1+1=3! Part 4 – First Trimester Screening (FTS)

As mentioned in my previous post, we were told by the KKH nurse during our first visit to KKH that we would have our First Trimester Screen at our next visit, where I would be about 12 weeks pregnant. Sunshine had taken leave to accompany me for the visit. However, due to some miscommunication on KKH’s end, I had to take urgent leave from work and rush down to KKH again for the FTS the next day after our second appointment. Sunshine was unable to leave work at a last minute’s notice.

During our appointment, I was offered two different types of screening for Down Syndrome:

  1. The FTS (or commonly known as OSCAR test), which included the Maternal Serum Screening (MSS) in KKH or
  2. The Non-invasive Prenatal Test (NIPT). KKH offers the Harmony Test for NIPT.

Sunshine had earlier read about these screening tests and had decided that he wanted both the OSCAR AND the Harmony tests =.=” He wanted the former for the included structural scan and he wanted the latter for the additional genetic tests offered, including Xiao Bu Dian’s gender. Hence, I told the counsellor our choice. As a subsidised patient, the FTS would be at a subsidised rate and costed about $170+. As we opted for the Harmony test without a doctor’s recommendation, we had to pay a private rate for it and it costed about $750+.

Part 4 FTS and NIPT
My invoice

I personally felt that the Harmony test was unnecessary and a waste of money for my case but as Sunshine insisted, I went ahead with it. As the counsellor explained the other optional genetic tests which could be done as part of the NIPT, I hesitated for a moment as I was conflicted. This was because Sunshine and I had never discussed about this since he did the research for the screenings and since I only knew the common chromosomal tests included for both OSCAR and Harmony, I had never thought about the other conditions and whether I would want to know my baby has them. Based on what I understood from her explanation, it seemed like these additional tests would test for conditions which would give me a dilemma on whether to keep our baby if it had the condition(s). She shared that some couples chose not to do these additional tests. For example, one of the optional tests offered was to check if baby has an additional sex chromosome such as Triple X syndrome (XXX). According to information posted on MayoClinic,

“Many girls and women with triple X syndrome don’t experience symptoms or have only mild symptoms. In others, symptoms may be more apparent — possibly including developmental delays and learning disabilities. Seizures and kidney abnormalities occur in a small number of girls and women with triple X syndrome.

Treatment for triple X syndrome depends on which symptoms, if any, are present and their severity.

Signs and symptoms can vary greatly among girls and women with triple X syndrome. Many experience no noticeable effects or have only mild symptoms.

Being taller than average height is the most typical physical feature. Most females with triple X syndrome experience normal sexual development and have the ability to become pregnant. Some girls and women with triple X syndrome have intelligence in the normal range, but possibly slightly lower when compared with siblings. Others may have intellectual disabilities and sometimes may have behavioral problems.

Occasionally significant symptoms may occur. If signs and symptoms are present, they are often variable.” Some of these signs and symptoms include learning and developmental delays and behavioural and psychological problems.

I was worried about what we would do if our Xiao Bu Dian unfortunately had one of these conditions. Based on my understanding, SOME babies with such conditions could live normally and have no apparent problems while some other babies with the same conditions might have to suffer physically and emotionally. What should we do if I had agreed to test for these optional, additional tests and we had to face the consequences of having to decide if we still want to go ahead with the pregnancy? Given the possibility that some of these babies could still live their lives normally, I already had the inclination then to not give Xiao Bu Dian up in the event our worst fears came true and just pray to God. On the other hand, I also knew that Sunshine, being the more logical and rational person, would not want to take a chance and let Xiao Bu Dian suffer. At that moment, I was angry and conflicted that I had to make this decision alone. However, the rational side of me decided to go ahead with these additional optional tests. Sunshine and I shall decide later on if we had to. I then had my blood taken for the FTS and NIPT tests and went for my scan.

Unlike the first time we saw Xiao Bu Dian, where it looked like an inverted comma, Xiao Bu Dian had grown considerably larger and had clearly taken the shape of a human being at week 12 of my pregnancy. Xiao Bu Dian was “bouncing” about in the water bag and stretching its limbs. So cute!!! <3 The kind sonographer tried to explain what she was scanning/what I was seeing on the screen while she did her work at the same time. However, she did not manage to get Xiao Bu Dian to show her its legs (if I remember correctly). Hence, she asked me to exit the room, walk about and see her again later. When I went back to her room, Xiao Bu Dian had switched positions! Xiao Bu Dian was originally facing left and at the second time, Xiao Bu Dian was facing right! I confirmed with the sonographer that it was indeed Xiao Bu Dian who moved and not that she had swapped some views on her ultrasound machine such that Xiao Bu Dian appeared in an opposite view then. Haha.

After the scan, I saw the doctor who explained that based on the results of my scan, Xiao Bu Dian seemed to be at a low risk of Down Syndrome. However, this was preliminary and that I would have to wait for my adjusted risks, calculated based on my age, scan and blood test results, which would be ready by my next appointment a month later. Despite this, I was elated that Xiao Bu Dian was very 争气 as she passed her tests with flying colours. Sunshine facepalmed me as I told him this. He said that he can already foresee that I would be a typical Singaporean, kiasu mummy and was worried about Xiao Bu Dian’s future happiness and sanity! Lol. So exaggerating!

Thank you Xiao Bu Dian for growing well and not giving me any major problems during my first trimester (excluding the scare when we were in Australia). Please continue to grow well and be healthy! Both Papa and Mummy love you loads! <3

Part 4 Xiao Bu Dian
Our love! <3

Click to read Part 3 here.
Click to read Part 5 here.

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