quad-screening results show increased risk for down's

We had the quad-screening done last Wednesday (I am 16wks)and my doctor just called today to let us know the results show an increased risk for Down's. She says our next step is to get a level II ultrasound and the nurse will call me back with information about when and where to get that done. I'm really confused because I keep reading conflicting information about whether or not these screenings are accurate for twins, and whether or not an amnio or CVS is recommended when carrying twins. I'm pretty sure we had the nuchal test done a few weeks earlier and everything looked normal. Has anyone else been through this? Did your triple-screen or quad-screen results come back positive, and what steps did you take after that? I'm sure everything will be fine, I'm just trying to get all the information I can so I can prepare myself for what's to come. Thanks for your help!

 

We had the quad-screening done last Wednesday (I am 16wks)and my doctor just called today to let us know the results show an increased risk for Down's. She says our next step is to get a level II ultrasound and the nurse will call me back with information about when and where to get that done. I'm really confused because I keep reading conflicting information about whether or not these screenings are accurate for twins, and whether or not an amnio or CVS is recommended when carrying twins. I'm pretty sure we had the nuchal test done a few weeks earlier and everything looked normal. Has anyone else been through this? Did your triple-screen or quad-screen results come back positive, and what steps did you take after that? I'm sure everything will be fine, I'm just trying to get all the information I can so I can prepare myself for what's to come. Thanks for your help!

 

We had the triple screen and the AFP with my 8 month old. they told us all the test came back high risk for Downs and pretty much demanded we do an amnio - so after much thinking, we did, and my DS is perfect. I think those tests are not accurate most of the time. I dont know if I would have the amnio with the twins this time though, I have heard too many horror stories of premature labor as a result. That would be a tough call. I hear those Level II ultrasounds are amazing though, we have ours on January 11.

 

Most likely the results are abnormal because it's twins, especially because the nuchal translucencies looked normal.

Here's my viewpoint, from my own experiences, and from what I've read: With twins, these tests are much more likely to be abnormal for no reason at all. Doctors offer them to their patients, because they have to, and it makes patients feel like they have to have it done, etc. The same goes for amnio and CVS.

My nurse asked me at our last appointment if we had done these blood tests and I told her "No." She said "Good for you. They often cause unnecessary worry, especially with twins."

In the end, I think the decision whether or not to have these tests and then maybe following with an amnio depend on what you will do with the information.

Another member, I think Jordari, went through something similar just a while ago. She went through 4 weeks of thinking something might be wrong, only to find out everything was fine!

 

My MFM dr told me to skip the quad test becasue it would show false positives because I was having twins, so I did. And I skipped the amnio, too, after we found out we were having twins due to the increased risk of labor and such. Sure - I have been a little worried all along, but I think I would have worried anyway. Just remember - the odds are in your favor that everything will be just fine! And I agree with the other posts - doctors suggest these tests on a routine basis and many of them show false positives anyway, with those chances incresing when you are having twins.

 

I did have the quad screen done. But going into it I knew the risk of false positives. So I had already decided if it came back positive, oh well. I would NOT have any more testing done. I would not terminate a pregnancy due to Down's or any other medical condition, so all the other testing seemed un-necessary.

It is a very private and personal decision. Whatever you decide to do will be the best for you and for your babies!

 

I would like to add that according to a mom who went through what you're going through, there are only 17 reported cases of Down's in twins EVER documented in the U.S.
This was from the Mono-mono support site, a place I went to when I was misdiagnosed with MoMo. They take their stats pretty seriously there.

I just wanted to help put it in perspective for you. The tests show all kinds of things that frankly, are out of the norm for docs unfamiliar with twins. Amnios are very risky in twins, please proceed with caution and as many facts as you can find if anyone pushes one on you.

 

I wouldn't worry too much.. there are a lot of false positives on them in general, and even more so with twins.

Mine came back with a positive risk for spina bifida, but it was before they knew I was having twins so the test was totally skewed anyway. The peri says the u/s looks fine every week, so try not to stress... see what the level II u/s shows before you decide on an amnio.

 

We had the amino becuase i'm over 35....and we wanted the piece of mind.

Also, with aminos, the more experienced the dr. the lower the risk - usually less than 1%. The only reason it's "higher" w/twins, is you have 2 aminos, one for each sac - but it's still @ 1%.

As others have said, it's a very personal decision.

Miriam

 

I agree with the previous posts... don't worry about it. My doctor had told be before taking the quad screen that a negative result meant very little chance of something being wrong, and a positive result only means they couldn't rule it out... it does not mean something is wrong, or even that there is a higher risk of something being wrong. He said the tests cover a very broad spectrum so they won't encounter a false negative, which also means many, many false positives.
My doctor said it isn't more or less accurate because it is twins, that just affects one of the tests... he said it couldn't be done because it isn't accurate with twins, all of the rest of the testing should be fine.
If you look up the statistics, the odds are very much in your favor that everything will be fine. It is easier said than done, but try not to worry about it.
Helen

 

I have known so many people that had false positives with this test. For that reason, we chose not to have this test. I hope everything works out. Try not to worry. I know these false positives are greater with twins.

 

Thank you everyone for responding, I feel much better after reading your thoughts on it. We've decided not to let it worry us, we wish we hadn't even done the screening to begin with. We're just going to look forward to the level II ultrasound, and see what happens from there!

 

I know it is impossible not to worry but my peri told us to skip the quad screen because of false positives - at the time my baby B was measuring big for her age - My doctor said that on top of being twins would almost assure a false result.

 

I opted out of the screening because of the inaccuracy with twins and honestly the results didn't really matter to us. I hope your Level II shows that it was a false alarm. Keep us posted.

 

Our doc recommended that we NOT do the test as they use the same stats for singleton preg and there are SO MANY false negatives, esp with twins. WE did not even do the test because of that.
I am glad you are going to just take it as it comes and not get worried over it!

 

Your kids will be fine!

I totally agree with Raneysmama - they do those test because they have to, and they worry and harm you more than they help.

For me and my husband has always been sure that we´d get our children, no matter what kind of disability they would eventually have. Still, my doctor did this test, and on twin A, it was positive.

I had another, detailed ultrasound, then, because she recommended it, but even then I thought it wasn´t really necessary - they can´t do anything about Down´s at all.

I could have done a punctuation of the cord then, which I refused to do, because of the risk to hurt a healthy child, and because the second ultrasound showed that Twin A (and B!) were both healthy, proper little boys. Well, we still don´t know a 100% for sure, although each ultrasound afterwards showed the same, so I´m in good hope, and the greatest moment of my life will be to hold my first son and knowing what´s up with him.

By now I know quite a lot of mummies that were in the same position - being totally worried and confused and crying because of their "damaged" children, and then they had just fine little ones being totally healthy.

So, head up, you´ll make this, too!

 

I was also under the impression that doing the test with twins could skew the results. We had it done and it came back normal but that was before we knew we were having twins. If they had taken twins into account who knows what the test would have said.

I had two amnioreductions done during my twin pregnancy due to TTTS. Amnioreductions are basically amnios where they take out jars of fluid. They both hurt and, IMO, the worry and chance of miscarriage afterwards is not worth the knowledge of whether or not the baby has a chromosomal abnormality. I was kept in the hospital for monitoring after my 2nd amnioreduction as I as 25 weeks at the time and they would have tried to save the babies had I gone into labor.