title: Uptake of noninvasive prenatal testing at a large academic referral center.
abstract: OBJECTIVE
  Noninvasive prenatal testing (NIPT) is a recently developed risk-assessment technique with high sensitivity and specificity for fetal aneuploidy. The effect NIPT has had on traditional screening and diagnostic testing has not been clearly demonstrated. In this study, NIPT uptake and subsequent changes in the utilization of first-trimester screen (FTS), chorionic villus sampling (CVS), and amniocentesis in a single referral center is reported.
  
  
  METHODS
  Monthly numbers of NIPT (in high-risk patients), FTS, CVS, and amniocentesis were compared between a 35-month baseline period (April 2009 through February 2012) before introduction of NIPT, and the initial 16 months following NIPT introduction divided in 4-month quarters beginning in March 2012 through June 2013.
  
  
  RESULTS
  A total of 1265 NIPT, 6637 FTS, 251 CVS, and 1134 amniocentesis were recorded over the 51-month study period in singleton pregnancies of women who desired prenatal screening and diagnostic testing. NIPT became the predominant FTS method by the second quarter following its introduction, increasing by 55.0% over the course of the study period. Total first-trimester risk assessments (NIPT+FTS) were not statistically different following NIPT (P = .312), but average monthly FTS procedures significantly decreased following NIPT introduction, decreasing by 48.7% over the course of the study period. Average monthly CVS and amniocentesis procedures significantly decreased following NIPT introduction, representing a 77.2% and 52.5% decrease in testing, respectively. Screening and testing per 100 morphological ultrasounds followed a similar trend.
  
  
  CONCLUSIONS
  NIPT was quickly adopted by our high-risk patient population, and significantly decreased alternate prenatal screening and diagnostic testing in a short period of time.
authors: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA.
authors: Sebastian
authors: S
authors: Larion
authors: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA. Electronic address: warsofsl@evms.edu.
authors: Steven L
authors: SL
authors: Warsof
authors: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA.
authors: Letty
authors: L
authors: Romary
authors: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA.
authors: Margaret
authors: M
authors: Mlynarczyk
authors: Department of Obstetrics and Gynecology, Ziv Medical Center, Bar-Ilan University, Faculty of Medicine in Galilee, Israel.
authors: David
authors: D
authors: Peleg
authors: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA.
authors: Alfred Z
authors: AZ
authors: Abuhamad
mesh_terms: D000046:Academic Medical Centers; D000649:Amniocentesis / Q000706:statistics & numerical data*; D000782:Aneuploidy; D015193:Chorionic Villi Sampling / Q000706:statistics & numerical data*; D025063:Chromosome Disorders / Q000175:diagnosis* / Q000235:genetics; D015331:Cohort Studies; D004247:DNA / Q000097:blood*; D004059:Diffusion of Innovation; D005260:Female; D005820:Genetic Testing / Q000706:statistics & numerical data; D006801:Humans; D048208:Nuchal Translucency Measurement / Q000706:statistics & numerical data*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011296:Prenatal Diagnosis / Q000639:trends*; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal
chemical_list: D004247:DNA
keywords: first-trimester screen; noninvasive prenatal testing; prenatal diagnosis; prenatal screening