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Screening Strategy Overview


So, what we’re going to do is talk for minute then about strategies. You could choose to have a screening strategy or not choose to have a particular screening, and there are different types of screening that we can do, and we’ve talked about the general principles. So let me read you a quote from the American College of OB/GYN. It says, “Ideally, all women should be offered aneuploidy screening before 20 weeks of gestation regardless of mother’s age, but it’s not practical to have patients choose from among the large array of screening strategies that might be used.” So two things: we should talk about it. We should offer you testing but we shouldn’t necessarily offer you every single test that there is because it’s not practical. There are too many tests. Okay. So what we’re going to do is condense them down and offer you key types of tests from each of the categories but we won’t talk about every single test. Okay.

One more thing, the American College of OB/GYN also says, “Regardless of which screening test you decide to offer your patients, information about detection and false positive rates, advantages, disadvantages, and limitations, as well as the risks and benefits of diagnostic procedures, should be available to patients so that they can make informed decisions.” That’s why we’re here. I want you to know. I want you to be informed so that you can make a good decision about what to do.

Now I haven’t talked to you yet about detection rates. We’ve talked about false positive and false negative things and some of the advantages and disadvantages of testing, but I haven’t talked to you yet about detection rates. I’m going to do that in just a second. Okay.

So the bottom line is we’re going to come up with some strategies. We’ll start with less aggressive, and there are more aggressive strategies, and it will depend on what you would do with the information.

So in terms of big categories, there are some tests that you can do in the first trimester. The best tests involve both ultrasound and blood draw in the first trimester. Okay, and then there are tests that we can do in the second trimester. We can do ultrasound, the screening ultrasound we’ve talked a lot about. We can do other blood tests, like the quad screening you may have heard about. Okay. Or there’s a penta screen. And then we have other tests, which are the diagnostic tests. We’ve also talked about them, the amniocentesis and the CVS. So this is basically the group of strategies. You could choose not to have any screening test. You could have a first trimester test that involves ultrasound and blood, or you could have a second trimester test that involves ultrasound and then the blood test is a separate test. Or you could actually go directly to a diagnostic test if you said, “Hey, I’ve got to know for sure. My risk is too high. I’m willing to take the risk of the amnio.” You could go right to an amniocentesis, if that’s what you feel like is the best thing for you.