Implementation of Noninvasive Prenatal Screening (NIPS) in Clinical Practice: Comparison of Developed Versus Developing Countries

Antenatal screening is extremely important for good pregnancy outcomes. With rapidly advancing technology, advancing age for first pregnancies, accessibility of resources a screening test with high accuracy and at the same time noninvasive and cost-effective test is need of the hour. Noninvasive prenatal screening (NIPS) holds a promising solution to this vital issue. It is based on measurement of cell-free fetal DNA in maternal circulation using maternal blood sample. It holds the scope of detecting common aneuploidies as well as copy number variants and single gene disorders. Though it has many applications, it is currently recommended only for common autosomal and sex chromosomal aneuploidies. It must be kept in mind that NIPS is a screening option only, and there is a need of definitive testing prior to taking any irreversible decision. NIPS is currently part of national guidelines in few developed countries. Several developed and developing countries offer it as out-of-pocket expenditure if couple wishes to get tests. There is a need to evaluate benefits and make this investigation available to communities across the world. This chapter discusses about details of NIPS, indications, limitations, and status in developed and developing countries and measures to optimise its utility globally.