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Changes to pregnancy screening

NHS Scotland is making changes to the National Pregnancy Screening Programme for women with a booking appointment from 28 September 2020.

  • Introduction of screening for Edwards’ syndrome and Patau’s syndrome in the first trimester
  • Second Line Test: Non-Invasive Prenatal Testing (NIPT)
  • Updated Screening for twin pregnancies

The changes will mean that

  • Down’s syndrome, Edwards’ syndrome, and Patau’s syndrome are three separate conditions which women can decide to be screened for using one blood test. This test is to find out how likely it is that their baby has either Down’s syndrome, Edwards’ syndrome or Patau’s syndrome
  • NIPT will be offered as a second-line screening test option to those women who have received a higher-chance result that their baby may have Down’s syndrome, Edwards’ syndrome or Patau’s syndrome
  • women will be offered the same screening choices if they are pregnant with twins as they would be if they were pregnant with one baby.

Women will have the option to choose whether they have these tests or not.

  • Women who receive a higher-chance result from first line blood screening tests will be given a choice of having
    • no further tests
    • a new, more accurate blood screening test called non-invasive prenatal testing (NIPT)
    • diagnostic tests: chorionic villus sampling (CVS) or amniocentesis.
  • NHS Scotland will offer NIPT equitably to all expectant families with a higher chance first-line screening result.

Key messages for health professionals

  • It is the role of midwives and other health professionals to provide non-directive information to support decision-making which feels right for expectant parents and families, and not to influence decision making with their own views or opinions.
  • Expectant parents and their families should be reassured that their decisions and choices will be respected and will not affect the level of professional support or care they receive.
  • NIPT screening is less sensitive for twin pregnancies than for singleton pregnancies, and parents expecting twins may need additional support to make informed choices about screening results.

Research

Public Health Scotland (PHS) conducted research to understand the information needs of expectant parents on the current pregnancy screening programme. It also gave us an understanding of the level of awareness of Down’s Syndrome, Edwards’ syndrome and Patau’s syndrome, the knowledge expectant parents have around NIPT and what information would support them in make screening choices.

More information about the expanded pregnancy screening pathway or the evaluative implementation of NIPT is available in the Chief Medical Officer's (CMO) letter or by contacting your Board Screening Coordinator.

Learning resource for professionals

An e-learning resource has been developed by NHS Education for Scotland (NES) to ensure midwives and other maternity staff have up to date knowledge of the three conditions screened for and the screening pathway changes. This is available through TURAS (external site).

Information for the public 

PHS’s booklet ‘You’re pregnant: Scans and tests’ will be updated to reflect the changes to screening. A new booklet will also be developed for expectant parents and their families who have been given a ‘higher chance’ result in the first trimester screening tests.

All resources will be made available in Polish, Arabic, Simplified and Traditional Chinese, BSL, audio and Easy Read. Requests for translations into additional languages will also be considered upon request.

NHS inform will also be updated to provide more information and videos to help expectant parents to make the right choices for them.