Down Syndrome occurs if a baby has three copies of its 21st chromosome instead of two copies. A chromosome is a bundle of genetic material, and if you have too many or too few of these bundles, severe abnormalities can result. In the case of Down Syndrome, these abnormalities include intellectual, heart, thyroid and other endocrine, facial appearance and others.
It is possible to detect early in the pregnancy whether your baby might be at high risk of having Down Syndrome. This is possible through consideration of your age and additional tests.
The additional tests are Combined First Trimester Screening and Non-invasive Prenatal Testing (NIPT). Clicking the test will link you to VCGS website explaining these tests.
It is important to realise that both of these tests are considered to be “screening test”. This means they wont tell you “yes, your baby has Down syndrome” or “no, it definitely does not have Down syndrome”. They will, however, say if your baby is at high risk of having Down syndrome, in which case you should have a diagnostic test. A diagnostic test is one that will tell you “yes” or “no”.
Combined First Trimester Screening requires a blood test at 10 weeks and an ultrasound between 12 and 13 weeks. Most patients choose this option. The blood test costs about $120 (no medicare rebate) and a specialised ultrasound costs about $150 after the medicare rebate, however this varies from clinic to clinic.
NIPT is no doubt the future of prenatal testing for Down Syndrome and other genetic abnormalities due to its incredible accuracy and lack of risk to the baby. It uses a maternal blood sample to find and test the baby’s cells in the mother’s bloodstream. Costs are constantly falling, but it is quite expensive costing about $500 and no rebate applies.
Most women would still opt for a 12 week ultrasound if doing NIPT; whilst the ultrasound has no impact on the Down Syndrome result when doing NIPT, it does provide other useful information about the development of the baby; so a saving is often not made by omitting the ultrasound.
Another test to consider is a genetic carrier screening test for cystic fibrosis (CF), fragile X syndrome (FXS) or spinal muscular atrophy (SMA). This recently available test identifies whether an individual carries the gene, and therefore increases the chance of having a child affected by the condition. If the unborn baby has a higher chance of having the condition based on the parent’s results, then diagnostic testing with amniocentesis or CVS will be offered. Clicking the test will link you to VCGS website explaining this test.
Kent will discuss these options with you at your first pregnancy appointment.
An ultrasound scan at 20 weeks is essential. It gives important information; an anatomy (organ) survey of the baby, assessment of the baby’s growth, check of where the placenta is growing and how long your cervix is.
A 12 week ultrasound is also important. Whilst not absolutely essential, about 99% of patients have a specialist scan at 12 weeks. Early fetal abnormalities are being diagnosed with increasing accuracy, plus it is at this scan that the nuchal translucency (NT), the thickness of a fluid layer behind the baby’s neck, is measure allowing for an estimation of the chance that the baby has Down Syndrome. Some of the time, the fetal sex can be determined at this scan.
Kent highly recommends that you have each of your ultrasounds at a specialist women’s clinic. You can be sure if you go to one of his recommended clinics you will be getting the most accurate and reliable scan possible.
Specialised ultrasound clinics can be a little more expensive than a non-specialist clinic (although non-specialised clinics often charge significant out of pocket fees, too) but it is money wisely spent, and eliminates the need for repeat ultrasounds should the first show an abnormality or if the non-specialist ultrasonographer is simply not sure what she is seeing. This can end up more stressful, too.
Dr Kent Kuswanto delivers babies at the following Hospitals.
Epworth Freemasons East Melbourne
Freemasons has an excellent reputation as one of Melbourne’s premier and most popular obstetric hospitals. It has an excellent location between the city and eastern suburbs, and offers postnatal care at the Park Hyatt.
St Vincent’s Private Hospital Fitzroy
Located close to the city centre, St Vincent’s is a vibrant hospital with a long tradition of outstanding pregnancy care. The hospital facilities are excellent, and postnatal care is offered at the Park Hyatt.
Mercy Hospital for Women Heidelberg
The Mercy is a large tertiary maternity hospital well renowned for having the best perinatal outcomes in Melbourne. It is suited for women with highest risks in pregnancy.
Weekend and Holiday Cover Arrangement
Kent is on call for his patients 24 hours a day. This only changes if he has a particularly special personal engagement (a child’s birthday, for example, and is usually for a few hours only), or if he is at a conference. Conferences are important as they ensure that you are offered the most up to date care.
Very occasionally during the week, Kent needs to be in two places at once. If this happens, he may call on a colleague to help out with your care. It will always be a specialist. It is always done with the safety of you and your baby in mind, and it is undoubtedly a good thing that obstetricians help each other out in this manner.
Kent remains on call for his patients on almost all weekends and public holidays too. He occasionally has another specialist obstetrician covering him when he needs to recharge. Kent is in a cover group with some of Melbourne’s finest obstetricians – Dr Len Kliman, Grant Saffer, Pregs Pillay, Sam Soo, Joseph Sgroi and Steve Cole. In any case, you can always be sure that an excellent obstetrician will be available for your care.
Annual leaves are planned well in advance so that patients are aware. If you are due around the times of his annual leave and would like to meet the covering obstetrician, this can be arranged.
Pregnancy Management Fee
We understand there can be significant costs incurred in having a baby under the private care of a specialist obstetrician in a private maternity hospital.
We are proud of the quality of service we provide, which includes highly qualified specialist care 24/7 every day of the year. Such service provision is subject to significant expenses, and these in turn determine our fees.
We try our best to keep fees within reach of many families with private health insurance.
Please do not hesitate to call or visit us to introduce yourself as a potential new patient to discuss this further, and obtain written information on our fees. We also encourage you to contact other obstetricians, as it is important to us that you feel completely comfortable with your specialist and the services provided. There is always an obstetrician suitable for you.
Pregnancy Related Links
Labour and Birth Related Links from RANZCOG
Parenting Related Links