Doing NIPT - would you bother with NHS screening?

[mamababy1955555]

Hi, all. I'm 10 weeks pregnant and I've got a private NIPT booked this week and then my NHS dating scan next week. When I had my son 3.5 years ago, I did the NHS trisomy screening even though we'd also done NIPT and thankfully they all came back low risk. This time, I'm wondering if there's any point consenting to the NHS trisomy screening if I'm also doing NIPT? I think I'd be worried if my result was high risk, even with a reassuring NIPT, and I'm 37 now so I feel like a high risk result is more likely.

Is there any benefit in doing the NHS screening if I'm doing NIPT anyway? Thanks.

We did Harmony and the midwife said she wouldn't do the NHS screening as Harmony was more sensitive. Also, if we'd been high risk onNHS screening, our trust then do Harmony!

Thanks so much, this is what I'm thinking. I have no idea why I did both last time...

I would ask your midwife, ours wanted to do it so they had Papp A results etc.

I would look closely as what is being screened, as are they like for like?

The harmony doesn’t cover the PAPP A blood test so I would both that for that reason only if doing the harmony test

Ah ok... thanks.

What does PAPP A help with?

If levels are low, there's an increased chance of growth restriction, I think, so in my area they offer extra growth scans etc

Low PAPP-A can be associated with smaller babies and/or preeclampsia ( high blood pressure + ) and your antenatal care would be adjusted to detect these . Majority of pregnancies with low papp a are fine .

I've had the nipt and haven't bothered with nhs combined screening. I would expect any issues with growth to be picked up despite not knowing my papp a levels.

It depends on where you do your nipt. If you have your harmony results back before nhs 12 weeks scan, I’d attend the scan but decline the blood test. Harmony is superior in detecting trisomy 18/21/23, however it doesn’t screen for things like spinal bifida.
I’d skip nhs 12 weeks scan all together if you’re having nipt at Fetal medicine centre. Reason being FMC gives you the 12 weeks scan/nuchal with harmony package. Their equipments are better and their scans are more thorough.
This is just my experience. My harmony results came back the day after my nhs scan so whilst I hadn’t received the results from nhs, harmony kept me at ease. After attending the private scan a10 days later, I can def confirm FMC was more thorough and they walk you through everything.

I had the NIPT and planned to the NHS one as well - just for extra piece of mind I suppose and you are there anyway?. In the end it was a good job we had the NIPT done as bit had twins wouldnt sit still for the NHS sonographer and they gave up!

Depends on your NIPT test but I did harmony and it only looks for Downs, Edwards and Pataus. The NHS screening (scan plus bloods) can flag up other potential chromosomal issues, as well as the Papp A thing (nb the only other way restricted growth may be flagged up post 20 weeks is fundal height, which is wildly inaccurate and unreliable), so I did both. NHS is free and only involves a blood test in addition to scan so no downsides to doing it that I can think of - you can always disregard the results which overlap with the NIPT as you know the NIPT is more sensitive.

Personally, if I were you I'd do both. I only had the NHS screening but that's because money is an issue. There are other things than Trisomies 21, 13, and 18, also, as a previous poster mentioned, it can be useful to be aware of your PAPP-A levels. Expecting an issue to be picked up regardless will only work if any growth issues occur before your anomaly scan. Low PAPP-A may mean you have additional scans after 20 weeks.

To be accurate - I had Harmony + scan at 11 weeks, then NHS scans (without abnomality testing) as scheduled. So just didn't have NHS bloods.

I would do both.
The NT measurement and papp A results can indicate other abnormalities that aren't tested in nipt.

I'd do both, I had NIPT after my NHS scan came back with high (ish) risk.

I also read that someone's NIPT came back after the window for the NHS scan with insufficient DNA for a result so they missed out on both - just had to have the less accurate blood test.

Thanks for the advice, it's not as clear cut as I thought! I'll give it some more thought...

At the place I did my NIPT (it was the Harmony test, at Harley St Centre for Women), they also did the PAPP-A and "NHS-style" results - which also told me my HCG was pretty high, though risks were low. I appreciated having both data sets. You'd get the same benefit just having the NHS bloods and the Harmony test, but it's worth asking if where you're getting the NIPT they roll in the lot, like I had.