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PATIENT HISTORY FOR NON INVASIVE PRENATAL TESTING

PATIENT HISTORY FOR NON INVASIVE PRENATAL TESTING 2025

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The document is a form for collecting patient history related to Non-Invasive Prenatal Testing (NIPT). It includes sections for patient information, ordering provider details, gestational age, weight, height, fetal sex, and indications for testing. The form outlines specific requirements for twin or surrogate pregnancies and provides options for different types of NIPT tests. Additionally, it emphasizes the need to submit this form alongside the test request form or electronic packing list.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the 'Patient Name' and 'Date of Birth' in the designated fields. This information is crucial for identifying the patient.
Fill in the 'Ordering Provider' details, including their NPI number and contact information. Ensure accuracy for seamless communication.
Indicate the 'Gestational age at draw' along with the patient's current weight and height. Use the provided options for units (lb/kg, in/cm).
For fetal sex, select from Male, Female, Ambiguous, or Unknown based on ultrasound results.
If applicable, check all relevant boxes under 'Indication for testing'. This section helps clarify the reasons for testing.
Finally, review all entries for accuracy before submitting your completed form with any required documents.

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Why would a physician recommend noninvasive prenatal screening?

NIPT stands for noninvasive prenatal testing. Its a screening test offered during pregnancy to see if the fetus is at risk for having a chromosomal disorder like Down syndrome (trisomy 21), trisomy 18 (Edwards syndrome) and trisomy 13 (Patau syndrome). The test can also determine the sex of the fetus.

How do you prepare for the NIPT test?

The NIPT test does not require any special preparation before the test. Its a simple blood draw similar to any other blood test you might experience during your pregnancy. However, there are a few things you can do to make the overall experience smoother: Fasting- You can eat and drink normally before the test.

When is NIPT recommended?

NIPT is a blood test that is more accurate than the first pregnancy screening test. Its offered to women who are carrying a baby identified from previous screening tests as having a higher chance of having either Downs syndrome, Edwards syndrome, or Pataus syndrome.

What are non invasive tests for prenatal diagnosis?

Noninvasive prenatal testing (NIPT), sometimes called noninvasive prenatal screening (NIPS), is a method of determining the risk that the fetus will be born with certain genetic abnormalities. This testing analyzes small fragments of DNA that are circulating in a pregnant womans blood.

When should you do non invasive prenatal testing?

This screening test is available to all people at least 10 weeks pregnant. A normal screening result can be reassuring, but it does not guarantee a healthy baby. Not all birth defects or genetic conditions are identified by NIPT.

What are the advantages of non invasive prenatal diagnosis?

Advantages There is no need to take a sample from inside the (in contrast with invasive prenatal diagnosis using amniotic fluid or chorionic villus sampling). This removes the small chance of miscarriage associated with invasive procedures. It is available for twin pregnancies.

PATIENT HISTORY FOR NON INVASIVE PRENATAL TESTING 2025

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