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Old 02-03-2009, 09:42 AM   #1
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Anyone do a triple screen?

Ok, my OB referred me for a triple screen and the perinatologists have called me to schedule this. I am pretty sure that I am going to decline it, but wanted to hear from others who chose to do it and why...and those who declined it and why.


Here is some info on it in case you aren't familiar with it:

Also Known as Triple Test, Multiple Marker Screening and AFP Plus
The triple screen test is a maternal blood screening test that looks for three specific substances: AFP, hCG, and Estriol.

AFP: alpha-fetoprotein is a protein that is produced by the fetus.

hCG: human chorionic gonadotropin is a hormone produced within the placenta

Estriol: estriol is an estrogen produced by both the fetus and the placenta

It is a non-invasive procedure done through a blood test with little to no known risk to the mother or developing baby.

What is a screening test?
It is very important to remember what a screening test is before getting one performed. This will help alleviate some of the anxiety that can accompany test results. Screening tests do not look only at results from the blood test. They compare a number of different factors (including age, ethnicity, results from blood tests, etc...) and then estimate what a personís chances are of having an abnormality. These tests DO NOT diagnose a problem; they only signal that further testing should be done.

How is the triple screen test performed?
The triple screen test involves drawing blood from the mother which takes about 5 to 10 minutes. The blood sample is then sent to the laboratory for testing. The results usually take a few days to receive.

What are the risks and side effects to the mother or baby?
Except for the discomfort of drawing blood, there are no known risks or side effects associated with the triple screen test.

When is the triple screen test performed?
The triple screen test is performed between the 15th and 20th week of pregnancy although results obtained in the 16th -18th week are said to be the most accurate.

All pregnant women should be offered the triple screen, but it is recommended for women who:

Have a family history of birth defects
Are 35 years or older
Used possible harmful medications or drugs during pregnancy
Have diabetes and use insulin
Had a viral infection during pregnancy
Have been exposed to high levels of radiation
What does the triple screen test look for?
The triple screen is measuring high and low levels of AFP and abnormal levels of hCG and estriol. The results are combined with the mother's age, weight, ethnicity and gestation of pregnancy in order to assess probabilities of potential genetic disorders.

High levels of AFP may suggest that the developing baby has a neural tube defect such as spina bifida or anencephaly. However, the most common reason for elevated AFP levels is inaccurate dating of the pregnancy.

Low levels of AFP and abnormal levels of hCG and estriol may indicate that the developing baby has Trisomy 21( Down syndrome), Trisomy 18 (Edwards Syndrome) or another type of chromosome abnormality.

Although the primary reason for conducting the test is to screen for genetic disorders, the results of the triple screen can also be used to identify:

A multiples pregnancy
Pregnancies that are more or less advanced than thought
What do the triple test results mean?
It is important to remember that the triple test is a screening test and not a diagnostic test. This test only notes that a mother is at a possible risk of carrying a baby with a genetic disorder. The triple screen test is known to have a high percentage of false positive results.

Abnormal test results warrant additional testing for making a diagnosis. A more conservative approach involves performing a second triple screen followed by a high definition ultrasound. If the testing still maintains abnormal results, a more invasive procedure like amniocentesis may be performed.

Invasive testing procedures should be discussed thoroughly with your healthcare provider and between you and your partner. Additional counseling and discussions with a counselor, social worker or minister may prove helpful.

What are the reasons for further testing?
The triple screen is a routine screening that is not an invasive procedure and poses no risks to the mother or baby. The abnormal triple screen results often warrant additional testing. The reasons to pursue further testing or not vary from person to person and couple to couple. Performing further testing allows you to confirm a diagnosis and then provides you with certain opportunities:

Pursue potential interventions that may exist (i.e. fetal surgery for spina bifida)
Begin planning for a child with special needs
Start addressing anticipated lifestyle changes
Identify support groups and resources
Make a decision about carrying the child to term
Some individuals or couples may elect not to pursue testing or additional testing for various reasons:

They are comfortable with the results no matter what the outcome is
Because of personal, moral, or religious reasons, making a decision about carrying the child to term is not an option
Some parents choose not to allow any testing that poses any risk of harming the developing baby
It is important to discuss the risks and benefits of testing thoroughly with your healthcare provider. Your healthcare provider will help you evaluate if the benefits from the results could outweigh any risks from the procedure.

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Old 02-03-2009, 09:49 AM   #2
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Re: Anyone do a triple screen?

I had it for my first because I did not know any better, and took every test and intervention, they offered. With my 2nd and 3rd, I did not bother. Ther "false positives" are very high, and why add more stress to a pregnancy than needed, especially yours! In my instances I figured, the results are not going to change the outcome, meaning I would not terminate pregnancy, so I just hoped for the best. If you feel like you should then do it. It really is no big deal, but if the results are positive, or the numbers are high or low, I would not worry yet. GL, and btw how is everything going? I have been thinking of you and your DH often. Heres to a great pregnancy. GL.
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Old 02-03-2009, 09:52 AM   #3
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Re: Anyone do a triple screen?

Nope. I waived it, along with other prenatal testing, during my pregnancy with DS2. We would not have aborted under any circumstance, so for us, the test was pointless.
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Old 02-03-2009, 09:58 AM   #4
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Re: Anyone do a triple screen?

I declined it with my first 3 kiddos. It was strongly recommended this time because of age, so I went ahead and did it. It was just another blood draw and everything came back good. We would not have aborted, but we could have been prepared if something were to be wrong and know better how to handle it.
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Old 02-03-2009, 10:02 AM   #5
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Re: Anyone do a triple screen?

I wouldn't do it. It won't change what is meant to be. A friend of mine worried herself sick after she did the test and it came back positive for trisomy 18 and for nearly 2 weeks she suffered with worry only to find out it was a false positive. Goodluck mama, do what you think is best for you and your little ones.
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Old 02-03-2009, 10:11 AM   #6
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Re: Anyone do a triple screen?

Nope, Didn't do it. We decided that the false positive results are just too high and we would not have terminated the pregnancy anyway so we didn't see the point. We also had no risk factors. I can see where it would be beneficial for a couple with a lot of risk factors, though so that they can mentally prepare if there are any issues with the baby.
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Old 02-03-2009, 10:12 AM   #7
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Re: Anyone do a triple screen?

Nope, we declined!
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Old 02-03-2009, 10:32 AM   #8
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Re: Anyone do a triple screen?

I declined it because I was not in any high or even moderate risk category with each of my pregnancies. I had no intention of terminating the pregnancy even if there would be severe birth defects or fetal demise. What difference does it make if I find out my baby has down's syndrome or tri 18 now? I will still mourn it the same, and love the baby equally either before or after birth.

The doctors really like to push the "well, if there's something wrong we can prepare for it at the birth... " theory but really there are very few things that would need THAT kind of preparation that they could not see at a later ultrasound IMO. The incidence of false positives is still uncomfortably high and not worth the stress to the parents or baby.
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Old 02-03-2009, 10:56 AM   #9
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Re: Anyone do a triple screen?

I had it done with DD, this time I opted for the nuchal translucency u/s and bloodwork. With both pregnancies my odds for the genetic conditions came back as less than 1:10,000, and with DD the risk of NTDs was about the same. The NT screen doesn't include an assessment for NTDs, and I have not gone in to have my AFP levels checked. (The AFP levels are what they use to assess the risk of NTDs.) I think it may be too late at this point anyway, and the spine and brain both looked great during my anatomy scan last week so I'm not too worried.

I opted for the tests because I wanted to know where I fell in the risk categories. But I also understand that even having high odds doesn't mean that there's necessarily anything wrong with the baby. Even a 1:10 chance only amounts to 10%...I think sometimes women and doctors forget this. I would have had an amnio if my odds came back above 1:250 for anything (considering I'm only 25, that is higher than average for my age) AND u/s showed markers for specific disorders, or if my odds came back above 1:25 for anything. But only so I could know what exactly we could expect, not because I would terminate the pregnancy. I'm one of those "need to know" kind of people.
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Old 02-03-2009, 11:15 AM   #10
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Re: Anyone do a triple screen?

I had the quad screen (blood test) with both girls and the Sequential Screen with this one (2 rounds of blood work and an u.s)
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