Dr. Marjorie Greenfield
Specializing in pregnancy and birth.
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 Ask Dr. Greenfield
High Risk Triple Check Results | | | QUESTION | | | Dear Dr. Greenfield,
I recently had a triple screen that came back high risk for Down syndrome. I am 36 and it says I have a 1 in 207 chance of having a Down's baby. I am curious about the numbers on the lab test. My hCG was 57,173, estriol mom was .95, and AFP was 1.12. From what the doctor tells me, the hCG and the estriol levels are normal and the high risk is mostly based on my age. I really don't want to have an amniocentesis. I would like to know your opinion on this lab work. I was 15 weeks pregnant when I had it done, what do you think?— Trudy in Ringgold, Ga | | | ANSWER |
January 24, 2002 | | | Dear Trudy,
This is a case of having asked a question (with the triple check) that you didn't want to know the answer to. But now you are stuck with the information and need to make some decisions.
The best estimate of the risk of Down syndrome in your case is the 1 in 207 that the computer came up with. They do take age into account, because that is one of the factors that influences the risk. In some "older" moms, the AFP, estriol, and hCG levels actually do change the risk--for the better or worse. Your values just didn't change your risk much from your known age-related risk. Unfortunately, these screening tests (including age) are all statistical--and your results show that if there were 207 women in exactly your situation, one would be carrying a baby with Down syndrome. Now you can look at the 1 in 207 chance and decide that it isn't worthwhile for you to have an amniocentesis or you can decide that you want to know now whether your fetus is or isn't affected by Down syndrome.
In my experience, some couples suspect that (since the Pandora's box has been opened) they are going to worry all throughout the pregnancy if they don't get the test done, while others feel that a one half of one percent risk isn't worth getting excited over. Often a consultation with a genetics counselor can be very helpful in clarifying your own priorities and coming up with a plan that feels right for you.
There isn't a perfect answer--you have to decide how you feel about the risks and benefits of the different options and then come to the best decision that you can. Good luck to you!— by Marjorie Greenfield, M.D. |
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