During this appointment we will explain the options for prenatal screening including the pros and cons of these tests. You will receive information in advance of this appointment about the different tests so you can prepare for the discussion. During the appointment we will answer your questions and help you to make an informed decision if needed. This appoinment is covered by your health insurance.

You can choose to test whether there is a risk of your baby having Down´s syndrome, Edward´s syndrome or Patau´s syndrome. You have a choice between the combination test or the NIPT (Non Invasive Prenatal Test).

If you find it difficult  to make a decision whether you want to make use of one of these tests, then the following questions may help you decide:

• How much do you want to know before your baby is born?
• How do you feel about a life with a baby with a syndrome?
• How do you feel about a life with and for a baby with a serious physical anomaly?
• How would this affect your current family situation?
• How do you feel about the risk of miscarriage with a chorin villus sampling or amniocentesis?
• And how do you feel about possible termination of pregnancy?

If the combination test shows an increased risk of a chromosome defect or the NIPT shows a risk of a syndrome, then you can opt for further testing (prenatal diagnostics).

Since April 2017 you can choose to have a Non Invasive Prenatal Test carried out. This is a blood test. From the mother’s blood genetic material (DNA) can be isolated that originates from the placenta. This DNA is almost identical to that of the baby. The laboratorium can research whether there are any signs the baby has Down’s~, Edward’s~ or Patau’s syndrome. The laboratorium can also identify other chromosome defects in the baby, in the placenta and less commonly by the mother. These are called secondary findings and you have the choice whether these are tested for or not.

The NIPT identifies more baby’s with Down’s~, Edward’s~ and Pataus’ syndrome and the results are more often correct when compared to the combination test.

The NIPT does not offer certainty, however if you have a good result then no further testing is necessary.

If you choose for the NIPT test, then you are taking part in a research program.

The NIPT is NOT covered by your health insurance.

Testing for whether the baby has physical anomalies can be done during the 20 week scan, or structural anomaly scan. This is a medical ultrasound. You can choose whether you want to have this test or not. The scan will be done around the 20^th week of pregnancy. During this ultrasound the development of the baby’s organs is checked. The growth of the baby and the amount of amniotic fluid will also be checked. Examples of possible defects that can be found during a 20 week scan are:

• Spina bifida
• Anencephaly
• Hydrocephaly
• Heart defects
• Diaphragmatic hernia
• Abdominal hernia
• Intestinal abnormalities
• Absent or abnormal kidneys
• Abnormal bone development
• Abnormalities of the arms or legs

The 20-week scan is a relatively reliable method of identifying serious congenital defects. However a good result is not a guarantee that the baby is healthy. Not all abnormalities are visible on an ultrasound scan. If the unborn baby has physical abnormality, then the consequences are not always clear. Some abnormalities are so serious that the baby can die before or during the birth.

There are also abnormalities whereby the treatment plans for the baby are improved when the abnormality is discovered before the birth.

The counselling appointment and the structural anomaly scan are both covered by your health insurance.