Weird cfDNA Results and ISSUES: May 2026 Data

Summary

---

Podcast Summary: Dr. Chapa’s OBGYN Clinical Pearls

Episode: Weird cfDNA Results and ISSUES: May 2026 Data
Date: May 6, 2026
Host: Dr. Chapa

---

Episode Overview

This episode dives deep into the complexities of cell-free DNA (cfDNA) screening in obstetrics, focusing on discordant results and their implications for both mother and fetus. Dr. Chapa reviews the latest evidence from the May 2026 American Journal of OB GYN (AJOG) publication—a systematic review and meta-analysis on discordant genome-wide non-invasive prenatal testing (NIPT) results—and synthesizes ACOG’s January 2026 Practice Advisory. The discussion is clinically focused, evidence-based, and delivered with Dr. Chapa’s characteristic dynamic, approachable style.

---

Key Discussion Points

1. Evolution of Medical Science and cfDNA

• Dr. Chapa briefly reflects on the historic progress from Ignaz Semmelweis’s “invisible” cadaveric particles to modern cfDNA testing (02:30–03:00).
  • Quote:
    “We go from that now to the finding of cell-free DNA circling around in the person's body that can now detect the possibility of maternal cancer.” — Dr. Chapa [02:22]
• Emphasizes that cell-free DNA isn’t just in pregnancy; everyone has some, leading to both diagnostic challenges and opportunities.

2. Understanding Discordant cfDNA Results

• Definition: Discordant genome-wide cfDNA results occur when NIPT suggests a chromosomal abnormality, but confirmatory testing (e.g., amniocentesis) shows a normal fetus.
• Two main etiologies:
  • Placental mosaicism: Part of the placenta carries a genetic abnormality not present in the fetus.
  • Maternal malignancy: Rarely, aberrant DNA may originate from maternal cancer (especially with complex/atypical results).
  • Quote:
    "If you do find complex discordant results ... that raises the flag by a lot, like by 200 to 300 fold, that she’s likely harboring some kind of malignancy." — Dr. Chapa [05:49]
  • “[cfDNA] can now find potentially, though it's rare, maternal cancer when she just wanted to find out if her child was okay.” — Dr. Chapa [07:02]

3. Take-Home on Discordant Results (“RATs”: Rare Autosomal Trisomies)

• Key Point: Do not dismiss abnormal cfDNA results as “just false positives” if confirmatory testing is normal.
• Risks:
  • Potential stillbirth, fetal growth restriction (FGR/SGA), preterm birth, especially when odd whole-chromosome trisomies (like 4, 6, 9, 15, 16, or 22) are found.
  • Maternal health may be at risk if the cfDNA result reflects a complex abnormality.

---

4. Recent ACOG Practice Advisory (January 2026): Key Recommendations (09:00–14:30)

Rapid-fire Highlights:

• cfDNA is a screening, not a diagnostic, test.
• Offer cfDNA routinely for trisomies 21, 18, and 13 to all pregnant patients, regardless of age or risk factors.
• Screening for sex chromosome aneuploidies should be opt-in, not automatic.
• Do not offer routine cfDNA screening for microdeletions to the general population; reserve for high-risk or with genetic counseling.
• cfDNA is valid for screening common trisomies in twins, but not for sex chromosome evaluation in multiple gestations.
• Avoid using cfDNA for genome-wide copy number deletions/duplications routinely.

Quote:

• “We do not recommend the routine use of cell-free DNA screening for large genome-wide copy number deletions or duplications.” — Dr. Chapa, quoting ACOG [14:31]

---

5. Systematic Review & Meta-Analysis: May 2026 AJOG Data (17:43–24:50)

Study Focus:

• Looked at prospective and retrospective studies (not case series/reports) where discordant genome-wide NIPT (not from the fetus) was found.
• Most false positives traced to focal placental mosaicism.

Key Findings:

• Simple discordant findings (single rare trisomy like 4, 6, 9, 15, 16, 22):
  • Most (80%) are false positives—good news for the fetus.
  • However, about 35% linked to adverse perinatal outcomes: FGR, SGA, preterm birth, increased (but still rare) risk for stillbirth.
  • Highest stillbirth risk with discordant trisomy 9 (24% higher than baseline; absolute risk still low, but notable).
• Complex discordant findings (multiple chromosomal abnormalities in cfDNA):
  • Raise the suspicion for maternal malignancy dramatically (41% in this pooled analysis).
  • “The probability goes up anywhere from 300 to 400 fold ... The pooled probability was 0.41, meaning 41% higher than the general population.” — Dr. Chapa [19:31]
• Management:
  • If a simple genome-wide discordant result, recommend close ultrasound monitoring for growth and placental function, but not necessarily intensive surveillance.
  • For complex/atypical findings, consult genetics/MFM; consider maternal malignancy workup.
  • “If the placenta is jacked, the child will tell you — with altered fetal growth. That's the biggest issue.” — Dr. Chapa [23:23]

---

Memorable Quotes

• “Careful what you ask for. Now remember, these are rare. But if you do find complex discordant results ... that raises the flag by a lot.” — Dr. Chapa [05:26]
• “The good news for the child is that 80% of these are false positive. … The not-so-good news is that a third … can be linked to some adverse perinatal outcome.” — Dr. Chapa [23:41]
• “Don’t ignore a discordant cell-free DNA result that is bizarre just because the amnio … is good.” — Dr. Chapa [06:17]
• “Don’t offer [microdeletion screening] for everybody. Unless there’s a family history or you’re really worried about it.” — Dr. Chapa [12:43]
• “If you find something weird and it’s got multiple weird things, it may be coming from mom. If it’s a single genome discrepancy … science says that pregnancy may be at risk.” — Dr. Chapa [24:34]

---

Important Timestamps

• [02:22] – Science evolution: Semmelweis and cfDNA
• [05:26] – What discordant cfDNA results may mean
• [09:00–14:30] – ACOG’s January 2026 practice advisory summary
• [17:43] – Systematic review/meta-analysis methodology
• [18:45] – Placental mosaicism as the usual cause
• [19:23] – Adverse outcomes linked to specific discordant trisomies
• [23:15] – Monitoring and management recommendations
• [24:34] – Final clinical pearl and take-home message

---

Summary Table: Discordant cfDNA Findings

| Type of Discordance | Probable Source | Main Risks | Next Steps | |----------------------------|--------------------------|-------------------------------|----------------------------------| | Single rare trisomy (“RAT”)| Placental mosaicism | FGR, SGA, preterm birth, rare stillbirth | Ultrasound monitoring, patient education | | Complex findings (multiple chromosomes) | Maternal malignancy (41% pooled risk) | Maternal cancer | Genetic/MFM consult, cancer workup | | Common trisomies (21/18/13)| (Appropriate context) | Accurate screening | Routine practice |

---

Key Take-Home Messages

• Don’t ignore discordant or weird cfDNA results—especially whole genome or complex atypical findings.
• Placental mosaicism is the usual culprit (false positive for fetus, but placental and perinatal risks rise).
• Complex, unexplained findings: Consider maternal malignancy; refer and investigate further.
• Routine cfDNA screening remains for common aneuploidies; be conservative, evidence-based, and deliberate for rare abnormalities or microdeletions.
• Parent/patient education and appropriate follow-up are central—be alert, but not alarmist.

---

Dr. Chapa’s Clinical Pearl:
"If you find something weird and it's got multiple weird things, it may be coming from mom. If it's a single genome discrepancy ... that pregnancy may be at risk ... So don't ignore a discordant cell-free DNA result." [24:34]

---

Transcript

[A]

This episode is brought to you by. Prime Obsession is in session. And this summer, Prime Originals have everything you want. Steamy romances, irresistible love stories, and the book to screen favorites you've already read twice off campus. Elle every year after the Love Hypothesis, Sterling Point and more slow burns, second chances, chemistry you can feel through the screen. Your next obsession is waiting. Watch only on Prime

[B]

Girl. Winter is so last season. And now spring's got you looking at pictures of tank tops with hungry eyes. Your algorithm is feeding you cutoffs. You're thirsty for the sun on your shoulders that perfect hang on the patio. Sundress those sandals you can wear all day and all night. And you've had enough of shopping from your couch. Done. Hoping it looks anything like the picture when you tear open that envelope. It's time for a little in person spring treat. It's time for a trip to Ross. Work your magic.

[C]

It's science.

[D]

It's amazing how far we've come as a scientific slash medical discipline. And for all the progress we've made, there's still some stuff that's still kind of hokey, but nonetheless, medicine and science have progressed in the right direction.

[C]

It's science.

[D]

So let me go over a few things here. Now just put this in proper perspective as a whole. Let's go to the mid 19th century. We're talking about 1840. And women are dying all over the world in childbirth, mainly because of childbirth or childbed fever. And Ignaz Semmelweis comes on the scene as an obstetrician. He was Hungarian practicing in Vienna and says, hey, maybe we should wash hands after we dig around in dead bodies trying to do gross anatomy class before we deliver patients. And of course people thought he was whack because you couldn't see bacteria. Bacteria wasn't a thing. This was 20 years before Lister, Joseph Lister had his germ theory. Is that amazing or what? So we go from that now to the finding of cell free DNA circling around in the person's body that can now detect the possibility of maternal cancer.

[C]

It's science.

[D]

Are you kidding me? I mean, first of all, how creepy is that that there's cell free DNA, right? Everybody thinks, oh, DNA, it's in the nucleus of the cell, it's in the center and like it never leaks out. Not the case. We've got a lot of cell free DNA. It's not just in pregnant women. Everybody's got some amount of cell free DNA floating around. And this is the issue here specifically with poor pregnancy. Now, even though cell free DNA as a Prenatal screen was first introduced in 2015 and then more widely accepted by 2019. Y', all, how long is it going to take for us to figure this thing out? Now, Let me explain two things. Just in January of 2026 and as point of reference, we're doing this in the middle of April, 2026, we're going to highlight something coming out in May of 2026, just to give you a time frame. Right? So this is. We're going to highlight something, but we're doing this middle to late April. But In January of 2026, ACOG released another practice advisory on screening for prenatal chromosome abnormalities using cell free DNA.

[C]

It's science.

[D]

You'd figure that we'd know this stuff already. But from 2015 to January of 2026. Yeah, we need reminders because people are still using this thing incorrectly. So we're going to get into a brand new systematic review and meta analysis that looks at something. Let me just say right now, it is rare. Okay? We're talking about genome wide discordant cell free DNA results. Let me explain what that means. Genome wide means you got a whole other genome, whole other chromosome, meaning typically a trisomy. When you get a cell free DNA back. And it's a weird one. All right, so genome wide discordant cell free DNA meaning discordant is, hey, the blood said there's something out there, but the baby gets a amniocentesis and it's not the kid. What does that mean? Now remember, there's two main issues here. Okay? So when you have a discordant cell free DNA result period, it's typically coming either from placental mosaism, so the placenta can be a little jank and we're gonna talk about that. Or it's coming, especially if it's a complex and discordancy, meaning it's got a lot of weird stuff that it was found. It could be a maternal malignancy. That's nothing new. We've known that for over a decade. All right, weird cell free DNA on mom's prenatal screening can come out with some weird stuff. So careful what you ask for. Now remember, these are rare. But if you do find complex discordant results, meaning more than one cell line is off, the result is like, this kid shouldn't even be in utero. It's so weird. It's like weird stuff. And the kid is like, hey, it's not me. My amnio is normal. That raises the flag by a lot. Like by 200 to 300 fold that she's likely harboring some kind of malignancy. And in general, it's either breast or like a lymphoma. This is amazing. So this is why, you know, don't take things for granted. Oh, we're just going to do a little blood test just to screen, see how your baby's doing. Oh, guess what? Your results were false positive. Baby's actually fine by the amnio, so don't worry about it. No, this is the take home message. If you have a discordant result, that is whole genome and it's weird like trisomy 6 or 16 or trisomy number 4, those are weird ones. Okay. It's not the typical 18, 13, 21 things of that nature. We're going to talk about this. That can be a flag that the placenta is jank. Okay, so ma', am, look super scary. You got back at cell free DNA that showed a weird trisomy like trisomy 16. Those are typically. Those kids typically don't ex the first trimester. Nature takes over for that and usually results in a stillbirth. But your kid's amnio is great. That's the good news. The not so good news is that we gotta find where that's coming from. And if it's not coming from you and your body, it's probably the placenta that's got issues and that may raise the risk of certain prenatal issues. And we need to talk about it. The take home message is don't ignore a discordant cell free DNA result. That is bizarre. Just because the amnio or whatever confirmation diagnostic test that is chosen is good. Okay? Two big outcomes here that we're going to summarize in systematic review and meta analysis. Weird results, especially genome wide whole genome, okay? They threw in a whole extra chromosome and it's not the kid could lead to some adverse prenatal issues. And we're going to talk about that Also when it's complex, the take home message is if you got weird stuff that you can't explain, consider the possibility of maternal malignancy. This is why science can now find potentially though it's rare maternal cancer. When she just wanted to find out if her child was okay.

[C]

It's science.

[D]

Unbelievable. Unbelievable. This is the stuff. Ignace Semmelweis, who talked about his cadaveric particles on hands that were invisible, could never have imagined. So I think I've said it up enough. We're going to talk about the May of 2026 gray journal. That's the American Journal of OB GYN publication that is a systematic review and meta analysis, the title of which is Discordant Findings in Genome Wide Non Invasive Prenatal Testing for Rare Chromosomal Abnormalities. By the way, that Rare Autosomal abnormalities or trisomies are also called rats. You like that? R A T S rats. And Adverse prenatal or pregnancy outcomes. We're going to talk about this coming out in May of 2026 and we're going to do right now. We'll be right back. We're just trying to fulfill our life calling and our mission. This is Dr. Chapa's OBGYN no Spin podcast. Ah, yes, the master scientist that is Ron Burgundy in Anchorman.

[C]

It's Science.

[D]

Oh my gosh, what a politically incorrect movie. And so friggin funny because of it.

[C]

It's Science.

[D]

I do have to give a Just all transparency. I started watching this with my wife. She's like, I'm not watching this anymore. I can't watch this. I'm like, it's funny. So she is not a fan, although I am.

[C]

It's science.

[D]

All right, now that we said that, thank you, Ron. Let's get back very quickly. Let's just summarize the issues here in ACOG's practice advisory that came out January of 2026, y'. All. Practice advisory for something that came out in 2015, widely adopted in 2019. We're still trying to figure this out. First of all, remember that cell free DNA is not a diagnostic test. It is still screening. So very quickly, rapid fire, boom, boom, boom. I'm just going to give you the summary of recommendations from the ACOG guidance. This has nothing to do with the May 2026 systematic review and meta analysis. But to be fair, we do need to remind ourselves of this. Number one, ACOG says, quote, we recommend that cell free DNA screening for common aneuploidies like trisomy 21, 18 and 13 be made routinely available to all obstetrical patients. Number two, we recommend cell free DNA as the most sensitive and specific screening test for the common fetal aneuploidies. Remember, it's not checking for all of them, but for the common fetal aneuploidies, trisomy 21, 18 and 13 in any patient population. So remember back in the day, it was like, oh, you got to leave that for the higher risk or advanced maternal age or pregnancy at age 35 or more, however you want to call it. It was kind of limited to that population. And then it was, well, it's Pretty much good for everybody. So it doesn't matter what age it is. And that's what this second recommendation it is, is for any patient population. Number three quote we recommend that screening for sex chromosome aneuploidies be made available to all obstetrical patients as an opt in consideration with appropriate pretest counseling, end quote. In other words, it shouldn't be done automatically and then they opt out. They have to ask for that in as a sex chromosome aneuploidy check. So trisomy 13, 18, 13 and the ability to opt in for sex chromosome aneuploidies. Of course, most patients just want to know is it male or female? Whatever we're looking for aneuploidies. But yes, obviously they get that information as well. Remember, it just says male. Normal male or normal female is not telling you the actual genotype that needs a microarray or a amniocentesis or karyotype. Okay, okay, so let's keep going. Number four quote. Listen to this. This is a big one. We do not gotta say that again. We do not recommend routine general population screening of any microdeletion condition. Patients who choose to undergo cell free DNA screening for 22Q 11.2 specifically should do so only after appropriate pretest counseling. Pregnant women who are interested in obtaining information regarding the risk for fetal copy number variants should be offered diagnostic testing as opposed to cell free DNA for microdeletion syndromes. End quote. In other words, and I get it, guys, you can check the little box. More information is better, right? Not always. Because be careful what you ask for. You're going to get something that we don't really know, the post test sensitivity, because it's based on pretest probability. So it's all statistics. My point is, don't offer that just for everybody. Unless there's a family history, you're really worried about it, or something else pops up and they should do that in line with a genetic counselor. All right. Number five quote we recommend cell free DNA as the first line screening option for trisomy 21 even in twin gestations. End quote. Notice that's for trisomy 21. Number 6 quote although the number of affected pregnancies are limited, the detection rates associated with trisomy 18 and 13 appear to be consistently high in twin gestations with cell free DNA. Screening for these conditions is also recommended, end quote. So even though, even though there's less data for twin gestations and cell free DNA doing trisomy 18 and 13, it still seems to be Legit. So it's definitely legit for trisomy 21 and twin as a screen. And it seems to be pretty legit also for 18 and 21. All to say those are two different wrecks. They could have stuck them together. But all to say twin gestation. Yep. Data does support cell free DNA for the common trisomies 21, 18 and 13. QUOTE because of lack of data. Oh, so now we're going the opposite direction. We're still in ACOGs practice advisory. Guys, this, this was just four months ago. Okay, January quote Because of lack of data, cell free DNA screening for sex chromosome aneuploidy in twin gestations or higher order multiples is not recommended, end quote. Don't do that. There's not enough data on that. We don't know what's going to, it's going to find. Just do it the old fashioned way with your eyeballs with the ultrasound to see if you see balls or you don't. Sorry, was that crude? Balls meaning scrotum as in a boy. Okay, so if you, if you have got twins or multiples, don't use cell free DNA for sex chromosome screening. There's not enough data for that. Might could work, but we don't really know yet. So for now, until the science catches up, don't do it yet. Right now use ultrasound to look for fetal sex versus cell free DNA in twin or higher order gestations.

[C]

It's science.

[D]

The science is moving fast and I'm sure we will get there at some point. Okay, so that brings us back now to the last recommendation. Quote we do not recommend the routine use of cell free DNA screening for large genome wide copy number deletions or duplications, end quote. Now guys, things move fast. Maybe in a year it will, but right now you don't. It's not recommended to look for copy number deletions or duplications. Now don't get this conf. Was what we're talking about in the publication from May. The publication from May has to do with genome wide entire results. Like a whole genome and a whole nother chromosome is in there like a trisomy 4 or 16 or 22, one of the weird trisomies, right? That's genome wide. That's different than what ACOG is saying. ACOG is saying don't look for genome wide copy number deletions or duplications. So it's the same kind of. It starts off with the same genome wide, but what we're gonna cover it has to do with genome Wide discordancy meaning a whole other chromosome is present when you found cell for DNA that's not in the kid. This is talking about genome wide copy number deletions or duplications. Right now we don't have that data for that. So routine use. Notice it says routine use, not never use, but routine use is not advised. You can do it. You can do it for specific markers when it's clinically indicated, when the post test probability is gonna be higher. Okay, so a couple of take homes microdeletion screening using cell free DNA right now in the general population not recommended. It is possible to do microdeletion testing again if your post test probability is very high. But in general, if you're looking for something that's a copy number variant, you need to offer a diagnostic true test like CVS or amnio as opposed to cell free DNA screening for microdeletion syndromes. Okay, so you might be able to get by with it in very select conditions, but ACOG recommends against microdeletion screening with cell free DNA and just going straight to an official diagnostic test for these issues. Okay, so we talked about multifetal gestation in twins where Trisomy 13, 18 and 21 is legit. But sex chromosome screening is not that good. We do not recommend ACOG says routine general population screening for any microdeletion condition. Rather use diagnostic testing and do not use cell free DNA for copy number deletion or duplications that are genome wide. All right, that's all just a quick review from January 2026. Don't worry because I know it seems kind of voluminous already. We've kind of been here for a while. But I'm just going to tell you very quickly what this new systematic review and meta analysis found and then we're going to walk away. Okay, guys, I know I used to have podcasts that lasted like an hour because there was a lot to cover. We're trying to do these much faster. There's our quickie ones which are ideally under 15 minutes. And there are typical ones we're trying to do no more than 20 or 25. Famous last words.

[C]

It's science.

[D]

So now that we've done the review from ACOG, let's get into this new publication from AJOG, May of 2026. So very simple. This is not like a systematic review meta analysis of RCTs. They used prospective studies and retrospective cohorts. They threw out case reports, case series. There was just prospective and retrospective. And these were all reports that stated Patients had these weird genome wide nips test that were proven to be false positive because the confirmation fetal test of whatever variety said it's not coming from the kid. Okay, Meaning it's some kind of focal placental mosaism that typically comes from like a unipaternal dysomy or just during the placenta formation kind of splits off and it does weird genetic stuff. So placental mosaism focally is usually to blame for this issue. Right? Genome wide non invasive result that the kid doesn't have. Now if it's a symbol. Symbol, simple genome wide non invasive result like trisomy 6, 16, 4 or 22. Notice these are rare, that's why they're called rats. Rare autosomal trisomies. And it's not coming from the kid. The thought is without a placental biopsy, there's a part of the placenta that's kind of jank. And if the placenta is kind of jank genetically, its function is going to be kind of jank. And. And that is the catch. Don't just ignore it as a false positive. This false positive can be linked to some issues and I'm going to tell you what those are here very quickly in just a minute. Now that's a simple genome wide result. If it is a complex result from cell free DNA, you're like whoa, there's like three things wrong with this and it's really weird. But the kids looks great sonographically. You did an amnio and it's normal. That raises the risk that that aberrant DNA is coming from a malignancy. Now let me just tell you this right off the bat. It's not 100%, but in this review it was about 41%. 41% of those with complex NIPS results that were discordant were harboring some kind of maternal malignancy. Again, how terrifying is that? They just wanted to know if their kid was fine and you end up with a potential malignant suspicion. Okay, it is rare. Let me be very clear. Cancer during pregnancy is like one in a thousand. But if your cell free DNA finds a aberrant complex result, the probability goes up anywhere from 300 to 400 fold. Some say 200, some say 500. The point is several hundred fold higher. And this publication found that the pro. The pooled probability was 0.41, meaning 41% higher than the general population. Don't ignore multiple weird stuff. Call your friendly geneticist, call your friendly neighborhood MFM and go. I heard on the podcast this could be Jank, I need help. That's why you have a consultant. Okay, but if it's a single genome wide variation, yes, those are linked to some real adverse issues. Mainly as you would think, things with the JANK placenta fetal growth restriction, even though they call it IUGR here, we haven't called that in a long time. But fgr, sga, preterm birth and they did try to look for stillbirth, but it was really hard to calculate that because thankfully the overall numbers of stillbirth was still overall low. But it still seemed to have a pooled prevalence higher when the placenta was janked over the general population. But it's hard to give it a true number. Anywhere from like 16 to 20% higher risk above the general population though the absolute number, hear me, the absolute number is still very low. Now before people freak out with that, because that is some scary stuff, guys, remember these are extremely rare findings and the highest risk for the worst outcome, which is stillbirth, was tied to a discordant genome wide finding of trisomy number nine. Weird, right? These aren't again, these aren't the common things. So trisomy 9 that had a high prevalence of like 0.24, meaning 24% higher. Again super rare and not the typical findings. Also trisomy 16 had the highest rate for issues overall. So these are not normal. These again, these are the weird things. And the most common discordant genome wide abnormalities were 6, 16, number 22, this chromosome number 9 that had the highest pooled prevalence for stillbirth. And even then it was at 24% but again super rare, also tries to be 15. So these are odd ones. Just to be clear, these are not ones that you should be finding like on a regular basis if you do need to fire whoever's doing your results and or get different patient population because this is really odd, right? So these genome wide discordant results are not common, I want to be very clear, are not common. And the good news for the child is that 80% of these are false positive. That's the good news. It's not coming from the kid, it's coming from a focal placental mosaism. The not so good news is that a third, and this is the end, guys, we're closing this up. Just over a third of this, actually like 35% in this systematic review and meta analysis can be linked to some adverse perinatal outcome. And so it's a good idea to at least do rate of growth ultrasounds, give patient education. I Don't think this requires surveillance because who knows what we're surveilling, but just pay attention. If the placenta is jacked, the child will tell you. With altered fetal growth, that's the biggest issue. Or fluid abnormalities, which you can find again on your rate of growth. Ultrasounds, not necessarily necessary to do antepartum fetal surveillance. I think that's overkill. The point is, don't ignore the weird stuff. These are rare. These are rare. I want to be clear. Rats, rare autosomal trisomies that are discordant on cell free DNA are not common and 80% are false positive. But they can be linked to a 35% rate of some adverse perinatal issues, mainly fetal growth, preeclampsia, preeclampsia with severe features, preterm birth, and maybe, maybe stillbirth. If it's the weird ones, like 9 or 16. But those are very, very unusual. Podcast family, we have learned so much about cell free DNA. And now in May of 2026, this just reminds us that if you find something weird and it's got multiple weird things, it may be coming from mom. If it's a single genome discrepancy, meaning a weird trisomy, science says that that pregnancy may be at risk. About a 35% chance of it, or 35 of those cases, 35% of those cases with some altered fetal growth or placental issues that should be monitored. So don't ignore a discordant cell free DNA result.

[C]

It's Science.

[D]

Podcast family, as always, we're thankful for you. We're glad you're part of our podcast community. And now that we've done all that one more time. Come on, Ron.

[C]

It's science.

[D]

It's science. We'll see you on the next episode of the OB GYN no Spin podcast. Michael, let's take it home.