First trimester screening in Germany Part I-X

During one prenatal care visit on my 10th pregnancy week, the nurse handed over two prenatal screening test options to me. She told me that I can take my time to read over the information and decide if I would take one of them or none at all.

The first one is a combined NT-measure (kombinierten NT-Messung); and the second one is a cell-free fetal DNA test (zellfreie kindliche DNA).

I. The first one comes as a letter to patient, from the print or quality of copy, it must have been used and practiced since the early days. A summary of this letter translated into English:

With the increase of mother’s age, the likelihood of a chromosomal disorder (Down Syndrome) also increases. For this reason, an invasive Amniocentesis test (invasive, take a sample from the amniotic water) is offered to women over 35 years old. However, only 30% of the sicked children are related to the age boundary. The other 70% are from mothers younger than 35 years old.

By this combined NT-Messung test, a specific ultrasound examination plus a blood test will be taken place during 12. to 14. pregnancy week. This invasive test has a ca. 90% accuracy and can avoid an invasive test, such as Amniocentesis.

On the upper corner of this letter, it states 130 EURO, 11-13-16 SSW (pregnancy week)

II. The second one is in fact a commercial brochure from one provider of such a genetic test. As the first one, it is non-invasive, and according to this brochure, this type of test (99.5% accuracy) provides a higher accuracy of detection as for the first one (85-90%) for detecting Trisomy 21.

This test requires also blood sample, and in fact only blood sample. It costs 199-334 EUR depending on the test option (Trisomy 21, 18, 13, XY chromasons-related tests).

So, now, what would you decide for?

i. To take the first test only
ii. To take the second test only
iii. To take the first and the second test
iv. To take none of them

What do you take into consideration when making this decision?

(1) Opinion of the partner, (2) opinion of the experts, (3) information on the internet, (4) the price, (5) the accuracy

And what do you plan to do if the test result would be positive?

to be continued…