Copy 3 of Vanliga frågor

Yes you are allowed to do NIPT as a Norwegian woman.

NIPT is offered to women in Norway if they are more than 38 years of age and have a ultrasound investigation indicating irregularity.

However if you do not meet the criteria above, set by the health care law in Norway, you may have to do the test outside of Norway.

NIPT, as many other medical investigations, is a personal choice, for some this is in accordance with the offers of the given health care system, for others not.

Read more about this specific topic here and about other common ponders here.

Du kan gjøre NIPT Screening som Norsk kvinne. Fra 1 Juli bestemte Stortinget at Norske kvinner kan få gjøre NIPT. Men ingen klinikker i Norge er igang ennå. Det betyr at du fortsatt må få veiledning, ha utenlandsk ansvarlig lege og bestille kit utenfor Norge.

1. Les all info på våre sider

2. Book en veiledningssamtale så du får forklaringer fra oss og er godt informert om NIPT som screening test og praktiske funderinger.

3. Kort sagt:

- Enten så drar du til Sverige, våre pasienter har siste 9 ukene ikke havnet i karantene men dette styrer man på grensen. Dette skyldes at du som pasient ikke vurderes å ha blitt eksponert bare basert på en 10 minutters blodprøvetagning under kontrollerte former.

- En norsk lege hjelper deg med prøvetagning, dette er helt opp til den norske legen, mange hjelper med dette men ikke alle. Da sender du prøven i henhold til nøye instrukser fra oss. Det er like trygt å sende NIPT fra Norge som å ta NIPT på klinikk i Sverige eller Danmark. Våre tester analyserer i Sverige, dvs. de sendes ikke til USA eksempelvis.

4. Det absolutt viktigste med NIPT screening er at du er godt informert og at du ivaretas om du får avvikende svar. Du får nøye informasjon og forklaringer på våre veiledningstimer og kan deretter finne ut hva som er rett for deg.

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.

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.

1. Vi må legge en bestilling i datasystemet. 2 dager før du skal ta test så texter du Dr. Kristian. Dere avtaler en tid for en rask gjennomgang.

2. På samtalen så informerer du om hvilke analyser du vil gjøre.

Om du ikke har bestemt deg så ta spørsmål med Charlotta eller ta det med Dr. Kristian på denne samtalen. Husk å lese linkene under nøye.

https://www.eddalabs.com/hva-kan-vi-teste

https://www.eddalabs.com/teleinfo

3. Harmony Prenatal Arket er det eneste arket som skal følge med kit. Dette må du fylle i.

Spørsmål til dette arket tar du på samtalen med Dr. Kristian.

OBS! DHL er steng på helgen så ring fredag om du vil ha pickup mandag.

DHL sier du kan bestille helt til kl 14:00 den dagen du vil ha din prøve hentet. Men vi anbefaler at du bestiller pickup dagen før.

Ring DHL +47 21002200

oppgi ditt Ditt Waybill nummer ( = sendings nummer)

- Ditt Waybill nummer står mellom strekkodene på DHL posen som er merket "Exemt Human Specimen"

Om de spør om vårt kundenummer så er det 960555527

Om de spør om Proforma Faktura (Tollpapirer ) så ligger de ferdig i 3 eksemplar i plastvinduet. Alt er ferdig ordnet du behøver ikke ta ut papirene.

- Med ditt Waybill nr kan du følge din pakke til laboratoriet på DHL.no. Tell 9dg fra dagen etter at du har sendt.

- Du avtaler med DHL om du vil ha Pickup hjemme hos deg eller på jobben. DHL henter på den adressen du vil.

-Du lurer nå på om dette er trygt, ja det er helt trygt. Om DHL henter hos deg eller på Rikshospitalet har ingenting å si. Det er ditt Waybill nummer som styrer status på din pakke, hvor fort den sendes, oppbevaring etc. NIPT prøver kan ligge i posten en uke uten problem, de er veldig robuste så dette er helt uproblematisk. Rikshospitalet sender sine prøver til Sverige. DHL Express er den aktøren som de fleste sykehus bruker. Danske klinikker sender nesten alltid sine prøver til USA. Mao. NIPT prøver sendes overalt.

Det er alltid best å ringe DHL +47 21002200 om du lurer på noe med sending.

De fleste på DHL kunderservice er kjent med oss og er veldig behjelpelige.

1. Du bestiller kit på våre sider

https://www.eddalabs.com/pris

Du kan bestille 2-3 uker før du tenker ta prøve eller 3 dager før. Det tar ofest 1 dag å få kit hjem. Du betaler ingenting på forhånd.

2. Om du ikke vet hvor du skal ta prøve og behøver tips så hør av deg, legg igjen et telefonnr. så vi kan nå deg. Det er alltid lettest å gjøre Ultralyd og ta prøve på samme sted.

3. Om du skal ta prøve i Sverige så booker du tid eller drar på dropin. Du må alltid ha med kit.

https://www.eddalabs.com/steder

4. Du må alltid ha en gjennomgang før du tar selve blodprøven. Det er for din pasientsikkerhet.

Om det ikke finnes tid så kontakt oss per email på info@eddalabs.com så finner vi en tid men du behøver ikke stresse med dette om du er i uke 7-8. Det er først om du nærmer deg 10+0. Vi må prioritere de som har det mest travelt i dette henseende.

Gratisk telefontid bookes her.

Før du kontakter oss så klikk igjennom NIPT-skolen

Du kan ta test 2 dager etter kontakt.

Man kan oftest gjøre NIPT via Edda Labs 2 dager etter at du har hatt rådgivning og bestilt via oss.

Om vi har samtale mandag, så kan du gjøre test onsdag osv.

Om du bestiller på en fredag så blir første prøvedag oftest tirsdag.

Når det er sagt så er det 2 poeng som du som pasient bør ha med deg.

1. Det viktigste med NIPT er tankene og planen du legger før du gjør screening. Å ta prøven er veldig enkelt, men du selv tenke igjennom hva du gjør ved avvikende svar.

Dette er akkurat det samme som om du går inn å gjør en ultralydsundersøkelse.

Prøven er enkel, det er dine tanker og forståelse av den som er viktig og på Edda Labs hjelper vi deg med å forstå NIPT.

2. Norske pasienter er opptatt av uke 12. Dette knytter seg til retten for selvbestemt abort.

I media så fremstilles NIPT som en prøve du kan ta og dernest bruke som beslutning for hvorvidt du evt. skal avbryte svangerskapet.

Slik er det ikke i realiteten.

NIPT og Ultralyd er screening undersøkelser. NIPT er den mest treffsikre, men får du avvikende svar så må du gå videre med morkake eller fostervannsprøve for å bekrefte svaret.

Om du gjør prøve i uke 10, og får svar på raskeste vis så behøver du fortsatt bekrefte dette svaret. Du kommer da til å passere uke 12, fordi ingen fostermedisinske sentre kommer til å kunne ta deg inn før uke 12 for å gjøre en bekreftende analyse.

Dette er typiske spørsmål vi får og som det er bra å prate om så man ikke stresser med NIPT.

Derfor, om du har tanker rundt dette så diskuter med oss på telefon fordi vi er vant til slike funderinger.

Vi ønsker at du som pasient forstår fullt og helt hvordan NIPT fungerer. Uansett om du bor i Norge, Sverige eller USA så er situasjonen tilnærmet lik på dette området.

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.

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.

Hun har jobbet ved Barn Endokrinologi Enheten og Onkologi Enheten.

Dr. Borgstrøm har hele sin karriere kombinert klinikk og forskning. Blant annet omhandlet hennes doktorgrad konsekvensene av endokrinologiske defekter hos barn.

Dr. Borgstrøm fungerer som medisinsk rådgiver innen syndromtilstandene vi kan screene for. Hennes dype innsikt endokrinologiske tilstander gjør at vi kan rådgi alle våre pasienter på en ansvarsfull måte. Dr. Borgstrøm har vært inngående involvert i klinikk og forskning relatert til hormonbehandling og fertilitetsbevaring hos barn med endokrinologogiske forstyrrelser, eksempelvis Turner syndrom.

Dr. Borgstrøm har gjennom sin kunnskap innen endokrinologiske syndrom vært sentral når rådgiving behøves relatert til syndromtilstander som detekteres ved fosterdiagnostikk.

Han jobber ved Fosterkardiologi og Barn Kardiologi enheten.

Dr. Winberg fungerer som medisinsk rådgiver, han har jobbet som generell barnelege, dernest som nyfødtlege før han rettet fokus på foster og barnkardiologi noe han har jobbet med de siste 30 årene. Han har dyp innsikt i syndromtilstander og dernest årsaker til karidiologiske avvikelser hos foster.

Tverrfaglighet er essensielt innen fosterdiagnostikk. Gravide kvinner rådgis og følges av Barneleger og Obstetrikere med innsikt og forståelse for tilstandene som foreligger. Dette slik at gravide kvinner får så informative og faktabaserte råd som mulig.

Yes you are allowed to do NIPT as a Norwegian woman.

NIPT is offered to women in Norway if they are more than 38 years of age and have a ultrasound investigation indicating irregularity.

However if you do not meet the criteria above, set by the health care law in Norway, you may have to do the test outside of Norway.

NIPT, as many other medical investigations, is a personal choice, for some this is in accordance with the offers of the given health care system, for others not.

Read more about this specific topic here and about other common ponders here.

Yes, you can do NIPT as a Norwegian woman.

Pregnant women in Norway 38 years or older are referred to Fetal Medical Centers at Rikshospitalet/ St.Olav etc, they offer CUB ( a special ultrasound investigation and hormone tests ). If this investigation indicates anomaly you are offered NIPT test.

However if you are younger than 38 you will have to do NIPT outside of Norway.

Rules regarding NIPT differ between countries and in Norway women are not offered NIPT, however as a patient you can choose to go abroad and do it.

As a patient you are allowed to do what feels right for you. A decision starts with gathering information, feel free to book a free phone consultation to understand more.

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.

Yes, you can do NIPT as a Norwegian woman.

Pregnant women in Norway 38 years or older are referred to Fetal Medical Centers at Rikshospitalet/ St.Olav etc, they offer CUB ( a special ultrasound investigation and hormone tests ). If this investigation indicates anomaly you are offered NIPT test.

However if you are younger than 38 you will have to do NIPT outside of Norway.

Rules regarding NIPT differ between countries and in Norway women are not offered NIPT, however as a patient you can choose to go abroad and do it.

As a patient you are allowed to do what feels right for you. A decision starts with gathering information, feel free to book a free phone consultation to understand more.

Short answer:

Most children are born healthy.
Prenatal diagnostics is not necessary.
Some want to do prenatal diagnostics, it is a personal choice.
Reflect on why you want to do diagnostics and what you will do with potential answers.
NIPT is today our most accurate prenatal genetic screening method.
Always discuss with health personell before intiating the process.

For the ones who wish to do prenatal diagnostics there are different methods. Ultrasound and NIPT are the risk free methods. NIPT is a newer method based on genetic analysis and has higher accuracy than ultrasound.

More elaborate answer:

1. When doing prenatal diagnostics in week 10-15 one screens for known conditions. Historically this has been done with ultradound, screening for conditions such as Pataus, Edwards and Downs syndrome. (Trisomy 13, 18, 21).

Sensitivity is a test ability to detect a condition.

NIPT has a sensitivity of 95-99% on the above conditions.

Ultrasound has a sensitivity of 75-85%

CUB ( Combined ultrasound and hormone Blood samples) has a sensitivity of 85-95%

In other words NIPT has a better sensitivity, ability to detect a condition, than ultrasound based methods and is therefore used more and more in prenatal diagnostics.

2. NIPT is an objective DNA analysis, not dependant on the person doing the investigation as opposed to ultrasound.

Ultrasound is a good method but it is dependant on the investigator, the equipment and the patients constitution. In short several factors come in to play.

NIPT does not have these factors and so is more reliable.

3. NIPT is risk free.

A regular venous blood sample from the pregnant mother is all that is needed.

"Early ultrasound" and CUB:

CUB is a spesific prenatal investigation. In Norway only available for women over the age of 38 and is performed at prenatal diagnostic centers at Rikshospitalet, St. Olav etc.

Sensitivity is 85-95% on conditions mentioned above.

"Early Ultrasound" is a term used in Norway related to ultrasound from week 6-18. It is not the same as CUB.

It is a less validated method.

"Early Ultrasound" has a sensitivity of 75-85% on conditions mentioned above.

Why isnt everyone using NIPT?

Costs: NIPT is expensive. It will become cheaper but genetic analysis is so far quite expensive.
Politics: Prenatal diagsnostics is controversial in some countries. A more accurate method increases the controversy. It has obvious ethical aspects to it. In some countries it is very regulated, in others the pregant women/couple has the final say. There is no clear answer, just different opinions.
Routines: It takes time to change an exisiting routine, for instance if a countrys prenatal diagnostic system is based on ultrasound and CUB it takes time to switch to NIPT.

A reasonable way to think:

Do you want to do prenatal screening?

Why do you want to do it?

If you want to do prenatal screening, ultrasound is one method, NIPT another, NIPT has better sensitivity with regard to the conditions above, however it is also more expensive.

If you want to do NIPT and futhermore follow up in the best way possible today do as follows.

1. Do NIPT in week 10.

2. Do ultrasound from week 16, or wait a few more weeks.

3. Make sure you do one ultrasound in week 18-19.

Doing to early ultrasounds is excessive. Do atleast one ultrasound week 18-19. This is when the more sublte abnormalities should be visible, abnormalities such as midline defects, heart valve defects, spinal hernia, diaphragmatic hernia etc.

This is the best approach we have to prenatal screening today.

If you want 1005 answers chorion or amnioticenticis is the only diagnostic test we have.

(Risk of miscarriage is 0,5-1%) These are not considered screening methods.

Remember, nothing is 100% in medicine.

Expecting a baby is an uncertain journey regardless of what you do.

Han jobber i barnenevrologi virksomheten.

Dr. Sallin har lenge jobbet med medisinsk etikk i sin forskning og gjennom sitt engasjement i Svenska Läkarsällskapet.

Dr. Sallin fungerer som etisk rådgiver. Han fungerer også som rådgiver i medisinke spørsmål gitt dyp innsikt i barnenevrologi og syndromforståelse.

Dr. Sallin vokste opp i Göteborg. Han er utdannet ved Göteborgs Universitet, og Cambrigde University i England.

Dr. Sallin har pågående forskning ved Centrum for forskning och bioetik ved Uppsala universitet.

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.

You can take the test from pregnancy week 10+0. Pregnancy Week is in medical terms often called gestational week and is based on couting weeks from the first day of your last menses and is commonly referred to as pregnancy week.

Before doing an NIPT screening you should do an ultrasound to know the number of fetuses. NIPT can be done with 1 or two fetuses but not 3. When doing an ultrasound you will also be informed of approximately what week you are in, which can then be compared to your calculations based on last menses.

Sometimes if you take the NIPT too early there is not enough fetal DNA in the mothers blood so it is important to waint untill week 10+0.

Nei, du har god tid.

NIPT kan gjøres fra uke 10+0 til uke 40 med lik nøyaktighet.

Mange vil gjøre det så fort som mulig, uke 10 + 0 er absolutt tidligst.

1. Om du ikke har gjort tidlig ultralyd så forsøk å dra til et sted som kan hjelpe deg med å ta blodprøve også.

- Før du bestiller si at du ønsker å gjøre NIPT men også en tidlig ultralyd, og hør om de kan hjelpe deg med blodprøven om du har med kit.

2. Om du har gjort tidlig ultralyd så er det å ta prøven kanskje litt vanskeligere men det er samme her, du behøver hjelp med prøvetaking og det er mange steder som hjelper. Det er råder desverre litt forvirring rundt dette så det er mange som ikke annonserer dette ved spørsmål på telefon. Dette skyldes at Stortinget har legalisert NIPT for Norske kvinner fra 1 juli mens Helsedirektoratet har bedt helsepersonell følge gamle retningslinjer intill videre.

Vi som tilbyr NIPT utenfor Norge kan ikke påvirke hva Norsk helsepersonell velger å gjøre men vi forsøker å hjelpe deg som pasient så godt det går. Det gjør vi på vår telefonprat evt. om du hører av deg i chat. Men vi ber om at du leser alle punkter under da vi har veldig stor pågang og det er vanskelig å svare på alle generelle spørsmål som kommer.

You can do NIPT screening from pregnancy week 10.

Pregnancy week is called gestational week in medical terms. It is based on counting Weeks from the First day of last menstruation.

Before you do NIPT you have to do a simple ultrasound to know the pregnancy is viable, the number of fetuses and approximate dating of your pregnancy.

NIPT is possible in single and twin prengancies but not in triplets or more.

If you do NIPT too early, before week 10, reserach has shown that the amount of fetal DNA is at times is too low for analysis. Then we have to do a new test. Hence a test after week 10 is recommended.

You can take the test from pregnancy week 10+0. Pregnancy Week is in medical terms often called gestational week and is based on couting weeks from the first day of your last menses and is commonly referred to as pregnancy week.

Before doing an NIPT screening you should do an ultrasound to know the number of fetuses. NIPT can be done with 1 or two fetuses but not 3. When doing an ultrasound you will also be informed of approximately what week you are in, which can then be compared to your calculations based on last menses.

Sometimes if you take the NIPT too early there is not enough fetal DNA in the mothers blood so it is important to waint untill week 10+0.

2 dager før du tar prøve så ringer du DHL +47 21002200 og opplyser om ditt Waybill nummer ( = sendings nummer).

- Ditt Waybill nummer står mellom strekkodene på DHL posen som er merket "Exemt Human Specimen"

- Du avtaler med DHL om du vil ha Pickup hjemme hos deg eller på jobben. De henter på den adressen du vil.

- Du kan også levere på Drop Off om det er enklere.

Gå inn på DHL.no for å finne den nærmeste Drop Off for deg.

Mange foretrekker denne løsningen.

Du lurer nå på om dette er trygt, ja det er helt trygt. Om DHL henter hos deg, på Rikshospitalet eller 7 Eleven har ingenting å si. Det er ditt Waybill nummer som styrer status på din pakke, hvor fort den sendes, oppbevaring etc. NIPT prøver kan ligge på posten i en uke uten problem, de er veldig robuste så dette er helt uproblematisk.

Det er alltid best å ringe DHL +47 21002200 om du lurer på noe med sending.

OBS!

Ikke send fra legekontor eller sykehus.

- Noen pasienter har sendt fra legekontor eller sykehus, det er oftest mer plundrete enn om du sender selv. Sykehus og legekontor har sine rutiner og da blir det krøll. Det er absolutt ikke sikrerer enn at du gir pakken til DHL eller at de henter på en kiosk. Dette er en stor misoppfattning, du er mye flinkere selv til å levere en pakke på Drop Off eller til DHL personen.

You can take the test from pregnancy week 10+0. Pregnancy Week is in medical terms often called gestational week and is based on couting weeks from the first day of your last menses and is commonly referred to as pregnancy week.

Before doing an NIPT screening you should do an ultrasound to know the number of fetuses. NIPT can be done with 1 or two fetuses but not 3. When doing an ultrasound you will also be informed of approximately what week you are in, which can then be compared to your calculations based on last menses.

Sometimes if you take the NIPT too early there is not enough fetal DNA in the mothers blood so it is important to waint untill week 10+0.

You can take the test from pregnancy week 10+0. Pregnancy Week is in medical terms often called gestational week and is based on couting weeks from the first day of your last menses and is commonly referred to as pregnancy week.

Before doing an NIPT screening you should do an ultrasound to know the number of fetuses. NIPT can be done with 1 or two fetuses but not 3. When doing an ultrasound you will also be informed of approximately what week you are in, which can then be compared to your calculations based on last menses.

Sometimes if you take the NIPT too early there is not enough fetal DNA in the mothers blood so it is important to waint untill week 10+0.

Kort Svar:

De fleste barn fødes friske.
Fosterdiagnostikk er ikke en nødvendighet.
Enkelte ønsker å gjøre fosterdiagnostikk, det er et personlig valg.
Tenk igjennom hvorfor du gjør diagnostikken og hva du gjør med svar du kan få.
NIPT er i dag den beste screening metoden vi har for genetiske avvikelser.

For de som ønsker å gjøre fosterdiagnostikk finns det ulike metoder. Av risikofrie metoder så finns Ultralyd og NIPT. NIPT er en nyere metode og har en høyere treffsikkerhet enn ultralyd.

Mer inngående svar:

1. Når man gjør fosterdiagnostikk i uke 10-15 så screener man primært for kjente tilstander. Historisk sett har Ultralyd blitt brukt som screening metode for å detektere tilstander som Pataus, Edwards og Downs syndrom ( Trisomi 13, 18 og 21).

NIPT har en sensitivitet på 95-99%,

Ultralyd har en sensitivitet på 75-85%,

KUB ( Kombinert Ultralyd og hormon Blodprøver) har en sensitivitet på 85-95%.

NIPT har med andre ord en bedre sensitivitet (evne til å detektere avvikelser) enn andre metoder og det er grunnen til at NIPT brukes mer og mer i fosterdiagnostisk screening.

2. NIPT er en objektiv DNA analyse og avhenger ikke av personen som gjør undersøkelsen.

Ultralyd er en bra metode men den er avhengig av personen som gjør undersøkelsen, utstyret og pasientens konstitusjon. Det er kort sagt flere faktorer som avgjør hva man ser og faktorene er dels utenfor undersøkerens kontroll.

Dette er noe alle utøvere av ultralyd kjenner til.

Disse faktorene spiller i prinsipp ingen rolle når man gjør NIPT screening ettersom det er en DNA analyse. Dette gjør metoden mer treffsikker.

3. NIPT er risikofritt.

NIPT er en metode som analyserer DNA fra fosteret som finnes i den gravide kvinnens blodbane. En vanlig blodprøve i armen er det som behøves.

"Tidlig Ultralyd" og KUB:

KUB (Kombinert Ultralyd og hormon Blodprøve) en en spesifikk fosterdiagnostisk undersøkelse. I Norge er metoden kun tiljgengelig for kvinner over 38 år og gjøres på fostermedisin på Rikshospitalet, St. Olav etc.

KUB har en sensitivitet på 85-95%

I flere land tar man nå ibruk NIPT fordi NIPT har en sensitivitet på 95-99%

"Tidlig ultralyd" er et begrep som brukes i Norge. Det er ikke det samme som KUB.

"Tidlig ultralyd har i undersøkelser vist en sensititivet på 75-85%.

"Tidlig ultralyd" er ikke en bestemt metode og derfor vanskelig å validere da den skiller seg fra utøver til utøver.

Hvorfor bruker ikke alle helsesystem NIPT?

Kostnader: NIPT er dyrt, så det er få helsesystem som tilbyr det gratis. Genetikk er fortsatt et ganske nytt område innen medisin. Det utvikles raskt, men analyser og utstyr er fortsatt kostbart så for eksempel ultralyd er billigere.
Politikk: I noen land er fosterdiagnostikk kontroversielt. En mer treffsikker fosterdiagnostisk screening metode som NIPT øker kontroversen. Fosterdiagnostikk kan sette gravide kvinner og par i vanskelige etiske situasjoner. I noen land ligger valget om fosterdiagnostikk hos kvinnen/paret, i andre land har man lagt sterkere føringer på hva man tilbyr av tjenester. Det finns ingen fasit, bare utfordrende problemstillinger og ulikt syn på hvordan man forholder seg til disse.
Etablerte rutiner: I noen land tilbyr man ikke fosterdiagnostikk rutinemessig, I andre er det en sentral del av svangerskapsomsorgen. Om man har bygd opp et system basert på eksempelvis ultralyd, så er det en viss utfordring forknippet med å slippe etablerte metoder og velge en helt ny tiilnærming. Dette gjøre at nye metoder ikke nødvendigvis innføres umiddelbart.
NIPT vil sannsynligivs bli mer og mer vanlig i årene som kommer, og på sikt kommer metoden med stor sannsynlighet spille en sentral rolle i fosterdiagnostikken.

En fornuftig fremgangsmåte:

Tenk igjennom om du ønsker å gjøre fosterdiagnstikk?

Tenk igjennom hvorfor og hva du vil gjøre med eventuelle svar.

Om du ønsker å gjøre fosterdiagnstikk så er ultralyd en metode og NIPT en annen.

NIPT har bedre treffsikkerhet i dette henseende.

1. Gjør NIPT i uke 10

2. Gjør evnt. ultralyd fra uke 16.

3. Gjør ultralyd etter uke 18.

Verdien av for tidlige ultralyder er omdiskutert, gjør en undersøkelse i uke 18/19.

Fra uke 18 bør mer vanskelige avvikelser som hjerteklaff avvikelser, midtlinje defekter, subtil ryggmarg/diafragmabrokk etc. være synlige samt at man ser tilvekst.

Dette er risikofritt og den beste tilnærminen vi har innen fosterdiagnostisk screeing i dag.

4. Er du en person som ønsker 100% svar så er morkake og fostervannsprøver de eneste metodene som vi kaller 100%. Disse er dog forknippet med en liten men eksisterende risiko for spontanabort (0,5-1%) og er derfor ikke regnet som screening metoder.

Det er også verdt å huske at ingenting er 100% sikkert innen medisinsk diagnostikk.

Å vente barn er forknippet med usikkerhet uansett hva man gjør.

You can take the test from pregnancy week 10+0. Pregnancy Week is in medical terms often called gestational week and is based on couting weeks from the first day of your last menses and is commonly referred to as pregnancy week.

Before doing an NIPT screening you should do an ultrasound to know the number of fetuses. NIPT can be done with 1 or two fetuses but not 3. When doing an ultrasound you will also be informed of approximately what week you are in, which can then be compared to your calculations based on last menses.

Sometimes if you take the NIPT too early there is not enough fetal DNA in the mothers blood so it is important to waint untill week 10+0.

You can take the test from pregnancy week 10+0. Pregnancy Week is in medical terms often called gestational week and is based on couting weeks from the first day of your last menses and is commonly referred to as pregnancy week.

Before doing an NIPT screening you should do an ultrasound to know the number of fetuses. NIPT can be done with 1 or two fetuses but not 3. When doing an ultrasound you will also be informed of approximately what week you are in, which can then be compared to your calculations based on last menses.

Sometimes if you take the NIPT too early there is not enough fetal DNA in the mothers blood so it is important to waint untill week 10+0.

Ja, du kan gjøre NIPT som Norsk kvinne men på ulike måter avhengig av alder.

Fra 1 juli er NIPT mulig i Norge men ingen klinikker er så lenge i gang da vi venter på retningslinjer fra Helsemyndigheter i Norge.

Enn så lenge gjelder da følgende:

Gravide kvinner i Norge som er 38 år eller eldre henvises til fosterdiagnostiske sentra på Rikshospitalet/St. Olav etc. der tilbys KUB ( Kombinert Ultralyd og hormon Blodprøver)

KUB er en spesiell fosterdiagnostisk screening undersøkelse og om KUB indikerer avvikelse så tilbys du NIPT analyse. Om du ønsker å gjøre NIPT uavhengig av hva KUB viser så må dette gjøres utenfor Norge.

Om du er yngre enn 38 år må du gjøre NIPT i regi av en aktør utenfor Norge.

Vi tilbyr kostnadsfri telefon konsultasjon slik at du er godt informert om NIPT og fostår hvordan det fungerer.

Vi følger alle våre pasienter tett og avklarer praktiske spørsmål på telefonkonsultasjonen.

Til syvende og sist er det et personlig valg hva man velger å gjøre.

Before NIPT screeing you need to do a simple early ultrasound. This can be done from 6 weeks of pregnancy. Why?

NIPT screening can only be done on single or twin pregnancies, and if there is as twin pregnancy it is important for the laboratory to know in advance. If for any reason the pregnancy is not viable or there are more than 2 fetuses the screening will not be accurate.

NIPT screening should be done after pregnancy week 10+0. When doin an ultrasound you will get an approximate dating on what week you are in. You can compare this with your first day of last menses calculations and hence make sure that you take the test after pregnancy week 10+0.

In short doing an ultrasound makes sure the screeing becomes as accurate as possible.

Remember, the ultrasound is only for distinguishing the number of fetuses and the approximate week you are in. This type of ultrasound is called early ultrasound and can be done in most ultrasund clinics from 6 weeks of pregnancy.