NIPT instead of nuchal translucency?!

[ProfessionalPirate]

I had my booking scan recently and the midwife brought up the subject of NIPT and I said that I was getting it (I've got a scan and blood test booked at 10 weeks) but that I would still like to have my NHS scan for nuchal fold etc. The midwife said that I didn't need both, so just put me down for a dating scan. But I've been looking online and found sources saying that NT is still important as it can flag up problems that would be missed by the NIPT.

I've just had my scan date through, and sure enough I will be 14+2 which I believe is too late for NT even if I asked the sonographer. Has anyone had any experience of this - Is the midwife correct, or should I be pushing for an earlier scan?

It's OK..... NT measurement is different from combined screening, which needs to be done by 13+6. They will still look at your NT measurement during your scan and will get a meaningful result about whether its OK.

Yes I think 14+2 is too late for NT. I'd ring the hospital and ask for an earlier appointment. You're entitled to the NHS scan and don't have to disclose that you're having NIPT privately. Personally I'd want both. In fact the new NHS procedure (being rolled out now) is to do the NT scan and subsequently offer free NIPT to women with high risk results - why would they do that if both tests were not necessary?

Thanks both, I think I'll ring the hospital on Monday and see what they say. I wasn't going to mention my NIPT at my booking appointment to avoid this situation, but the midwife asked me directly about it so I felt I had fess up!

The reason the NHS do the combined and then offer NIPT (in some places) to people who have high risk combined results, is because the NIPT is FAR better at detecting issues (99.+% compared to 85%). But the NIPT is significantly more expensive. The NHS can't afford to offer it as a first line test to everyone when they have an adequate and cheaper alternative.

(They are offering NIPT now in some places as a second step rather than straight to amniocentesis as they recognise combined has issues and NIPT is very reliable, cheaper and less invasive than amnio. If your NIPT came back high, you'd still have the option of amniocentesis, which is the only 100% reliable/diagnostic test).

If cost was no issue, everyone would have NIPT on the NHS (which is usually a scan and a much more accurate blood test) and they'd stop doing combined tests on people. Its purely a cost issue that some people end up having both.

We still had an NHS scan at 12/13w where they looked at nuchal measurements but they didn't bother sending off the bloods to do the combined test as we'd already had NIPT at 10w, so it would've been pointless.