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  • "MammaMia09" started this thread

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Reg: Jun 19th 2009

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Saturday, October 24th 2009, 2:02pm

Mixed news at 20 week scan - advice pls on amnio with twins or hyperechogenic bowel

Hi everyone,

Am faced with a difficult decision after 20 week scan this week and feeling really upset.

At the 12 weeks scan the nuchal fold tests etc came back absolutely fine with both twins very low risk.

At my 20 week scan on Wednesday this week one of the twins had a hyperechogenic bowel, so they asked us to come back on Friday so we went back and saw a consultant. She said that this can be a marker for Down’s syndrome or other chromosomal abnormalities, or even cystic fibrosis, or on the other hand it could mean absolutely nothing.

The consultant also said that had she seen the scan on the Friday, ie two days later, she wouldn’t even have picked it up as it was gone by that point. However now that they have seen it, it increases the risk of abnormalities by three times, even though it’s gone now. This still means it is a very low risk given our previous results. But now that they have seen it I can’t stop thinking about it and what it means. Also, the other twin could also have it as it seems to be a transient thing where you can see it one day but not the next, but if you do see it, the risk is there.

They said we could have amniocentesis, but that the risk of miscarriage is probably higher than the risk of the abnormality. This is such a difficult situation. I don’t really have much faith in the actual statistics. Just to be told there is a marker and a risk is enough for me to want to go ahead with the amnio and find out for sure. However, I need to weigh it up against the risk of miscarriage. DH doesn’t want me to have the amnio but will support me whatever we decide.

I know a lot of people on here have strong feelings about the amnio and would not consider it. If I was just having one baby I think I would feel differently, but the fact that it is twins makes me want to prepare myself for the outcome. Also, I will worry about it for the remainder of the pregnancy and I know I will end up a wreck.

Everything else was absolutely fine, both growing well and I can feel them moving about a lot.
They also took blood tests from both of us to rule out infection from me and cystic fibrosis from both me and DH.

Does anyone have any general advice or know anything about amnio with twins, or about hyperechogenic bowel?

Thanks in advance
Mia xxx
Age 31
TTC 2yrs
Severe Male Factor diagnosed July 08
1st ICSI cycle June 09 BFP - Twins!
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Saturday, October 24th 2009, 2:48pm

Hi MammaMia,
I'm so sorry you had this worry from your scan, but it is fab that the nuchal went so well and that apart from this one thing yesterday, everything else was spot on.
Did they give you a new risk score for Down's?
And do they want to scan you before your next scheduled scan?
The bit I've read about hyperechogenic bowel is the same as you have been told, it could be absolutely nothing, or it could be something. I'm glad you had the tests for infection and CF done and hopefully you won't have to wait long for the results and everything will be normal.
Amnio with twins is tricky... there is of course the risk of the procedure, but then what to do with the results. You have less options than if it was a singleton pregnancy because of the risk to the other twin. I can understand if you need to do it purely for knowledge so that you can prepare if necessary.
If it was me, I would ask for my new estimated risk of Downs, compare that with the risk of miscarriage from an amnio, and if the risk of miscarriage was higher than the risk of Downs, I would not have the amnio and instead, wait and see. BUT of course it is a very personal decision. I had one amnio in my first pregnancy (singleton) but refused an amnio in this pregnancy because my nuchal risk score was low. It is difficult...
I hope that helps a little,

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Saturday, October 24th 2009, 4:34pm

Hi MammaMia

I know I'm not in your position but friends went through a similar situation with their second baby that it was raised at the twenty week scan about having an amnio. She was really against it but her DH wanted it so she said ok we'll have it but what will you do if the tests come back that the baby has downs. He thought about it and said nothing. So she then asked what the point was to have the test, whatever the result would be they wouldn't do anything.

The big question is if you're not going to do anything then what will cause you more worry and stress, not knowing or knowing the worst and that there is something wrong?

Only you can make the decision but I kind of agree with Mavis you need to find out the new risk of downs against the risk of miscarriage from the test.

Fingers croseed everything works out for the best. Thinking of you all!

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Saturday, October 24th 2009, 5:35pm

Hi Mia,

I didn't want to read and run. Obviously I am not at all in any position to advise you but I just wanted to let you know that I am thinking of you and hope things work out fine.

Lots of love to you, your DH and the two little ones.

Nav x

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Sunday, October 25th 2009, 11:18am

Can't give you any advice but just wanted to say I'm really feeling for you. It's such a difficult and personal decision. When i was deciding whether to have amnio, I did what Mavis did and weighed up the risk of m/c against risk factor for downs and decided against having it in the end.
Good luck with whatever you choose to do.
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Sunday, October 25th 2009, 1:26pm


Hi Mia,

Good to hear from you, but sorry to hear about your stress at the 20 week scan.

I agee with the others, you need a few more numbers to base any decision on. You need to know the new Down's risk and the results of your blood tests. Plus the rate of miscarriage with amnio and twins.

I think overall it probably depends on what you would do if it came back positive... If it makes no odds and you'd change nothing, then doing the amnio is merely for preparation, and I wouldn't take the risk. But then again, I'm pretty sure my DH would want to have the test - because he'd think it was important to know. So I guess t's personal choices.

I don't think I've been ANY help there darling, I'm sorry... Let us know how you get on... Glad they are wriggling around plenty in there.

Lots of love, Sarah xxx
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Sunday, October 25th 2009, 2:17pm

Oh MamaMia, I'm sorry to read about your worry, you're the same as me, I've written a couple of posts about the soft marker (a short hypoplastic nose) they found in one of my twins at the 20 wk scan last week. This is a Downs marker and has increased the risk 10 times compared to the other twin. I don't know about hyperechogentic bowels but wish you all the best with your decision. We have decided against an amnio and are preparing ourselves for the fact that one twin may have Downs. I'm one of those people who likes to be prepared and if it all turns out ok in the end well that's just fantastic. PM me if you want to talk hun x

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Wednesday, October 28th 2009, 11:11pm

Evening MamaMia, I'm so sorry you're having such a worrying time.

The result of my combined screen gave me a 1:24 result so I understand how difficult it is to weigh up all the issues. Here's a link to the thread I started.

combined screening result

If you would like to talk to someone who can listen, answer queries etc then this is a really good organisation.

Sending you lots of love.


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  • "MammaMia09" started this thread

Posts: 126

Reg: Jun 19th 2009

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Sunday, November 8th 2009, 5:16pm

Hi everyone,

Sorry i have not written back - thank you all for your replies.

After much soul searching I booked in for the amnio which was supposed to be last Tuesday. I went to the Twins Clinic and saw the prof that runs it. He scanned me again and then said that bascially he wouldn't really recommend the amnio as the risk to the babies was greater than the risk of anything being wrong.

He was very reassuring so I decided at that point not to have it, DH was delighted, we went home and I tried to relax.

All our bloods etc came back normal.

The doc did say however that I could have an amnio at a later stage if I wanted - at any point in the pregnancy. This was very surprising - has anyone ever heard of having it so late?

Anyway now I am trying to forget about it but I still can't help feeling scared and that I can't really relax. After our 12 week scan and after the MS had stopped I had really begun to enjoy the pregnancy and now I feel like I did when we first found out we had fertility issues and it was like our world was falling apart.

I have been trying to start thinking about the nursery and what we need to buy, but my heart's not really in it.

Before the appointment I did loads of research on the internet. Even though our overall risk was still really low – I am not even going to post the odds here cos if I do you will all think I am being ridiculous – I felt that the presence of the marker (the hyperechogenic bowel) was significant enough to go ahead. I read loads of medical studies on the internet which said that it was present in high numbers of babies with ‘adverse outcomes’ and that for me was more significant than the odds they give you based on the combined factors of the blood, nuchal fold, etc. Maybe I have been reading things out of context but it was enough to scare me. However at the scan I told the doc about some of these things but he kind of brushed them off.

I know no one can really advise, just wanted to firstly say thank you for replying, give you an update and just get things off my chest!

Thanks again
Mia xx
Age 31
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Severe Male Factor diagnosed July 08
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Sunday, November 8th 2009, 7:12pm

Just to answer your question on amnio. I was told by my fetomedicine consultant that she does amnio at all stages of pregnancy. and she did one as late as 36 weeks. I am guessing it was done that late so that parents could prepare themselves incase of positive result.
I know it is difficult time, but its only a single marker and the rest of the results seem to be alright. So easy for me to say but try and not think about it too much. xxx

  • "MammaMia09" started this thread

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Friday, November 13th 2009, 6:24pm

Thanks a lot for your reply rightans - that's interesting.

I have another scan on the 24th with the same specialist, so we'll see what happens then.

In the meantime would be grateful for anyone else's thoughts!

Love to all
Mia xx
Age 31
TTC 2yrs
Severe Male Factor diagnosed July 08
1st ICSI cycle June 09 BFP - Twins!
Praying for a smooth ride from here



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Saturday, November 14th 2009, 8:50pm

Hi Mia,

Don't have any input but just wanted to say I was thinking about you and hope you are ok.


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  • "MammaMia09" started this thread

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Tuesday, November 24th 2009, 9:50am

Thanks for your message Flic.

I have another scan this afternoon so will update afterwards.

Love Mia xxx
Age 31
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Thursday, December 3rd 2009, 9:59pm

Sorry you've been having a rough time. I have a friend who has twins - one with downs and one without and I know it is difficult but both kids are gorgeous and fantastic. Hope the scan today provided some more answers x

Ps having twins is the most wonderful thing in the world :D

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