Assessment of a change of protocol of prenatal screening by inclusion of non-invasive prenatal diagnosis

Abstract

<jats:title>Abstract</jats:title><jats:sec id="j_almed-2020-0011_abs_001_w2aab3b7c27b1b6b1aab1c14b2Aa"><jats:title>Objectives</jats:title><jats:p>Non-invasive prenatal screening (NIPS) is a test for the detection of major fetal chromosomal abnormalities in maternal blood during pregnancy. The purpose of this study was to assess the performance of NIPS implemented within the framework of the Screening Program for Congenital Abnormalities of the Andalusian Health System.</jats:p></jats:sec><jats:sec id="j_almed-2020-0011_abs_002_w2aab3b7c27b1b6b1aab1c14b3Aa"><jats:title>Methods</jats:title><jats:p>A retrospective observational study was undertaken to determine the number of NIPS tests performed since its introduction. The number of invasive diagnostic tests done after the implementation of NIPS in the patients included in the program between March 2016 and August 2017 was also quantified.</jats:p></jats:sec><jats:sec id="j_almed-2020-0011_abs_003_w2aab3b7c27b1b6b1aab1c14b4Aa"><jats:title>Results</jats:title><jats:p>A total of 6,258 combined first- and second trimester screening tests were performed, covering 95% of the population. In total, 250 subjects were identified as high risk, of whom 200 underwent NIPS after loss to follow-up. NIPS showed a sensitivity of 100% (95% CI: 76.84–100%) and a specificity of 99.46% (95% CI: 97.04–99.99%).</jats:p></jats:sec><jats:sec id="j_almed-2020-0011_abs_004_w2aab3b7c27b1b6b1aab1c14b5Aa"><jats:title>Conclusions</jats:title><jats:p>This test has proven to have a very high sensitivity and specificity. The results obtained demonstrate that the incorporation of NIPS in clinical practice minimizes the rate of miscarriages and reduces the frequency of invasive procedures by 70%.</jats:p></jats:sec>