Cambridge Fetal Care

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Frequently Asked Questions

Do I need to be referred by my GP or midwife?

We do not require a referral for our ‘screening’ scans (for example nuchal scans, dating scans, 20 week scans or growth scans) although it is often useful for a GP or midwife to write to us if there are specific issues relevant to your pregnancy or scan. If there is a problem detected by your GP, midwife or hospital and you are coming to us for a further opinion, confirmation of a diagnosis or invasive testing then we would require a written referral to be sent or faxed to us before your appointment.

 

Why does the Nuchal have to be done between 11+2 and 13+6 weeks in pregnancy? Why are these dates so strict?

Measuring the nuchal translucency in this gestation range is well validated as a way of risk assessing Down’s. Earlier and later than this range, it is not accurate therefore we cannot give a risk prediction for Down’s.

 

Do I have the PAPP-A and Quadruple blood tests at the same time as the nuchal scan ?

It is possible to have the PAPP-A blood test at the time of your scan. However many women wish to have this taken before the nuchal scan so that we can combine the result from this blood test with the scan findings to provide you with a provisional risk at the appointment.  The best time to have the quadruple test is after 14 weeks. We perform the nuchal at the best time for the nuchal, and the quadruple test at the best time for the quadruple test. So we give you a provisional risk assessment for Down’s after the nuchal scan, and then a final combined risk assessment after 14 weeks.

 

When and where is the Quadruple test done and how do I get the results?

The quadruple test is done from 14 weeks and 2 days. In the Eastern region, it is an NHS test, therefore you can have it either here at the Rosie Hospital, with your midwife or at your GP’s surgery providing that the quadruple test blood is sent here for analysis. If there is any doubt about where the blood is sent, or if you would not normally have a quadruple test sent to the Rosie, we will discuss this with you and make the appropriate arrangements.

 

Do I get the results of the nuchal scan immediately?

Yes, our software system allows us to give you a Down’s risk based on the nuchal scan and PAPP-A bloods (if sample taken prior to scan date) immediately after the scan.

 

Can you tell the sex of the baby at a Nuchal Scan?

It is technically possible to tell the sex from 12 weeks onwards, but as this is not yet a validated method of sexing and the error rate is higher than at 20 weeks, we would not normally offer this except in certain situations (for example, concern about a sex linked genetic condition).

 

Can other problems (spinal bifida, heart problems, etc) be picked up at a Nuchal Scan?

We perform a detailed early scan when you come for a nuchal scan, and this means that we can identify certain major structural fetal problems. The more severe forms of spina bifida, and major heart defects, can often be detected as can severe limb problems and conditions that affect the abdominal wall.

 

What happens if the Nuchal shows I am high risk?

If the nuchal measurement is increased, then we will discuss the possible implications of this, which include chromosomal disorders (such as Down’s), cardiac and genetic conditions. We will also discuss which investigations might be appropriate-for example, invasive testing (CVS or amniocentesis) or further detailed scans.

 

What is considered ‘high risk’ for Down’s syndrome?

A generally agreed ‘high risk’ figure is of a Down’s risk, after screening, of greater than 1:250. This 1:250 risk is equivalent to an 0.4% chance of the baby having Down’s, or a 99.6% chance that the baby doesn’t have Down’s. Of course, how you look at this risk depends on your age, pregnancy and family history, and many other factors.

 

Can you tell if the baby has Down’s syndrome from a 20 week scan?

No, we can never tell for sure unless we do an invasive test (amniocentesis or CVS). We do however look for ‘markers’ of Down’s syndrome at the detailed scan, but this only gives an indication of risk-never a certain diagnosis one way or the other.

 

Can I get scan pictures?

Yes, we will normally take several photos for you. This does depend on the position of the baby, however! We do not charge for scan photographs.

 

Can I bring my child/children with me?

Yes, but we normally suggest that you don’t bring more than 2 people with you into the room, so it is normally best to bring another adult to look after a child when you are having your scan.

 

Do I need to have a full bladder for the scan?

For dating and nuchal scans, it is best if your bladder is medium filled-not uncomfortably full, but not empty. For later scans, a full bladder is not necessary.

 

Who will do my scan?

At Cambridge Fetal Care, you will be scanned by a Doctor with recognised obstetric scanning expertise and many years’ experience in fetal medicine. This means the technical ability to perform scans and also confidence and competence to counsel you if you have queries, concerns, or a problem is found on scan, and the ability to make arrangements for further tests if necessary.