The Pregnancy Quad Screen: Should I get one to detect birth defects?
OK lets start off with the basics.. What in the world am I talking about when I mention a Quad Screen? In a nutshell, this blood test is preformed on expectant mothers anywhere between weeks 16-18 to determine the statistical likelihood of genetic birth defects and abnormalities. I'm talking specifically down syndrome here, although it it could also assist in determining a number of other potential defects as well. The test is preformed by drawing blood from your baby's mamma, and is no different then when you go to the lab to get blood work done. There are no apparent side effects, and this is not considered an invasive procedure and therefore is generally considered to be safe for both mom and baby.
Now lets get more specific.. The Quad screen actually tests for four different things in the blood, of which I personally know nothing about since I'm not into all the "science stuff": AFP, hCG, Estriol, Inhibin-A. Incidentally there is also a triple screen test that may be performed which only screens 3 of the four.. More is better right? Might as well supersize and go for the quad as it is supposedly more accurate. Ok, so what do the certain levels mean? I have no earthly idea. Basically the levels are measured on all four of the categories and your results are compared against a statistical chart or database based on the age, race, ect., to give you the odds based on other people's results.. Sorta like when you took the SAT's as a kid and you were in the highest percentile... Sorta the same concept, it gives you the odds.
Now I'm certainly not a betting man, hell I lost my shirt in Vegas last time I went, but there are a few things to consider here.. We were given the choice to have this test performed, it was not forced upon us. Certain factors may influence if you decide to do this test: if you have a history of birth defects in your family, if the mother is over 35, and other risk factors may come into play. We were just about floored with the OBGYN Dr. when he advised us he recommended the test so if it came back with bad results we had the option to terminate................ Yes there was a moment of awkward silence there because we had NEVER considered termination, and we quickly dismissed that as an option. The Dr. must of known we were floored because he spouted off some statistics at us, of which I have no way to backup, I'm just repeating what I was told here.. Out of 3000 women that have the test 30 will bring a result that the baby may have a birth defect. Of those 30, only 4 are truly positive. That's a pretty big margin of error in my opinion.
Well if the test comes back as a potential candidate for a birth defect and you're one of the 30 couples that get the dreaded news, there are other tests that can confirm genetic disorders. Remember the quad screening is just that; a screening, it's not definitive answer. If you are one of the 30, you would ultimately want to talk to your doctor about other procedures, some may be more invasive and may potentially be harmful to the unborn kiddo. That is why the Dr.s don't just jump right in and offer that option. Now a word of caution though, a close friend of my sister actually had this test done as well as other tests, and was advised by her Dr. to terminate the pregnancy. She and her husband refused, and they had a beautiful healthy baby, with no defects.. It just goes to show you that the Docs don't always get it right.
So why have the test in the first place if it's not always right? My wife and I decided that regardless of what the results were we would continue on and have the baby no matter what. We aren't particularly religious folks, but do have a Christian background and personally believe we would love a child no matter what cards are dealt. We simply wanted to have the test done for planning purposes. If you are having a baby with down syndrome, there is allot more research that needs to be done, possibly more testing, and other things to prepare for. We just didn't want to be blind sided in the delivery room. Bottom line we are planners, and hate surprises. It's up to you and more realistically your baby making partner if you get this test, but it's a personal choice.
If you want to read up on more of the science behind the test as well as more specifics, be sure to checkout the American Pregnancy Association for more information:
- Quad Screen : American Pregnancy Association
The quad screen is done in the second trimester.