Week 19: Heirloom Tomatos and Paranoia

Week 19...

It is at the 'almost half-way' point of your pregnancy that you get the results back from a rather frightening test--if you elected to get the "maternal blood Quad Screen," that is.  Don't let your first introduction to the Quad Screen be pregnancy message boards, as they are rife with all sorts of women freaking out over their results--pages of statistical risk factors written in five-point-font.  You don't have to take this test or its alternative--the First Trimester Screen.  So, what is this Quad Screen all about?  Should you do it?

The Maternal Blood Quad Screen is a non-invasive test that gives your likely risk of carrying a bambino with chromosomal defects and neurological issues.  Quad stands for "quadruple marker," and the test measures four different substances in your blood: alpha-fetoprotein, human chorionic gonadotropin, estriol, and inhibin A.  The levels of these four chemicals then gauge the likelihood of Down's and Edwards syndromes and neural tube defects.

Down's Syndrome is the most common birth defect in the United States--about 1 in 800 children have this condition described by John Langdon Down in 1866.  Children with Down's syndrome may need extra care and services, but have a much longer life expectancy (60 years) after the advent of antibiotics and heart corrective surgery, and lead fulfilling lives.

Edwards Syndrome, or Trisomy 18, is a much more severe genetic chromosomal condition, with only about 5-10% of children with this condition living beyond their first birthday.  It is a lot less common than Down's Syndrome, affecting 1 in 6000 live births in the US.

Finally, the Quad screen assesses the level of risk of neural tube defects like spina bifida--where the fetus's spinal cord doesn't close completely in the first month of development (before you even know you are pregnant).  Dosing yourself with B vitamins, especially folic acid, prevents most of these defects.

It sounds pretty straight forward, right?  Should you take the test?  Do you want to know if your child has these conditions?  Why wouldn't you do the test?

CNP, 2014

Well, for me, understanding the Quad screen test required a comfort with statistical analysis--as it just assesses your risk factor for these conditions--it does not predict, nor specifically tell you if your child has these conditions.  If you are at higher risk (maternal age, obesity, and anti seizure meds are factors) you might want to get more information.  Or you might just want to sit back, have a cup of tea, and just let your baby keep growing, whatever the outcome.  Either way, take a deep breath and don't freak out.

(Author's note: I know that the cartoon this week is really text heavy.  I thought that it might help you feel the overwhelming nature of speed reading three pages of analysis to find answers about your baby's genetics.  Oh--and our baby is in the clear--statistically speaking that is.)

Right now your little bambino is about the size of a large tomato.  Pregnancy books describe him as an heirloom tomato, which is fine with me, as they are more fun to draw anyway.  Like some produce, he is also covered with a waxy coat, in his case to protect him from getting pickled by the amniotic fluid.  Fun fact: it is called the vernix caseosa, or "cheese varnish." Between the downy coat of hair and the cheesy residue, your baby probably doesn't seem too appetizing...

By far though the most incredible milestone is the incredible neurological development and sensory explosion that has been happening.  Neurons are connecting all over the body and brain, enabling kicks, turns, and what occasionally feels like a trampoline circus in my abdomen.

CNP, 2014

Until next week,
Cat