**7. Ethical and social aspects**

The introduction of NIPT by the technique of NGS used in prenatal diagnosis has raised some ethical and social concerns. NIPT can theoretically provide information on the entire genome of the mother and the fetus with relative ease. In fact, NIPT has already revealed a small number of occult malignancies [66]. The sequenced DNA, however, could also reveal a BRCA mutation or mutations on genes encoding for neurodegenerative diseases such as Chorea Huntington that would have major consequences for the mother and the unborn child [67]. It becomes obvious that the professional societies and national guidelines need to carefully regulate which data will be analyzed, stored, and reported. Clearly, the mother needs to give written informed consent to each specific analysis that is performed and needs to approve any individuals or institutions that receive this type of information. Although most of today's available NIPT tests directly report to the physician who indicated the test there remains a concern that NIPT could be offered directly to the pregnant woman without a medical request or indication. It seems of highest importance that the expectant mother is appropriately counseled by a trained health care professional who can offer and discuss all implications for testing, provide for and interpret all options, discuss prognosis and can assist with the management of the pregnancy and the subsequent prenatal care [68,69]. An important further aspect is that adequate educational material is offered to health care professionals and to the public, as it will assist in avoiding misunderstandings about the technology and possible misuse, thereby ease public anxieties [70].
