EP18.09: Patient preference for invasive prenatal testing before and after implementing first trimester morphology scan in high nuchal translucency pregnancies
Year: 2024
Type: conference-abstract
Abstract: To evaluate the patients' preference for invasive prenatal testing before and after implementing the first trimester morphology scan (FTMS) for singleton pregnancies with high nuchal translucency (NT). A retrospective cohort study examined singleton pregnancies with high NT (>=3mm) during first trimester combined Down syndrome screening at a university hospital. Two groups were compared: cases 3 years before and after FTMS implementation. Exclusions: high-risk non-invasive prenatal testing and loss to follow-up. Primary outcome: proportion of patients choosing invasive prenatal testing before midtrimester morphology scan. Secondary outcome: diagnostic yield comparing those without FTMS and after positive/negative FTMS. Statistical significance: p < 0.05 with Chi-square or Fisher's exact test. Between August 2017 and July 2023, 588 women had singleton pregnancies with NT >=3mm. After exclusions, 510 cases were analysed: 312 (61.2%) before FTMS implementation and 198 (38.8%) after. After implementing FTMS, 79 (39.9%) cases had positive findings, and 119 (60.1%) cases had negative findings. The proportion of patients opting for invasive prenatal diagnostic testing prior to midtrimester morphology scan was 36.5% before implementation. After a positive FTMS, it increased to 82.3% (p < 0.001), but not with a negative FTMS (30.3%, p 0.221). The diagnostic yield of chromosomal/genetic abnormalities in these groups of patients were 22.8%, 61.5%, and 8.3% for no FTMS, with positive and negative FTMS, respectively. The change was statistically significant when comparing no FTMS with positive FTMS (p < 0.001), but not with negative FTMS (p 0.088). Our study has shown that a positive FTMS significantly increases the number of patients choosing prenatal diagnostic testing before midtrimester morphology scan and improves the positive diagnostic yield. A negative FTMS does not affect the patients' preference but halves the positive diagnostic yield.
DOI: 10.1002/uog.28746
Authors: A.W. Tse, L. Wong, Y. Wah, Y. Ting, K. Law, L.C. Poon, T. Leung
Institutions: Prince of Wales Hospital, Chinese University of Hong Kong
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4402360336