The Best Way Of Looking At A Non Invasive Prenatal Test (NIPT)
Detection of chromosome abnormalities can be done by means of invasive and non-invasive. Examination in invansif can be done by way of Amniocentesis by sampling the amniotic fluid is done on gestational age around 16 – 18 weeks. In addition there is also a way of Chorionic Villus Sampling (CVS), i.e. the taking of tissue samples from the babies are wont to do at the time of the gestational age 9 – 12 weeks. However, the risk of occurrence of invasive checks abort or abortion is high enough.
As an alternative to avoid the risk of the occurrence of the abort, there is an examination in a non invasive. Examination by means of ULTRASOUND is commonly performed at the age of 10-14 weeks of pregnancy, with how to view the fetal neck (nuchal hump translusensi) and there is an absence of nasal bones. Then proceed with the examination of advanced morphology, which is done at the age of 18-22 week. The level of accuracy of ultrasound assessment only ranged from 75-80%.
In addition to the ultrasound assessment, currently a non-invasive examination itself can be done by examination of the blood (triple test). A non-invasive examination of current type i.e. non-invasive prenatal screening test (NIPT), i.e. the examination can detect 99% of chromosome abnormalities by examining only the mother's blood through the high technology test panel so there is no intervention against the fetus. This examination admittedly done after 9 weeks of gestation. These tests can provide high accuracy by taking blood tests of mother with no fetal intervention. The results provide high accuracy with the results of the chromosome abnormalities are often like Down syndrome (trisomy 21), Edward's Syndrome (Trisomy 18), and includes information on pregnancy, fetal gender will be 10-12 week.
NIPT in USA
There are more than 5 million pregnancies each year in Indonesia, and most of them undergo K4 (four times the minimum contacts to obtain prenatal health services) to a certain extent. But still, the minimum health care provided have not included the testing of pranatal such as AFP (alpha-fetoprotein), MSS (maternal serum screening), or even an ultrasound. Such tests are still considered a luxury and did not reach the entire population of pregnancy in Indonesia.
The field of clinical testing, including Genomics genome prenatal non-invasive (NIPT) at the level of the karyotype, has been getting a lot of interest, both in the research study or practical in the application itself. Presence of Next Generation Sequencing nanopore technology, such as giving the progress of handling testing for the last ten years. Those odds is one of the possibilities that should be understood by the medical practitioners in Indonesia as a new tool, or even approach, to develop a more sophisticated method of prevention for the disease in babies before birth with use the sorting technology to assess fetal abnormalities on the entire genome.
In General, the NIPT can be the right solution in clinical applications because it is much more secure and have a higher accuracy than conventional methods before. However, its implementation depends not only on the technology itself.
Various barriers remains a stumbling block in massive NIPT usage. In addition to moral and ethical issues, the presence of pressure for parents to decide to follow up on test results is also a consideration. Knowing that a baby conceived the mother happens to have a particular genetic disease, it is believed that parents will be placed in a position where they have to make a decision. Of course, abortion is not an option in Indonesia.
According to a study in the United States, health professionals claim that extra prudence may be required to ensure that this pressure has no influence on decision-making related to pregnancy abortion patients. Liveliness and granting of a clear explanation is required from various health professionals and service providers a Non Invasive Prenatal Test (NIPT).