First Trimester Screening Patient Prep

What is First Trimester Screening?

First Trimester Screening (FTS) is a simple noninvasive test recommended for all pregnant women of all ages to assess the health of their pregnancies. FTS, the earliest and most accurate screening tool available, is a combination of an ultrasound (sonogram) exam and a blood test that identifies babies who may have the genetic disorders of Trisomy 13, Trisomy 18 and Down Syndrome (Trisomy 21).

Who Should be Screened?

All pregnant women should be offered this well accepted genetic screening assessment for Down syndrome and Trisomies 13 and 18. The risk for a genetic abnormality, especially Down syndrome, increases for the individual mother with advancing age. However, most affected babies are born to mothers that are young (less than 35) simply due to the fact that more children are born to women in this age group.

How Accurate Is This Exam?

WRA typically works with NTD Labs, an independent medical genetics laboratory, which has a proven detection rate of 91–95% for Down syndrome pregnancies. (When the ultrasound assessment of the presence or absence of the fetal nasal bone is added to the exam the detection rate improves to 95% for Down syndrome.) The detection rate is 95% for Trisomy 18 and 13 pregnancies. In the second trimester of pregnancy a second blood test to analyze serum proteins can then be added to the first trimester information. This “sequential” exam improves the detection rate greater than 95%. The good news is that the majority of these screening exams show that the baby is at low risk and thus is reassuring to the parents. However, if the test is abnormal this information will allow you and your doctor/healthcare provider to make an informed decision about performing additional invasive diagnostic exams such as CVS or amniocentesis if desired.

How Is First Trimester Screening Performed?

First Trimester Screening consists of a combination of an ultrasound (sonogram) exam and a blood test. The ultrasound exam must be performed between 11 weeks 1 day and 13 weeks 6 days gestational age. This exam, performed by a certified technologist and a board certified radiologist, documents fetal age, heartbeat, measurement of the fluid-filled space at the back of the fetal neck (called nuchal translucency or NT), and the presence or absence of the nasal bone. This information is then combined with a maternal blood test, which is analyzed by NTD Labs for two proteins, free Beta human chorionic gonadotropin (free Beta hCG, patented by NTD) and plasma protein–A (PAPP-A). This combination of the information from the ultrasound and the blood work will give a statistical risk assessment for Trisomies 21, 18 and 13 (95% detection rate and 2% false positive rate).

Sequential Blood Testing

Your physician also may order a “sequential” blood test in the second trimester of the pregnancy usually around 16 weeks of gestation. NTD Labs will analyze the blood for certain pregnancy proteins as in the first trimester and also evaluate AFP (alpha fetal protein) to assess for a neural tube defect (i.e., opening of the spine). This sequential information will then be combined with the information from the First Trimester Screening to further improve the detection rate of the genetic disorders of Down syndrome and Trisomies 18 and 13. If your physician has ordered a sequential blood test, WRA will schedule your follow-up blood draw visit at the time of your initial First Trimester Screening exam, typically around 16 weeks gestation.

Follow-up Testing

First Trimester Screening offers early reassurance for most patients. If the test shows low risk/normal most patients are then scheduled for an ultrasound of the fetus around 19-20 weeks of gestational age to assess the fetal anatomy and other pregnancy parameters. If First Trimester Screening demonstrates that the fetus may be at increased risk for a genetic disorder, the patient will have added time to discuss with their doctor/healthcare provider the options of invasive diagnostic procedures such as CVS or amniocentesis that can determine definitely the presence or absence of Trisomies 21, 18 and 13.

Important Information About Insurance Coverage

First Trimester Screening consists of a diagnostic ultrasound examination and a blood test, which are billed separately. The initial part of the First Trimester Screening involves a diagnostic ultrasound examination performed by a board certified ultrasound radiologist at Washington Radiology Associates. To confirm insurance coverage for your OB ultrasound, we recommend that you contact your insurance company to review the list of accepted insurance plans. For more detailed WRA insurance/billing questions, please call us at (703) 641-9133.

Washington Radiology works with NTD Labs to provide the blood test portion of First Trimester Screening. NTD works with many insurance companies and the NTD fee is generally covered under the patient’s plan. In many cases the patient is responsible only for the associated insurance co-payment, co-insurance, or deductible as specified in the individual policy. However, the NTD list of accepted insurance plans may differ from the insurance plans that WRA accepts so please call NTD prior to your study to confirm your level of insurance coverage for the NTD blood test.

If the blood test analysis is not covered under the insurance plan, the patient may request an order from their health care provider for an independent lab such as LabCorp or Quest. If the patient prefers NTD Labs, they will be invoiced directly for blood testing. NTD provides a financial assistance discount for uninsured patients. This discount only covers the blood test, and not any associated ultrasound fees. To determine your insurance coverage for the blood test portion prior to your appointment, please contact NTD Lab’s Customer Care Department: 80 Ruland Road, Suite 1, Melville, NY 11747; Tel: 1-888-683-5227.

WRA Performs First Trimester Screening At These Locations:

Washington, DC

University Medical Building
2141 K Street, NW
Suite 900
Washington, DC 20037

Suburban Maryland

Camalier Building
10215 Fernwood Road
Suite 103
Bethesda, Maryland 20817

Northern Virginia

Four Seasons Three
3022 Williams Drive
Suite 200
Fairfax, Virginia 22031

Lakeside At Loudoun Tech Center I
21351 Ridgetop Circle
Suite 150
Sterling, Virginia 20166

Scheduling Appointments

Washington Radiology provides imaging services for patients upon referral from a physician. Patients are seen by appointment. However, emergencies do occur and we make every attempt to accommodate these cases. To schedule a First Trimester Screening at Washington Radiology, please call centralized scheduling at (703) 280-9800.