title: Maternal plasma DNA testing: experience of women counseled at a prenatal diagnosis center.
abstract: OBJECTIVE
  To evaluate the early introduction of circulating cell-free (ccf) DNA testing in a prenatal diagnosis center serving a statewide population.
  
  
  RESULTS
  A retrospective chart review of patients at high aneuploidy risk counseled during the two 10-week periods that documents indication, risk, maternal age, insurance coverage, decisions, and reasoning behind that decision. Among the 299 included women, indication was advanced maternal age (17% with and 56% without an additional indication), positive serum screen (15%), and abnormal ultrasound (12%). Uptake increased from 10% to 17%, as did patient awareness of the test (4% to 14%). Women with lower copayments were more likely to complete testing (23% vs. 5%, p<0.001). Most women completing testing (75%) wanted to avoid an invasive procedure, while those declining cited testing would not change anything (47%), preferred diagnostic testing (16%), negative follow-up testing (20%), and cost/insurance issues (9%). One of 42 tests was positive (trisomy 21).
  
  
  CONCLUSIONS
  Individual patient follow-up allows us to document ccfDNA-related patient decision-making. Nearly half of the women did not want further testing and one in seven preferred immediate diagnostic testing. Patient costs were a barrier to testing that, if avoided, could increase test uptake by 50% or more.
authors.affiliation: 1 Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women & Infants Hospital, The Alpert Medical School of Brown University , Providence, Rhode Island.
authors.forename: Barbara M
authors.initials: BM
authors.lastname: O'Brien
authors.forename: Edward M
authors.initials: EM
authors.lastname: Kloza
authors.forename: Jacquelyn V
authors.initials: JV
authors.lastname: Halliday
authors.forename: Geralyn M
authors.initials: GM
authors.lastname: Lambert-Messerlian
authors.forename: Glenn E
authors.initials: GE
authors.lastname: Palomaki
mesh_terms: D004247:DNA / Q000097:blood*; D005260:Female; D005817:Genetic Counseling; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis
chemical_list: D004247:DNA