First trimester screening strategies: A balance between costs, efficiency and diagnostic yield

Non-invasive prenatal testing (NIPT) using cell-free DNA has revolutionized first-trimester screening (FTS) policies. While NIPT is commonly offered as a second-line screening after the combined test (CT), there is a growing trend to replace the CT with NIPT altogether. This raises the question of whether a separate first-trimester scan should be offered alongside the mid-trimester scan. This commentary examines the advantages and disadvantages of four different first-trimester screening strategies that combine NIPT and ultrasound, based on evidence from the literature. By considering these strategies, healthcare providers can make informed decisions regarding prenatal screening approaches.