During the intake interview, our midwives will ask if you would like to get more information about prenatal examination. If you are 36 years of age or older, prenatal diagnostics will be discussed. To consider this beforehand, please read the information below If you want to know more about one of these tests after reading, we will provide more information during the first consultation.
NIPT is an abbreviation of “non-invasive prenatal test” and is being offered to all pregnant women in The Netherlands since April 1st, 2017. This test is currently being conducted as part of a scientific study (TRIDENT-2), which means you participate in a study when choosing for NIPT. NIPT is a test in which a blood sample is taken from the pregnant woman and is examined. The blood is tested for chromosomal abnormalities in the child and focuses on the Down, Edwards, or Patau Syndromes (the same syndromes as in the combined test).
The laboratory can also find other chromosomal aberrations in the baby, in the placenta and very rarely, in the pregnant woman herself. You decide whether you want to take the NIPT and if you want to know these additional findings. You can read more about the NIPT on this website. On this website you will also find a form that will help you make a choice regarding taking the test. The NIPT costs € 175, -. Without medical indication, the costs will not be reimbursed.
The combined test consists out of a nuchal translucency scan and a blood test. This, along with other information (the age of the mom, the duration of the pregnancy, the size of the fetus), helps us determine the chance that the child will be born with Down’s syndrome. The combined test is carried out between the 11th and 13th week, plus6 days of pregnancy. We want to emphasize that this is a probability calculation: the test is never conclusive. As of April 1, 2011, a probability calculation will be made for the Patau and Edwards syndromes. These are syndromes that occur much less frequently than Down's syndrome and, unlike Down's syndrome, these babies are often not viable. The combined test gives an 85% to 90% reliable result for Down’s syndrome and 70% for the Patau and Edwards syndromes, where the limit is at 1 in 200. If you have an increased chance of Down’s, Patau’s and Edwards syndromes then you qualify for additional exams (Amniocentesis, chorionic villus sampling or NIPT).
Probability calculation explained
The tests described above only calculate the chance of having a child with Down’s, Patau’s and Edwards syndromes. A relatively high chance, for example, of 1 in 80, means that of the 80 women with such a chance, one woman gets a child with one of these syndromes. On the other hand, 1 in 1200 means that the chance is low: 1199 women do not get a child with this condition, but one woman does get a child with one of these syndromes.
Who are eligible?
Any pregnant woman, regardless of age, may perform a combined test (nuchal translucency scan and blood test).
What are the costs?
The cost of the combined test is € 167.87. Unfortunately, this is not covered by most health insurances, but we recommend that inform about it regardless. Only on clinical indication, the combined test will be covered.
The 20-week ultrasound is performed between the 19th and 21st week of pregnancy. It aims to assess the child's growth and anatomy so that early growth retardation or anatomical aberration can be detected; it’s impossible to determine this before that time as the child is still too small. Birth defects occur relatively little. A more or less serious aberration is only observed in 2 to 4 percent of pregnancies, before or after birth.
Unlike a "normal" ultrasound during pregnancy (for example, to determine the duration of pregnancy), all the organs of the child are carefully examined at the 20-week echo. The head, torso and limbs are also examined. The exam will take about 30 minutes and will take place in the center Diagnostiek voor U. If an abnormality is suspected, this will be discussed with you. You will be referred to a specialist in obstetric sonography as soon as possible, who will take another extensive look at the baby sonographically.
Although it does not happen often, it is possible an abnormality is found in an ultrasound, that cannot be found again in a follow-up exam, or turns out not to be serious.
From a 20-week gestation period, extensive sonographic examination is a reliable method of determining birth defects. Generally, serious birth defects are also likely to be observed. However, it is possible that an abnormality that is present is not detected. Other conditions such as chromosomal aberrations are seldom accompanied by abnormalities that are observed in this examination.
Baby movements during the ultrasound or excess body weight of the mother can complicate the exam. A positive result in the 20-week ultrasound is not a guarantee that your baby is healthy.
The costs of the 20-week ultrasound will be fully reimbursed by health insurance.
More detailed information on prenatal screening and prenatal diagnostics can be found at www.zwangernu.nl. Our midwives would be happy to answer any questions.