Pregnancy and DNA Question

You can extract fetal DNA from the amniotic fluid, e.g. [link removed upon request from the company linked to] -- but the procedure is not without risk and so is normally only done for health reasons (to detect genetic disorders). The greatest risk at 5months would be loss of the baby, as much as a 1% chance.

I think it's called an amniocentresis, if that's of any help.

An MD who did it would still be liable, legally, if the child died. Ergo, most wouldn't risk doing it unless a medical reason could be trumped up.

triceretops said:

Okay, I'll think of something that would endanger her, prompting the procedure. I admit, it's a fine line here.

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The most common reason for an amnio would be to check for chromosomal abnormalities or genetic disorders, so a family history of a disorder or "advanced maternal age" (I forget what the cutoff is, but younger than it sounds; can increase the risk for chromosomal abnormalities) might be the easiest way to go if it fits with the story. Leaving aside consent issues etc.

True, but if it's just a cover story they could probably ignore that. (Claim not to be sure of the dates?)

I don't have anything new to add, except to say that I immediately thought: "Heck, they could check the DNA of the fetus -- even at 5 months, an amnio would be called for, assuming the pregnant woman wasn't really young."

FYI, regarding Down's Syndrome:

"For example, the risk of having a baby with Down's at age 20 is 1 in 1500, at age 35 it is 1 in 350 and at age 40 it is 1 in 100."

DNA

In real life, they'd just wait until the baby is born.

Sounds like a Maury Povich topic....

I think it can be done. Wether that is harmful or not, I'm clueless. I say work in the mistery of waiting until birth to find out. Maybe a relationship with another guard develops....then the "guilty guard" confesses after birth.

Reasons for an amnio at 5 mos would be age: Often routinely to women over the age of 35 because of increased risk of defects. Another reason is an abnormal reading on her "tri-screen" for a possible chromosomal defect. I tested high for possiblity of downs on my last baby but refused the amnio because of the risk of miscarriage. I wasn't willing to jeapordize his life just to know. We knew from the sonograms that his heart was healthy.

It depends.

I had a patient who would have had an abortion if the baby's father was one guy vs. another guy. An amnio would have established paternity, and yes, people will perform an amnio for this reason. She paid for it out of pocket to prove paternity before carrying the baby to term. She was about 14 weeks. "Five months" is not very specific and might depend on your states' laws re: when an abortion could occur. You could play with the gestational age to make it more plausible. An amnio can be done at any stage of the pregnancy, but it comes down to why are you doing it and what would you do with the information.

For your story, could a woman be bullied into giving consent and could there be a sleazy doc who would do it? I would say yes. There are people who would do an amnio to check for paternity. It would be a challenge, but it would not be impossible. If a 41 year old wants to have an amnio in her mid-trimester to check for Downs, that would be very realistic and they could compare it to potential FOB's (father-of-baby) to establish paternity.

Edited to add: you could have a blood type incompatibility as well. Say her antibody screen comes back showing her body has learned to (potentially) attack the baby's red blood cells. You could do a cordocentesis and get dna that way, although that is messing with some serious stuff and she would need to be in the loop with some perinatologists. An amnio would be simpler. Also, there are some newer studies finding fetal cells in maternal circulation. If this is set in the near future (2008 possibly) one could isolate fetal cells from a maternal blood draw. That is cutting edge (where I live anyway). Sorry for the rambling. There have been many babies in my life recently and very little sleep.

triceretops said:

Okay, I'll think of something that would endanger her, prompting the procedure.

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Why not just wait until the baby's born? What's the rush? If the issue is the baby's adoption, etc., can't it wait?

I'm guessing that the doctor would still be guilty of a breach of medical ethics even if the amniocentesis didn't trigger a miscarriage--just doing it is the violation, regardless of whether a miscarriage occurs. If one occurred the doctor would be liable for more things, but merely doing the test could well be a violation of medical ethics that would get him/her in potentially serious trouble with the licensing board.

ColoradoGuy said:

Good suggestion, although 5 months would be late to do this--it's typically done in the first trimester. And yes, "advanced maternal age" means older than 35.

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I wasn't offered any type of genetic testing until I was in my 5th month, which would have included amnio if any results were wonky. Also, at 5 months I was most definitely not showing yet. (I'm still not, on month 6.) So it's plausible for the purposes of fiction that the pregnancy wasn't discovered until very late.

I could also see an unethical prison doc giving misinformation to an inmate/patient or doing something else shady to get the test done, if the timeline is important.