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Initially, doctors are expected to use the new blood test with women at risk for a Down syndrome pregnancy, such as those older than 35. A negative result would indicate a woman could skip the amnio or CVS; a positive result would suggest she get one done to be sure.

Eventually it might replace the routine screening tests offered to all pregnant women. Since the test sounds fewer false alarms than current tests, fewer women would be told they need the invasive follow-up procedures, experts say. And some suggest that with further fine-tuning, it could largely replace amnio and CVS. With no miscarriage risk, more women might be willing to take it, and so more women would find out they have a Down syndrome pregnancy.

Two California companies, Sequenom Inc. and Verinata Health Inc., hope to offer the test to doctors in the United States by next April. They say it could be done in the first trimester, with Sequenom aiming as early as 10 weeks, and Verinata as early as eight weeks. Results would be available 7 to 10 days later. In addition, LifeCodexx AG of Germany says it wants to start offering its test in Europe by the end of this year, to be performed at 12 to 14 weeks initially. None of the companies would discuss its cost.

“I would have definitely taken a noninvasive test over the struggle for deciding whether to do an amnio or not,” says Nancy McCrea Iannone of Sewell, N.J., who gave birth six years ago to a daughter with Down syndrome. She’d been alerted by screening results, but hesitated to get amniocentesis because of the risk of a miscarriage and the prospect of “a needle in my belly,” she recalls. Ultimately, she did have one.

Iannone now counsels women who plan to deliver babies with Down syndrome. Her charitable group, Down Syndrome Pregnancy Inc., lists several reasons for getting a diagnosis before birth, such as more time to adjust, grieve and learn about the condition, preparing friends and family, and checking on available medical care and insurance.

But detecting the condition earlier in a pregnancy through the new blood test would be a mixed blessing, Iannone said.

The time between diagnosis and birth is “an unnatural state,” she said, and “the longer that time period is, the harder it is.”

“All you know is that they have Down syndrome. You’re coping with that diagnosis in a vacuum, without a baby… It’s fear of the unknown, you haven’t met your baby yet. You spend a lot of time worrying.”

That might weigh heavily on women who haven’t decided whether to continue the pregnancy or not, she said.

Since the new blood test could deliver an answer so early _ before a pregnancy is showing or the baby is kicking _ it might make getting an abortion easier, several observers said. Women haven’t bonded so much, and “they wouldn’t have to explain to as many people,” said Christie Brooks, who moderates an online support group for women who’ve gotten abortions for medical reasons.

“No one needs to know you’re pregnant,” said Skotko. “Maybe you haven’t even told your husband.”

Skotko said he respects that a woman’s right to continue or terminate a pregnancy is a personal one for couples. But he’s concerned that in the case of Down syndrome, many women may be getting bad information about what having the baby would mean. And if the new test became routine it would only exacerbate that problem, he said.

Studies show medical students are poorly trained about people with disabilities and that some doctors who make a prenatal diagnosis emphasize negative information about the condition, he said.

“We have a fleet of physicians who are saying they’re untrained, unprepared and sometimes knowingly inserting their own personal bias,” he said. “How are women today able to make a truly informed decision?”

Others say the blood test could thrust some women into a choice they didn’t ask to make.

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