This question was answered on Wed 12, Feb 2014 04:24pm by Dr.Kokil Mathur

pregnancy

    
Asked by Unregistered (Female; 36; UNITED STATES ) on Wed 12, Feb 2014 12:11am
Priced at $49.00

I recently had an ultrasound at 17 weeks it showed I had placenta previa. that same day I did my second set of blood work for AFP they came back 1/63 down syndrome and 1/10 spinabifida. with my last child in 2009 I had her at 24 weeks due to HELLP syndrome she also was high risk for down syndrome but when she had her ultrasounds they looked fine and she was born with no down syndrome. is this high for a false positive?

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Answer by Dr.Kokil Mathur  on Wed 12, Feb 2014 04:24pm:

Hi! I do appreciate your concerns. AFP levels alone are not indicative of Down Syndrome. You will need other tests (blood estrogen and HCG levels) and ultrasound to confirm or refute the suspicion. In Downs Syndrome, AFP and estrogen are low and HCG is very high (triple test). Amniocentesis is done in highly suspicious cases. The alpha-fetoprotein or AFP and estriol levels are low in a Down syndrome pregnancy, so their levels would be below the average (less than 1.0 Multiples of the Median [MOM]). The hCG in a Down syndrome pregnancy would be greater than 1.0 MoM. These results are then correlated with fetal age on ultrasound. Then the results are correlated with maternal age. If all the components are greater than 1.0 MoM (another way of interpreting the results of this triple test is taking a cut off at 1/270), and woman is younger than 25 years, then risk is comparatively low. But in a woman 30 years or above, the risk is pretty high. On Ultrasound, collection of fluid at the back of the fetal neck, called nuchal transluceny is taken as a high level risk factor for Down syndrome. Soft markers on ultrasound indicate a probability of Downs syndrome in the fetus. These markers are just indicators and not confirmed diagnosis of Downs, which can be achieved only through amniocentesis. An echogenic intracardiac focus however is considered a high level marker and shows increased probability. CPC is a mid level marker and the two together show a good chance that baby has Down. This should be followed up with amniocentesis. Having said all this-the combined results can only predict the risk-it does not say that fetus has Downs Syndrome. For confirmation amniocentesis will have to be done. Since you are 36 years old, the triple test and ultrasounds should be done to assess risk, followed up with amniocentesis if need be. Please discuss with your doctor. Please feel free to ask anything else you may want to know. Take care!

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Comment by Dr Arti Sharma on Thu 13, Feb 2014 05:27am:

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