title: Trends in Invasive Prenatal Diagnosis: Effect of Sequential Screening and Noninvasive Prenatal Testing.
abstract: OBJECTIVE
  To examine trends in the incidence and method of invasive prenatal diagnosis due to the impact of sequential screening and noninvasive prenatal testing.
  
  
  METHODS
  This is a retrospective review of all pregnancies that have undergone invasive prenatal diagnostic testing between June 2002 and June 2014, divided in 3 periods: period 1 from June 2002 to October 2006, period 2 from November 2006 to December 2011, and period 3 from January 2012 to June 2014. The main outcome measures were trends in the incidence and method of each procedure.
  
  
  RESULTS
  There were 88,135 deliveries and 6,080 invasive procedures during the study period. In period 1, 2,755 (8.8%) procedures were carried out, in period 2 2,820 (7.3%), and in period 3 505 (2.5%; p < 0.01). In period 1, there were 1,990 (6.3%) cases of amniocentesis, 1,646 (4.3%) in period 2, and 254 (1.2%) in period 3 (p < 0.01). In addition, in 765 (2.5%) cases, chorionic villus sampling (CVS) was performed in period 1, compared to 1,174 (3.0%) cases in period 2 and 251 (1.3%) cases in period 3 (p < 0.01). Advanced maternal age as the sole indication for invasive procedures decreased significantly over time, while the indication of abnormal serum screening and abnormal ultrasound findings increased (p < 0.01).
  
  
  CONCLUSIONS
  There was a significant decline in the incidence of invasive prenatal testing over the 12 years of the study. The decrease in amniocentesis was more marked than that in CVS.
authors.affiliation: Department of Obstetrics and Gynecology, Sidney Kimmel College at Thomas Jefferson University, Philadelphia, Pa., USA.
authors.forename: Adeeb
authors.initials: A
authors.lastname: Khalifeh
authors.forename: Stuart
authors.initials: S
authors.lastname: Weiner
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Berghella
authors.forename: Alan
authors.initials: A
authors.lastname: Donnenfeld
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D008423:Maternal Age; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends*; D012189:Retrospective Studies