() Historical III-3 15,418 Aim: To describe the changes over a 9-year Combined screen peaked at control tests period in the number and rate of diagnostic 1,836 in 2009-2010 but declined by 48.1% testing after the introduction of the after cfDNA testing was introduced. combined first-trimester screen and Combined first-trimester screen per 100 subsequent cfDNA testing. morphologic ultrasonograms also significantly decreased (P<0.05) after cfDNA Setting: United States testing introduction. Population: women participating in prenatal CVS peaked after combined first-trimester screening at a maternal-fetal medicine screen introduction in 2007-2008 with 100 group practice. procedures, representing an 81.8% increase Methods: The number of prenatal screening from prefirst-trimester screen. After the and diagnostic tests was recorded over a introduction of cfDNA, CVS declined by year period from billing records. Three time 68.6% during 2012-2013. CVS per 100 intervals were considered: 20 months before morphologic ultrasonograms followed the a combined first-trimester screen was same trend. offered; 72 months after a combined Amniocentesis declined every year of the screen was offered; and 16 months study period (78.8% overall), including 60.3% after cfDNA testing introduction. Prenatal after combined first-trimester screen and a testing was compared per year, per time further 46.7% after noninvasive prenatal interval, and per 100 morphologic testing. Monthly amniocentesis procedures ultrasonograms to account for fluctuations in per 100 morphologic ultrasonograms patient number. significantly decreased (P<.05) after rates of combined first trimester Outcomes: introduction of a combined first-trimester screening, CVS and amniocentesis screen and cfDNA.
() Historical control III-3 15,418 tests Aim: To describe the changes over a 9-year period in the number and rate of diagnostic testing after the introduction of the combined first-trimester screen and subsequent cfDNA testing. Setting: United States Population: women participating in prenatal screening at a maternal-fetal medicine group practice. Methods: The number of prenatal screening and diagnostic tests was recorded over a period from billing records. Three time intervals were considered: 20 months before a combined first-trimester screen was offered; 72 months after a combined screen was offered; and 16 months after cfDNA testing introduction. Prenatal testing was compared per year, per time interval, and per 100 morphologic ultrasonograms to account for fluctuations in patient number. Outcomes: rates of combined first trimester screening, CVS and amniocentesis Combined screen peaked at 1,836 in 2009-2010 but declined by 48.1% after cfDNA testing was introduced. Combined first-trimester screen per 100 morphologic ultrasonograms also significantly decreased (P<0.05) after cfDNA testing introduction. CVS peaked after combined first-trimester screen introduction in 2007-2008 with 100 procedures, representing an 81.8% increase from prefirst-trimester screen. After the introduction of cfDNA, CVS declined by 68.6% during 2012-2013. CVS per 100 morphologic ultrasonograms followed the same trend. Amniocentesis declined every year of the study period (78.8% overall), including 60.3% after combined first-trimester screen and a further 46.7% after noninvasive prenatal testing. Monthly amniocentesis procedures per 100 morphologic ultrasonograms significantly decreased (P<.05) after introduction of a combined first-trimester screen and cfDNA. year
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