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<ul><li><p>Page 1 of 7 </p><p>PATIENT TEST INFORMATION - INFORMAII TESTARE PACIENT </p><p>Non-Invasive Prenatal Genetic Screening - Examinare genetic prenatal non-invaziv </p><p>For the physician: this test information sheet should be reviewed together with the patient prior to signing the consent form. </p><p>Pentru medic: prezenta fi de informaii de testare ar trebui s fie revazuta mpreun cu pacientul nainte de semnarea formularului de consimmnt. </p><p>What is NIFTY? </p><p>NIFTY stands for Non-Invasive Fetal TrisomY test. It is a genetic screening test pregnant women can take from week 10 of their pregnancy. </p><p>The NIFTY test determines the risk of the baby having trisomy 21, trisomy 18 or trisomy 13. The term "trisomy" is used to describe the presence of an extra chromosome or three </p><p>instead of the usual pair. For example, trisomy 21 (Down syndrome) occurs when a baby is born with three copies of chromosome 21. NIFTY also offers additional testing for certain </p><p>sex chromosome aneuploidies (an abnormal number of sex chromosomes), deletion syndromes (a loss of part of a chromosome) and inherited genetic disorders (a disorder caused by </p><p>a gene mutation, which is passed down from parent to child). We offer these additional tests as optional extras at no extra cost (see details below). Should you wish to know, the </p><p>NIFTY test can also provide gender information. </p><p>Ce este NIFTY? </p><p>NIFTY nseamn test non-invaziv al trisomiei fetale. Este un test de examinare genetic pe care femeile nsrcinate l pot efectua ncepnd cu sptmna 10 de sarcin </p><p>Testul NIFTY determin riscul de apariie la ft al trisomiei 21, trisomiei 18 sau trisomiei 13. Termenul trisomie se folosete pentru a descrie prezena unui cromozom suplimentar </p><p>cu alte cuvinte a trei cromozomi n loc de perechea obinuit. De exemplu, trisomia 21 (sindromul Down) apare atunci cnd un copil se nate cu trei copii ale cromozomului 21. </p><p>NIFTY ofer de asemenea testri suplimentare a anumitor aneuploidii ale cromozomilor de sex (un numr anormal de cromozomi de sex), sindroame de tergere (o pierdere a unei </p><p>pri dintr-un cromozom) i tulburri genetice motenite (tulburare cauzat de o mutaie genetic, care este transmis de la printe la copil). Oferim aceste testri suplimentare ca </p><p>servicii opionale, fr costuri adiionale (a se vedea detaliile mai jos). n cazul n care dorii s aflai, testul NIFTY poate oferi, de asemenea, informaii privind sexul ftului. </p><p>How does NIFTY work? </p><p>During pregnancy DNA originating from the baby circulates in the mothers blood. NIFTY works by taking a small blood sample of around 10ml from the mother and comparing the </p><p>total maternal and fetal DNA in this sample to a control sample using advanced bioinformatics analysis. The test poses no risk to the mother or baby. </p><p>n ce const NIFTY? </p><p>n timpul sarcinii ADN-ul provenind de la ft circul n sngele mamei. NIFTY const n prelevarea unei probe de snge de aproximativ 10 ml de la mam i compararea ADN-ului </p><p>total matern i fetal din aceast prob cu o prob de control prin intermediul unei analize bioinformatice avansate. Testul nu prezint nici un risc pentru mama sau ft. </p><p>Test Result Information </p><p>Your test results will be sent to the healthcare provider at which you ordered the NIFTY test. In around 2.5% of samples received there is inadequate concentration of fetal DNA in </p><p>the blood sample. In these cases your sample must be reanalysed and you may experience a mild delay in receiving your report. </p><p>Low Risk means there is a very low chance of the baby having an abnormal number of chromosomes for the conditions tested for. For singleton pregnancies the risk score will be </p><p>listed on the NIFTY report provided to you. For twin pregnancies a general risk assessment will be given. </p><p>High Risk indicates the baby has an increased chance of having one of the genetic conditions tested for. For singleton pregnancies the risk score will be listed on the NIFTY report </p><p>provided to you. For twin pregnancies a general risk assessment will be given. </p><p>Note, NIFTY is NOT a diagnostic test, a high risk result should be followed by confirmatory diagnostic testing. </p><p>Resample Required In a small number of cases (around 2.8%*** of all samples received) we are unfortunately unable to analyse the fetal DNA in enough detail in order to provide </p><p>you with a result. In these cases we require a new blood sample in order to run a new test. There is no additional cost for resampling. </p><p>No Call means that we have been unable to detect a result despite resampling. The incidence of this happening is extremely low at only 0.069%*** of all samples received. In such </p><p>cases, a refund of the NIFTY test will be issued. </p><p>Rezultatele obinute la test </p><p>Rezultatele testului dumneavoastr vor fi trimise la furnizorul de servicii medicale la care ai efectuat testul NIFTY. In aproximativ 2,5% din probele primite exist o concentraie </p><p>inadecvat a ADN fetal n proba de snge. n aceste cazuri, proba trebuie s fie reanalizat i este posibil s apar o mic ntrziere n primirea raportului. </p><p>"Risc sczut" nseamn c exist o ans foarte sczut ca ftul s aib un numr anormal de cromozomi pentru afeciunile testate. Pentru sarcinile cu un singur ft scorul de risc va </p><p>fi listat n raportul NIFTY care v va fi nmnat. Pentru sarcinile cu gemeni va fi furnizat o evaluare general a riscurilor. </p><p>"Risc ridicat" indic faptul c ftul prezint un risc ridicat de a avea una dintre afeciunile genetice testate. Pentru sarcinile cu un singur ft scorul de risc va fi listat n raportul NIFTY </p><p>care v va fi nmnat. Pentru sarcinile cu gemeni va fi furnizat o evaluare general a riscurilor. </p><p>Not, NIFTY NU este un test de diagnostic, rezultatul de risc ridicat ar trebui s fie urmat de teste de confirmare a diagnosticului. </p><p>"Necesitate prelevare prob nou" - ntr-un numr mic de cazuri (aproximativ 2,8%*** din toate probele primite) nu putem, din pcate, analiza ADN-ul fetal suficient de detaliat, </p><p>pentru a oferi un rezultat. n aceste cazuri, avem nevoie de o nou prob de snge pentru a efectua un nou test. Nu exist nici un cost suplimentar pentru aceast procedur. </p><p>"Neconcludent" nseamn c nu s-a putut stabili un rezultat, n ciuda unei noi prelevri. ansele ca acest lucru s se ntmple sunt extrem de sczute, doar 0,069%*** din toate </p><p>probele primite. n astfel de cazuri, se ofer o rambursare pentru testul NIFTY </p><p>Test Information </p><p>- Although the NIFTY test is highly accurate for identification of trisomies 21, 18 and 13, NIFTY is NOT a diagnostic test and may result in a false positive or false negative result. </p><p>In order to definitively confirm whether a condition exists, a diagnostic procedure, such as amniocentesis, is required. It is recommended that a HIGH RISK result is always </p><p>confirmedby a diagnostic procedure. </p><p>- Potential sources of false positive or false negative results include but are not limited to maternal, fetal and/or placental mosaicism (mixtures of chromosomally normal and abnormal </p><p>cells in the pregnancy) and low fetal fraction. Blood transfusion, transplant surgery, immunotherapy and stem cell therapy can also affect test accuracy. In the case of twin pregnancy </p><p>testing, vanishing twin syndrome may also cause test inaccuracy. Prior to testing, you should consult with a qualified healthcare provider as to whether any of these conditions apply </p><p>to you and/or advise your healthcare provider if you are already aware that any of these conditions apply to you. Test results should always be interpreted in the context of other clinical </p><p>and family information. </p><p>- The result of the test does not eliminate the possibility of other abnormalities of the tested chromosomes and it does not test for other genetic disorders or birth defects. </p><p>- Testing is available for twin pregnancies for trisomies 21, 18 and 13 only. Testing is available for egg donor and IVF pregnancies for all trisomy conditions screened for. </p><p>Before undertaking any non-invasive prenatal testing and thereafter, you should consult with a qualified healthcare professional regarding any risks diagnoses, treatment and/or any </p><p>other potentially relevant healthcare issues. A healthcare professional can supply more information about the conditions being tested for, and whether you should consider testing. You </p><p>should never make decisions regarding your pregnancy without prior consultations with a qualified healthcare professional who is aware of the healthcare regulations relevant to your </p><p>country of residence. BGI does not administer NIFTY tests directly. Rather, NIFTY tests are administered by BGIs local partners. </p></li><li><p>Page 2 of 7 </p><p>Informaii legate de test </p><p>- Dei testul NIFTY este foarte precis pentru identificarea trisomiilor 21, 18 i 13, NIFTY NU este un test de diagnostic i poate duce la un rezultat "fals pozitiv" sau "fals negativ". </p><p>Pentru a confirma cu adevrat existena unei afeciuni, este necesar o procedura de diagnosticare, cum ar fi amniocenteza. Se recomand ca un rezultat de RISC RIDICAT s fie </p><p>ntodeauna verificat printr-o procedur de diagnosticare. </p><p>- Cauzele poteniale ale rezultatelor fals pozitive sau fals negative includ dar nu se rezum la mozaic cromozomial matern, fetal i/sau placentar (combinaii de celule cromozomiale </p><p>normale i anormale n timpul sarcinii), i la fraciuni fetale sczute. Transfuziile de sange, transplantul, imunoterapia i terapia cu celule stem pot afecta, de asemenea, precizia </p><p>testului. n cazul testrii la sarcina cu gemeni, "sindromul geamnului disprut" poate provoca, de asemenea, inexactitatea testului. nainte de a efectua testul, ar trebui s consultai un </p><p>furnizor calificat de asisten medical, pentru a vedea dac oricare dintre aceste condiii se aplic n cazul dumneavoastr i/sau s cerei sfatul personalului medical dac stii deja </p><p>c suferii de oricare dintre aceste afeciuni. Rezultatele testelor trebuie s fie ntotdeauna interpretate innd cont de alte informaii clinice i legate de familie. </p><p>- Rezultatul testului nu elimin posibilitatea prezenei altor anomalii ale cromozomilor testai i nu verific alte tulburari genetice sau malformaii congenitale. </p><p>- La sarcinile cu gemeni, testarea vizeaz doar trisomiile 21, 18 i 13. Testarea se poate efectua pentru sarcinile obtinute prin donare de ovule i sarcinilor FIV pentru toate trisomiile. </p><p> nainte i dup ntreprinderea oricrei testri prenatale non-invazive, consultai un furnizor calificat de asisten medical cu privire la orice riscuri, diagnostice, tratament si/sau orice alte probleme medicale care pot fi relevante. Un cadru medical poate furniza mai multe informaii legate de afeciunile pentru care se efectueaz testarea i dac ar trebui s o </p><p>efectuai sau nu. Nu trebuie s luai niciodat decizii cu privire la sarcina dumneavoastr fr a consulta n prealabil un furnizor calificat de asisten medical care cunoate </p><p>reglementrile de sntate aflate n vigoare n ara dumneavoastr de reziden. BGI nu furnizeaz n mod direct testarea NIFTY. Testele NIFTY sunt administrate de partenerii </p><p>locali BGI. </p><p>What does NIFTY screen for? </p><p>Pentru ce se efectueaz testarea NIFTY? </p><p>Sensitivity Rate (singletonpregnancies) Rata de detecie (sarcina cu un singur ft) </p><p>Available for Twin Pregnancy Valabil pentru sarcina gemelara </p><p>Trisomies (Trisomii) Trisomia 21 </p><p>(Sindromul Down) Trisomia 18 </p><p>(Sindromul Edwards) Trisomia 13 </p><p>(Sindromul Patau) </p><p>99.12%* </p><p> Yes (Da) </p><p> + Additional Testing Options (+ Opiuni de testare suplimentar) </p><p> Gender Identification (Identificarea sexului genetic) </p><p> 98%** </p><p> No (Nu) </p><p>Trisomies (Trisomii) Trisomia 9 Trisomia 16 Trisomia 22 </p><p> Sensitivity rate not yet validated Rat de detecie nevalidat nc </p><p> No (Nu) </p><p>Sex ChromosomeAneuploidies (Aneuploidii ale cromozomilor de sex) Monosomia X (Sindromul Turner) XXY ( Sindromul Klinefelter) XXX XYY </p><p>95%** </p><p> No (Nu) </p><p>Deletion Syndromes (Sindroame de deletie) 5p (Sindromul Cri-du-Chat) 1p36 2q33.1 Sindromul Prader-Willi/Angelman (15q11.2) Sindromul Jacobsen (11q23) DiGeorge Syndrome II(10p14-p13) 16p12 Sindromul Van der Woude (1q32.2) </p><p> Sensitivity rate not yet validated Rat de detecie nevalidat nc </p><p> No (Nu) </p><p> *Non-Invasive Prenatal Testing For Trisomy 21, 18 and 13 **Clinical Experience from 146,958 Pregnancies, Wei Wang et al, Journal of Ultrasound in Obstetrics and Gynecology ***Figure quoted based off internal data of total samples processed worldwide (around 450,000), end of 2014. </p><p> * Testare prenatal non-invaziv pentru trisomiile 21, 18 i 13. ** Experien clinic de la 146,958 de sarcini, Wel Wang, Journal of Ultrasound in Obstetrics and Gynecology (Jurnalul de Ultrasonografie n Obstetric i Ginecologie) *** Procent bazat pe date interne i numrul total de probe procesate la nivel mondial (aproximativ 450.000) la sfritul anului 2014. </p><p> </p><p></p></li><li><p>Page 3 of 7 </p><p>TEST REQUEST FORM </p><p>Non-invasive Prenatal Genetic Screening </p><p>FORMULAR DE SOLICITARE A TESTRII </p><p>Examinare genetic prenatal non-invaziv </p><p> For the physician/referring clinic: please fill in clearly using black pen and capital letters. Please ensure the test request form accompanies the sample(s). Please retain a copy for your records. </p><p>Pentru medic/clinic: v rugm s completai lizibil folosind un stilou negru i litere de tipar. Asigurai-v c formularul de solicitare a testrii va fi nsoit de prob </p><p>(e). V rugm s pstrai o copie pentru evidenele dumneavoastr. </p><p>BGI Barcode </p><p>(Filled by Istenhegyi GeneDiagnostic Center) </p><p>(Completat de Istenhegyi GeneDiagnostic Center) </p><p>Lab Ref No. </p><p>(Filled by Istenhegyi GeneDiagnostic Center) </p><p>(Completat de Istenhegyi GeneDiagnostic Center) </p><p>Ref No. (ID Filled by requesting institute) (ID intern pacient completat de institutia care soloicita) </p><p>REQUESTING INSTITUTE (INSTITUTIA CARE SOLICITA) </p><p>Institute name (Numele institutiei): ______________________________________ State/Province/Country (Judet/Sector): ___________________________________ </p><p>Screening coordinator Dr: (Medic coordonator screening): ___________________ City/Country (Oras / Tara): ____________________________________________ </p><p> Zip/Postal code (Cod postal): __________________________________ _________ </p><p> Street address (Adresa): ______________________________________________ </p><p> Contact number (Numar _____________________________________ E-mail Rresults will be sent to this email address. Rezultatele vor fi trimise la aceasta adresa de email...</p></li></ul>