After we began enrolling women in the study and the new ACOG guidelines were issued, the prenatal testing decision support guide we had created was out-of-date with respect to the array of available prenatal screening and diagnostic tests and restrictions on invasive test use based upon maternal age. We therefore decided to end the original trial (N=381). We completely revised the decision support guide to describe the new screening options and better represent the current policy landscape. We also reformulated our primary hypothesis to eliminate the age dichotomy, and initiated a new randomized trial using the revised decision support guide to be completed within the time and budgetary constraints of the initially funded project.