To Quad Screen or Not


To Quad Screen or Not

The Mayo Clinic describes the Quad Screen as “a routine prenatal test that measures levels of four substances in a pregnant women’s blood. It evaluates your chance of carrying a baby who has any of the following conditions: Down Syndrome, Trisomy 18, Spina bifida, or Abdominal wall defects.”

I remember getting the call while at work. It was a mid-morning in May and I was sitting at my temporary desk in the church library. Seeing the number for my OB’s office flash across my screen I thought maybe it was to confirm an appointment. Upon answering the phone however, I discovered that my quad screen had come back positive for Down Syndrome. I didn’t know how to react. I had no words. The nurse was calm, reassured me that it was possible it was a false positive, and had set up an appointment for us to do additional testing at the Regional Obstetrical Consultants. As she put it, “They just happened to have a cancellation for an 8:30am appointment tomorrow.”

After hanging up, the flood gates opened, primarily from shock, but the hormones didn’t help any.

I called my husband, followed by family members and went home early from work. I did nothing the rest of the day. I had no idea what to do. I’m thankful for my husband and his levelheadedness. He was calm and reassured me that if it was a true positive that we would be ok. We would know early enough that we could prepare as much as possible for the future and that the Lord already knew what was going to happen. I don’t remember if I slept much that night because pregnancy comes with many restless evenings.

Arriving at the office the following morning, there were more people in the waiting room than I anticipated. I wondered how many were there because of a false positive and how many were there because the result was a true positive. When they called us, we first saw the genetic counselor who rattled off ratios and percentages of which I could only focus on the bad ones. Thankful my husband has a math brain and could process it all. She also mentioned that my age played a factor and that I was at a higher risk. I was thirty! This hit me hard because I knew women who had had babies well into their 40s and had no issues. After seeing the counselor, we were to have a longer ultrasound where the nurse would measure all the baby’s limbs and head, then the doctor would see us, followed by either a blood test or an amniocentesis. We opted for the blood test because it was 98% accurate and less invasive than an amniocentesis.

The ultrasound and waiting for the doctor seemed to take forever because the technician is not allowed to speak to you and then they have to go converse with the doctor. The doctor then performs the ultrasound again and gives you a diagnosis. Our results were negative based simply on the ultrasound and we would have to wait for full confirmation from the blood test to be sure. We wouldn’t get those for about 10 days; by then we were to be in England on vacation. We had an army of people praying for us, and as we sat in the airport waiting to board our final plane to England, there it was. The email from the office saying that the test was in fact a negative! We had to have a follow up appointment three weeks later to make sure everything was still ok and then we’d be released to not come back.

As we consider having more kids, I find myself asking whether I want to go through the quad screen again. On the one hand, I want to be prepared, but on the other I don’t want to go through all the emotions and uncertainty again. But then life is full of emotions and uncertainty all the time. Just look at the state we are in now. As I do more research, the more I discover that false positives are slim and it’s possible that it may not happen again with another pregnancy. Looking back, I was actually quite calm from when we had our first appointment to when the results came back. While on vacation, I didn’t once think of the quad screen and everything we had just gone through. In a way, I feel bad that I felt that way because there are many women whose test comes back as a true positive. Many who may not happen to get an appointment the following day to see a specialist, and many who may not have someone there to support them.

If you are someone who has gone through the same situation or is currently going through it, I am listening. I want to hear your story because whether it is a false positive or a true positive, it is part of your story. Why don’t we talk about this more?

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Kimberly Casey
Hi, my name is Kimberly and I am a new stay at home mom. I am a nomad of sorts. Born in Arkansas to a military family of five children, I was speaking German by the age of 4. I have lived in Germany, England, and the United States and have traveled to countless other countries. In 2006 I moved to Providence, Rhode Island in order to attend Johnson & Wales University where I received a Bachelor's degree in Food Service Management, an Associate's in Culinary Arts, and an Associate's in Baking and Pastry Arts. So you could say that I'm a foodie.  After college I worked in Collegiate Ministry for many years and loved every second of it. I would do it again in a heartbeat if given the chance today. I met my husband, Wade, in 2011 through Collegiate Ministry but we didn't start dating until 2015. Our entire relationship was long distance and we saw each other a total of 10 times before our wedding. After our wedding in 2016, I moved to Chattanooga where my husband is an associate pastor and I can say that this move was one of the hardest things I had ever done. After two years of marriage we welcomed our daughter into the world this past October. She is a joy, loves to smile, and has turned our world upside down. If I'm not in the kitchen baking or cooking, you can find me outside enjoying nature. 


  1. We had a similar experience! It was our first pregnancy, so when they offered us the quad screen, we assumed we were supposed to do it….so we said yes. When my doctor called, she said we were at a slightly elevated risk for Downs, which was likely due to my age (I was 31). We had our appt at ROC, which was a wonderful experience in spite of it all bc the staff was so great. The ultrasound was negative, and then the blood test was negative too. We prayed about it and ultimately opted not to do the quad for our second pregnancy (I was 35). The Lord just gave me a peace about it, and I felt like everything would be ok. If anything had been discovered at the 20 week ultrasound, we would’ve pursued further testing, but everything was fine. That’s our story (briefly), and thank you for sharing yours! FYI, my husband, Adam, and I went to high school with Wade! Small world!

  2. I still have mixed feelings about whether I would test again or not. My story is somewhat long, but short version is our positive test results for Turners Syndrome were true. My daughter is perfectly heathy and thriving and I would never know there was anything genetically “wrong” with her if I hadn’t done that test (her karyotype is 45X/47XXX). The reason I’m glad I know is we are armed with the knowledge we need for any future issues. I became pregnant with my son when my daughter was only 5 months old and I did the test with him too, everything normal. Considering I am almost 34, if we do decide to have a third I will most likely to the testing, but I definitely have a different perspective on things than with my first!

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