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https://phescreening.blog.gov.uk/2021/02/04/what-midwives-need-to-know-ahead-of-introduction-of-nipt/

What midwives need to know ahead of introduction of NIPT

Posted by: and , Posted on: - Categories: NHS Fetal Anomaly Screening Programme
We’ll soon be adding information about NIPT to the Down’s syndrome, Edwards’ syndrome and Patau’s syndrome chapter of Screening tests for you and your baby. The version shown here is a draft and has not been published yet.

As we mentioned the other day, an updated version of Screening tests for you and your baby (STFYAYB) will be available on 29 March 2021 for services to start ordering.

The updated version includes information about the offer of non-invasive prenatal testing (NIPT) and how it fits into the existing NHS screening pathway for Down’s syndrome, Edwards’ syndrome and Patau’s syndrome.

NIPT information

Women who receive a higher chance result from a combined or quadruple test taken on or after the 1 June 2021 will be offered NIPT. This applies to women pregnant with singletons or twins.

Some women who book for maternity care before 1 June 2021 will be eligible for the offer of NIPT and some will not. It depends the timing of the combined or quadruple test (if the woman chooses to have screening).

Screening for Down’s syndrome, Edwards’ syndrome and Patau’s syndrome should continue to be offered to women within the timeframes set out by the NHS Fetal Anomaly Screening Programme (FASP).

We've outlined 3 different scenarios, below, to help midwives understand how this will look in practice and how this will affect the information the woman needs.

Scenario 1

A woman has her booking appointment with her midwife on 14 May 2021. She is about 9 weeks pregnant. She chooses to have the combined test, which is planned for 4 June 2021. This is when she is about 12 weeks pregnant. If this woman receives a higher chance result, her choices will be:

  • no further testing
  • NIPT
  • prenatal diagnosis (PND)

Because this woman will have the combined test taken after 1 June 2021, discussions at booking must include:

  • NIPT
  • how NIPT fits into the screening pathway
  • the version of STFYAYB with information about NIPT

Scenario 2

A woman has her booking appointment with her midwife on 14 May 2021. She is about 10 weeks pregnant. She chooses to have the combined test, which is planned for 28 May 2021. This is when she is about 12 weeks pregnant. If this woman receives a higher chance result, her choices will be:

  • no further testing
  • PND

Because this woman will have the combined test taken before 1 June 2021, discussions at booking must include:

  • the screening pathway which does not include NIPT
  • the version of STFYAYB without information about NIPT

Scenario 3

A woman has her booking appointment with her midwife on 28 May 2021. She is about 14 weeks pregnant. She is too late for the combined test, so is offered and accepts the quadruple test. This is planned for 4 June 2021 when she is about 15 weeks pregnant. If this woman receives a higher chance result, her choices will be:

  • no further testing
  • NIPT
  • PND

Because this woman will have the quadruple test taken after 1 June 2021, discussions at booking must include:

  • NIPT
  • how NIPT fits into the existing screening pathway
  • the version of SYFYAYB with information about NIPT

When combined screening cannot be completed

As per current NHS FASP guidance, a woman who chooses to have the combined test but cannot complete screening, must be referred to a health care professional able to discuss the benefits and limitations of the quadruple test. Depending on the timing of the quadruple test, this may or may not include information about NIPT.

A quick recap

All of this means there will be a 6-week period between 19 April and 1 June 2021 when 2 versions of the digital and printed information are available.

Depending on the timing of the combined or quadruple test during these 6 weeks, women will either need:

  • information about NIPT and the version of the STFYAYB with information about NIPT
  • the version of STFYAYB without information about NIPT

Ordering information

Here's a reminder about our new one-stop-shop providing information, resources and support for local NHS antenatal and newborn screening services. Please have a look if you haven't already.

Services which need to order reduced quantities of the updated version of STFYAYB can do so from our national print provider APS Ltd.

More to come

Keep an eye out for blog articles in the coming weeks about:

  • NIPT clinical guidance
  • the process of developing NIPT public information and training

PHE Screening blog

The PHE Screening blog provides up to date news from all NHS screening programmes. You can register to receive updates direct to your inbox, so there’s no need to keep checking for new blogs. If you have any questions about this blog article, or about population screening in England, please contact the PHE screening helpdesk.

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