Prenatal testing

During the intake interview, our midwives will ask if you would like to get more information about prenatal examination. If you are 36 years of age or older, prenatal diagnostics will be discussed. To consider this beforehand, please read the information below If you want to know more about one of these tests after reading, we will provide more information during the first consultation.

The following prenatal examinations are possible:
Non-invasive prenatal test (NIPT)
Chorionic villus sampling
20-week ultrasound

NIPT is an abbreviation of “non-invasive prenatal test” and is being offered to all pregnant women in The Netherlands since April 1st, 2017. This test is currently being conducted as part of a scientific study (TRIDENT-2), which means you participate in a study when choosing for NIPT. NIPT is a test in which a blood sample is taken from the pregnant woman and is examined. The blood is tested for chromosomal abnormalities in the child and focuses on the Down, Edwards, or Patau Syndromes (the same syndromes as in the combined test).

The laboratory can also find other chromosomal aberrations in the baby, in the placenta and very rarely, in the pregnant woman herself. You decide whether you want to take the NIPT and if you want to know these additional findings. You can read more about the NIPT on this website. On this website you will also find a form that will help you make a choice regarding taking the test. The NIPT costs € 175, -. Without medical indication, the costs will not be reimbursed.

A child’s chromosomal aberrations, such as Down syndrome, DNA disorders and metabolic disorders are tested with a medical procedure called amniocentesis, or amniotic fluid test. Moreover, the fetus is also tested for spina bifida and anencephaly. During the test, the amniotic fluid is taken through the abdominal wall with a hollow needle. The place where the needle needs to be inserted is determined using an ultrasound device. The baby’s cells reside in the amniotic fluid – a little bit of that fluid is taken with the syringe. The baby’s cells are examined closely – the amniotic fluid test is almost perfectly conclusive about whether the baby has chromosomal aberrations, DNA disorders or metabolic disorders, or none at all.

However, there is a chance of miscarriage with the amniotic fluid test – the chance of miscarriage due to this test is 3 to 5 in 1000. Amniocentesis is performed after 15 weeks of pregnancy, which is relatively late. This means that, if desired, the pregnancy can only be terminated by bringing on labor.

Chorionic villus sampling is used to test a child’s chromosomal aberrations, such as Down’s syndrome, DNA disorders and metabolic disorders. With a hollow needle, a little tissue of the placenta is removed from the uterus via the vagina or through the abdominal wall. The location where the needle needs to be inserted is determined using an ultrasound device. The chorionic villi are wispy projections of placental tissue that share the baby’s genetic makeup. Chorionic villus sampling is done between 11 and 14 weeks of pregnancy. Just like in amniocentesis there is a slightly greater chance of miscarriage. Also, there is a larger chance of an unclear result.

The 20-week ultrasound is performed between the 19th and 21st week of pregnancy. It aims to assess the child’s growth and anatomy so that early growth retardation or anatomical aberration can be detected; it’s impossible to determine this before that time as the child is still too small. Birth defects occur relatively little. A more or less serious aberration is only observed in 2 to 4 percent of pregnancies, before or after birth.

Unlike a “normal” ultrasound during pregnancy (for example, to determine the duration of pregnancy), all the organs of the child are carefully examined at the 20-week echo. The head, torso and limbs are also examined. The exam will take about 30 minutes and will take place in the center Diagnostiek voor U. If an abnormality is suspected, this will be discussed with you. You will be referred to a specialist in obstetric sonography as soon as possible, who will take another extensive look at the baby sonographically.

Although it does not happen often, it is possible an abnormality is found in an ultrasound, that cannot be found again in a follow-up exam, or turns out not to be serious.

From a 20-week gestation period, extensive sonographic examination is a reliable method of determining birth defects. Generally, serious birth defects are also likely to be observed. However, it is possible that an abnormality that is present is not detected. Other conditions such as chromosomal aberrations are seldom accompanied by abnormalities that are observed in this examination.

Baby movements during the ultrasound or excess body weight of the mother can complicate the exam. A positive result in the 20-week ultrasound is not a guarantee that your baby is healthy.

The costs of the 20-week ultrasound will be fully reimbursed by health insurance.

More detailed information on prenatal screening and prenatal diagnostics can be found at Our midwives would be happy to answer any questions.