History of down syndrome
Screening for Down syndrome is offered as a routine part of prenatal care. A mother's age has traditionally been a factor in the decision to screen for Down syndrome. But now, the American Congress of Obstetricians and Gynecologists recommends offering various screening tests for Down syndrome to all pregnant women, regardless of age. Although screening tests aren't perfect, they can help you make decisions about more-invasive diagnostic tests and the course of the pregnancy.
If your baby is diagnosed before birth with Down syndrome, you'll also have more time to prepare for caring for a child with special needs. Your health care provider can help you weigh the pros and cons of these tests. Screening tests during pregnancy Various screening tests can help identify whether you have a high risk of carrying a baby with Down syndrome. In the past, blood tests typically have been offered around the 16th week of pregnancy to screen for Down syndrome, spina bifida and various other chromosomal disorders. Currently, more women are electing the first trimester combined test, done in two steps during week 11 to 13 of pregnancy.
The first trimester combined test includes:
Ultrasound. The doctor uses ultrasound to measure a specific region on the back of a baby's neck. This is known as a nuchal translucency screening test. When abnormalities are present, more fluid than usual tends to collect in this tissue. Blood tests. Results of the ultrasound are paired with blood tests that measure levels of pregnancy-associated plasma protein-A (PAPP-A) and a hormone known as human chorionic gonadotropin (HCG). Abnormal levels of PAPP-A and HCG may indicate a problem with the baby.
If early assessment isn't your first priority, you can have full integrated testing, which is done in two parts during the first two trimesters of your pregnancy. The results of the two parts are combined to estimate the risk that your baby has Down syndrome. This test can achieve the same level of detection as the first trimester combined test but with a lower false-positive rate, meaning that fewer women are incorrectly identified as carrying a baby with Down syndrome. First trimester. Part one includes an ultrasound to measure nuchal translucency and a blood test to measure PAPP-A. Second trimester.
Done at 15 to 20 weeks of pregnancy, the quad screen measures your blood level of four pregnancy-associated substances, alpha fetoprotein, estriol, HCG and inhibin A. Of all the women who undergo screening tests for Down syndrome, about 5 percent are identified as being at risk. But the overall risk of Down syndrome among pregnant women is far below 5 percent. So the screening tests, by design, are much better at identifying women who may be at risk of having a baby with Down syndrome than women who actually have a baby with Down syndrome.

