Scannning Room

Non-Invasive Prenatal Testing (NIPT)

Why have NIPT?

Currently screening for Trisomy 21, Down’s syndrome, is offered by the NHS as a combined test between 11+3 to 14+1 weeks. The pregnancy is dated, the fluid at the back of the neck (Nuchal Translucency) is then measured and a blood test from the mother is taken to assess the hormone levels in the blood. This information along with the scan findings is combined and generates a chance of 1:>150 for a low probability result and 1:<150 for an increased probability result. The detection rate is around 70-80% sensitive dependent on the literature you read.

Non-invasive prenatal testing (NIPT) has a 99% probability detection rate – A blood sample from the mother is analysed for fetal DNA which circulates within her blood.

The cell-free DNA can be tested in the most accurate screening process to detect the probability of the baby having Trisomy 21 (Down’s syndrome); trisomy’s 18 (Edward’s syndrome) and 13 (Patau’s syndrome) are also tested. It must be remembered that NIPT is NOT diagnostic giving you a yes or no answer; it is still screening that works in levels of probability and chance.

The effectiveness of this screening test is that it will massively reduce the need to have invasive testing such as an amniocentesis of CVS (Chorionic Villus Sampling) to less than 1% which carries a risk of miscarriage.

A low probability result does not mean there is absolutely no chance and a high probability result will require invasive testing such as an amniocentesis to provide a definitive, diagnostic answer.

The NHS is currently offers this type of testing only for those women with an increased chance/probability from their combined screening.

If you have had a scan after 10 weeks gestation we can offer you a service where we only need to take the bloods. This option can only be performed if you have a scan report showing that you have a viable pregnancy over 10 week’s gestation.

This test does not require any referral from your healthcare providers; it is a safe and non-invasive screening test. All singleton and twin pregnancies whether naturally conceived or by IVF including those with use of donor eggs can be assessed.

The test can be performed from 10 weeks of pregnancy until 40 weeks.

The Scanning Room strongly advise that the mother has all the routine scans offered by the NHS during her pregnancy. The NIPT does not check or provide information on growth problems or physical defects for e.g. Spina bifida, heart or brain abnormalities.
This test does not assess probability for mosaicism, partial trisomy’s or translocations. The findings of the test may not give you a result and may suggest that further testing is more appropriate.

What we do…

A scan needs to be performed to confirm viability and that the pregnancy is over 10 weeks gestation before the paperwork is completed and bloods are taken.

The dating scan is performed over the tummy as transabdominal scan, having a fairly full bladder will help to see the pregnancy more clearly. From 10-14 weeks we measure the baby crown to rump (CRL) to get an estimated due date and over 14 weeks we measure the head, tummy and thigh. Over 14 weeks the due date is based on the head circumference measurement.

The scan can also see if you are having just the one baby or a couple of surprises! We also check your little one to see how well it is developing by checking the skull/brain, arms and legs, stomach and cord insertion.

We also check the uterus and ovaries to ensure everything appears normal.

Throughout the scan we will be talking about what your baby is doing, how it is developing and what it can do – such a lovely insight into your baby’s world.
After the scan we complete the paperwork and you read through and sign the consent form. We then take 1 tube of blood and send this to the lab.
If you are having the bloods only option we will complete the paperwork and take the bloods as above. There is plenty of time to ask any questions.

After the test…

The blood sample is sent to The Doctors Lab in London who have the license to process the samples. The results take up to 10 days to come back to us. Once we receive the results via email, we call you to discuss the findings and then email you the copy of the results. Once you receive the email/results you can always contact us if there is anything you need to discuss.

The results will come back as 0.01% probability which is your low chance result or 99.9% which is your increased probability result. If low probability the report can be put in your notes and no further follow up required. If the results show an increased probability we will with your consent refer you to your screening midwife at your local hospital. The screening midwives will talk you through further options from this point.

In approximately 2% of blood samples taken there is not enough fetal DNA to provide a result. In these cases another sample of blood is requested by the lab which will delay the results being released. If an additional sample is requested this is processed at no extra charge. At times the lab do request further information or clarification about details, in this case we will contact you with the details requested.

For further information follow this link to The Doctor’s Lab website, https://www.tdlpathology.com/specialties/genetics/non-invasive-prenatal-testing-nipt/

13 weeks old.

Growth Scan

Why have a growth scan?

Sometimes the wait from seeing your baby at the half way stage at the 20 week scan to it being in your arms can be a long time! This scan does not need a referral from a healthcare professional so can be performed whenever you feel the need for additional reassurance of how well your baby is growing and what it is up to in there.

If a concern has been raised about reduced fetal movements, slow fundal growth height, or even increased fundal growth height we can give that visual reassurance that your baby is doing beautifully at a timescale that suits you.
What we do..

We have a good look at your little one and discuss everything as we move around your baby. For the growth assessment we measure the head, tummy and thigh to get an estimated weight and compare this in relation to the due date which will demonstrate where your baby is within the growth range. We assess the placenta and also the position of your baby to the placenta, so if reduced movements are a concern, we can show you where you will expect to feel your baby move. The fluid is assessed either visually or measured to ensure it is within the normal range.

We also see what your baby is up to in there and check its general behaviour – pictures are taken where possible (dependant on position and gestation) and if we can we will also have a look in 4D. IF YOUR BABY IS IN A GOOD POSITION WE CAN UPGRADE THE SCAN TO A 4D ONCE ALL CHECKS HAVE BEEN MADE.

As with all our scans you are given the opportunity to ask questions throughout the scan.

After the scan..

We will discuss everything that we have seen throughout the scan and create a report with our findings for you to take away.

If any problems are found, these will be discussed with you and where possible/known the implications will also be discussed. A referral will be made for you to your local midwife, GP or local hospital/antenatal clinic and appropriate follow up will be arranged.

25 weeks old

36 weeks, chubby cheeks in 4D

4D Growth Scan

Why have a 4D growth scan?

An amazing opportunity to see what your little one gets up to in the womb! This unique bonding experience allows you to see your baby smile, yawn and even see if it has little fat cheeks!

As with all our scans ensuring your baby’s wellbeing is our priority and we always talk you through everything that we see.

The best time to perform a 4D scan is between 26-32 weeks gestation due to the size of your baby and the amount of amniotic fluid present.

After 32 weeks the amniotic fluid naturally starts to reduce which can affect the images we get of your baby due to its position and often unwillingness to move! If you are outside of the suggested range, we will try our hardest to achieve the best possible images but this is not always possible.

What we do..

With our 4D growth scans we take both 2D and 3D pictures which are saved onto a memory stick, black and white pictures for you to take away, we also take measurements to ensure you baby is growing well. We spend time looking around your baby and seeing what it is up to. If you would like the gender to remain a secret that is no problem at all, if you do already know we can always double check for you!

For the growth assessment we measure the head, tummy and thigh to get an estimated weight and compare this in relation to the due date which will demonstrate where your baby is within the growth range. We also assess the placental position and amniotic fluid.

During the scan the ideal position for your baby is to be laying on its back, from previous scans I am sure you have experienced a comfy baby that doesn’t want to help. If this happens we will try a variety of things to get your baby moving. If despite our best efforts your little bean is far too comfortable and won’t move we will book a further one off 20 minute scan free of charge.

As with all our scans you are given the opportunity to ask questions throughout the scan.

After the scan..

We will discuss everything that we have seen throughout the scan and complete a report with our findings along with your memory stick and pictures we have taken throughout the scan.

We don’t have a maximum number of pictures we take, all dependant on how helpful your little one is.

If any problems are found, these will be discussed with you and where possible/known the implications will also be discussed. A referral will be made for you to your local midwife, GP or local hospital/antenatal clinic and appropriate follow up will be arranged.

Too embarrassed!

Chubby cheeks

Group B strep screening

Why have Group B Strep screening?

Group B Streptococcus is the most common cause of life threatening infections in newborn babies in the UK. GBS is a common bacteria that can be found on our bodies which often doesn’t cause any harm. Approximately one in five pregnant women in the UK carries GBS in their vagina or digestive tract, during labour and birth many babies can come into contact with GBS and become colonised by the bacteria.

Most babies are unaffected however a small number can become infected during labour and birth. Rarely, GBS infections can cause serious complications that can become life threatening.

Most GBS infections can be prevented by giving antibiotics intravenously (through a vein) at the start of labour to all women where GBS has been detected during their current pregnancy.

Without prophylactic antibiotics around 1 in 1000 babies in the UK would develop a GBS infection (approx 700 babies a year).

What we do..

The test is performed from 35 weeks gestation (ideally between 35-37 weeks) by taking two swabs, a low vaginal and rectal swab. The swabs are then sent to our designated lab for testing, who are also the designated lab for the Group B Strep support group.

After the test..

We receive the results electronically and contact you by phone with them usually 3-5 working days after the swabs have been taken. You will also receive a hard copy of the report in the post.

The results will come back as positive or negative, if negative no further follow up required and the report can go in your maternity notes. If your result is positive the lab report should be shown and discussed with your midwife or obstetrician and placed within your maternity notes.
UK guidelines recommend that when GBS is isolated in pregnancy intravenous antibiotics should be offered in labour which is highly effective in stopping GBS infections from developing in newborn babies.

Presentation scan

Why have a presentation scan?

At times trying to clearly identify which way round your baby is can be difficult! You think it is one way, your midwife thinks it’s another but no one is quite convinced – we can help and see for certain whether your baby is head down (cephalic) or bottom down (breech). This scan does not need a referral from a healthcare professional so can be performed whenever you feel the need for additional reassurance of how well your baby is growing and which way around it is.

What we do..

We have a good look at your little one and discuss everything as we move around your baby. For the growth assessment we measure the head, tummy and thigh to get an estimated weight and compare this in relation to the due date which will demonstrate where your baby is within the growth range. The fluid is assessed either visually or measured to ensure it is within the normal range. We will of course check the position of your baby for that final reassurance.

We also see what your baby is up to in there and check its general behaviour – pictures are taken where possible (dependant on position and gestation) and if we can we will also have a look in 4D.

As with all our scans you are given the opportunity to ask questions throughout the scan.

After the scan..

We will discuss everything that we have seen throughout the scan and create a report with our findings for you to take away. If your baby is not in the cephalic position we will advise you to contact your midwife for follow up.

If any problems are found, these will be discussed with you and where possible/known the implications will also be discussed. A referral will be made for you to your local midwife, GP or local hospital/antenatal clinic and appropriate follow up will be arranged.

Head or bottom first?