Pre-natal Screening Tests

Pre-natal Screening Tests Have been Recommended

You are here because your medical professional has recommended you have a pre-natal screening test to determine if the child you carry has Down syndrome.

If a screening test has already been performed, with results that your child has an increased chance of having Down syndrome, please view Baby May Have Down Syndrome.

If you are seeking information regarding screening tests, please continue.

Your health care professional may have been quite assertive in making the recommendation. If so, we recommend you take a pause before agreeing – a pause in which you collect facts and do some deep thinking.

The National Down Syndrome Congress does not oppose screening tests. You should, however, have complete and accurate facts – about the screening tests and what they might tell you – before continuing.

You may have been told that screening tests are routine.

That is a fact. In late 2006 the American College of Obstetricians and Gynecologists – the ACOG – recommended extension of screening tests to all pregnant women, regardless of age as a practice standard.

The reason: eighty percent of babies with Down syndrome are born to women under age 35.

That may surprise. Many think it most common among children of older mothers. The chance that a baby will have Down syndrome goes up as the age of the mother increases, suggesting most babies with Down syndrome are born to moms in their thirties or forties.

Pregnancy, however, is more common among women between 18 and 35. So, while the incidence is lower, the actual number of babies with Down syndrome born to women in that age group is far higher.

So, a screening test has been offered to determine if the baby you carry has Down syndrome.

Noticed the term ”screening”.

That defines technologies, including blood sampling and ultrasound, that may establish the probability that a fetus has Down syndrome.

We underscore probability – these procedures are not “diagnostic.” They cannot confirm that a fetus actually has Down syndrome (extra material from chromosome 21).

They define a degree of chance. All pre-natal, non-invasive technologies currently available have error factors – some are accurate but 60 percent of the time.

There are additional reasons for offering a screening test.

First, we assume you are relatively early in your pregnancy. One reason for the timing is to permit termination if Down syndrome is diagnosed. Assuming all else about your pregnancy is normal, there is nothing that might be revealed by a first trimester screening that will change in your pre-natal care, however, second trimester screening or high quality ultrasounds can be helpful in planning your delivery and newborn care.

We must be clear. A high percentage of children with Down syndrome are born with cardiovascular and gastrointestinal issues. Many may be detected by prenatal ultrasound.

Should you receive a diagnosis, your health care professional may recommend additional tests to inform decisions regarding your delivery and immediate post-natal care for your child.

If you will not consider terminating your pregnancy, there is no reason for a screening test. If that is your decision, you may want to discuss other pre-natal tests to rule out the chance of cardiovascular and gastrointestinal involvement.

Second, obstetricians pay the highest malpractice insurance rates of any medical specialty. Some have been sued when they did not offer pre-natal screening tests. Where plaintiffs have won, the financial awards have been significant.

We do not suggest that your provider is motivated by anything other than your health and well being. You can, however, alleviate such concerns by offering to complete a statement that a screening test was offered and you declined.

If you decline, your decision should be respected. You should not be unduly challenged regarding your decision. If you believe you have been subjected to such treatment, you may consider contacting the physician or health professional in question and notifying the office of risk-management at the hospital to file a written complaint. This will help put an end to such practices in the future.