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Q. Is NIPT required in the second trimester?

Answered by
Dr. Prabha Ranjan
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Feb 01, 2018

Hello doctor,

My 37-year-old wife is 14 weeks pregnant with my second child. Her level one scan is normal and the double marker is also fine. But, the doctor has told to get DNA test that is an NIPT test. Is it important? If level 1 and the double marker are fine then DNA and NIPT test should also be fine right?

Dr. Prabha Ranjan

Obstetrics And Gynaecology
#

Hello,

Welcome to icliniq.com.

Double marker, level 1 scan and NIPT (non-invasive prenatal testing) all are screening test and not diagnostic.

They just suggest a possibility of the disease. So, if both the testsare normal you can avoid taking NIPT test.

It is not a compulsory test and again a screening test but it is very costly and this test also does not identify all chromosomal disorders as others.

Rather you should go for quadruple or triple test and level 2 scan at 28 to 19 weeks. These two tests are always recommended at this age.

If there is a family history of chromosomal disorders or previous pregnancy with any disease then only one should opt for NIPT.

For more information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist


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Thank you doctor,

The doctor told me that NIPT is DNA test and it is a very strong test and of course I will go for level two scan and triple test anyways. Can I avoid NIPT? I hope NIPT will be fine if double marker and level one scan are fine?

Dr. Prabha Ranjan

Obstetrics And Gynaecology
#

Hello,

Welcome back to icliniq.com.

Yes. NIPT (non-invasive prenatal testing) also is expected to be normal if double marker test is normal.

But you also know that as NIPT is a DNA (deoxyribonucleic acid) based test so it is claimed to be more sensitive.

But above all, all these tests are screening tests and not 100% sensitive and do not screen all diseases but only the common and frequent ones.

So directly or indirectly we take chances and believe that everything will be fine if one or two screening tests are normal.

With NIPT, cost constraint is there and so not routinely accepted by the patients.

So, hopefully, if double and triple marker tests and level one and two scans are normal then we can expect a normal healthy baby.

For more information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist


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Thank you doctor,

Cost is not a problem here. But all I want to know is if it is not actually necessary to do NIPT if already double marker and ultrasounds are normal?What is the extra benefit of this test?

Dr. Prabha Ranjan

Obstetrics And Gynaecology
#

Hello,

Welcome back to icliniq.com.

If cost is not a problem then you should go for NIPT (non-invasive prenatal testing) also because the sensitivity of NIPT is much more than double marker test.

It means pick rate with NIPT is higher than with the double marker and level one ultrasound.

Age of 37 is a high-risk factor for chromosomal disorders so do not take chance and go for NIPT.

It is a non-invasive test and it will not cause any harm to the mother or fetus and it is safe.

For more information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist


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Thank you doctor,

But what are the chances of the test going wrong if double marker and level one scan are fine?

Dr. Prabha Ranjan

Obstetrics And Gynaecology
#

Hello,

Welcome back to icliniq.com.

Chances of the test going wrong are very less, maybe around 5%.

The double marker test exhibit sensitivities mean pick-up rate of 70% to 85% alone.

Combined with level one ultrasound that is integrated screening tests yield sensitivities of 90% to 95% and sensitivities of 98% to 100% with NIPT (non-invasive prenatal testing).

So if the double marker and ultrasound are normal then the chances of NIPT to be positive is not much.

For more information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist


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