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What Do These Following NT Scan And Double Marker Test Reports Indicate?

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Posted on Fri, 10 Jul 2015
Question: Respected Dr. ,
As per attached report of my NT Scan & Double Marker Test, kindly clarify me the following points-

1} Blood Test Report Shows Screen Positive Cut off With Trisomy 21 (Down) 1:250 and Trisomy 18/13 1:100. Does this indicate my baby has a risk of Down Syndrome?

2}My HCG, Free Beta is high @ 82.10, whereas PAPP-A is only 1.42, IS PAPP-A Levels & Beta HCG normal as in 11th Week Pregnancy when the test was done?

3} Nasal Bone is unknown as per ultrasound result of 11th Week Pregnancy- is it normal at this time? If Nasal Bone is not visible even on 20th Week Scan do i have to take Calcium Supplements? Or should i start intake of Calcium Supplements from now onwards only? If yes, which tablet should I take for Calcium, My Dr. has said me not to worry about Nasal Bone when all other things are correct, Is it true?

4} I understand my Nuchal Thickness (NT) is 1.38mm which is very much in normal range,
Is there anything to be concerned for me or everything is normal as of now.

Reports are attached herewith for your reference. Mine is IUI ( First Attempt Successful) Pregnancy
doctor
Answered by Dr. Aarti Abraham (17 minutes later)
Brief Answer:
All reports are normal, dont worry please.

Detailed Answer:
Hello
Thanks for writing to us with your health concern.
Congratulations on your pregnancy first of all !
LEt me clarify your doubts.
1. Your double marker report is normal. The screen positive means that if the risk is more than that ratio, only then there is a risk of Down Syndrome in your child.
Your risk cut off is lower than screen positive cut off . It is pretty complicated for a lay person to understand, but in essence your report is normal , and there is no risk for your child to have Downs Syndrome. Please relax.
2. Yes, the values are appropriate for the 11th week of pregnancy. Free BHCG is normally supposed to be high, and PAPP-A is supposed to be low. That is normal. Your values are perfectly normal.
3. See, the nasal bone should be seen between 11 - 14 weeks. You are borderline, so right now it is normal sometimes for the nasal bone not to be visible. Moreover, your blood tests are normal, so there is no risk for Downs Syndrome. If the nasal bone is not visible in the next scan ( I would advise a scan around 14 - 16 weeks again to see the nasal bone ), then further blood tests ( Triple Marker ) can be done. I am sure it will be visible after 4 weeks, Please get a scan repeated at that time.
Calcium supplements have no corelation with nasal bone.
In your history, you have already mentioned that you are taking Calonat - D3, I think those are calcium and vitamin D supplements.
So you are already taking them, right ?
It is a proper tablet, and should be started from the 12th week onwards, but if you are already taking it, no issues, please continue taking it.
4. The NT is perfectly within normal range.
All over, there is nothing to worry in your reports.
Risk of any chromosomal disorder is absent.
Please repeat the scan after 4 weeks for the Nasal bone.
All the best.
Please feel free to discuss further.
My direct link is -
http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623
You can reach me directly by clicking on that link and asking a direct query.
Wish you luck for your pregnancy, and a wonderful journey of motherhood !
Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (28 minutes later)
Thanks a lot Dr XXXXXXX for your such a explanatory reply by which I am really convinced. I have started taking this calcium supplements from 12th week onwards only.
My Dr. has replaced Folvite to Fol XT from 12th Week, can u please state the reason for the same? Whats the difference between Folvite and Fol XT.

I am also taking Thyrox 100 for my high TSH Level ( 5.5) in recent test couple of weeks ago. Should I do once a month test for TSH during pregnancy for TSH monitoring?

Also please advised whether i can take the following medicines on SOS basis as when very much needed- 1. Calpol 650 2. Doxinate 3. ENO XXXXXXX

Your kind reply made me much relaxed Dr. XXXXXXX .
doctor
Answered by Dr. Aarti Abraham (2 hours later)
Brief Answer:
As below.

Detailed Answer:
Thank you so much for your appreciation.
Continue the calcium supplements that you are taking.
Regarding Folvite and Fol XT, Fol XT contains the biologically active form of folic acid, which is easier to absorb and acts better.
It is a better composition compared to Folvite, which is plain Folic acid.
Fol XT also contains a few Vitamin B complex components, which are essential to fetal growth and development.
TSH levels should be monitored every 4 - 6 weeks throughout pregnancy, in order to decide dosage levels and see the response to Thyrox.
Calpol 650 can be taken SOS for fever, body ache, headache, etc
Doxinate can be taken when you feel nausea and vomiting XXXXXXX A better tablet is Sinate - OD, try it, if you have nausea.
ENO XXXXXXX can be taken anytime that you wish.
You can always contact me for any doubts that you might have.
I have given you the direct link to my profile, where the question can be posted directly to me, instead of going to the general pool.
I wish you a safe and wonderful journey of pregnancy again !
Take care of yourself.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (18 hours later)
Dr. XXXXXXX

Thanks a lot for giving me your direct link from next time onwards I would post all my queries there only.
Dr. Can you please put some light on the role of Duphaston medicine during pregnancy. Can it be take safely till 16th-20th week of pregnancy?

Also can u suggest some medicines for Stretch Mark post pregnancy, i have heard it should be started by first trimester of pregnancy only.

Thanks & awaiting your reply
doctor
Answered by Dr. Aarti Abraham (1 hour later)
Brief Answer:
As below.

Detailed Answer:
Hello again.
Yours is an IUI pregnancy, so it is very important to have good progesterone support to the baby all throughout pregnancy, to avoid risk of miscarriage or any adverse event.
So progesterone supplementation is essential.
Duphaston contains progesterone, so it is vital for the development of the baby.
Yes, it can safely be taken until the second trimester, or even the third trimester.
Better formulation is of natural micronized progesterone, such as Susten, Naturogest etc.
Please discuss with your doctor, as these are considered better than Duphaston.
Stretch marks occur more often in women who take inadequate protein during pregnancy.
Optimum protein intake is a must.
INcrease your intake of egg, fish, chicken, tofu, paneer, beans, nuts, pulses, dal etc.
Apply virgin coconut oil on your tummy and body.
Also, Palmer's Coconut Butter is an excellent preparation.
There are various expensive formulations that claim in the market to be preventive against stretch marks, however, the fact is, some women are genetically more prone to stretch marks.
IT is best to moisturize well with the products I told you , and to have good intake of Protein and Vitamin C ( you can take oranges, kiwi, strawberry, amla ), that will prevent against stretch marks.
Looking forward to hearing from you.
Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (19 minutes later)
Dr,
Thanks a lot for your reply. At present me taking Duphaston 10 mg twice daily, for better formulation you suggested Susten, so is Susten 200 mg twice daily enough to compensate duphaston 10 mg twice daily?
doctor
Answered by Dr. Aarti Abraham (39 minutes later)
Brief Answer:
Yes, you are right.

Detailed Answer:
Yes, Susten 200 vaginally twice a day is equivalent to the dosage of Duphaston you are taken.
You can use Susten / Crinone gel also.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 6004 Questions

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What Do These Following NT Scan And Double Marker Test Reports Indicate?

Brief Answer: All reports are normal, dont worry please. Detailed Answer: Hello Thanks for writing to us with your health concern. Congratulations on your pregnancy first of all ! LEt me clarify your doubts. 1. Your double marker report is normal. The screen positive means that if the risk is more than that ratio, only then there is a risk of Down Syndrome in your child. Your risk cut off is lower than screen positive cut off . It is pretty complicated for a lay person to understand, but in essence your report is normal , and there is no risk for your child to have Downs Syndrome. Please relax. 2. Yes, the values are appropriate for the 11th week of pregnancy. Free BHCG is normally supposed to be high, and PAPP-A is supposed to be low. That is normal. Your values are perfectly normal. 3. See, the nasal bone should be seen between 11 - 14 weeks. You are borderline, so right now it is normal sometimes for the nasal bone not to be visible. Moreover, your blood tests are normal, so there is no risk for Downs Syndrome. If the nasal bone is not visible in the next scan ( I would advise a scan around 14 - 16 weeks again to see the nasal bone ), then further blood tests ( Triple Marker ) can be done. I am sure it will be visible after 4 weeks, Please get a scan repeated at that time. Calcium supplements have no corelation with nasal bone. In your history, you have already mentioned that you are taking Calonat - D3, I think those are calcium and vitamin D supplements. So you are already taking them, right ? It is a proper tablet, and should be started from the 12th week onwards, but if you are already taking it, no issues, please continue taking it. 4. The NT is perfectly within normal range. All over, there is nothing to worry in your reports. Risk of any chromosomal disorder is absent. Please repeat the scan after 4 weeks for the Nasal bone. All the best. Please feel free to discuss further. My direct link is - http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623 You can reach me directly by clicking on that link and asking a direct query. Wish you luck for your pregnancy, and a wonderful journey of motherhood ! Take care.