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Straight to amnio?


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#1 melro

Posted 14 November 2019 - 05:22 PM

Hi all, I'm 40, expecting my first, nervous. I am keen to get a diagnostic test (amnio) rather than a screening test - due to personal circumstances I just feel that I need certainty. I've had a lot of push back when I've made the appointment or mentioned it to doctors and midwives. I've found the push back really stressful and although I understand it's my choice it has made me question my choice a lot.
I was further along than I realised and missed the window for NT.
I've read research papers that say amnio is actually lower risk then most people state. And I understand NIPTs has a very low false negative rate of about 1 in 10,000. But I have heard of a case where a false negative occurred at the hospital I am going to, and other checkpoints like the 20 week scan also failed to pick anything up.
I'm keen to hear from anyone who has gone straight for amnio, and any thoughts on how to deal with the push back from drs. Also open to any other thoughts on false negative NIPTs etc or if you think I've missed something about the risks of amnio.
Thank you!

Edited by melro, 14 November 2019 - 05:23 PM.


#2 rowd

Posted 14 November 2019 - 06:02 PM

My circumstances are different, however we opted straight for CVS. The actual risk stats are, like you said, much lower than what is quoted online. Our clinic said approx 1 in 1000 for amnio.

NIPT certainly has a place, but the reality is that is screens for so few things. I personally believe that it gives a lot of people false security and the idea that a good result means a healthy baby is misguided. Of course, most people do have a healthy baby, but screening can't actually tell you that. I will readily admit that I have a skewed perspective, but I do believe that testing (whether pre-conception and/or during pregnancy) can be very valuable.

This is your baby and your pregnancy, and you are completely within your rights to request testing. The doctors or midwives should inform you of the risks and benefits, but they should not try to pressure you in to a decision either way.

#3 ali-song

Posted 14 November 2019 - 06:09 PM

I did with both my DDs, for exactly the reason you state. If something was detected, I’d need a diagnostic test anyway, so why waste several hundred dollars?

For DD8 when I was 38, I had a CVS test, and it was uncomfortable but fine. For DD5 when I was 42, I wasn’t able to have a CVS as there was a vanishing twin, so I had to wait a couple more weeks for an amino. Also uncomfortable, but fine. I didn’t get any pushback from doctors - in fact, my GP was very supportive of this approach.

#4 Ivy Ivy

Posted 14 November 2019 - 07:13 PM

Screening has changed since my time, but:  I had a low risk on nuchal scan 10y ago but opted to have an amnio anyway.  Just before the procedure the doctor asked "why are we doing this?" and I told him, "because I'm extremely anxious and want it".  That was that, no more questions.

#5 daybreaker

Posted 14 November 2019 - 07:49 PM

I had my last child at 37 years old and asked my highly respected OB if I should have an ammonia after my NT scans and he said no but if I was over 40 he would say yes. So that would be reason enough for me to have one at your age now.

#6 MwahMum

Posted 14 November 2019 - 09:35 PM

My situation different to yours.

I had the NT. I had the NIPTS. Both were low risk (apart from my age at the time).

I still opted for an amnio as I wanted a diagnostic test.

I wanted to make the best decision for my family.

While I was discouraged from having the amnio based on how accurate the NIPTS is, at every step I was reassured that the decision was mine to make.

I opted for all the tests I could have and am glad I did. It was one less thing I had to worry about during my pregnancy.

The amnio was uncomfortable, even in expert hands,  and I am glad I don't  have to do it again. If I had to make the decision again whether to do it or not, I'd still have the test for the diagnostic outcome. Noting that it doesn't test for everything...

Best of luck with your decision.

#7 MwahMum

Posted 14 November 2019 - 09:37 PM

I think IvyIvy said it better than I did.

For me too, it was about alleviating anxiety.

Also, congratulations OP. Exciting times.

Edited by MwahMum, 14 November 2019 - 09:37 PM.


#8 melro

Posted 15 November 2019 - 05:09 AM

Greatly appreciated everyone sharing their experiences and perspectives, thanks so much. I feel less stressed hearing from  others who have been here!

#9 melro

Posted 15 November 2019 - 05:11 AM

View Postrowd, on 14 November 2019 - 06:02 PM, said:

The doctors or midwives should inform you of the risks and benefits, but they should not try to pressure you in to a decision either way.

Thanks @rowd - there were some who did this really well. And some who presented the information in a very biased, emotional way. I guess it's an emotional topic and there's a fine art to presenting the information well. I was in much admiration for those who managed to present it without pressure!

#10 melro

Posted 15 November 2019 - 05:15 AM

View Postali-song, on 14 November 2019 - 06:09 PM, said:

I didn’t get any pushback from doctors - in fact, my GP was very supportive of this approach.

Thanks ali-song, that's really great you had a supportive GP. My initial GP presented it like this was a done thing for older mums to be. But since then, she's been on leave and I've  discovered this is not the 'popular' opinion.

#11 melro

Posted 15 November 2019 - 05:17 AM

View PostIvy Ivy, on 14 November 2019 - 07:13 PM, said:

Just before the procedure the doctor asked "why are we doing this?" and I told him, "because I'm extremely anxious and want it".  That was that, no more questions.

Thanks Ivy Ivy, that's really helpful. I think being clear about why i'm making this choice and that I've thought this through will help people understand and push back less. I was just so baffled initially as I didn't realise this was not the done thing!

#12 melro

Posted 15 November 2019 - 05:23 AM

View Postdaybreaker, on 14 November 2019 - 07:49 PM, said:

I had my last child at 37 years old and asked my highly respected OB if I should have an ammonia after my NT scans and he said no but if I was over 40 he would say yes. So that would be reason enough for me to have one at your age now.

Thanks daybreaker! I haven't known who the people were that I was speaking to, it was all the first time I'd ever spoken with them. It's great that you had that understanding and communication with your OB. And useful for me to hear another practitioner's perspective.

#13 melro

Posted 15 November 2019 - 05:29 AM

View PostMwahMum, on 14 November 2019 - 09:37 PM, said:

I think IvyIvy said it better than I did.

For me too, it was about alleviating anxiety.

Also, congratulations OP. Exciting times.

Thanks MwahMum, it's really been helpful for me to hear from everyone. And to hear how the actual procedure itself was.
Everyone has said ultimately it's my choice, but some after making a lot of assumptions and being quite aggressive. I'm glad you met more supportive practitioners.
And thanks for the congrats, I am nervous but also grateful and excited. Still a bit in shock too :-)




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