellent booklet on prenatal screening.  Here's the link:

http://www.mountsinai.on.ca/care/family-medicine-genetics-program/resources/prenatal_screening2008.pdf

Basically, what it says is, if your first visit with your health care provider is BEFORE 14 weeks, then you would do one of the following prenatal screening tests: First Trimester Screening (FTS), Integrated prenatal Screening (IPS) or Serum Integrated Prenatal Screening (SIPS).

FTS is the NT scan + 1st blood sample (11-14 wks)
                   ->if positive result, then CVS recommended (11-13 wks)
IPS is the NT scan + 2 blood samples (11-14 wks & 15-20 wks)
                   ->if positive result, then amnio recommended (15-22 wks)
SIPS is 2 blood samples (11-14 wks & 15-20 wks) and NO NT scan (ie, if the u/s scan is not available in your region)
                   ->if positive result, then amnio recommended (15-22 wks)

If your first visit with your health care provider is AFTER 14 weeks, then you would have Triple or Quad prenatal screening, though Triple has been replaced by Quad in most areas because it is a little more accurate.  Both Triple & Quad screens are blood samples taken at 15-20 wks with amnio recommended at 15-22 wks if results are positive.

So basically, if you've done the NT scan and are doing 2 sets of bloodwork (IPS), then you don't need a Quad screen.  

According to the booklet, screening for open neural tube defects (eg, spina bifida) are usually done as part of IPS, SIPS, Quad or Triple screening or as an additional blood test if a woman is having FTS.  The Anatomic Scan done at or around 18 wks also gives info about open neural tube defects.

The booklet adds, "Remember that most babies are born healthy."

Hope that helps.              

[sbumblebeeo]

I had all that done at my NT scan.  I must have b/c they told me that they were testing for down's and spina bifada and trisomy 18 and that they would be looking for any other fetal defects.  They also asked if I had history of either downs or spina bifada in my family.  They pulled several tubes of blood but I didn't ask what they were for just let them poke me.  My next scan should be my anatomy scan at 20 weeks.  

[wanting4#1]

Just to clarify sbumblebeeo, there is bloodwork done with your NT scan, but it isn't the Quad Screen. It's another test that is done, like Lance06 said, around 15-20 weeks.  There's also another set of b/w called the Ultra-screen 2 (it's what I had done).

The Quad Screen tests Down Syndrome, Trisomy 18 and Open Spina Bifada (the NT scan doesn't test for Spina Bifada).  The Ultra-screen 2 is combined with the AFP-only screen and tests for the same things, but the AFP test is specific to Spina Bifada.

Since the pregnancy has progressed, the tests are more conclusive than the NT scan alone. (Although the AFP test has been known to produce false positives).

Hope this helps!

[sbumblebeeo]

Mine was done at my NT scan last Friday.  If you had an NT then you had the testing for Downs.  I wouldn't worry about it.  it's all I have had too.

[Lance06]

I think you mean quad screening....>Its bloodwork they do to detect possiblities of down syndrome and other related things. It is completely optional...and it is done between weeks 16-19 i believe. I will have mine at 16 weeks.