General standards and guidelines for prenatal testing are available from the American College of Medical Genetics (2006 Edition of Standards and guidelines for clinical genetics laboratories. Operator experience and sample quality in genetic amniocentesis. Maternal cell contamination: a problem in amniocentesis. However, contamination in … Hum Genet. But these anatomical locations have markedly different niches and functions in vivo, whereas none compare fetal and maternal … DOI: https://doi.org/10.2353/jmoldx.2007.070017. Objectives: To establish the genotype of cultured cells from a cohort of amniotic fluid and chorionic villus samples, and compare this genotype with that obtained from uncultured material from the same sample, in order to assess the frequency and significance of maternal cell contamination of prenatal samples. If the assay was uninformative by their own criteria, additional markers were added by two thirds of the laboratories, whereas one third did not expand the assay. Methods: A prospective observational study was performed. Domino, FJ editor. Maternal Cell Contamination (MCC) study is important test which provides assurance that the results of molecular analyses such as sequencing and microarray performed on fetal specimens are accurate and are not influenced by maternal DNA. View … Although the presence of MCC does not always lead to diagnostic errors, if such errors do occur, the consequences in the prenatal setting could result in an inappropriate termination of a pregnancy. AF and CVS have their respective advantages and disadvantages, reflected in the spectrum of accepted sample types by the surveyed diagnostic laboratories (, Even though MCC has been recognized as a potential cause of misdiagnosis in prenatal testing, our survey of 35 clinical diagnostic laboratories indicated that these laboratories use different assays and MCC testing practices. of maternal cell contamination (MCC) confounds isolation of MSC from placenta, and their mixed origin confuses the stem cell com-munity. 4 days - 3 weeks. The test is based on differences between maternal and fetal hemoglobin. MCC testing was performed in the majority of molecular diagnostic laboratories, but guidelines for standardization are needed to ensure optimal and accurate prenatal patient care. Alkali denaturation test; Purpose: differentiate neonatal from maternal blood: The alkali denaturation test, also known as A or Apt test, is a medical test used to differentiate fetal or neonatal blood from maternal blood found in a newborn's stool or vomit, or from maternal … The lower limit of detection is indicated in the legend on the right and by the columns of the histogram, whereas the number of laboratories for each category is listed on top of the columns. Compared with AF, CVS is performed at ∼11 weeks of gestation and has a higher overall risk of MCC (<5%), because it is difficult to thoroughly remove the maternal decidua from the fetal cells. With this approach, diagnostic laboratories obtain the greatest amount of information to address optimally the pitfalls of prenatal testing. We thank all participating laboratories for their participation in this study. Clinical practice questionnaire, used in phone interviews. CPT Code: N/A. Cytogenetic diagnosis of “normal 46, XX” karyotypes in spontaneous abortions frequently may be misleading. In practice, the Apt test may not be done when there is suspicion of vasa previa, because the time to fetal collapse with bleeding from vasa previa is often very short. Maternal cell contamination in uncultured amniotic fluid. Thus, more information can be gleaned from an expanded assay with multiple markers associated with a requirement of several informative markers. 1. Confined placental trisomy 7: pitfall for cystic fibrosis prenatal diagnosis. in 5-Minute Clinical Consult, 15th ed. Although some laboratories request samples from both the mother and the father, only the maternal sample is strictly required to perform MCC testing, also avoiding issues of potential nonpaternity. The purpose of this investigation is to assess the frequency of maternal cell contamination (MCC) in chorionic villus samples and to evaluate selected parameters which might predict where contamination is … The quantity of material requested for direct AF testing ranged from 2 to 25 ml, whereas the sample requirements for direct CVS testing ranged from no minimum to 30 mg (, Testing for MCC in prenatal samples is considered the standard of care as described in the 2006 edition of Standards and Guidelines for Clinical Genetics Laboratories at. If MCC is present, the maternal DNA may … A variety of commercially available DNA typing assays (by Applied Biosystems, Foster City, CA, and Promega, Madison, WI) were used by 71.4% (20 of 28) of participants, whereas 28.6% (8 of 28) had developed a method in their own laboratory. Fetal hemoglobin is resistant to alkali (basic) denaturation, whereas adult hemoglobin is susceptible to such denaturation. However, it also illustrates that clinical practice is not yet standardized. Four laboratories provided MCC testing at no cost at all. Maternal cell contamination of amniotic fluid samples obtained by open needle versus trocar technique of amniocentesis. Lipponcott Williams & Wilkins, Philadelphia, PA. 2007. The blood is mixed with a small amount of sterile water to cause hemolysis of the RBCs, yielding free hemoglobin. This level is routinely … Forms: New York Clients-Informed consent is required. The incidence of recognized cases of … Percutaneous umbilical cord blood sampling (PUBS), also called cordocentesis, fetal blood sampling, or umbilical vein sampling is a diagnostic genetic test that examines blood from the fetal umbilical cord to detect fetal abnormalities. An Informed Consent for Genetic Testing (Supply T576) is available in Special Instructions. One example of variation between laboratories was in the number of markers in the MCC assay, which ranged from 2 to 16. To determine the pure fetal origin of all prenatal specimens undergoing genetic analysis, it is recommended that MCC analysis be … EDTA whole blood) Maternal Cell Contamination, Blood Test (LAB4139) must be ordered with Maternal Cell Contamination Analysis Test (LAB 4138). Key words Maternal cell contamination Prenatal diagnosis Microsatellite markers Short tandem repeats Genotyping Sample identity This is a preview of subscription content, log … In addition, three of the four laboratories that were developing MCC testing had decided on their approach, and one of three laboratories that sent out their samples for MCC testing was readily familiar with the method used by their reference laboratory. Contacts . The Apt test can also be used to detect the presence of fetal blood in the maternal circulation in cases of suspected fetal-maternal hemorrhage. The reported lower limit of detection for MCC in US diagnostic laboratories. Four laboratories did not perform MCC testing at all. © 2007 American Society for Investigative Pathology and Association for Molecular Pathology. Early amniocentesis versus chorionic villus sampling for fetal karyotyping. If a prenatal specimen (CVS or amniotic fluid) has not already been submitted to LabCorp for other testing, it must now be provided to complete maternal cell contamination (MCC) analysis. This would reduce the number of MCC assays in cases of testing for autosomal recessive conditions by almost 50%, if all cases of multiple gestation and those in which both parents carry the same mutation would still receive MCC testing. Sixty percent of participating laboratories performed testing on direct and cultured amniotic fluid, whereas forty percent tested cultured cells only. The number of identity markers included in individual tests was comparable between commercial and homebrew MCC assays with 4 to 16, and 2 to 13, respectively. The utility and efficiency of the algorithm proposed in. To eliminate errors in prenatal testing as much as possible, we recommend that MCC testing be performed on all prenatal samples and for all modes of inheritance. Even low levels of MCC may interfere with correct molecular diagnoses because PCR can, under optimized circumstances, detect a subpopulation of cells at levels of 0.1%. Therefore, exposing the blood specimen to sodium hydroxide (NaOH) will denature the adult but not the fetal hemoglobin. Phone: 1300 11 8247 Email: [email protected] Specimen Requirements. Thirty-five clinical molecular laboratories that conduct prenatal testing agreed to participate in a clinical practice survey. Maternal Cell Contamination, B Overview Useful For Ruling out the presence of maternal cell contamination within a fetal specimen This test is required for all prenatal testing performed in Mayo's molecular and biochemical genetics laboratories Genetics Test Information Required in conjunction with molecular and biochemical prenatal testing only. Increasing knowledge of inherited genetic conditions, the characterization of associated genes, and continuing advances in diagnostic techniques have enabled genetic testing of prenatal samples in cytogenetic and molecular laboratories. Prenatal diagnosis of genetic disorders, however, is often not straightforward. Rapid prenatal diagnosis of trisomy 21 in 5049 consecutive uncultured amniotic fluid samples by fluorescence in situ hybridisation (FISH). The single laboratory that required four informative markers used an assay developed in-house with up to 10 markers, adding them as needed to reach a status of informative results. Synonyms: MCC. A practical testing algorithm for prenatal samples. TAT: 24-72 hrs. Maternal cell contamination of chorionic villi (CV) samples used for first trimester prenatal diagnosis can cause obvious and/or unrecognized diagnostic dilemmas. The pink hemoglobin-containing supernatant is then mixed with 1 mL of 1% NaOH for each 5 mL of supernatant. The survey included questions about sample requirements, test indications, assay type, test performance and limitations, criteria and management of uninformative test results, reporting, and billing. "My two-week-old daughter is throwing up blood", Obituary: Leonard Apt, 90, doctor-scientist who gave gift of vision to millions of children, "An easy-to-use method for detecting fetal hemoglobin-- a test to identify bleedingfrom vasa previa", Percutaneous umbilical cord blood sampling, Mean corpuscular hemoglobin concentration, https://en.wikipedia.org/w/index.php?title=Alkali_denaturation_test&oldid=997496046, Articles with unsourced statements from July 2020, Creative Commons Attribution-ShareAlike License, differentiate neonatal from maternal blood, A positive test would indicate that blood is of fetal origin, and could be due to. Additional Info: Maternal Cell Contamination, Blood Maternal Cell Contamination Analysis. View and print a requisition form for this test. Be the first one to write a review. ML-maternal-cell-contamination. Diagnostic mid trimester amniocentesis: how safe?. The potential presence of maternal cell contamination (MCC) in chorionic villus or amniotic fluid samples poses a serious preanalytical risk for prenatal misdiagnosis. Conventional sequencing begins with a culture of identical cells as a source of DNA.However, early metagenomic studies revealed that there are probably large groups of microorganisms in many environments that cannot be cultured and thus cannot be sequenced. In these situations, MCC can … A negative test indicates that the blood is of maternal origin. Contamination of a CVS sample with cells of maternal origin may result in analysis of the maternal rather than the fetal karyotype or genotype, especially when the sample size is small. Heath, K. Abruptio Placentae. The reported lower limit of MCC detection ranged from 1 to 20% but was not determined in all laboratories. The aim of this study was to identify current diagnostic practices in the absence of comprehensive practice guidelines. The laboratory should be familiar with the band intensities of specific primers and be alert to novel bands or changes in band intensities. Fetal and maternal pMSC have been compared to MSC isolated from amniotic membrane (fetal) and decidua (maternal). Individual methods for determination of the lower limit of detection were not disclosed. Four laboratories never test for MCC, nine perform MCC testing on occasion, six performed it whenever a maternal sample was available, and 15 performed it without exception. This question was answered by the 24 laboratories that currently performed MCC testing in-house. 3177. DA, direct amniotic fluid; CA, cultured amniotic fluid; DCVS, direct chorionic villus sample; CCVS, cultured chorionic villus sample. These early studies focused on 16S ribosomal RNA (rRNA) sequences which are relatively … F. A. Davis Company, Philadelphia, PA. 2005. The vast majority of participating laboratories used two or three markers to determine that the assay was informative. Nonradioactive PCRs were performed on 30 sets of prenatal tissue using VNTRs as primers. The different modes of inheritance associated with genetic conditions deserve brief consideration because they may be impacted by MCC in different ways. Ruling out the presence of maternal cell contamination within a fetal specimen . The aim of this study was to identify current diagnostic practices in the absence of comprehensive practice guidelines. The reported lower limit of detection for the MCC assays included in this study ranged from 1 to 20% but was not determined in all laboratories (. For heavily bloodstained amniotic fluid samples, a maternal blood specimen may help interpret the results of rapid trisomy testing, followed by confirmation of the fetal origin of cultured cells. State funding for Victorian patients. CONCLUSIONS: For heavily bloodstained … MCC testing practice for 34 US laboratories. In CVS and abortus samples, the culturing process increases the risk of detectable MCC given the colocalization of maternal and fetal cell lineages in the placenta. A negative Apt test would indicate that the blood is of maternal origin, suggesting that the neonate swallowed or aspirated maternal blood, either during delivery or during breastfeeding (e.g., from breast fissures). Fetal hemoglobin will stay pink and adult hemoglobin will turn yellow-brown since adult hemoglobin is less stable and will convert to hematin which has a hydroxide ligand.[5]. Copyright © 2021 Elsevier Inc. except certain content provided by third parties. The results of standard cytogenetic analysis of the long-term cultures of embryonic fibroblasts of 478 first-trimester spontaneous abortions were … As a consequence of allelic identity between mother and fetus, an MCC assay can be uninformative. A simple and effective approach for detecting maternal cell contamination in molecular prenatal diagnosis. Rapid prenatal diagnosis of chromosomal aneuploidies by fluorescence in situ hybridization: clinical experience with 4,500 specimens. This is don … Maternal cell contamination (MCC) affects 0.3-0.7% and 1-2.5% of AF and CVS specimens, respectively (Steed et al. … It consists of three parts: Utilities for: Working with VCF files; Using a pretrained model to recalibrate the genotype (GATK output) of a contaminated sample comment. The alkali denaturation test, also known as A or Apt test, is a medical test used to differentiate fetal or neonatal blood from maternal blood found in a newborn's stool or vomit, or from maternal vaginal blood. Even though the risk of maternal cell contamination (MCC) in CVS or AF may not be entirely avoidable, the magnitude of this risk depends on several variables. Since the test is only a qualitative determination of the presence of fetal hemoglobin in maternal blood, the quantitative Kleihauer-Betke test is more commonly used. If cultured cells are needed, an additional 7-12 days may be required. The risk of MCC is associated with procedures such as chorionic villus sampling, amniocentesis, or extraction of fetal blood from the umbilical cord (cord blood). Amniocentesis is the most frequently applied procedure for prenatal diagnosis of inherited conditions. Image, Download Hi-res But these anatomical locations have markedly different niches and functions in vivo, whereas none compare fetal and maternal … Thus, all prenatal samples should be subjected to testing for maternal cell contamination. This test is required for all prenatal testing performed in Mayo's molecular and biochemical genetics laboratories. The laboratory testing, on the other hand, depends on the certainty that the tested material is of fetal origin. This phenomenon of maternal cell contamination (MCC) confounds isolation of MSC from placenta, and their mixed origin confuses the stem cell community. Of these, 58.6% (17 of 29) billed separately, and 27.6% (8 of 29) billed for the MCC test as an integral part of the performed prenatal test. Venes, D. Taber's Cyclopedic Medical Dictionary - 20th Ed. 2002;Steinberg et al. The combination of two VNTRs (YNZ22 and APOB) provided information on all 30 cases, distinguishing maternal-fetal genotype patterns and detecting maternal cell contamination … A second genotype, interpreted as maternal cell contamination, was identified in direct and/or cultured preparations in 9.1% of samples, 17.8% of which were not bloodstained. Lab/Phone: 330-543-8722. Twelve laboratories charged less than $300, and one laboratory, which uses a variable number of markers (depending on informativeness), charged less than $300 when less than eight markers were used and between $300 and $500 when 13 markers were used. Required in conjunction with … One laboratory, using three to eight identity markers as needed, reported a percentage (75 to 80%) of informative markers instead of a number. Thus, routine performance of this procedure seems paramount to achieving and maintaining competence. One survey question addressed the type of MCC assay used in each laboratory. Seven amniotic fluid samples (2.8%) showed maternal cell contamination in cultured material. Genetics and Genomics; Laboratory Services; Cost. Four did not offer CVS testing at all (, Of the 35 participating laboratories, 24 performed MCC testing in-house at the time of the survey. simulated_maternal_cell_contamination Identifier-ark ark:/13960/t91913x1w Scanner Internet Archive HTML5 Uploader 1.6.4. plus-circle Add Review. The only practice guidelines available for the assessment of MCC during prenatal testing are described in the 2006 edition of Standards and Guidelines for Clinical Genetics Laboratories at, Laboratories in the United States were selected for the study based on their Genetests (, All participating molecular diagnostic laboratories offered AF testing. The 19 laboratories that provided a report for MCC assays with uninformative results and with no evidence of MCC in any of the markers tested, reported to sign out such results as “uninformative” or “equivocal.” A comment was added reflecting that MCC was unlikely but could not be excluded or stating that the results are consistent with fetally derived cells and that no MCC was detected. MCC is more common with clinicians who perform less than 50 amniocenteses annually, and these physicians also have a higher rate of fetal loss after the procedure. For conditions with autosomal recessive inheritance, one quarter of the tested fetuses are expected to carry the maternal mutation and cannot be distinguished from the mother by mutation analysis alone. Of note, however, this laboratory had only recently initiated MCC testing and had not yet encountered MCC in a prenatal sample. One laboratory provided MCC testing but did not issue a report because this assay was not considered part of the diagnostic testing ordered by the clinician. 1976 Sep 10;34(1):115-6. [Maternal cell contamination of cultures of spontaneous abortion fibroblasts: importance for cytogenetic analysis of embryonic lethality]. Two samples (0.65%) were mosaic for an aneuploidy cell line. Twenty-nine laboratories commented on their billing practice. One additional laboratory was in this price range. A simple VNTR-PCR method for detecting maternal cell contamination in prenatal diagnosis. LabCorp buccal swab kits can be ordered using PeopleSoft No. Thus, the samples are essentially irreplaceable, and often only small amounts or suboptimal specimens are submitted. Of the 17 laboratories that charged for MCC testing separately, 15 provided information about pricing. Seven amniotic fluid samples (2.8%) showed maternal cell contamination in cultured material. Previous studies have shown that such contamination can occur relatively frequently, estimated at 2–20% of collected samples, but it makes up a very small fraction of fetal blood, with ~10 −4 to 10 −5 fetal nucleated cells estimated as maternal [7,8,9,10]. [4], The Apt test is most commonly used in cases of vaginal bleeding late during pregnancy (antepartum haemorrhage) to determine if the bleeding is from the mother or the fetus. History. This is done using quantitative fluorescent PCR (QF-PCR) of short tandem repeat (STR) markers. Conclusions. Four were in the process of setting up the assay and had already decided on the sample type they would accept, and three other laboratories sent their samples to a reference laboratory for MCC evaluation. Ten laboratories tested CVS cultures but not direct CVS. Reviews There are no reviews yet. On the one hand, amniotic fluid (AF) or a chorionic villus sample (CVS) is obtained by the obstetrician/gynecologist during an invasive procedure that is associated with potential pregnancy loss. Fetal blood contains fetal hemoglobin composed of two alpha and two gamma subunits (aka hemoglobin F or HbF; i.e., normal fetal hemoglobin). For any prenatal sample, a larger volume or tissue amount, older gestational age, and highly robust prenatal assays are preferable. Direct, as well as cultured CV samples were tested in 67.7% of those facilities (21 of 31). Verbal communication was most often used for complex cases, or performed routinely for all cases positive for MCC. Purpose: The purpose of this study is to evaluate the incidence of maternal cell contamination (MCC) in the first few milliliters of amniotic fluid withdrawn during amniocentesis. Although MCC testing of fetal samples is recommended in guidelines by the American College of Medical Genetics, only 60% of surveyed laboratories performed it without exception. Breast milk or mother's milk is milk produced by mammary glands located in the breast of a human female to feed a young child. Fetal and maternal pMSC have been compared to MSC isolated from amniotic membrane (fetal) and decidua (maternal). This question was answered by 27 laboratories. The effectiveness of variable number tandem repeats (VNTRs) was evaluated in the detection of maternal cell contamination. Implication of maternal-cell contamination in the clinical banking of umbilical cord blood. This repository contains accompanying code for the paper Accurate Fetal Variant Calling in the Presence of Maternal Cell Contamination. In addition, laboratories face demands of fast turn-around-time to minimize anxiety in the prospective parents and to allow for counseling with informed decision making during the ongoing pregnancy. The contamination of fetal samples with maternal cells is cause for concern in prenatal testing. [1][2], The test was developed by Leonard Apt (1922–2013),[3] an American pediatric ophthalmologist. The potential presence of maternal cells in CVS or AF samples poses a significant preanalytical risk for prenatal misdiagnosis. By continuing you agree to the Use of Cookies. One of the risks associated with prenatal testing is maternal cell contamination (MCC), which can occur when a fetal specimen comes into contact with maternal blood or tissue. This small amount of contamination should have negligible effects on the assessment of DNA or RNA. The majority of participating laboratories also offered CVS testing (88.6%, 31 of 35). Maternal blood contains adult hemoglobin composed of two alpha and two beta subunits (aka hemoglobin A or HbA; i.e., normal adult hemoglobin). Some caveats in PCR-based prenatal diagnosis on direct amniotic fluid versus cultured amniocytes. DNA profiling (also called DNA fingerprinting) is the process of determining an individual's DNA characteristics. Although the number of markers used is somewhat arbitrary, the inclusion of a low number of markers may provide a false sense of security if MCC is not detected. Detection of maternal cell contamination in amniotic fluid cell cultures using fluorescent labelled microsatellites. Each individual column represents a reported sensitivity category of the MCC assays in use. The problem of contamination of amniotic fluid cultures with maternal cells is described in 3 cases. The initial 2-3 ml of amniotic fluid withdrawn during amniocentesis was divided into direct analysis (uncultured) and cultured samples. Published by Elsevier Inc. All rights reserved. Breast milk is the primary source of nutrition for newborns before they are able to eat and digest other foods; older infants and toddlers may continue to be breastfed, but solid foods should be introduced in combination starting from six months of age. Overall, however, fewer markers were used in homebrew assays. … The fetal hemoglobin will appear as a pinkish color under the microscope while the adult hemoglobin will appear as a yellow-brownish color. [citation needed]. Most also accepted chorionic villus samples. A nationwide survey has been carried out to establish the incidence and factors determining maternal cell contamination (MCC) of amniotic fluid cultures. The test was originally used to identify the source of bloody stools in newborn infants. The frequency of maternal cell contamination varies considerably due to sampling protocol, operator and culturing of cells from the fetal sample. A Comprehensive Survey of Current Diagnostic Practices in 35 Molecular Diagnostic Laboratories, CYP1B1 Mutation Profile of Iranian Primary Congenital Glaucoma Patients and Associated Haplotypes, A Comparative Study of Five Technologically Diverse CFTR Testing Platforms. This large survey of 35 US diagnostic laboratories that perform prenatal testing demonstrates that the majority perform MCC testing in conjunction with the diagnostic test. Fetal and maternal blood supply are typically connected in utero with one vein and two arteries to the fetus. Uninformative results had not been encountered by 12 laboratories. In this laboratory, MCC testing was primarily interpreted for internal QA/QC purposes. Not surprisingly, the latter testing facilities all used nine markers or more (up to 16). February 23, This page was last edited on 31 December 2020, at 20:04. DNA analysis intended to identify a species, rather than an individual, is called DNA barcoding.. DNA profiling is a forensic technique in criminal investigations, comparing criminal suspects' profiles to DNA evidence so as to assess the likelihood of their involvement … When biopsying a fetal tissue like chorionic villi or amniotic fluid, there is a chance of getting some maternal material that could contaminate the fetal specimen and might lead to a misdiagnosis. MATCC / Maternal Cell Contamination, Molecular Analysis must be ordered on both the prenatal and maternal specimens under separate order numbers. [Article in Russian] Nikitina TV, Lebedev IN, Sukhanova NN, Sazhenova EA, Nazarenko SA. We use cookies to help provide and enhance our service and tailor content and ads. It has been modified to distinguish fetal from maternal hemoglobin in blood samples from any source. The number of informative markers between the maternal and fetal samples deemed necessary for an overall informative test interpretation was reported to range from one to four for validated assays. This difference in composition gives the different types of hemoglobin different chemical properties (in addition to the higher affinity HbF has for dissolved blood oxygen over HbA, allowing baby to extract oxygen from the mother's blood). Sixty percent (21 of 35) performed diagnostic prenatal testing on direct and cultured AF, whereas 40% (14 of 35) used only cultured AF cells. This is particularly of concern with sensitive polymerase chain reaction (PCR)-based molecular assays that may lead to a positive result based on the presence of a very small amount of mutation-positive maternal cells. Finally, the Apt test can be used after birth (postpartum hemorrhage) if the newborn has bloody vomiting, bloody stool, or active bleeding from the nasogastric tube. The color of the fluid is assessed after 2 minutes. Another example of variation between laboratories was in the reported lower level of detection for MCC assays, which varied from 1 to 20% (. The potential presence of maternal cell contamination (MCC) in chorionic villus or amniotic fluid samples poses a serious preanalytical risk for prenatal misdiagnosis. We use cookies to help provide and enhance our service and tailor content and ads. Address reprint requests to Iris Schrijver, M.D., Department of Pathology and Pediatrics, L235, Stanford University Medical Center, 300 Pasteur Dr., Stanford, CA 94305, Departments of Pathology and Pediatrics, Stanford University School of Medicine, Stanford, California, Department of Pathology, Stanford University School of Medicine, Stanford, California. The sample is next centrifuged for several minutes. Please document on the request form or electronic order that a copy is on file. Accepted: It has been proposed to perform the diagnostic assay first and only to proceed to MCC testing if the fetal sample appears positive for the known maternal mutation. A positive apt test would mean that the blood is either due to gastrointestinal or pulmonary bleeding from the neonate. Please enter a term before submitting your search. (1.0 mL min. Thus, all prenatal samples should be subjected to testing for maternal cell contamination. It also requires robust assay performance with unambiguous and accurate test results, because a positive result for a genetic condition may result in termination of the pregnancy.
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