AFJOG

GUIDELINES Basic scan Pregnant Genetic counselling Consider termination Screening for trisomies? Normal? Normal? Screening for structural anomalies? Reason for declining? Risk for structural anomalies Pregnancy duration Preference logistics finances Basic scan Advanced scan *First trimester combination test FMF accredited operator 12-13w *NIPT MS-AFP 15-20w Biochemistry (free b HCG / PAPP-A) 9-12w Biochemistry Triple or quadruple test 15-20w Decisions Blood tests Ultrasound Invasive tests #CVS 12-13w or #Amniocentesis 15-20w Basic scan 18-22w *Advanced scan 18-22w *Detail scan 18-22w Accepted Accepted Declined Abnormal Abnormal First trimester Normal singleton Normal singleton Second trimester Low risk High risk High risk Low risk Low risk Normal Trisomy High risk Declined Low risk Would not terminate Low risk High risk High risk Logistics Finances etc. Prenatal Screening Flowchart * Available to all patients if requested / accessible Always donewhen patients opt in for screening #Genetic screening available to all patients if requested / accessible and after genetic counselling Intermediate risk Intermediate risk Intermediate risk Preference logistics finances High risk Figure 1 African Journal of Obstetrics and Gynaecology | Volume 1 | Issue 2 | 2023 | 30