Friday, March 2, 2012

AFP Question

I need a little input- I will be putting this out on facebook so I can get responses as well, but this is a topic I have no personal experience with.

Between 15-20 weeks there is a blood test that pregnant women can do that tests for the risk of trisomy 18, trisomy 21, and open neural tube defects. It is known as the "AFP test" or "downs syndrome test" and sometimes referred to as "triple screen" or "quad screen."

I have never had this test done in either of my pregnancies. This is a very personal decision and I don't think it is right or wrong. I just feel that I didn't need to have the test done.

But that is not what I am talking about, is it right or wrong. I am wondering how much do you think about the test? For those mothers who had the test done in pregnancy, did it weigh on your mind? Did your provider call and tell you the negative or positive results? Or just wait until the next visit.

In my office we only call if the levels are abnormal. We don't call to tell people their results were normal. We wait until their next visit to let them know. This is usually 4 weeks after the blood test was drawn. We get the results in the office within 2-3 days, but our patients wait 4 weeks for the answer. Is this okay? I don't really have time to call all the normal labs because of the amount of patients I have, but I could figure out a way.

It is okay that no news is good news? Or do you feel you need to know? Did you sit and wonder what the results were? Or did you not think about it again until the next visit?

I honestly don't know because I never had the test done. Please let me know your input so that I can better serve my patients.


Anonymous said...

7 pregnancies, never wanted or took this test. As far as notification, could there be a form letter normal results paper sent out to those who get them when their results come back?

K said...

10 pregnancies, did it twice for 7 and 8 won't do it again. The anxiety isn't worth it. Each of those babies had one soft marker for t21. One also had a positive screen. I declined the amnio. Both are chromsomally normal children. I will not terminate for any reason, I have an anatomical scan at 20 weeks, my hospital has a level III NICU. A quad screen just doesn't make sense for me.
My MFM at that time had a policy of calling himself for abnormal results.and waiting for appt on normal but I knew it. Such a policy is.fine as.long as the patient knows what it is.

Anonymous said...

I've had 9 opportunities for testing. I have declined in the past, but have taken it for the majority of my pregnancies. The first 5 tests all were fine and I thought nothing of it in the wait until the next appointment. In the next two pregnancies, I had abnormal results, testing positive for trisomy 18 in one and trisomy 21 in another. It was very stressful in the pregnancy that tested positive for T-18. I was very scared. We did get some follow up sonograms, but I knew it might not show markers. I couldn't relax until the baby was born and in my arms. My husband still doubted she was okay until the pediatrician came by to check her. For some reason, our doctor was not called and we had to wait 24 hours after birth before he looked her over. She was fine and still is. My next baby didn't have T-21 either. For some reason, I have shifted and now test positive despite babies being unaffected. We chose not to test this time around. But, of course, the sonogram at 19 weeks showed cysts in the brain, so we again have a chance for T-18. Ahhh, the stress! But, I am much more relaxed. I will take what comes as it comes. I think age really plays a lot into whether a woman tests positive falsely or not. It would be nice not to know at all, but at the same time, knowing for sure something is different can prepare a woman.

LauraT said...

Never did the test with any of my 6 pregnancies. Too many false positives and wouldn't have done anything anyway. Perhaps ask the patient to self address an envelope and place it in her chart. When the results come back normal, it is super easy to make a couple of check marks on a standard form, hand it off to the secretary who can slap a stamp on it and out the door it goes. The patient is informed, relieved, and this took you almost no time at all. Or, perhaps the patient might prefer e-mail contact instead. This would be no cost to you at all. My husband's medical office sends all the results of his lab work to our house by mail on a standardized form whether the results were normal or not. I love that! With a test like the AFP, which is nerve wracking, I think patients should be informed one way or the other.