Prenatal examination
Between 8 and 10 weeks, you will have a counseling appointment with us if you would like more information about prenatal testing. During this counseling you will receive information about prenatal tests that can be done during pregnancy. These tests can provide insight about the health of the baby. These tests are not obligatory and therefore we take the time to inform you as well as possible. This allows you to decide if this is something you want to do or not.
You don’t have to pay for these surveys: all three are paid for by the government.
There are three types of tests: the NIPT, the 13-week ultrasound & the 20-week ultrasound. Below is more information about the tests.
Initial Prenatal Examinations
The Non-Invasive Prenatal Test (NIPT) is a test for chromosomal abnormalities, such as Down syndrome. It is examined with a blood test on the pregnant woman. In the blood, DNA from the placenta is examined. This almost always matches the baby's DNA. By examining this, we look for chromosomal abnormalities. This could mean that there is an extra chromosome (trisomy), or that there is a piece of chromosome too many or too few. This can lead to such things as intellectual disability or physical abnormalities. 993 out of 1000 women get a normal result. In that case, follow-up testing is not necessary. In 7 out of 1000 women who do the test, an abnormal result is found. In that case, you do qualify for follow-up testing. The NIPT is safe for the pregnancy and therefore poses no risk of miscarriage.
When is NIPT possible to do?
NIPT can be used from the 10thweek of pregnancy.
How long will it take for me to get the results?
The results often follow within 10 working days.
Will the NIPT be reimbursed?
The counseling session you have with us to decide whether or not you want to have the NIPT is paid for by the government.
The NIPT itself is paid for by the government.
If it turns out that follow-up testing is necessary, such as chorionic villus testing or amniocentesis, this will then be reimbursed again by the insurance company.
For more information about the NIPT, visit
www.pns.nl
In September 2021, the 13-week ultrasound was introduced in the Netherlands. The 13-week ultrasound (also called "first trimester screening (ETSEO)" is very similar to the 20-week ultrasound. This is because in both ultrasounds, the ultrasound technician looks to see if the baby has any physical abnormalities. During the counseling session, we explain this ultrasound and what to expect. At the moment you decide you want this ultrasound, it can be performed at a term of 12+3 weeks pregnant and 14+3 weeks pregnant. The ultrasound will not take place at our practice, but at the Echo Point. The ultrasound itself takes about 30 minutes. The result is told immediately by the ultrasound technician.
In 95 out of 100 women, no physical abnormality is found. No follow-up examination is then necessary. After this, you often go on for the 20-week ultrasound. A good result at the 13-week ultrasound does not automatically mean a good result at the 20-week ultrasound. It is an addition, not a replacement.
In 5 out of 100 women, something is seen that could be a possible abnormality. It is not always immediately clear whether there is indeed an abnormality, how serious it is and what effect it will have on your baby. In that case, it is possible to have follow-up testing. You will receive a referral to the hospital for this. In the case of the 13-week ultrasound, this always means a referral to the AUMC.
Imitas study
The 13-week ultrasound is currently only available if you participate in the scientific study IMITAS. This study investigates the advantages and disadvantages of the 13-week ultrasound. During the counseling interview you will receive more information about this.
Will this ultrasound be reimbursed?
This ultrasound is paid for by the Ministry of Health, Welfare & Sport.
For more information, visit:
www.pns.nl
The 20-week ultrasound is the second prental examination for physical abnormalities in the baby. It is a follow-up to the 13-week ultrasound. If you chose not to have the 13-week ultrasound, this may be the first examination for you. Another name for the 20-week ultrasound is also called the "second trimester structural ultrasound examination (TTSEO). This examination is a medical ultrasound and not a "pretecho.
The ultrasound is preferably done at a gestational age between 18 and 21 weeks. During this examination, an ultrasound technician looks at all visible organs and structures of the baby, the growth of the baby and the amount of amniotic fluid. Major abnormalities may become visible during this. If any abnormalities are visible on the ultrasound, you will be referred for further testing. It is important to know that a good result from the SEO does not fully guarantee that the baby is completely healthy.
Fortunately, very few abnormalities are found in the group of healthy pregnant women.
Also this ultrasound will not take place at our practice, but at the
Echo Point.
Not mandatory
Ultrasound testing during pregnancy is definitely not mandatory. Many parents do opt for ultrasound testing during pregnancy, but not everyone wants further testing at 20 weeks.
Is the 20-week ultrasound covered?
This ultrasound is paid for by the Ministry of Health, Welfare & Sport.
More information about the 20-week ultrasound can be found at: www.pns.nl
Follow-up studies
If the NIPT results are abnormal, and in some cases also if the 13-week or 20-week results are abnormal, you will be offered follow-up testing. In some cases, this means chorionic villus testing or amniocentesis. You can read more about these tests below.
In the placenta test, the gynecologist removes a small piece of placental tissue through the vagina or through the abdominal wall. This is examined for chromosomal abnormalities.
- How long does the procedure take? 15 to 20 minutes.
- When can I have the test done? From the eleventh week of pregnancy.
- Who performs this examination? The gynecologist.
- Risk of miscarriage? There is a small risk of miscarriage due to the chorionic villus test; this risk is 0.5%.
- When will the results be known? After about 5 to 10 days.
If an abnormality is found
In case of an abnormal result - a chromosomal abnormality is then shown - you can opt for a termination of pregnancy. Until the 14th week of pregnancy this can be done with a suction curettage, after the 14th week you will be given vaginal tablets in the hospital to make the body reject the pregnancy.
In amniocentesis, a small amount of amniotic fluid is taken through the abdominal wall. The cells in this amniotic fluid are examined for chromosomal abnormalities.
- How long does the procedure take? 15 to 20 minutes.
- When can I have the test done? From the 16th week
- Who performs this examination? The gynecologist.
- Risk of miscarriage? Amniocentesis carries a miscarriage risk of 0.3%.
- When will the results be known? The result of a rapid test, for chromosomal abnormalities and gender is known after 3 to 5 working days, depending on the day of collection. You will receive a result by phone 3 to 7 working days after the test.
However, this test does not examine all chromosomes. Therefore, you will receive the final result of amniocentesis after 3 weeks, after examination of all chromosomes.
If an abnormality is found
If amniocentesis reveals a chromosomal abnormality and you choose to have the pregnancy terminated, the pregnancy is already too advanced to have it terminated by curettage and delivery will have to be initiated with medication.