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Madam Now my wife is pregnant of 12 week 5

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Posted on Sun, 3 Feb 2019
Question: Madam
Now my wife is pregnant of 12 week 5 days.
Today first trimester scan is done & reports are attached.
The noteworthy point as told by doctor is
1) Single Umbilical artery.
2) Hypoplastic nasal bone.
He told that finding may be associated with chromosomal abonormalities or could be normal & requires further investigation.
Option of first trimester combined screening;NIPS; CVS/ aminocentesis ; TIFFA scan.Risk of downs syndrome.
He said there is two vein near head instead of three.
Double marker report is positive. NIPT Test done on 03.12.18
I am very worried, wife is in very tension
Please advise further course of action/ 2nd advise
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Follow up: Dr. Chetna Jain (0 minute later)
Madam
Now my wife is pregnant of 12 week 5 days.
Today first trimester scan is done & reports are attached.
The noteworthy point as told by doctor is
1) Single Umbilical artery.
2) Hypoplastic nasal bone.
He told that finding may be associated with chromosomal abonormalities or could be normal & requires further investigation.
Option of first trimester combined screening;NIPS; CVS/ aminocentesis ; TIFFA scan.Risk of downs syndrome.
He said there is two vein near head instead of three.
Double marker report is positive. NIPT Test done on 03.12.18
I am very worried, wife is in very tension
Please advise further course of action/ 2nd advise
doctor
Answered by Dr. Chetna Jain (13 hours later)
Brief Answer:
You are following a correct path.

Detailed Answer:
Since you have already given Nipt, let's wait for the result. If the report says with surity that there is a chromosomal abnormality which makes the child incapable of leading a normal life then a termination of pregnancy is recommended. If the report comes normal it's better to do amniocentesis which is 100 percent confirmatory. After that u need an early second trimester anomaly scan at 18 weeks and a fetal cardiac evaluation at 22 weeks. After this we can feel settled. As of now you stand a very high risk of abnormality in the baby. Good wishes.
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Chetna Jain (0 minute later)
Brief Answer:
You are following a correct path.

Detailed Answer:
Since you have already given Nipt, let's wait for the result. If the report says with surity that there is a chromosomal abnormality which makes the child incapable of leading a normal life then a termination of pregnancy is recommended. If the report comes normal it's better to do amniocentesis which is 100 percent confirmatory. After that u need an early second trimester anomaly scan at 18 weeks and a fetal cardiac evaluation at 22 weeks. After this we can feel settled. As of now you stand a very high risk of abnormality in the baby. Good wishes.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Chetna Jain (17 minutes later)
Madam
But how risk is high ?
1) single umblical artery is common
2) nasal bone is seen not absent in 12 week 2 day.
3) The hcg level is 43.17
4) The PAPPA is 922
5) age of mother is less than 35 yrs.
So I feel there is chance.that foetus is normal be because I am very nervous
Nest question how many cases are there who have positive double marker + ve but nipt is negative ( data base)
Can d& c may be done in 20 weeks.
Please give me real figure so that I become ready for loosing my baby
For next issue I want to find out root cause of chromosomal abnormalities so that next issue is healthy.
Double marker reports attached.

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Follow up: Dr. Chetna Jain (0 minute later)
Madam
But how risk is high ?
1) single umblical artery is common
2) nasal bone is seen not absent in 12 week 2 day.
3) The hcg level is 43.17
4) The PAPPA is 922
5) age of mother is less than 35 yrs.
So I feel there is chance.that foetus is normal be because I am very nervous
Nest question how many cases are there who have positive double marker + ve but nipt is negative ( data base)
Can d& c may be done in 20 weeks.
Please give me real figure so that I become ready for loosing my baby
For next issue I want to find out root cause of chromosomal abnormalities so that next issue is healthy.
Double marker reports attached.

doctor
Answered by Dr. Chetna Jain (3 days later)
Brief Answer:
This double marker has given you a 4 percent risk.

Detailed Answer:
hello. I can fully understand the anxiety. Double marker has a false positive . We must wait for nipt report. As mentioned by you single umbilical artery , hypoplastic nasal bone and screen positive double markers are common phenomenon. But when multiple markers are seen in one fetus the chances become higher. Now this problem is not correctible hence if trisomy 21 is confirmed pregnancy termination is recommended. The recurrence of such a condition is negligible. There is no natural technique to prevent it.A preimplantation genetic diagnosisl can be done in an ivf setting.

In practice we don't see a repeat downs. As of now please keep the hope that the nipt will come normal.

In XXXXXXX the law permits termination of pregnancy till 20 weeks. At gestation larger than 14 weeks dilatation and evacuation is not a good option. It is generally delivered vaginally. However the treating Dr will make the correct decision.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Chetna Jain (0 minute later)
Brief Answer:
This double marker has given you a 4 percent risk.

Detailed Answer:
hello. I can fully understand the anxiety. Double marker has a false positive . We must wait for nipt report. As mentioned by you single umbilical artery , hypoplastic nasal bone and screen positive double markers are common phenomenon. But when multiple markers are seen in one fetus the chances become higher. Now this problem is not correctible hence if trisomy 21 is confirmed pregnancy termination is recommended. The recurrence of such a condition is negligible. There is no natural technique to prevent it.A preimplantation genetic diagnosisl can be done in an ivf setting.

In practice we don't see a repeat downs. As of now please keep the hope that the nipt will come normal.

In XXXXXXX the law permits termination of pregnancy till 20 weeks. At gestation larger than 14 weeks dilatation and evacuation is not a good option. It is generally delivered vaginally. However the treating Dr will make the correct decision.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Chetna Jain (1 hour later)
Ok
We are waiting for nipt result & further action plan will be decided.
Can we should consult endocrinologist/ chromosomal specialist for detecting root cause of abnormalities in fetus.
So that next issue is healthy one. actually wife age is 33 yrs & my age is 36 .
Should I repeat NT scan in another multispeciality hospital as there may be chance of wrong result.
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Follow up: Dr. Chetna Jain (0 minute later)
Ok
We are waiting for nipt result & further action plan will be decided.
Can we should consult endocrinologist/ chromosomal specialist for detecting root cause of abnormalities in fetus.
So that next issue is healthy one. actually wife age is 33 yrs & my age is 36 .
Should I repeat NT scan in another multispeciality hospital as there may be chance of wrong result.
doctor
Answered by Dr. Chetna Jain (3 days later)
Brief Answer:
Waiting is the only option

Detailed Answer:
we can't measure NT now as that window is till 13 weeks. We must wait for NIPT report. If the report comes normal then there is no need to see a clinical genetics. Hope it helps. Regards
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
doctor
Answered by Dr. Chetna Jain (0 minute later)
Brief Answer:
Waiting is the only option

Detailed Answer:
we can't measure NT now as that window is till 13 weeks. We must wait for NIPT report. If the report comes normal then there is no need to see a clinical genetics. Hope it helps. Regards
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Chetna Jain (10 hours later)
What is procedure of termination of gestation at 14 week- 15 week
Is d& c / I& d should be done.If d& c/ I& d is Done .
How many days to remain in hospital.
I
Is there is any risk to mother.
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Follow up: Dr. Chetna Jain (0 minute later)
What is procedure of termination of gestation at 14 week- 15 week
Is d& c / I& d should be done.If d& c/ I& d is Done .
How many days to remain in hospital.
I
Is there is any risk to mother.
doctor
Answered by Dr. Chetna Jain (3 hours later)
Brief Answer:
Did you get nipt result

Detailed Answer:
Did you get nipt report.
Since you have asked I will answer. You Did not mention if previous delivery was normal or caesarean
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Chetna Jain (0 minute later)
Brief Answer:
Did you get nipt result

Detailed Answer:
Did you get nipt report.
Since you have asked I will answer. You Did not mention if previous delivery was normal or caesarean
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Chetna Jain (18 hours later)
Madam
Today we got report of NIPT but Tests not provide a result.
Pathologist suggest to carry out retest.
We consulted doctor & he suggested that there is high chance of chromosomal abnormalities & if we will wait for results of re test of NIPT, gestation period will increase & may require surgery for termination of gestation.
So it is advisable to terminate the gestation.however at this stage D&E is not possible so delivery through vaginal to be done & require 2-3 days.
I have small son & my wife is afraid of pain .
Please advise & tell about procedure of vaginal withdraw.is there any risk to mother.
We are in anxious state & wife is thinking that she will not get normal child.
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Follow up: Dr. Chetna Jain (0 minute later)
Madam
Today we got report of NIPT but Tests not provide a result.
Pathologist suggest to carry out retest.
We consulted doctor & he suggested that there is high chance of chromosomal abnormalities & if we will wait for results of re test of NIPT, gestation period will increase & may require surgery for termination of gestation.
So it is advisable to terminate the gestation.however at this stage D&E is not possible so delivery through vaginal to be done & require 2-3 days.
I have small son & my wife is afraid of pain .
Please advise & tell about procedure of vaginal withdraw.is there any risk to mother.
We are in anxious state & wife is thinking that she will not get normal child.
doctor
Answered by Dr. Chetna Jain (3 days later)
Brief Answer:
Please wait for some time

Detailed Answer:
A positive double marker is common. Most of these babies are normal. Since inadequate fetal fraction was found nipt has probably failed.
You may undergo amniocentesis and FISH and get the result in 3 to 4 days and then decide. Painless vaginal delivery is possible under epidural analgesia.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Chetna Jain (0 minute later)
Brief Answer:
Please wait for some time

Detailed Answer:
A positive double marker is common. Most of these babies are normal. Since inadequate fetal fraction was found nipt has probably failed.
You may undergo amniocentesis and FISH and get the result in 3 to 4 days and then decide. Painless vaginal delivery is possible under epidural analgesia.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Chetna Jain (3 hours later)
Madam
It is late & today we have terminated gestation as doctor advised that repeat nipt result/ Aminocentesis will take further 10 days & then it will be operated surgically to terminate the foetus if found abnormal.so seeing the situation I decided for termination .
But one question is in my mind that is there any method to see abnomalites before first trimester so that termination of foetus can be done.
I also want to meet you in your clinic if possible . Address may please be provided.
We are thinking whether we would be able to get healthy child or not.
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Follow up: Dr. Chetna Jain (0 minute later)
Madam
It is late & today we have terminated gestation as doctor advised that repeat nipt result/ Aminocentesis will take further 10 days & then it will be operated surgically to terminate the foetus if found abnormal.so seeing the situation I decided for termination .
But one question is in my mind that is there any method to see abnomalites before first trimester so that termination of foetus can be done.
I also want to meet you in your clinic if possible . Address may please be provided.
We are thinking whether we would be able to get healthy child or not.
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Follow up: Dr. Chetna Jain (2 minutes later)
NIPT result enclosed in attachment.
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Follow up: Dr. Chetna Jain (0 minute later)
NIPT result enclosed in attachment.
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Follow up: Dr. Chetna Jain (11 days later)
Madam
It is late & today we have terminated gestation as doctor advised that repeat nipt result/ Aminocentesis will take further 10 days & then it will be operated surgically to terminate the foetus if found abnormal.so seeing the situation I decided for termination .
But one question is in my mind that is there any method to see abnomalites before first trimester so that termination of foetus can be done.
I also want to meet you in your clinic if possible . Address may please be provided.
We are thinking whether we would be able to get healthy child or not.
NIPT report attached.
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Follow up: Dr. Chetna Jain (0 minute later)
Madam
It is late & today we have terminated gestation as doctor advised that repeat nipt result/ Aminocentesis will take further 10 days & then it will be operated surgically to terminate the foetus if found abnormal.so seeing the situation I decided for termination .
But one question is in my mind that is there any method to see abnomalites before first trimester so that termination of foetus can be done.
I also want to meet you in your clinic if possible . Address may please be provided.
We are thinking whether we would be able to get healthy child or not.
NIPT report attached.
doctor
Answered by Dr. Chetna Jain (3 days later)
Brief Answer:
The nipt report was inconclusive

Detailed Answer:
I am sorry to hear about termination. Downs syndrome does not repeat. By 12 weeks a lot can be looked at on ultrasound however not all anomalies can be ruled out before birth. Some appear after several days and months after birth.
You can safely plan another pregnancy. Methods to rule out chromosomal abnormality before 12 weeks is nipt and cvs. They are recommended when indicated.
Please ask healthcaremagic people if they can give u my address.
Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. Chetna Jain (0 minute later)
Brief Answer:
The nipt report was inconclusive

Detailed Answer:
I am sorry to hear about termination. Downs syndrome does not repeat. By 12 weeks a lot can be looked at on ultrasound however not all anomalies can be ruled out before birth. Some appear after several days and months after birth.
You can safely plan another pregnancy. Methods to rule out chromosomal abnormality before 12 weeks is nipt and cvs. They are recommended when indicated.
Please ask healthcaremagic people if they can give u my address.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Chetna Jain (19 minutes later)
Madam
Thank you for query reply.
Actually NIPT does not shown any result due to overweight & low haemoglobin.
But I feel that Aminocentesis should be carried out for confirmatory test.
Can termination of gestation be carried out between 15 week- 20 week ??
My doctor told me that that beyond 15 week ; surgical intervention would be required for termination of gestation.
Please comment.only opinion will not be quoted.
This is the reason why I couldn't out carried out Aminocentesis .
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Follow up: Dr. Chetna Jain (0 minute later)
Madam
Thank you for query reply.
Actually NIPT does not shown any result due to overweight & low haemoglobin.
But I feel that Aminocentesis should be carried out for confirmatory test.
Can termination of gestation be carried out between 15 week- 20 week ??
My doctor told me that that beyond 15 week ; surgical intervention would be required for termination of gestation.
Please comment.only opinion will not be quoted.
This is the reason why I couldn't out carried out Aminocentesis .
doctor
Answered by Dr. Chetna Jain (2 days later)
Brief Answer:
Termination of pregnancy

Detailed Answer:
If proven life threatening disability, termination is allowed in XXXXXXX till 20 weeks with consent of two doctors from the speciality.
different Drs can have their own preferences on how they terminate. The most common method once the decision is finalised is to induce labour and do normal delivery.
It's important to have a confirmatory test before such decisions are taken
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Chetna Jain (0 minute later)
Brief Answer:
Termination of pregnancy

Detailed Answer:
If proven life threatening disability, termination is allowed in XXXXXXX till 20 weeks with consent of two doctors from the speciality.
different Drs can have their own preferences on how they terminate. The most common method once the decision is finalised is to induce labour and do normal delivery.
It's important to have a confirmatory test before such decisions are taken
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Chetna Jain (34 hours later)
1)when we can plan for next child ?
2) Is there any chromosomal test to be done of me & wife so that further problem of Trisomy 21 do not occur ?
3) I think wife age is 34 yrs & me 36 yrs so we should plan for next issue without any delay.
4) Can we start folic acid for wife or another medicine prior to conceive ?
5 ) Is there requirement to meet Geneticist for taking opinion ??





0
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Follow up: Dr. Chetna Jain (0 minute later)
1)when we can plan for next child ?
2) Is there any chromosomal test to be done of me & wife so that further problem of Trisomy 21 do not occur ?
3) I think wife age is 34 yrs & me 36 yrs so we should plan for next issue without any delay.
4) Can we start folic acid for wife or another medicine prior to conceive ?
5 ) Is there requirement to meet Geneticist for taking opinion ??





0
doctor
Answered by Dr. Chetna Jain (2 days later)
Brief Answer:
Your wife does not fall into a category which needs testing

Detailed Answer:
You can plan a next pregnancy as soon as she is emotionally ready. Plan after 1 or 2 periods. Start folic acid now. it's not essential to consult a generics specialist.
The chances of healthy pregnancy are high.
Please do a blood test AMH for her.
It's ok to do chromosomal analysis for both of you.
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
doctor
Answered by Dr. Chetna Jain (0 minute later)
Brief Answer:
Your wife does not fall into a category which needs testing

Detailed Answer:
You can plan a next pregnancy as soon as she is emotionally ready. Plan after 1 or 2 periods. Start folic acid now. it's not essential to consult a generics specialist.
The chances of healthy pregnancy are high.
Please do a blood test AMH for her.
It's ok to do chromosomal analysis for both of you.
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Chetna Jain (10 hours later)
Madam
Thank you for guidance.I am feeling relaxed as you said that chance of healthy pregnancy are high.
What are chromosomal test for parents & how it is done.
Can Chromosomal tests be done in any lab but my recent Gyanocologist do not recommended any test & advised to may plan for next pregnancy after 3 month.But definitely I will discuss with my doctor to go for chromosomal test for parents.
Do you know any doctor in XXXXXXX who can be reffered for testing & have mental peace.
My wife is taking metacard 50 mg as suffering from BP; can these medicine also causes abnormalities in foetus.
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Follow up: Dr. Chetna Jain (0 minute later)
Madam
Thank you for guidance.I am feeling relaxed as you said that chance of healthy pregnancy are high.
What are chromosomal test for parents & how it is done.
Can Chromosomal tests be done in any lab but my recent Gyanocologist do not recommended any test & advised to may plan for next pregnancy after 3 month.But definitely I will discuss with my doctor to go for chromosomal test for parents.
Do you know any doctor in XXXXXXX who can be reffered for testing & have mental peace.
My wife is taking metacard 50 mg as suffering from BP; can these medicine also causes abnormalities in foetus.
doctor
Answered by Dr. Chetna Jain (3 days later)
Brief Answer:
Chromosomal analysis is not indicated in your case

Detailed Answer:
Sorry for the delay in my answering!

If this analysis gives you peace of mind it can easily be done by blood. You may do it with any good lab.

You may plan safely whenever you are ready...

Metacard needs to be changed to Labetalol once she is pregnant. However, the treating Doctor can decide better.

Best wishes


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
doctor
Answered by Dr. Chetna Jain (0 minute later)
Brief Answer:
Chromosomal analysis is not indicated in your case

Detailed Answer:
Sorry for the delay in my answering!

If this analysis gives you peace of mind it can easily be done by blood. You may do it with any good lab.

You may plan safely whenever you are ready...

Metacard needs to be changed to Labetalol once she is pregnant. However, the treating Doctor can decide better.

Best wishes


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Chetna Jain (21 minutes later)
Thank you madam.I really thank you for advice.
I want to ask that Is chromosomal test is necessary for me & my wife ; then only I should go for test.The best judge is you who can decide.Last 1 year we are only going to different doctor & certainly our life become very tense.
So suggest whether such test is necessary for us or not
If not necessarily then why ??
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Follow up: Dr. Chetna Jain (0 minute later)
Thank you madam.I really thank you for advice.
I want to ask that Is chromosomal test is necessary for me & my wife ; then only I should go for test.The best judge is you who can decide.Last 1 year we are only going to different doctor & certainly our life become very tense.
So suggest whether such test is necessary for us or not
If not necessarily then why ??
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Madam Now my wife is pregnant of 12 week 5

Madam Now my wife is pregnant of 12 week 5 days. Today first trimester scan is done & reports are attached. The noteworthy point as told by doctor is 1) Single Umbilical artery. 2) Hypoplastic nasal bone. He told that finding may be associated with chromosomal abonormalities or could be normal & requires further investigation. Option of first trimester combined screening;NIPS; CVS/ aminocentesis ; TIFFA scan.Risk of downs syndrome. He said there is two vein near head instead of three. Double marker report is positive. NIPT Test done on 03.12.18 I am very worried, wife is in very tension Please advise further course of action/ 2nd advise