Table 2. Counselors’ correctly answered knowledge questions at T0 (N = 1,635) and T1 (N = 913).
| Knowledge Theme | Question | Answer | T0: N (%) | T1: N (%) |
|---|---|---|---|---|
| Prenatal anomaly screening program | The pregnant woman is free to decide whether or not to have a fetal anomaly scan. | True | 1,634 (99.9) | 911 (99.8) |
| If a pregnant woman is NOT considering terminating the pregnancy, then it is NOT necessary to discuss the prenatal, anomaly screening options. | False | 1,625 (99.4) | 910 (99.7) | |
| The pregnant woman has the right to decide whether or not to receive information about prenatal screening options. | True | 1,623 (99.3) | 907 (99.3) | |
| As a counselor, it is important to advice the pregnant woman whether or not to opt for prenatal anomaly screening, because a counselor has a better insight into the risks than the pregnant woman herself. | False | 1,579 (96.6) | 887 (97.2) | |
| If a woman chooses NIPT, she can also have a nuchal fold measurement taken as part of the screening program. | False | 650 (39.8) | 823 (90.1) | |
| Women who had previously been pregnant with a child with trisomy 21, 18, 13 only receive counseling in a prenatal diagnosis center for screening for trisomy 21, 18 and 13. | True | 417 (25.5) | 627 (68.7) | |
| If NIPT finds signs of cancer in a pregnant woman, this is always reported to her even if she did not opt for disclosure of incidental findings. | True | not applicable | 622 (68.1) | |
| Trisomy 13, 18, 21 | Most infants with Edward’s syndrome die before birth or shortly after birth. | True | 1,602 (98.0) | 900 (98.6) |
| The most common form of Down syndrome is hereditary. | False | 1,515 (92.7) | 850 (93.1) | |
| Approximately half of all infants born with Down syndrome have a heart defect. | True | 1,361 (83.2) | 815 (89.3) | |
| Delays in the development of motor skills in an infant with Down syndrome does NOT affect other areas of development. | False | 1,117 (68.3) | 614 (67.3) | |
| Most babies with Down syndrome are born to women under the age of 36. | True | 1,019 (62.3) | 633 (69.3) | |
| 5–10% of infants with trisomy 13 survive beyond the first year of life. | True | 693 (42.4) | 449 (49.2) | |
| Test characteristics of NIPT | NIPT determines whether the fetus is healthy. | False | 1,631 (99.8) | 910 (99.7) |
| If the result of NIPT is: "negative for trisomy 21,18 and 13", then there is NO chance that the baby has trisomy 21,18 and 13. | False | 1,313 (80.3) | 753 (82.5) | |
| If NIPT gives a positive result for trisomy 21 in the initial screening, there is an average 25% chance that the infant does NOT have trisomy 21. | True | 921 (56.3) | 655 (71.7) | |
| The cell-free fetal DNA in maternal blood used for NIPT comes from the placenta. | True | 899 (55.0) | 827 (90.6) | |
| A failed result in NIPT (no result) occurs in 2 out of 100 tests. | True | 867 (53.0) | 657 (72.0) | |
| If NIPT gives a positive result for trisomy 13 in the initial screening (Patau syndrome), there is an average of a 75% probability that the infant does NOT have trisomy 13. | True | 174 (10.6) | 428 (46.9) | |
| NIPT versus FCT | NIPT has a higher sensitivity than the first trimester combined test. | True | 1,463 (89.5) | 880 (96.4) |
| When using NIPT as the initial screening test, fewer pregnant women are sent for follow-up testing than after the first trimester combined test. | True | 1,363 (83.4) | 830 (90.9) | |
| For initial screening, the personal cost for the first trimester combined test and NIPT are approximately the same as of 1-4-2017. | True | 1,224 (74.9) | 882 (96.6) | |
| Additional findings NIPT and FCT | Additional findings (other than trisomy 21, 18 or 13) can result from the first trimester combined test. | True | 1,119 (68.4) | 505 (55.3) |
| For initial screening with NIPT, the pregnant woman can choose whether she wants to hear additional findings. | True | 840 (51.4) | 901 (98.7) | |
| If the pregnant woman DOES want to know additional findings, chromosomes other than chromosomes 21, 18 and 13 can also be examined. NIPT results can include more than trisomy 21, 18 and 13. | True | 766 (46.9) | 856 (93.8) | |
| As an incidental finding, abnormalities of the placenta can also be detected by NIPT. | True | not applicable | 741 (81.2) | |
| Inclusion and exclusion criteria for NIPT and FCT | The first trimester combined test CANNOT be performed if a woman is pregnant with monochorionic twins. | False | 898 (54.9) | 640 (70.1) |
| A thickened nuchal fold (≥3.5 mm) is NOT an indication for NIPT. | True | 814 (49.8) | 794 (76.0) | |
| NIPT CAN be performed if a woman is pregnant with monochorionic twins. | True | 741 (45.3) | 481 (52.7) | |
| Monochorionic twin pregnancies are monozygotic. | True | 489 (29.9) | 577 (63.2) | |
| If a pregnant woman has a chromosomal abnormality herself, she may NOT eligible for NIPT. | True | 384 (23.5) | 649 (71.1) | |
| If a pregnant woman is 17 years old, she CAN be screened by NIPT. | False | 348 (21.3) | 719 (78.8) | |
| Follow-up tests | Chorionic villus sampling and amniocentesis can demonstrate with more certainty than NIPT whether there is a trisomy in the fetus. | True | 1,484 (90.8) | 885 (96.9) |
| If the first trimester combined test shows an increased risk of 1 in 200 or higher, the woman can then still opt for NIPT. | True | 1,521 (93.0) | 826 (90.5) | |
| If the nuchal fold measurement in the first trimester combined test is ≥3.5 mm, and the karyotyping appears normal in the subsequent invasive test, the parents can be reassured. | False | 1,081 (66.1) | 633 (69.3) | |
| Fetal structural Anomaly Scan | A Fetal Anatomy Scan is used to investigate physical abnormalities in an unborn baby. | True | 1,613 (98.7) | 901(98.7) |
| The primary responsibility for making a medical indication for Advanced Ultrasound Examination lies with the counselor. | True | 1,498 (91.6) | 840 (92.0) |
NIPT = Non-Invasive Prenatal Test, FCT = First trimester Combined Test. Grey fields indicate that <70% of the counselors answered an item correctly.