Prenatal diagnosis : Drum check before you release?

imagine that You're pregnant, and You need only a few milliliters of a blood sample, to learn whether or not Your child is healthy. Awesome? No, because the blood test for "non-invasive prenatal diagnostics" (NIPD) for the past six years available, does not meet this full-bodied promise.

as revolutionary as controversial

Nevertheless, it can be regarded as revolutionary: for the First time, it is possible for the genome to detect an Unborn child in the blood of his mother, and to test for changes in the chromosomes, as trisomy 13, 18, trisomy 21 (also Down's syndrome) known. The study achieved a high confidence level of 99.8 percent, the blood test can be done starting from the ninth week of pregnancy. Procedures such as the examination of amniotic fluid (amniocentesis) and tissue from the placenta (chorionic villus sampling) or the puncture of the umbilical cord, however, are only a few weeks later possible, include a procedure in the uterus, and are associated according to the Federal centre for health education (BZgA) with a risk of one and a half to two percent, causing a miscarriage.
In a statement, which it drew up on behalf of the Federal Joint Committee (G-BA), has established the Institute for quality and efficiency in health care (IQWiG) in this year (without mentioning any exact Numbers): If Pregnant do a blood test, which carry an increased risk to have a child with a trisomy 21, can be reduced to the conventional invasive examinations, consequently, the risk for failure decreases births. This speaks in favour of the blood test, which currently costs 200 to 400 Euro, in the power catalogue of statutory health insurance funds. A decision is expected in the summer.
That it will not be easy, recently showed a cross-party Initiative of deputies of the German Bundestag, the parliamentary debate on the NIPD call. They fear the technical simplicity and health and safety aspects of the Tests could lead to Pregnant women and their partners want to exclude your child has a trisomy 21, with the today, many people live happy – routinely.

prenatal doctors Kalebet warn against uncritical application

the professional Association of practising prenatal physicians warns in a position paper in front of it, the blood test is not critical. The doctors also criticize the "simplistic advertising of the industry" and calling for a clear framework for the use of. First of all, it is important to advise the Pregnant well – about the fact that you come to a time in the invasive investigation of around, the blood test is a striking result. Or that, on the basis of the DNS-snippets of the child in the mother's blood does not reveal whether the child has a malformation, such as a heart defect that can be dealt with later. The ultrasound is used anyway. "The blood test should therefore only be carried out in connection with an ultrasound examination," said Alexander Sharp, President of the professional Association. The blood test should not be automatically offered to all Pregnant women, but only if particular risks exist, the point about the ultrasound.
The Wuppertal prenatal doctor Nilgün Dutar pointed out during the presentation of the position paper to the fact that even today, after the legally required technical advice for the Pregnant women, the risk for trisomy 21 and other Trisomies from a combination of ultrasonic findings and specific markers from maternal blood can be calculated. The detailed counseling of the Pregnant woman must be in front of a NIPD duty.

Switzerland as a model

As an example, Switzerland could serve. The NIPD of the General health insurance will be paid, if previously conducted other investigations result in a note on risk and the Pregnant woman was well aware of the limitations of blood tests. The Argument that the women of the way to the Test and, if necessary, termination of the pregnancy will be facilitated, the Physician and sociologist Tanja Krones, Clinical ethics Committee at the University hospital of Zurich does not apply to: "Is a lower-risk method is available, which increases the scope of Decision-making of pregnant women, then it is not for reasons of Justice acceptable to pay for this in the framework of the statutory health insurance."