Professional Documents
Culture Documents
PARADIGM SHIFTS IN
PRENATAL DIAGNOSIS
Verinata
Reporting sex chromosomes (Normal = XX, XY) and identification of
sex chromosome aneuploidies (XXX, XXY, XYY, monosomy X)
Sequenom
Reporting absence or presence of Y chromosome material on all
patients (99.4% accuracy quoted)
Three
separate
groups
have now
shown
high
sensitivity
NIPT IN CLINICAL CARE and
specificity
with low
false
positive
rate
NIPT
Current limitations
Validation
Limited validation studies in low risk women
Validation study in twins had only 25 sets
Not validated in triplet or higher order multiples
Not validated in pregnancies conceived with egg donors
Not validated past 22 weeks gestation
Cost and insurance coverage
Does not include screening for ONTD
NIPT Specifics
Laboratory Technology Conditions Sensitivity Specificity Reporting
(Test name) Tested For
So many options!
Accurate and balanced discussion of options with patient is ver y
impor tant
Benefits
Limitations
Risks
Assist the patient in making informed, autonomous decision
Be sensitive to per sonal nature of decision
Family values
Religious beliefs
Family and life situations
Concerns about having a child with an abnormality
Concerns about risk of miscarriage
PRENATAL DIAGNOSTIC TESTING
Laser Scanner
del 22:q11.21
EXAMPLE- NORMAL RESULTS
EXAMPLE- TRISOMY 21
CHROMOSOMAL MICROARRAY ANALYSIS
IN PRENATAL CLINICAL PRACTICE