Short answer:
Most infants are born healthy!
It is not necessary to do prenatal screening.
It´s is a personal choice and you should understand what you are screening for and how you want to go about potential answers.
However, if you want to do genetic prenatal screening, then NIPT is the best we have in 2019.
Long Answer:
1. NIPT is more reliable and accurate than existing screening methods
(such as CUB: ultrasound+hormone test) in screening for genetic abnormalities.
2. NIPT collects genetic material safely, you do not need to go into the belly so you do not risk causing any harm to the fetus by doing the test.
Can you explain more ?
NIPT is better than CUB: ultrasound+hormone test because ultrasound is hard at the early stages of pregnancy. Abnormalities may not be very visible, and the markers that you look for in ultrasound and hormone levels that you analyse are indirect signs. This means that the investigations done in ultrasound, if done the right way, gives you a probability score when putting together a number of factors. So when screening for genetic conditions reserach has shown that NIPT is more reliable, NIPT gives less false negative and less false positives than ultrasound.
Just doing an ultrasound and not following the CUB protocol is even less accurate someting many examiners do not inform patients about.
But why don´t all health systems/doctors go with NIPT then?
Money: NIPT is expensive, so not all systems have it. Genetics is still in its infancy and it is an expensive analysis and naturally it is not all systems who can afford it.
Politics: In some countries prenatal diagnostics in itself is controversial. A more accurate prenatal screening test like NIPT may only increases the controversy. However to claim right or wrong is beyond politics, these are really hard questions that pregnant women/couples should be supported in.
Established routines: In many countries pregnant women are not offered a systematic prenatal screening in the early trimesters, in some countries systems are built around ultrasound screening later in pregnancy, in others ultrasund is simply considered the method to go by. Furthermore ultrasound is a good way to screen later in pregnancy so you still need, hence new methods are not always introduced.
Tradition: With improved techniques, data and lowered prices we will most likely see more test similar to NIPT among other reasons because it is more reliable than using investigations based on "human skills". But most likely a combination will be the best. However, for now NIPT is fairly new hence not a common screening method offered to all.
So how should I think?
First of all make up your mind whether you want to do prenatal diagnostics or not. And think about the differents answers you may get and how you will react to them. Read on these, and on other pages that are serious, to get a good understanding.
If you do want to proceed with prenatal screening and you want the gold standard of prenatal screening in 2019, you should go at it the following way:
- NIPT in week 10-12, screening for genetic conditions
- Ultrasound in week 13-16, screening for anatomical defects, midline defects and follow the growth of the fetus.
- Ultrasound in week 16-20 screening for anatomical defects, midline defects and follow the growth of the fetus.
Feel free to discuss this with us on the phone, that is why we are here.
6. If you want 100% answers you have to do an invasive procedure, chorion villus sampling, or rather amniotic fluid sampling. Unfortunately this type of procedure can cause harm to the fetus and hence is not recommended as a screening method.
Note;
When talking about ultrasound we here refer to a proper prenatal ultrasound screeing aka. CUB (ultrasound and hormone tests and all of this put into a know scientific algorithm) If you do not want to do NIPT but rather ultrasound make sure the investigation is a proper CUB.