Follow-up testing after the 20-week ultrasound
Have you had the 20-week ultrasound, and is there a reason to suspect that your child has a chromosomal abnormality? Or do you have a medical indication? Then you will be offered follow-up testing for clearer results. Another term for follow-up testing is prenatal diagnostics.
You can have follow-up testing done at a hospital. By having more tests done, you can be sure if your child has a physical abnormality.
When can you choose to have follow-up testing?
You can have follow-up testing done if:
- You had an abnormal result on the 20-week ultrasound. There are indications that your child has a physical abnormality.
- There are medical reasons for follow-up testing – for example, if you were previously pregnant with a child with a physical abnormality. Your midwife can tell you more about this.
Types of follow-up testing
A comprehensive ultrasound scan: Advanced Ultrasound Examination
Have you decided that you want follow-up testing? This starts with a comprehensive ultrasound scan. This advanced ultrasound examination is similar to the 20-week ultrasound, but often takes longer. The equipment is more accurate than the equipment used for the 20-week ultrasound. This allows the specialized ultrasound technician at the hospital to see more details about the baby. Sometimes another specialist is present to observe the ultrasound. The ultrasound does not hurt at all and does not harm your child. A comprehensive ultrasound scan is performed at the Curaçao Medical Center (CMC).
Sometimes the doctor then suggests having a blood test or amniocentesis. This depends on the abnormalities found during the follow-up testing. The doctor will explain everything to you first. It is up to you to decide whether you want to have one of these tests.
Blood test
You give a blood sample, which is then examined in a laboratory.
Amniocentesis
During an amniocentesis, the doctor inserts a needle into the abdomen and removes a small amount of amniotic fluid. To avoid harming your baby, the doctor uses an ultrasound to check the position of your child. You can have an amniocentesis from 16 weeks of pregnancy. An amniocentesis is performed at the Dr. Horacio E. Oduber Hospital (HOH) in Aruba. It usually takes 1 to 2 weeks to get the results.
There is a minor risk of miscarriage after amniocentesis. This happens in 1 out of 200 women.
Results of follow-up testing
The doctor will give you the results of the follow-up tests. The results may show that everything is fine. However, there is also a chance that the test will show that you are carrying a child with a physical abnormality. This news may make you anxious or sad. You will probably have many questions. That is why you will quickly have an in-depth talk with one or more doctors. This could include a gynecologist, a clinical geneticist, or a pediatrician. There are various options. Who you talk to depends on the abnormalities that are found.
Does your child have an abnormality?
If your child has an abnormality, you will have a talk with one or more experts at the hospital. They will tell you more about your child’s abnormality and what it means. With this abnormality, what is the expected quality of life? What options for treatment are available? How long might your child live? What decisions can you make?
Options after an abnormal result
The options depend on the abnormality. Here is what you can do with the result:
- You can carry your pregnancy to term and allow the child to be born.
You can prepare for the arrival of a child with an abnormality. You can also arrange for extra care during your pregnancy and delivery. - Sometimes an abnormality is so severe that the child will die during pregnancy or shortly after birth.
The midwife will guide you through this process. - You can also choose to terminate the pregnancy.
With a 20-week ultrasound, you only have a few weeks to do follow-up tests. That means you only have a short time to think about what to do next. Talk to the experts. Ask all your questions. Have you decided to terminate the pregnancy? This is possible up to 24 weeks of pregnancy.
You decide what to do with the results
It can be very difficult to decide what to do if your unborn child has an abnormality. It is important that you make a choice that is right for you.
Do you need support?
Experts at the hospital can help you. You can also talk about it with your midwife, gynecologist, or family doctor. Sometimes it can also help to talk to a pediatrician, a clinical geneticist (a doctor specializing in genetics), or a social worker at the hospital. Patient support organizations may also be able to help you. Ask your midwife, gynecologist, or family doctor about this.
Talk to people who are important to you
It can also help to talk to other people who are important to you before you decide. That could include your partner, parents or friends, a minister or pastor, an imam or a rabbi.