Down’s screening for Twin pregnancies the best approach.

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Down's screening for Twin pregnancies the best approach.

Down’s screening for Twin pregnancies the best approach.

Down’s screening for Twin pregnancies the best approach.

twins-pregnancyScreening for T21 Down’s syndrome has become an integral part of antenatal care for every pregnancy. The most common approach is the combined first trimester screening done between weeks 11-13+6 of pregnancy. However when your are pregnant with twins you have to be aware of some basic differences in best screening test for Down’s syndrome;
The following are some of the fundamental issues you need to clarify with the help of your obstetrician ;

1. Is screening relevant for you?

Many parents would not change their views for their pregnancy even if their baby was found to have Down’s syndrome. For this group of parents screening may not be useful. It may even create unnecessary anxieties without helping you to decide the best management for your twin pregnancy. Discuss with your obstetrician and your partner what would be your actions in the event of a bad/ abnormal result at your dwons screening for twins?

2. Is your pregnancy a monochorionic or a dichorionic twin pregnancy? This is an important distinction that has to be made for every twin pregnancy as the management is very different. In particular for screening for Downs syndrome in twin pregnancies;

a. monochorionic twins they are always identical so there is only one risk calculated as if one baby has Down’s syndrome the other will have it as well.
b. Dichorionic twins each baby has each own risk calculated. However, always remember that you have two babies. Think of this simple example; lets assume that the risk for each one of the babies is 1/1000. Because you have TWO babies at the SAME time the risk for either  of them been affected is 1/1000 + 1/1000 = 2/1000=1/500.
c. in monochorionic twins the Nuchal translucency can be affected by other conditions like twin to twin transfusion syndrome.

3. The biochemistry markers do not perform as well in twin pregnancies

as they do in singleton pregnancies. As there is no way to know what is the contribution of each placenta  to the hormones in the maternal blood their result need to be interpreted very carefully.

4. Good quality first trimester ultrasound scan

Due to the high importance of accurate Nuchal translucency measurement ensure the doctor who performs the test is experienced and provides you with a detailed report identifying each baby and the type of twin pregnancy your have.

5. New developments; Screening for Twin pregnancy Non Invasive Prenatal Screening NIPT using fetal DNA in the maternal circulation can offer accurate results even in twin pregnancies.

In monochorionic twins it will let you know if the babies are or not affected with very high accuracy.
In  dichorionic twins a normal result can be reassuring for both babies while an abnormal it indicates that one of the babies is affected but does not say which one so you will need further testing (amnio or CVS).
At Genesis Perinatal Care Clinic Dubai we have the experience knowledge and appropriate equipment to offer the best screening for twin pregnancies. Dr George Michailidis will allow appropriate time for counselling on screening for twin pregnancies and by providing the right information ensure you take the decisions that are right for you and your family.

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