The Triple Check Decision

November 21, 2009

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The Triple Check Decision

by Marjorie Greenfield, M.D.
reviewed by Laura Jana, M.D., F.A.A.P.

The purpose of the triple check test is to identify those who would benefit from further testing for certain fetal problems. The test detects problems with chromosomes (such as Down Syndrome), and problems where there has been incomplete closure of a body cavity (such as spina-bifida).

There are two general reasons why some people choose not to have the triple check done:

People who are going to have amniocentesis and ultrasound anyway do not benefit from triple check testing. The triple check only helps to identify who should have the amnio and/or ultrasound done. If you are going to have an amniocentesis regardless of the result of the triple check, you will not benefit from the triple check. Many (but not all) women who will be 35 years old at delivery fall into this category.

People who are going to have an in-depth ultrasound done anyway and would decline amniocentesis even if it were recommended probably should not have the triple check. Again, the triple check is to see who needs further testing, and if the testing will be declined, why do the triple check? Many (but not all) people who would not terminate a Down Syndrome pregnancy fall into this category.

Making the decision
It is important to think through what you will do with the information you get from your triple check test. If that information will help you make decisions about your pregnancy, then you probably should get the blood test done. If you are not willing to get the further testing that might be recommended, it may be better to forego the triple check, rather than spend the rest of your pregnancy worrying about a small increase in risk.

A note for people who are not going to have an ultrasound
The triple check can also give a hint of findings usually seen on
ultrasound: inaccurate estimate of the due date, twins, major birth defects that prevent survival (like anencephaly), and some anatomical problems that would make vaginal birth unsafe for the baby. If you are not going to have an ultrasound, these other factors should be taken into account when making the decision about triple check.


RELATED INFORMATION

			Second Trimester Experiences
			The Developing Fetus, Weeks 9-24
			Fetal Assessment
			Genetic Testing in Pregnancy
			Moms-to-Be Testing

Created September 18, 2000
Reviewed September 29, 2000

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