We thank the authors for continuing the discussion on this extremely topical and important subject of screening for foetal anomalies in the first trimester and non-invasive prenatal testing (NIPT) for foetal aneuploidy using cell-free foetal DNA in maternal plasma.
We agree fully with the authors that informed consent and informed choice must highlight both the advantages and limitations of any particular test. We are delighted that the authors describe their own systematic attempt to offer routine antenatal screening in the first trimester to prevent the miscarriage of healthy foetuses, and that they agree that NIPT could “help avoid unnecessary miscarriages associated with invasive testing”.

Yours sincerely,
Mahesh Choolani, Arijit Biswas
Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.