Panorama, the most ordered NIPT, can assess conditions that can affect your baby’s health by doing a simple blood draw on you.1,2
CA residents: Find out more about how NIPT is offered under the California Prenatal Screening program and how Panorama can supplement it by clicking here.*
Panorama offers a personalized report, which indicates whether your baby has a high or low chance for certain genetic conditions. Your report could state the following:
A low risk result means that the chance that your baby has one of the conditions tested by Panorama is very unlikely but not zero — less than 1 in 10,000 for most conditions.1,3
Panorama is a screening test, which means that this test does not make a final diagnosis. A high risk result means that your pregnancy has a higher chance of having a specific genetic condition. However, you cannot know for sure if your baby has that condition based on screening results alone.
If you receive a high risk Panorama result, speak with your healthcare provider (HCP) to discuss which next steps you could decide to pursue, such as genetic counseling, detailed ultrasound, and the option of diagnostic testing.
All medical decisions should be made after discussion with your HCP regarding diagnostic testing during the pregnancy, like chorionic villus sampling (CVS) or amniocentesis, or testing the baby after birth.
About 1 in 65 tests could receive a no result or other type of result.3 You should speak with your HCP about these result types and whether you should consider having a second blood draw to do the test again. There is also a small chance that Panorama will have a result relating to your genetics or your physical health.1
Complete Test Specifications for Singleton, Egg Donor, Gestational Carrier, and Monozygotic (Identical) Twins
Definition of performance terms
Sensitivity is the ability to correctly identify a truly high risk case as high risk. For example, in a group of Trisomy 21 cases, Panorama will correctly identify more than 99% of those cases.
Specificity is the ability to correctly identify an unaffected case as low risk.
Positive Predictive Value (PPV) is the likelihood the result says high risk and the fetus is actually affected. For example, when Panorama shows a high risk result for Trisomy 21, there is a 95% chance that the fetus is affected by Trisomy 21. In other words, 5% of the time, you could get a high risk result when the fetus is not affected by Trisomy 21.
Negative Predictive Value (NPV) is the likelihood the result says low risk and the fetus is truly not affected.
|Condition||Sensitivity (95% CI)||Specificity (95% CI)||PPV||NPV|
|Trisomy 21*3,5||99.0% (CI 97.1-100)||>99% (CI 99.93-99.99)||95%||>99.99%‡|
|Trisomy 18*3,5||94.1% (CI 82.9-100)||>99% (CI 99.96-100)||91%||>99.99%‡|
|Trisomy 13*3,5||>99% (CI 73.5-100)||>99% (CI 99.96-100)||68%||>99.99%‡|
|Monosomy X**5-8||94.7% (CI 74.0-99.9)||>99% (CI 99.7-100)||78%||>99.99%‡|
|Triploidy**9,10||>99% (CI 66.4-100)||>99% (CI 99.5-100)||11%||>99.99%‡|
|XXX, XXY, XYY**11||73.1% (CI 61.0-85.1)||99.9% (CI 99.90-99.99)||86.4%||99.87%‡|
|22q11.2 deletion syndrome**12||83.3% (CI 51.6-97.9)||>99% (CI 99.91-99.98)||53%||99.9%||(CI 99.9-100)|
|1p36 deletion syndrome**13,14||>99% (CI 2.5-100)||>99% (CI 99.1-100)||7-17%||||99.98-99.99%|||
|Angelman syndrome**†13,14||95.5% (CI 77.2-99.9)||>99% (CI 99.1-100)||10%§||>99.99%|
|Cri-du-chat syndrome**13,14||>99% (CI 85.8-100)||>99% (CI 99.1-100)||2-5%||||>99.99%|
|Prader-Willi syndrome**†13,14||93.8% (CI 69.8-99.8)||>99% (CI 99.1-100)||5%||>99.99%|
|Female6,7,8||>99.9% (CI 99.4-100)||>99.9% (CI 99.5-100)|
|Male6,7,8||>99.9% (CI 99.5-100)||>99.9% (CI 99.4-100)|
Test Specifications for Dizygotic (Nonidentical) Twins1
1Natera internal data on file
2Definitive Healthcare report to identify billing for NIPT based on US Clearinghouse for Medical Claims using CPT codes 81420, 81507, 81422.
3Dar et al. Am J Obstet Gynecol. 2022 Aug;227(2):259.e1-259.e14.
4ACOG Practice Bulletin 226. Obstet Gynecol. 2020 Oct;136(4):859-867.
5DiNonno et al. J Clin Med. 2019 Aug 26;8(9):1311.
6Nicolaides et al. Prenat Diagn. 2013 June;33(6):575-9.
7Pergament et al. Obstet Gynecol. 2014 Aug;124(2 Pt 1):210-8.
8Ryan et al. Fetal Diagn Ther. 2016;40(3):219-223.
9Nicolaides et al. Fetal Diagn Ther. 2014. 35;(3):212-7.
10Kantor et al. Prenat Diagn. 2022;42:994–999.
11Martin et al. 25th International Conference on Prenatal Diagnosis and Therapy Meeting; June 6-8, 2021.
12Dar et al. Am J Obstet Gynecol. 2022 Jul;227(1):79.e1-79.e11.
13Martin et al. Clin Genet. 2018 Feb;93(2):293-300.
14Wapner et al. Am J Obstet Gynecol. 2015 Mar;212(3):332.e1-9.
* CA residents: If your clinician ordered screening through the California Prenatal Screening program using Natera's Vasistera™ NIPT, Panorama™ will only screen for supplemental conditions. If this is the case, trisomies 21, 18 and 13, and fetal sex (optional) will be screened using Vasistera™ NIPT and will be reported separately.
** Not available for egg-donor or gestational carrier pregnancies or in cases of dizygotic (nonidentical) twins. Triploidy and microdeletions except for 22q11.2 deletions are not available for monozygotic (identical) twins.
† This test has been validated on full region deletions of Prader-Willi syndrome/Angelman syndrome (PWS/AS) only and might be unable to detect smaller deletions. It has not been validated for other molecular mechanisms which could cause PWS/AS such as uniparental disomy (UPD) or methylation.
‡ Ongoing clinical follow-up is performed to ensure the NPV does not fall below the quoted value but follow up is not obtained for all low risk calls.
§ PPV for 22q11.2 deletion syndrome and Angelman syndrome in published studies was 53% and 10% respectively when no ultrasound anomalies were seen and was up to 100% when ultrasound anomalies were seen prior to testing.
|| Dependent upon fetal fraction (FF). For 22q11.2 deletion syndrome, only the paternal allele is evaluated at FF ≤ 6.5%. For 1p36 deletion syndrome and Cri-du-chat syndrome, only the paternal allele is evaluated at FF < 7%. For Angelman syndrome, no risk assessment is reported at FF < 7%. For Prader-Willi syndrome, no risk assessment is reported at FF ≤ 2.8%.