High Risk Screening Result: Complete Guide
Being told your combined screening or quadruple test result is "high risk" can feel frightening, but it's important to understand what this actually means. A high-risk result is not a diagnosis — it's a signal that further testing would give you clearer answers, and the great majority of women who receive one go on to have straightforward pregnancies.
What "high risk" actually means
Screening tests like the combined test (11-14 weeks) or quadruple test (14-20 weeks) don't diagnose a condition — they calculate a probability based on your age, blood markers, and, for the combined test, the nuchal translucency measurement from your scan. A result is usually classed as "higher chance" (sometimes still called "high risk") when the calculated probability is 1 in 150 or higher for conditions such as Down's syndrome (T21), Edwards' syndrome (T18), or Patau's syndrome (T13).
This means that out of every 150 (or fewer) women with the same result, most will not be carrying an affected baby. The number itself doesn't tell you whether your baby is affected — only further testing can do that.
What happens next
- You'll be offered a follow-up appointment, usually with a midwife or genetic counsellor, to talk through your result and options.
- Non-invasive prenatal testing (NIPT) is commonly offered as a next step. It's a blood test that analyses fragments of the baby's DNA in your blood and is highly accurate, without any risk to the pregnancy.
- If you want a definitive answer, diagnostic tests are available: chorionic villus sampling (CVS), usually from 11 weeks, or amniocentesis, usually from 15 weeks. Both carry a small risk of miscarriage and are entirely your choice.
- A genetic counsellor can help you weigh up the accuracy, timing, and risks of each option against what the result would mean for you.
- Nobody will pressure you into further testing — you can choose to have no further tests at all and simply continue routine antenatal care.
Coping while you decide
It's completely normal to feel anxious between getting a high-risk result and having further tests or reassurance. Try to lean on your midwife, partner, or a support organisation for information rather than searching general forums, which can amplify worry. Many hospitals can offer an appointment within days precisely because they understand how stressful the waiting period is.
Frequently Asked Questions
Does a high-risk result mean my baby has a condition?
No. A high-risk (or "higher chance") result means the calculated probability meets a certain threshold, usually 1 in 150 or higher — it does not confirm a diagnosis. Most babies with a high-risk screening result do not turn out to have the condition being screened for. Further testing, such as NIPT or a diagnostic test, gives a much clearer picture.
What should I do after a high-risk result?
Speak to your midwife or a genetic counsellor about your options, which typically include NIPT (a highly accurate blood test with no risk to the pregnancy) or diagnostic testing such as CVS or amniocentesis for a definitive answer. You can also choose not to have any further testing. There's no rush to decide immediately — take the time you need to understand your options.
How accurate is NIPT compared with the initial screening test?
NIPT is significantly more accurate than combined or quadruple screening because it analyses the baby's own DNA rather than calculating a statistical probability from blood markers and scan measurements. It's still a screening test rather than a diagnostic one, so a positive NIPT result would usually be confirmed with CVS or amniocentesis before any decisions are made.
This article is for informational purposes only and does not constitute medical advice.
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