AMA and amnio.. thoughts anyone

ream02 · August 2013

So, I'm at a age where some consider me AMA. I'm in my older 30's. I don't feel it most day's. I'm in relatively good health aside from lower back pain and sciatica. So I was thinking, at what point do they recommend amnio and what are your thoughts on the subject? Is this standard with age, or is this only if you are considered high risk in other avenues aside from age? Not only does the increased risk of m/c with amnio scare me, but just the thought of that huge needle scares me to death.

On a totally unrelated note. I need to get ice cream so I can stop obsessing over it. I've been thinking about it for a few days now and if I don't get it soon I'm going to drive you all nuts. lol

BackseatDriver · August 2013

Generally an amino is offered at 35 or 32 if you are having twins. There are some risks associated with amnios but the most serious risks are half a percent at most. A quad screen or integrated screen might better help clarify your risk if you are considering an amino, but aren't sure. You might find your risk go up, it might be low, or it might go down but still be considered an elevated risk. If you know that you will not be reassured by getting a very low risk based on screening then IMO you should just skip it and have the amino or look into Materni21 testing.

Materni21 is another test that your OB might offer which does not have risks to the pregnancy. Based on your age it would be available to you in lieu of a quad or integrated screen. Cost/insurance coverage might potentially be an issue. I do not know if all OBs offer it routinely. It is not 100% accurate but it is close. If abnormal an amnio would probably be offered at that time.

Declining all of these tests is perfectly reasonable too of course.

BackseatDriver · August 2013

As for the needle it is long but they don't stick it all the way in. It is actually a very thin needle which is what matters. It looks scarier than it is!

wiggyslilsis · August 2013

No advice on the AMA and amino other than what backseat said but I wanted to say I hope you get your ice cream soon! I think I will have some tonight as well

ream02 · August 2013

Thanks ladies! I think when I go for my first apt I'll talk to my Dr about her recommendations on testing. I'll have to read up on the ones you mentioned @backseatdriver They didn't offer me the amnio with DS but maybe since I'm a couple years older this pregnancy it will be different.

@wiggyslilsis totally taking a break from work and going for that ice cream. I can't wait anymore. lol

ILoveRedVino · August 2013

I had one but I was high risk.

The needle was big, but honestly, it didn't hurt at all. The whole thing took just a few minutes and it was scary, but definitely not painful at all.

My perinatalogost said that the risk of an amnio causing a miscarriage was 1:300. That risk was higher if the baby did have a genetic problem. We were at a point where ultrasound had already basically proven that there was a problem and we just wanted the amnio to figure out exactly what it was.

Are you doing second-trimester testing/NT scan? I did the amnio because numbers in that test came back odd. I'd start with that, and if everything looks fine, skip the amnio. If you're high risk for something, then consider it an option.

ream02 · August 2013

Thanks @ILoveRedVino Appreciate your response!

spin25 · August 2013

BackseatDriver said:

Generally an amino is offered at 35 or 32 if you are having twins. There are some risks associated with amnios but the most serious risks are half a percent at most. A quad screen or integrated screen might better help clarify your risk if you are considering an amino, but aren't sure. You might find your risk go up, it might be low, or it might go down but still be considered an elevated risk. If you know that you will not be reassured by getting a very low risk based on screening then IMO you should just skip it and have the amino or look into Materni21 testing. Materni21 is another test that your OB might offer which does not have risks to the pregnancy. Based on your age it would be available to you in lieu of a quad or integrated screen. Cost/insurance coverage might potentially be an issue. I do not know if all OBs offer it routinely. It is not 100% accurate but it is close. If abnormal an amnio would probably be offered at that time. Declining all of these tests is perfectly reasonable too of course.

I will be 34 when the twins arrive, and the genetics counselor I spoke with after the NT scan and accompanying bloodwork made no indication of an increased risk of genetic problem due to having twins. I don't really understand why there would be a greater likelihood of a problem with twins vs a singleton. Obviously there are other risks associated with multiple pregnancy, but no one has mentioned genetic problems. Can you explain why?

ETA: Sorry to hijack the post, ream.

PinkinProvence · August 2013

spin25 said:

BackseatDriver said:

Generally an amino is offered at 35 or 32 if you are having twins. There are some risks associated with amnios but the most serious risks are half a percent at most. A quad screen or integrated screen might better help clarify your risk if you are considering an amino, but aren't sure. You might find your risk go up, it might be low, or it might go down but still be considered an elevated risk. If you know that you will not be reassured by getting a very low risk based on screening then IMO you should just skip it and have the amino or look into Materni21 testing. Materni21 is another test that your OB might offer which does not have risks to the pregnancy. Based on your age it would be available to you in lieu of a quad or integrated screen. Cost/insurance coverage might potentially be an issue. I do not know if all OBs offer it routinely. It is not 100% accurate but it is close. If abnormal an amnio would probably be offered at that time. Declining all of these tests is perfectly reasonable too of course.
I will be 34 when the twins arrive, and the genetics counselor I spoke with after the NT scan and accompanying bloodwork made no indication of an increased risk of genetic problem due to having twins. I don't really understand why there would be a greater likelihood of a problem with twins vs a singleton. Obviously there are other risks associated with multiple pregnancy, but no one has mentioned genetic problems. Can you explain why?

ETA: Sorry to hijack the post, ream.

I am 32 with twins and no one ever mentioned the word "amnio" to me.

There are lots of tests that I think I would consider first before amnio, like the Materniti21, etc. I am not sure of all the names because I didn't have any, but I would just speak to my doctor and see what is out there that can be used before amnio to rule out certain disorders. Hopefully, those can eliminate the need to ever have an amnio.

BackseatDriver · August 2013

The overall risk of a chromosome issue is increased with multiples only because each baby has a chance of having a chromosome problem. The more babies you have the more chances for a problem. Does that make sense? The individual risk for each baby of a twin pregnancy is not higher than the risk for a pregnancy with a single baby.

There is nothing magical that happens at 35. At that point the risk of a chromosome problem is about the same as the risk of an amino so that was considered advanced maternal age an an amnio was offered or screening may be done first. For women with multiples the risk of a chromosome problem is a little earlier for the reason I described above. This a younger woman may be considered advanced maternal age.

I'm sure different offices handle it differently- some might offer or discuss an amnio, some might encourage screening tests first, and others might encourage testing like materniT21. Definitely a good idea to discuss with your doctor or health care provider!

spin25 · August 2013

BackseatDriver said:

The overall risk of a chromosome issue is increased with multiples only because each baby has a chance of having a chromosome problem. The more babies you have the more chances for a problem. Does that make sense? The individual risk for each baby of a twin pregnancy is not higher than the risk for a pregnancy with a single baby.

Thank you, that makes perfect sense.

rebaann · August 2013

I was 43 and had an IVF baby and all kinds of other high risk things and no one suggested that I might need/want an amnio, Since our NT scan was awesome and they didn't see anything there that warranted a better look, there was no need for one.

BackseatDriver · August 2013

rebaann said:
I was 43 and had an IVF baby and all kinds of other high risk things and no one suggested that I might need/want an amnio, Since our NT scan was awesome and they didn't see anything there that warranted a better look, there was no need for one.

The risk is calculated based on the age of the egg donor, if you used one.

rebaann · August 2013

BackseatDriver said:

I was 43 and had an IVF baby and all kinds of other high risk things and no one suggested that I might need/want an amnio, Since our NT scan was awesome and they didn't see anything there that warranted a better look, there was no need for one.
The risk is calculated based on the age of the egg donor, if you used one.

I know, but I had other things that made me high risk.

BackseatDriver · August 2013

rebaann said:

BackseatDriver said:

rebaann said:
I was 43 and had an IVF baby and all kinds of other high risk things and no one suggested that I might need/want an amnio, Since our NT scan was awesome and they didn't see anything there that warranted a better look, there was no need for one.
The risk is calculated based on the age of the egg donor, if you used one.

I know, but I had other things that made me high risk.

Oh gotcha.

ream02 · August 2013

spin25 No worries, I'm an equal opportunity poster.. I believe are all here to help and support each other. >-

@rebaann So happy that you had your little bundle. I always prayed you'd be blessed with a little one back before I went MIA. Also checked out your blog and love the pics of the little cutie! ;;)

uk2usa · August 2013

I was 36 when I had M. I didn't have an amino. We chose to do the NT screen with the quad screen blood work. There was no pressure for amino over the other tests because if my age. I did have to do the 1hr glucose test twice though in first and second tri - that was because of my age. I failed the second 1hr and had to do the 3hr where I failed one of the draws. Then they made me follow the GD diet even though I didn't have GD.

ream02 · August 2013

I was also 36 with DS and they didn't even ask me if I wanted to do the NT, that I recall. But I had pregnant brain so maybe I just declined. I think I'll go with that and only do something more extensive should it show something.

My SIL was 38 when she was pg with her first and only and she had the NT which showed potential downs and she had to do genetic counseling and an amnio. She spent nearly a month being freaked out because they took so long for the extra testing and results. Thankfully my insurance is pretty quick at everything and they have their lab in the same building as everything else.

thanks ladies! Appreciate all of your responses.

AMA and amnio.. thoughts anyone

Re: AMA and amnio.. thoughts anyone

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