Letter: Bart's test warning for older mothers

Sir: The introduction of the Bart's screening test for all pregnant women would be a significant advance, especially if it can alert otherwise low-risk mothers that they might be carrying a Down's syndrome baby and as you report (14 August), it will reduce the number of Down's babies born overall. May I, however, sound a note of caution on behalf of 35-plus expectant mothers.

My fourth baby, a normal, healthy girl, was born at Addenbrooke's Hospital, Cambridge, in April 1992. I am 40. When I requested an amniocentesis at my first antenatal visit, I was told that the hospital was no longer routinely offering amniocentesis on request unless the Bart's test showed a high risk. The Bart's test only detects a proportion of Down's syndrome babies, so for a pregnant woman who is 40, there is still a risk that she could be carrying an undetected Down's syndrome baby. Amniocentesis is 100 per cent accurate.

Health authorities should offer the choice to the high-risk, older mother and not see this as a chance to save money. The Bart's test has another disadvantage to the older mother: the delay caused by the Bart's test and then waiting for the result of amniocentesis could mean that she is faced with aborting a pregnancy of 20 or more weeks. It is now possible to offer amnios at 14 weeks, with the results coming through at 17 weeks. By the way, I stood up to my formidable consultant and he agreed to give me an amnio at 14 weeks.

Yours sincerely,

JANET DANIELS

Hempsted,

Saffron Walden

14 August