instruction: hi doctor currently I am 14 weeks pregnant with my second baby I am attaching my it and double marker report for your reference I have a year old son and no abortion in the past I have conceived naturally both times my doctor has asked me to do either nip or cos and I am not sure if I really need to do any she has asked me to take ecospirin 150 immediately if not doing cos else start after cos I have some queries do I really need to go for either nip or cos or I can forgo these tests should I take ecospirin 150 as my previous pregnancy did not have any complications and at present also I am in good condition with no health issues also I do not drink and smoke are there any issues with my beta hug and pa a value do you see any other concerns in my report please reply
output: hi I have seen the report now every laboratory has its own calculation methods to come to a risk ratio after the test hug and papp a levels are also different at different times of pregnancy and also has some effects of weight and age on it this is a genetic screening test and we do this test to find out what is the risk of this pregnancy having a congenital abnormal baby specifically downs edward turner and patau syndromes this risk ratio has cut off values means trisomy 21 downs has a risk ratio of 365 in your case and cut off is 250 now with this report we are calculating the risk of having a baby with downs syndrome is in 365 pregnancy with your age and with the test and ultrasound reports you have we are calculating the risk and the report is always low risk or high risk there is never no risk practically also after doing all available tests we never can rule out all the possible abnormalities in the baby cos chorionic villas sampling and sometimes amniocentesis are 100 if they found baby dna in the procedure to rule out that the baby does not have trisomy 21 or other major chromosomal anomalies that does not mean all genetic abnormalities are ruled out both of these procedures also have some risk of abortion during or after and that is why we advise these test in high risk double marker nip non invasive prenatal testing is also a screening test like double marker but the test is less risky as compared to cos and amniocentesis but at the same time more costly and test sensitivity to rule out trisomy 21 and other is 99 after all these details you must be confused now other trisomies are definitely low risk but in case of trisomy 21 your report is 365 and which is somewhat near cut off 250 ideally I advise further testing of cos and amniocentesis if the value is below cut off value but 365 is also near the cut off value so it is a debatable issue 365 means that out of 365 pregnancy 364 will be normal and pregnancy will have trisomy 21 secondly you can start ecosprin tablets we usually start it in some high risk patients if you have pregnancy after 30 years then you come under high risk group so you should start it in cos there is chance of bleeding inside and that is why your gynecologist does not ask to start it if you are going for cos and every pregnancy is different and we cannot say that if previous pregnancy did not have any problem nor the baby has any problem then this pregnancy will not have anything wrong yes we can say that if previous pregnancy was normal then there is somewhat more chance that this pregnancy will also normal go through all details two or three times to understand it properly and then ask anything if you have more questions I hope this helps I am not able to open it scan report yes but the second report is saying that it is 93 and nasal bone is seen mostly these two sonography markers are also used to calculate the risk in double marker apart from hug beta human chorionic gonadotropin and papp a pregnancy associated plasma protein a both it nuchal translucency and no nasal bone are normal