[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-505983-105":59,"doc-detail-505983-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","critical-assessment-of-noninvasive-prenatal-testing-before-or-after-anomaly-scan","Critical Assessment of Noninvasive Prenatal Testing: Before or after Anomaly Scan","","Noninvasive prenatal testing (NIPT) uses cell-free DNA in maternal serum to screen for fetal chromosomal abnormalities, with commercial availability as early as 10 weeks. The text critically examines the timing of offering NIPT before the anomaly scan, emphasizing that cfDNA screening is not diagnostic and can yield false-positive results requiring invasive confirmation. Limitations include poor detection of many chromosomal abnormalities early in pregnancy and inadequate counseling that may reduce or eliminate subsequent anatomical evaluation.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/critical-assessment-of-noninvasive-prenatal-testing-before-or-after-anomaly-scan/505983/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/critical-assessment-of-noninvasive-prenatal-testing-before-or-after-anomaly-scan/505983.png","ImageObject",300,407,{"name":92,"@type":93},"asba","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-10-04",true,{"@type":102,"interactionType":103,"userInteractionCount":14},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"How does NIPT work and what does it screen for?","Question",{"text":112,"@type":113},"NIPT analyzes cell-free DNA from maternal blood. It screens accurately for Down syndrome and less effectively for other trisomies and certain structural chromosomal abnormalities.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why is NIPT before an anomaly scan considered problematic?",{"text":117,"@type":113},"Offering NIPT at around 10 weeks can precede the anomaly scan, and the technique’s limitations may lead to missed abnormalities and inadequate anatomical evaluation.",{"name":119,"@type":110,"acceptedAnswer":120},"What should be done if an NIPT result is positive?",{"text":121,"@type":113},"Positive results require secondary testing with invasive diagnostic techniques because cfDNA analysis is a screening test and not considered diagnostic.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},505983,1792693240,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":39,"preview_page_count":4},3985747872567,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","DSJUOG   \n10.5005/jp-journals-10009-1574  \nOPINION ARTICLE  \nCritical Assessment of Noninvasive Prenatal Testing: Before or after Anomaly Scan  \nYaron Zalel  \nHow to cite this article: Zalel Y. Critical Assessment of Noninvasive Prenatal Testing: Before or after Anomaly Scan. Donald School J Ultrasound Obstet Gynecol 2018;12(4):255-257 . Source of support: Nil  \nConflict of interest: None  \nNoninvasive prenatal test (NIPT) analyzes cell-free DNA (cfDNA) in the maternal serum. Approximately, 3–15% of cfDNA in the maternal blood is of fetal origin.  \nThe NIPT examination, based on the existence of this cfDNA, is accurate in screening for Down syndrome and less for other trisomies, as well as other structural chromosomal abnormalities. The commercial companies offer this technique as early as 10 weeks of gestation.  \nThe purpose of this critical assessment is to challenge the timing of offering the NIPT to women at 10 weeks gestation, emphasizing the limitations of this technique before the anomaly scan is done.  \nThe utilization of NIPT for genetic screening has increased rapidly since the introduction of the first clinical test in October 2011. However, its performance early in pregnancy hasnot been recommended by the commercial companies only. Likewise, Bianchi et al.1 have even examined their patients from 8 weeks gestation, Lo et al.2 stated that it can be done after 9–10 weeks' gestation and the Israeli Society of Medical Genetics NIPT Committee Opinion 0720133 stated that it can be done as early as 10 weeks of gestation.  \nFurthermore, although the 99% detection rate for trisomy 21, using cfDNA screening, one should remember, that cfDNA analysis is a screening test and is not considered diagnostic because of the potential for falsepositive results. Positive results require secondary testing with invasive techniques.  \nMoreover, 17% of chromosomal abnormalities detected by a traditional screening test were not detectable by cfDNA screening.4,5 These abnormalities included rare trisomies, unbalanced rearrangements, and large deletions or duplications.  \nProfessor  \nExpert Clinic, Habarzel 9a Tel-Aviv, Israel  \nCorresponding Author: Yaron Zalel, Professor, Expert Clinic, Habarzel 9a Tel-Aviv, Israel, Phone: 972-52-6666462, e-mail: [zalel1954@ gmail.com](zalel1954@ gmail.com)  \nI have published in 2015 an article named: NIPT–it is all a matter of timing.6 I have described, during the first year after the introduction of the technique to Israel,6 women with various malformations (including severe heart, brain, and renal abnormalities) found in anomaly scan a few days after a normal NIPT. These women were falsely reassured of the “normality” of their pregnancies, eventually either underwent a further invasive procedure or terminated the pregnancy and even paid considerable sums of money for the blood test.  \nWhile preparing this opinion, I have turned toG-Med raising the same issue.  \nGlobal Online Medical Community (G-Med) is the largest community for physicians, true medical crowdsourcing enabled by peer-to-peer consultation of hundred thousands of physicians worldwide ([www.g-med.info](www.g-med.info)).  \nI have added a recent case of mine (a 41 years old woman, para 0, after normal NIPT examination at 10 weeks gestation, who was diagnosed with multiple anomalies, including a large omphalocele containing liver, complex heart disease and IUGR (Figs 1 to 4) found at early anomaly scan that led to a termination of pregnancy) and raised the question of timing of the NIPT.  \nThese were the results:  \nSo, although we have succeeded to raise the importance of performing an anomaly scan before the NIPT, there are still 38% of the physicians worldwide that would send their patients for NIPT first.  \nFurthermore, in various countries, includingthe US, there are many NIPT examinations done  \nDonald School Journal of Ultrasound in Obstetrics and Gynecology, October-December 2018;12(4):255-257 255  \nFig. 1: The fetus “watches” large ompha","cbCaijINLC2Y5An8","https://ap.wps.com/l/cbCaijINLC2Y5An8","pdf",992110,"English","# Critical Assessment of NIPT Timing\n## Principles and screening limits of cfDNA\n## Need for anomaly scan before NIPT\n## Diagnostic confirmation and counseling consequences","[{\"question\":\"How does NIPT work and what does it screen for?\",\"answer\":\"NIPT analyzes cell-free DNA from maternal blood. It screens accurately for Down syndrome and less effectively for other trisomies and certain structural chromosomal abnormalities.\"},{\"question\":\"Why is NIPT before an anomaly scan considered problematic?\",\"answer\":\"Offering NIPT at around 10 weeks can precede the anomaly scan, and the technique’s limitations may lead to missed abnormalities and inadequate anatomical evaluation.\"},{\"question\":\"What should be done if an NIPT result is positive?\",\"answer\":\"Positive results require secondary testing with invasive diagnostic techniques because cfDNA analysis is a screening test and not considered diagnostic.\"}]","Critical Assessment of Noninvasive Prenatal Testing: Before or after Anomaly Scan | PDF",1791156331]