Non-invasive prenatal testing — DRCOG MCQ

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HardAntenatal CareNon-invasive prenatal testingDRCOG

A 35-year-old woman receives a higher-chance combined screening result for trisomy 21 at 12 weeks. She is anxious about miscarriage risk from invasive testing and asks what can be offered next. What would you advise?

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Correct answer: E — Discuss non-invasive prenatal testing or diagnostic testing after counselling

The best answer is “Discuss non-invasive prenatal testing or diagnostic testing after counselling”. A higher-chance combined screening result is not diagnostic and should trigger counselling about options, including NIPT and invasive diagnostic testing. NIPT can refine risk but does not replace diagnostic testing if a definitive result is required. Termination cannot be based on screening alone without proper counselling and confirmation. Delay would remove meaningful reproductive choices. Antenatal decisions combine gestation, maternal stability, fetal risk and whether care can safely remain in the community. Screening, diagnostic testing and urgent assessment are not interchangeable. The UK pathway should be followed with clear safety-netting whenever symptoms may evolve before the next routine appointment.

Reference: NICE NG201: Antenatal care: https://www.nice.org.uk/guidance/ng201/chapter/recommendations