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114 Maternity and Obstetrics 2020 | NMH Annual Rep t Prof Peter McParland, Consultant Obstetrician and Gynaecologist, Director of the Fetal Medicine Unit. of our ultrasonographers include performance of CTGs, phlebotomy, preparation, attendance and assistance at invasive procedures, gynaecology scans, counselling, department audits, clinical guidelines, bereavement counselling and liaising with social work, GPs and other disciplines in addition to providing general antenatal care. All patients are offered an anatomy scan and 20-21 wks. A detailed information leaflet is given to patients outlining the limitations of ultrasound. There is a daily early pregnancy assessment service. Prenatal Screening/Diagnosis The demand for prenatal diagnosis and screening continues with a further 17% increase in non-invasive prenatal screening (NIPT/Harmony) in 2020. Table 1 and figure 1 outline the trend over the last ten years. It is interesting to note that almost 49% (figure 2) of the hospital population were 35 years of age or more (compared with nearly 31% 10 years ago) and 10.7% of those were aged 40 or more. 35% of all nulliparous deliveries were aged 35 or older. The figure of 49% over 35 years of age contrasts with our two sister hospitals where the rate is 38%. There continues to be no formal local or national policy on which patients should be offered these tests. The adoption and implementation of a nationally agreed equitable prenatal screening/diagnosis programme is needed urgently. The responsibility for funding and implementation for this lies with the HSE/NWHIP. Non-Invasive Prenatal Testing (NIPT) NIPT (Harmony) was introduced in June 2013 and the numbers of patients availing of this test has rapidly increased with this trend highly likely to continue as the test becomes more affordable (figure 3). Currently this test is not state or hospital funded and is unlikely to be in the near future. There was a falloff in first trimester screening numbers reflecting the superiority of NIPT as a screening test. A total of 2,127 NIPTs were performed with 47 screen positive results (T21, 27; T18, 6; T13, 7; gender, 7). Figure 3 outlines the trends of numbers attending for NIPT. The number of prenatal diagnostic procedures showed a slight decrease in 2020 with 49 CVSs and 118 amniocentesis (total=167) carried out (Table 2). The majority of prenatal diagnostic testing was carried out when there was an ultrasound suspicion of an abnormality. Table 2 outlines the indications for amniocentesis/CVS over the past ten years and table 3 outlines the various abnormalities detected by these procedures. There was a high incidence of abnormal results with 83 out of 167 (50%) yielding abnormal karyotypes in those undergoing diagnostic testing which is a very similar yield to previous years (Table 3). In addition to the above prenatal diagnostic procedures, there were a total of 44 other invasive procedures: 7 intrauterine transfusions, 4 shunt drainage procedures, 6 amniodrainage and 21 photocoagulation laser procedures (jointly with the Rotunda) for twin to twin transfusion syndrome (TTTS), 1 vesicocentesis, and 5 fetal blood samples. The demand for prenatal diagnosis and screening continues with a further 17% increase in non-invasive prenatal screening