instruction: hello doctor sub ne for nip downs reg my wife aged 30 years is 17 weeks pregnant with our second child prenatal first trimester screening report indicated a calculated risk for downs syndrome as 544 final it at 12 weeks days was 8 my considering this an intermediate risk our obgyn advised early anomaly scan during 17th week the findings in ultrasound scan for soft markers came negative and the risk for downs was improved to 2837 our obgyn said that there is an option of nip available for further confirmation but she indicated that it is only optional there is no history of downs edwards or pataus in both our families and our first child is normally active first child no downs was born at weeks pre term because of pre eclampsia through lscs should we get the nip done please help us because we are confused
output: hello considering the fact that firstly your it scan measured 8 my which was below 5 my cut off and hence was normal for gestational age secondly the cut off for trisomy 21 being 250 and age related risk as well were lower with 544 and 815 so the screen was negative and there was no intermediate risk as to be considered the age is 30 and does not qualify for advanced maternal age and also the first baby was not a down syndrome hence no increased risk in present pregnancy thirdly the anomaly scan as well do not show any evidence of structural cardiac anomalies or endocardial cushion defects indicating that the chances of the child being down is way too low nip with these reports is not recommended at all