First trimester screening strategies: A balance between costs, efficiency and diagnostic yield.

The introduction of non-invasive prenatal testing (NIPT) by cell-free DNA (cfDNA) has reshaped first-trimester screening (FTS) polices. In most countries NIPT is offered as second line screening, after the combined test (CT). However, there is an increasing tendency to replace the CT by NIPT. In this second case the question arises as to whether a separate first-trimester scan should be offered next to the mid-trimester scan. In this commentary we use evidence from the literature to present the pros and cons of four different first-trimester screening strategies combining NIPT and ultrasound. This article is protected by copyright. All rights reserved.