{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T10:06:55Z","timestamp":1773050815469,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,4,2]],"date-time":"2019-04-02T00:00:00Z","timestamp":1554163200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1105603"],"award-info":[{"award-number":["1105603"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1021252"],"award-info":[{"award-number":["1021252"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess trends in ultrasound\u2010indicated prenatal diagnostic testing performed over the past two decades in the Australian state of Victoria, in the context of rapidly changing practices in aneuploidy screening and chromosome analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective analysis of all ultrasound\u2010indicated prenatal diagnostic testing (amniocentesis and chorionic villus sampling) performed in the state of Victoria between 1994 and 2016. Ultrasound indications for testing included: fetal structural abnormality, fetal death, fetal growth restriction, abnormal amniotic fluid volume, genetic \u2018soft marker\u2019 and unspecified ultrasound abnormality. Maternal age, indication for testing, type of diagnostic procedure, gestational age, type of chromosome analysis (G\u2010banded karyotyping or chromosomal microarray (CMA)) and test results were obtained. Diagnostic yield (i.e. percentage of tests yielding a major abnormality) was analyzed by year, maternal age and gestational age. Statistical analysis was performed using the \u03c7<jats:sup>2<\/jats:sup> tests for trend or difference in proportions, as appropriate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the 23\u2010year study period, 1\u2009533\u2009317 births were recorded and 16\u2009152 diagnostic procedures were performed for the primary indication of ultrasound abnormality. In recent years, ultrasound abnormality became the most common indication for prenatal invasive testing (29.4% of diagnostic tests between 2013 and 2016) due to a steep decline in testing for other indications such as positive result on combined first\u2010trimester screening or advanced maternal age alone. In 2016, over 95% of ultrasound\u2010indicated procedures were performed with CMA; among these, pathogenic copy number  variant (CNV) was the most common (3.5%) abnormality detected, followed by trisomy 21 (2.8%). The diagnostic yield of ultrasound\u2010indicated tests performed &lt;\u200916\u2009weeks was significantly higher than that of tests performed after 20\u2009weeks (31.5% <jats:italic>vs<\/jats:italic> 9.0%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ultrasound\u2010indicated invasive testing is contributing to prenatal diagnosis in new ways in the genomic era. A pathogenic CNV is now the most likely diagnosis after ultrasound\u2010indicated testing, rather than trisomy 21 or other whole\u2010chromosome aneuploidy. Despite steady improvements in first\u2010trimester screening for aneuploidy, the diagnostic yield of ultrasound\u2010indicated tests &gt;\u200920\u2009weeks has remained stable due to increased utilization of CMA. Procedures performed for structural abnormalities &lt;\u200916\u2009weeks continue to have the highest diagnostic yield, supporting the benefits of early fetal structural assessment at 11\u201313\u2009weeks. Copyright \u00a9 2018 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.19107","type":"journal-article","created":{"date-parts":[[2018,6,7]],"date-time":"2018-06-07T06:32:16Z","timestamp":1528353136000},"page":"503-511","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Population\u2010based trends in invasive prenatal diagnosis for ultrasound\u2010based indications: two decades of change from 1994 to 2016"],"prefix":"10.1002","volume":"53","author":[{"given":"E.","family":"Lostchuck","sequence":"first","affiliation":[{"name":"MD Undergraduate Program University of British Columbia  BC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Poulton","sequence":"additional","affiliation":[{"name":"Reproductive Epidemiology, Murdoch Children's Research Institute  Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Halliday","sequence":"additional","affiliation":[{"name":"Reproductive Epidemiology, Murdoch Children's Research Institute  Parkville Victoria Australia"},{"name":"Department of Paediatrics University of Melbourne  Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9720-3562","authenticated-orcid":false,"given":"L.","family":"Hui","sequence":"additional","affiliation":[{"name":"Reproductive Epidemiology, Murdoch Children's Research Institute  Parkville Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology University of Melbourne  Parkville Victoria Australia"},{"name":"Department of Perinatal Medicine Mercy Hospital for Women  Heidelberg Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology The Northern Hospital  Epping Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,4,2]]},"reference":[{"key":"e_1_2_6_2_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199309163291201"},{"key":"e_1_2_6_2_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2017.11.005"},{"key":"e_1_2_6_2_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8831"},{"key":"e_1_2_6_2_5_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.201.3.8939206"},{"key":"e_1_2_6_2_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000263659"},{"key":"e_1_2_6_2_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)11280-6"},{"key":"e_1_2_6_2_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000015"},{"key":"e_1_2_6_2_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17484"},{"key":"e_1_2_6_2_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/gim.2017.55"},{"key":"e_1_2_6_2_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1203382"},{"key":"e_1_2_6_2_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.07.016"},{"key":"e_1_2_6_2_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14604"},{"key":"e_1_2_6_2_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4329"},{"key":"e_1_2_6_2_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15995"},{"key":"e_1_2_6_2_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17483"},{"key":"e_1_2_6_2_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13270"},{"key":"e_1_2_6_2_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13488"},{"key":"e_1_2_6_2_19_1","volume-title":"2010 and 2011, Victoria's Mothers and Babies: Victoria's Maternal, Perinatal, Child and Adolescent Mortality","author":"Consultative Council on Obstetric and Paediatric Mortality and Morbidity","year":"2014"},{"key":"e_1_2_6_2_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.04.029"},{"key":"e_1_2_6_2_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/gim.2012.113"},{"key":"e_1_2_6_2_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.38042"},{"key":"e_1_2_6_2_23_1","unstructured":"MBSItem Statistics Reports. 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