Prenatal tests at OpenMed Warsaw
At OpenMed Warsaw we perform prenatal tests that allow the development and anatomy of the fetus to be assessed, along with the risk of selected chromosomal abnormalities. The scope of diagnostics covers the first trimester ultrasound performed between 11+0 and 13+6 weeks of pregnancy, the PAPP-A test, the mid-pregnancy ultrasound, the third trimester ultrasound and selected non-invasive prenatal blood tests such as Harmony, NIFTY and SANCO.
After the examination the doctor discusses the result, explains the significance of the measurements taken and presents further recommendations. An increased risk in a screening test does not mean a disease has been diagnosed, but it may be an indication for more detailed diagnostics or a genetic consultation.
Who we help
We perform prenatal tests for patients who:
- want to check the development and anatomy of the fetus at successive stages of pregnancy,
- are planning a first trimester ultrasound with assessment of markers such as CRL, NT and the nasal bone,
- want to have the PAPP-A test and receive an assessment of the risk of trisomy 21, 18 and 13,
- need a mid-pregnancy ultrasound assessing the organs and structure of the baby,
- require monitoring of fetal growth and wellbeing in the third trimester,
- received an abnormal or inconclusive result from an earlier test,
- previously had a pregnancy or a child with a congenital defect or genetic disease,
- have a positive family history,
- have a multiple pregnancy and need individually selected diagnostics,
- want to have a selected NIPT from the mother's blood,
- need their results discussed and further care planned.
Doctors performing prenatal tests in Warsaw
Meet the doctors at OpenMed Warsaw who perform prenatal ultrasound scans and review test results at different stages of pregnancy. During the visit the doctor assesses the development of the baby, takes the appropriate measurements and indicates whether standard follow-up or extended diagnostics is needed.
Prenatal tests in Warsaw - when are they worth having?
Prenatal tests are intended for every pregnant woman, regardless of age and the presence of risk factors. Individual tests are performed in specific weeks, which is why it is worth setting out the schedule at the very beginning of pregnancy.
The most important dates are:
- 11+0-13+6 weeks - first trimester prenatal ultrasound and the PAPP-A test,
- weeks 18-22 - detailed mid-pregnancy ultrasound,
- weeks 28-32 - third trimester ultrasound,
- from around week 10 - selected NIPT from the mother's blood.
An earlier consultation may be needed for patients with an abnormal ultrasound result, a positive family history, a previous pregnancy with a fetal defect, or a genetic abnormality diagnosed in one of the parents.
Which prenatal tests do we perform at OpenMed?
At OpenMed Warsaw prenatal diagnostics covering successive stages of pregnancy is available. Depending on the week of pregnancy, results so far and the doctor's indications we perform:
- first trimester prenatal ultrasound,
- mid-pregnancy ultrasound in the second trimester,
- third trimester ultrasound,
- the PAPP-A test together with an assessment of the risk of trisomy,
- selected NIPT tests, including the Harmony, NIFTY and SANCO tests,
- Doppler ultrasound assessing blood flow,
- fetal echocardiography,
- additional tests monitoring fetal growth,
- CTG in the final period of pregnancy or as indicated.
Every examination ends with a discussion of the result. If an abnormality or increased risk is detected, the doctor indicates whether additional follow-up, a genetic consultation, fetal echocardiography or invasive diagnostics at an appropriate centre is needed.
Prenatal ultrasound in the first, second and third trimester
The scope of the ultrasound changes as the baby develops. A normal result from one scan does not replace the following stages, because some organs and abnormalities can only be assessed accurately later in pregnancy.
First trimester prenatal ultrasound
The examination is performed between 11+0 and 13+6 weeks of pregnancy. The doctor assesses, among other things, the crown-rump length CRL, the nuchal translucency NT, the nasal bone, the heart activity and the basic anatomy. The number of fetuses is also determined and, in a multiple pregnancy, the chorionicity and amnionicity.
Mid-pregnancy ultrasound in the second trimester
The mid-pregnancy ultrasound is most often performed between weeks 18 and 22 of pregnancy. It includes a detailed assessment of the brain, face, spine, heart, chest, abdomen, kidneys, bladder and limbs. The doctor also checks the growth of the baby, the position of the placenta, the volume of amniotic fluid and the structure of the umbilical cord.
Third trimester ultrasound
The examination performed at around weeks 28-32 serves above all to assess the growth rate and estimated weight of the fetus. The position of the baby, the volume of amniotic fluid, the condition and location of the placenta and selected elements of anatomy are also checked. Where indicated, the examination is supplemented by an assessment of Doppler blood flow.
The PAPP-A test and the first trimester ultrasound - basic risk assessment
The combined test links the results of the first trimester ultrasound with measurement of the PAPP-A protein and the free beta-hCG subunit in the mother's blood. The calculations also take clinical data into account, such as the age of the pregnant woman, the week of pregnancy, body weight and obstetric history.
On the basis of this information an individual risk is calculated for:
- trisomy 21, that is Down syndrome,
- trisomy 18, that is Edwards syndrome,
- trisomy 13, that is Patau syndrome.
The result is presented as a proportion, for example 1:1000 or 1:100. The PAPP-A test is a screening test - it neither diagnoses nor excludes a chromosomal disease. An increased risk result means that further diagnostics should be discussed with the doctor.
NIPT from the mother's blood as an extension of prenatal diagnostics
NIPT analyses fragments of cell-free DNA present in the blood of the pregnant woman, coming mainly from the placenta. Depending on the test chosen, they may assess the risk of the most common trisomies and of selected chromosomal abnormalities. At OpenMed the Harmony, NIFTY and SANCO tests are available.
Blood collection can usually be performed from around week 10 of pregnancy, once its age and the number of fetuses have been confirmed on ultrasound. NIPT has high sensitivity in assessing the risk of the most common trisomies, but it still remains a screening test. A high risk result should be confirmed by a diagnostic test such as chorionic villus sampling or amniocentesis.
NIPT does not replace prenatal ultrasound. It does not assess the structure of the organs, the growth of the baby, the placenta or the amniotic fluid, and it does not detect all genetic diseases. The scope of individual tests may differ, which is why the choice is worth discussing with the doctor.
What can be assessed during prenatal tests?
Prenatal tests provide information about various elements of the development of a pregnancy. Depending on its stage they allow assessment of:
- gestational age and fetal growth,
- the number of fetuses and the type of multiple pregnancy,
- the heart activity of the baby,
- basic and detailed anatomy of the organs,
- markers of increased risk of chromosomal abnormalities,
- the risk of trisomy 21, 18 and 13,
- the position and structure of the placenta,
- the volume of amniotic fluid,
- blood flow in selected vessels,
- the structure and function of the fetal heart,
- the position of the baby before delivery.
No prenatal test guarantees the detection of all congenital defects and genetic diseases. Diagnostic possibilities depend, among other things, on the week of pregnancy, the position of the baby, the quality of the image obtained and the type of abnormality detected.
When may the doctor recommend extended prenatal diagnostics?
Additional tests may be needed if a standard ultrasound or screening test shows an increased risk. Indications may include:
- increased nuchal translucency,
- an absent or abnormal image of the nasal bone,
- a suspected anatomical defect,
- an increased risk in the PAPP-A test,
- a high risk result or no result from NIPT,
- an abnormal rate of fetal growth,
- Doppler blood flow abnormalities,
- a previous pregnancy or child with a congenital defect,
- a genetic disease in the family,
- an abnormal karyotype in one of the parents.
Further care may include a more detailed ultrasound, fetal echocardiography, a genetic consultation, an additional screening test or invasive diagnostics. With a clear anatomical abnormality another screening test is not always the best solution - the doctor may recommend a diagnostic test directly.
The prenatal test result - discussion and next steps
After the ultrasound the patient receives a report containing the measurements taken and an assessment of the structures examined. In the case of a combined test or NIPT the result states the level of risk of selected abnormalities rather than a definite diagnosis.
A low risk result means that the probability of the abnormality assessed is small, but it does not fall to zero. An increased risk result likewise does not determine that the baby has a given disease. The doctor interprets it together with the ultrasound image, the gestational age and the documentation so far.
Further care may include:
- another ultrasound at the standard date,
- repeating the examination if the position of the baby prevented a full assessment,
- a more detailed anatomical examination,
- fetal echocardiography,
- a genetic consultation,
- chorionic villus sampling or amniocentesis.
An inconclusive NIPT result also requires discussion. No result is not the same as a normal result and should not be ignored automatically.
How to prepare for a prenatal test
It is worth bringing your pregnancy record, the results of previous ultrasound scans, laboratory test results and documentation from previous pregnancies, if it may matter for the current diagnostics.
The doctor should be told about:
- the date of your last period,
- how the gestational age was established,
- a pregnancy achieved through assisted reproduction,
- a multiple pregnancy,
- chronic conditions and medication taken,
- previous miscarriages or fetal defects,
- genetic diseases occurring in the family,
- the use of a donor egg, if applicable.
For blood collection for the PAPP-A test or NIPT you usually do not need to fast, unless the clinic gives different instructions. For an ultrasound through the abdominal wall the way the bladder should be prepared depends on the week of pregnancy. If a transvaginal examination is needed, it is usually performed after emptying the bladder.
Safety and comfort of prenatal diagnostics
Prenatal ultrasound uses ultrasound waves and does not involve ionising radiation. Blood tests such as PAPP-A and NIPT do not interfere with the environment of the fetus. When performed in line with medical indications they are considered safe for the pregnant woman and the baby.
The ultrasound is most often performed through the abdominal wall. At an earlier stage of pregnancy, or when obtaining an adequate image is difficult, the doctor may suggest a transvaginal examination. The duration of the examination depends on the week of pregnancy, the position of the baby, the number of fetuses and the scope of the assessment required.
Invasive tests such as amniocentesis and chorionic villus sampling require the environment of the pregnancy to be breached and carry a small risk of complications. For this reason they are performed for specific indications, after discussing the benefits and the possible risk.
Frequently asked questions about prenatal tests in pregnancy
Yes. Chromosomal abnormalities and developmental defects can occur in a pregnancy in a woman of any age. Prenatal ultrasound and screening tests are not intended only for patients over the age of 35.
No. The ultrasound assesses the anatomy of the fetus and selected markers, while the blood test measures PAPP-A and the free beta-hCG subunit. Combining these results with the data of the pregnant woman produces the combined test.
No. A low risk means a lower probability of the trisomies covered by the test, but it does not give a one hundred per cent guarantee. The test also does not detect all genetic diseases or anatomical defects.
The PAPP-A test assesses biochemical markers in the blood of the mother and links them with the ultrasound result. NIPT analyses fragments of cell-free DNA coming from the placenta and has higher sensitivity for the most common trisomies. Both are screening tests, not diagnostic ones.
Yes. NIPT does not assess the anatomy of the baby, the nuchal translucency, the number of fetuses, chorionicity or early developmental defects. A normal blood test result does not replace an ultrasound examination.
No. The scope depends on the panel chosen, and even a broad test does not cover all possible chromosomal changes and single-gene diseases. NIPT also does not serve to detect most structural defects.
The cause may be, among other things, too small an amount of DNA for analysis, collection that was too early, or factors related to the pregnancy or the body of the pregnant woman. Such a result should be discussed with the doctor, who will decide on repeat collection or another diagnostic method.
No. This is a screening result indicating an increased probability of an abnormality. Before medical decisions are taken the result should be confirmed by a diagnostic test.
Yes, but the way risk is calculated and the range of tests available may differ from a single pregnancy. Chorionicity and amnionicity should be established during the first trimester ultrasound, because they affect the later schedule of care.
A referral is not required. It is enough to contact the OpenMed reception desk and arrange a date for the examination.
Prenatal test price list
Service available at the following clinics:
- Warsaw Wola - price list
Have questions? Contact us - 22 100 45 20.