Today we're delighted to welcome @R_Arkell to talk about her research on sodium valproate and pregnancy. SV is a potentially lifesaving medication for epilepsy and BPD. Its association with foetal risk raises questions of consent, autonomy and risk in pregnancy prevention.

Delighted to announce that the PRECAS Project PI, Prof @CathyHerbrand, is giving her inaugural lecture on Tuesday 25th March (in person only). This is to celebrate her promotion to professor. There will be a drinks reception afterwards, all welcome.

Shana Riethof visited the @CRRDMU while writing up her thesis. This blog is on Noninvasive prenatal testing in Belgium: how to make technologies reliable #nipt

We have joined BlueSky, come say hello… https://t.co/1DptQtE4gx

A reminder the CRR is taking expressions of interest for ESRC-funded post-doctoral fellowships. Please get in touch by 1 February.

Fantastic piece from CRR member @conceivablefer1 using her expertise to review the new ESHRE POI guidelines - exploring what is new in the guidelines and the context in which practitioners will be trying to deliver them.

Looking to do a post-doc in social studies relating to reproduction? Recently completed your PhD in the UK? We are taking expressions of interest. Email cathy.herbrand@dmu.ac.uk before 1 Feb for a discussion in the first instance. More info on the scheme: https://t.co/jEn1Rz8Ow8.

Thanks so much to @reed_sza for a really though provoking talk!

- patients did not have a good understanding of risk. Errors in results were put down to human interpretation rather than errors with the test itself. Gynaecologists felt they could be more reliable and give more consistent advice.

The reliability of NIPT could provide some certainty but exome testing gave more uncertainty because of the number of conditions that could potentially be positive. For ob-gyns, one of the advantages is less time spent explaining the risks of the test itself -

The discussions were on how to screen and factors that made it more effective but not why to screen in the first place. For patients it could offer reassurance that the baby was fine and reliability was important. But testing for so many conditions made some women worry more.

NIPT is more accurate than the combined test and triple test, avoiding unnecessary amniocentesis which puts the foetus at risk and avoiding unnecessary stress for pregnant couples. NIPT was viewed as important progress towards certainty.

Methods were a mix of interviews with health professionals and women who used NIPT, and also lab ethnography. The talk focuses on interviews with professionals and women who had a positive result.

For doctors performing prenatal screening, it is routine, but for patients, it is a disruption to routine and they are looking for reassurance. There is a different language for patients and for doctors. The accuracy of NIPT is central to understanding how NIPT became routine.

Does NIPT present new ethical challenges or does it present a development of existing ethical challenges around prenatal screening? 'Collective fiction' of prenatal screening as routine conceals that it can reveal information that can lead to some very difficult decisions.

In Belgium there was little discussion about NIPT before it was implemented and it quietly replaced the existing methods of testing and risk assessment. This hides that it is a routinisation of a disruptive technology - it provides data that previous screening methods could not.

Screening so early has a different impact on choices than screening later in pregnancy. NIPT is seen as personalised genomic medicine which can improve prenatal care. Women with results other than the common trisomies are facing new types of reproductive choice.

It is not targeted at specific trisomies but is genome wide, meaning there can be incidental findings for the foetus, the placenta, and for the mother. NIPT is a new prism of knowledge and action on pregnancy with an impact on the maternal-foetal relationship.

In Belgium it is offered in national genetics centres - academic hospitals - rather than commercial companies. So the centres decide on the panel and a geneticist verifies the results before they are reported back.

Goal of this was to enhance reproductive autonomy (not 'improve health') - to provide information about foetal health. The uptake rate is 90%. NIPT is more expensive than the existing screening methods but reduced unnecessary amniocentesis because it was more accurate.