The Panorama prenatal test is a noninvasive prenatal screening (NIPT) that analyzes fragments of your baby’s DNA circulating in your blood to assess the risk of certain chromosomal conditions. Made by Natera, it can be performed as early as 10 weeks of pregnancy and requires only a standard blood draw from your arm. Results typically come back within 5 to 7 calendar days.
Unlike older screening methods that rely on ultrasound measurements or hormone levels, Panorama looks directly at DNA. It screens for the most common chromosomal conditions, including Down syndrome, Edwards syndrome, and Patau syndrome, and it can also reveal your baby’s sex if you want to know.
How It Works
Starting around 10 weeks of pregnancy, tiny fragments of DNA from the placenta (which shares the baby’s genetic makeup) enter your bloodstream. These fragments are called cell-free DNA, and they mix with your own cell-free DNA. The challenge for any prenatal screening is figuring out which DNA belongs to the baby and which belongs to you.
Panorama approaches this differently from most other NIPTs on the market. Most competing tests use a counting method: they tally up DNA fragments from specific chromosomes and look for an excess that would suggest an extra copy. Panorama instead analyzes natural genetic variations called SNPs (single nucleotide polymorphisms), which are tiny points in the genome where people differ from one another. By reading these variations, the test identifies the mother’s unique DNA pattern and essentially subtracts it out, isolating the baby’s genetic signature. Natera uses a proprietary algorithm called NATUS to perform this calculation and deduce the baby’s genotype.
This SNP-based approach has a few practical advantages. It can measure exactly how much of the DNA in the sample actually comes from the baby (the “fetal fraction”), which is important because too little fetal DNA can produce unreliable results. It also allows the test to work in some situations where counting methods struggle, like egg donor pregnancies and pregnancies where a twin was lost early on (sometimes called a vanishing twin).
What It Screens For
The primary targets are the three most common trisomies, conditions in which a baby has an extra copy of a specific chromosome:
- Trisomy 21 (Down syndrome): The most common chromosomal condition at birth. Panorama detects it with 99% sensitivity and greater than 99% specificity.
- Trisomy 18 (Edwards syndrome): A serious condition that affects multiple organ systems. Sensitivity is about 94%, with specificity above 99%.
- Trisomy 13 (Patau syndrome): A rare and severe condition. Sensitivity is above 99%, though the confidence interval is wider due to fewer cases studied. Specificity is above 99%.
Beyond these three trisomies, Panorama can screen for sex chromosome conditions (such as Turner syndrome or Klinefelter syndrome) and certain microdeletion syndromes, which are conditions caused by a missing piece of a chromosome rather than an extra whole one. The most well-known of these is 22q11.2 deletion syndrome (also called DiGeorge syndrome), which can cause heart defects, immune problems, and developmental delays.
Accuracy and Its Limits
Panorama is highly accurate for the common trisomies, but “highly accurate” and “diagnostic” are not the same thing. This is a screening test, not a definitive answer. A high-risk result means the probability of a condition is elevated, not that the condition is confirmed. A low-risk result makes a condition very unlikely but doesn’t completely rule it out.
The distinction matters most for rarer conditions. For Down syndrome screening, the positive predictive value (the chance a high-risk result is a true positive) is relatively strong because Down syndrome is the most common trisomy. For microdeletions, the picture is much less reliable. Studies have found that the positive predictive value for 22q11.2 deletion varies widely depending on the population being screened. In high-risk groups, confirmed positives have ranged from about 20% to 72% of positive screens. In low-risk populations, one study found only about 7% of positive screens were confirmed. That means the majority of “high-risk” microdeletion results in low-risk patients turn out to be false alarms.
This is why the American College of Obstetricians and Gynecologists does not recommend routine screening for microdeletions in the general population. ACOG’s updated guidance states that patients interested in learning about microdeletion risk should be offered diagnostic testing (amniocentesis or chorionic villus sampling) rather than relying on cell-free DNA screening for these conditions. If you do opt into microdeletion screening and receive a high-risk result, confirmatory diagnostic testing is strongly recommended before making any decisions.
Who Can Take the Test
ACOG now recommends that cell-free DNA screening for the common trisomies be made routinely available to all pregnant patients, regardless of age or risk level. This is a shift from earlier guidance that reserved NIPT primarily for higher-risk pregnancies. After appropriate counseling about what the test can and cannot tell you, you can choose to pursue or decline it.
Panorama works for singleton pregnancies and twin pregnancies. For twins, its SNP-based technology can determine whether the twins are identical or fraternal and calculate separate fetal fractions for fraternal twins, which helps maintain accuracy. It also accommodates some special situations that other NIPTs cannot handle well. Egg donor and surrogate pregnancies (singleton only) are eligible, as are pregnancies with a confirmed vanishing twin.
The earliest you can take the test is 10 weeks of gestation. Before that point, there typically isn’t enough fetal DNA circulating in your blood to produce a reliable result.
What Happens After the Blood Draw
Your provider draws a tube of blood and ships it to Natera’s lab. Most results return within 5 to 7 calendar days from the date the lab receives the sample. Your results will indicate either low risk or high risk for each condition screened.
Sometimes the lab cannot produce a result at all, called a “no-call.” This usually happens when the fetal fraction is too low, meaning not enough baby DNA was present in the sample. Low fetal fraction can occur if the blood was drawn too early, if the mother has a higher body weight (which dilutes the fetal DNA concentration), or simply due to normal variation. If you get a no-call, your provider will typically recommend a redraw, often a week or two later to allow fetal fraction to increase.
A low-risk result is reassuring but does not guarantee a chromosomally typical pregnancy. A high-risk result is not a diagnosis. Your provider will recommend genetic counseling and likely offer confirmatory diagnostic testing, such as amniocentesis or chorionic villus sampling, which analyze fetal cells directly and provide a definitive answer. These procedures carry a small risk of complications, so the decision to proceed is yours.
Sex Chromosome and Optional Screening
Panorama can report your baby’s sex as early as 10 weeks, which is earlier than a typical anatomy ultrasound at 18 to 20 weeks. Sex reporting also includes screening for sex chromosome aneuploidies, where there is an extra or missing sex chromosome. These conditions, such as Turner syndrome (one X chromosome) or XXY (Klinefelter syndrome), have wide ranges of severity and are often milder than the trisomies.
ACOG recommends that sex chromosome screening be offered as an opt-in choice with appropriate counseling beforehand, since a positive result for these conditions can raise complex questions and the clinical impact varies significantly from person to person.