Noninvasive Prenatal Testing Using Next Generation Sequencing: Pilot Experience of the D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology

2019 
In recent years, noninvasive prenatal testing (NIPT) for fetal chromosomal abnormalities has come into wide use. NIPT allows detection of fetal chromosomal abnormalities without invasive sampling of fetal material: by analyzing cell-free fetal DNA in maternal blood. Here, we report on the pilot results of using NIPT at the D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology (St. Petersburg, Russia). The results obtained in 149 blood samples from pregnant women proved the clinical value of NIPT for detection of fetal trisomies 21, 18, and 13. Aneuploidy was detected in 20 out of 149 samples. Among these 20 aneuploid cases, trisomy 21 amounted to 60%, trisomy 18 – to 25%, and trisomy 13 to 5% of cases. In one sample, double aneuploidy involving chromosomes 13 and 21 was detected, and in one case, trisomy X was identified. In 100% of cases, aneuploidies were confirmed by prenatal karyotyping advocating for the absence of false positive NIPT results. The observed high specificity was consistent with the declared test specificity level of >99.9%. The sensitivity of the method was 100%. To summarize, NIPT is a new reliable technique that will probably soon replace the conventional first trimester combined screening. The only disadvantages of implementing NIPT in Russia are its relatively high cost and the lack of coverage by insurance companies. NGS-based NIPT is suitable for clinical practice and will be widely deployed due to a further cost decrease.
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