DescriptionCell-free DNA (cfDNA) screening has been offered to pregnant women for the last decade to screen for aneuploidy. While professional societies have recommended this technology be used to screen for aneuploidies involving chromosomes 21, 18, and 13, and have recommended informing women of its ability to screen for sex chromosome aneuploidies and select copy number variants, there is a genome-wide platform available clinically that is not yet endorsed for routine use by these societies. Our retrospective chart review sought to assess uptake rates of cfDNA screening with a specific focus on patient motivations for selecting targeted versus genome-wide cfDNA screening. In summary, low-risk patients are more likely to either decline cfDNA screening or to opt for the targeted platform, while high-risk patients are more likely to opt for the genome-wide platform. When reviewing data from patients with ultrasound findings, most patients who decline cfDNA screening pursue invasive testing instead. In contrast, patients that opt for cfDNA screening in the presence of ultrasound findings are more likely to choose the genome-wide platform, possibly to get as much information as possible without the risk associated with invasive diagnostic testing. This study also sought to evaluate whether abnormal noninvasive prenatal screening (NIPS) results affected pregnancy management decisions and had clinically relevant outcomes. While our study echoed a previous study’s findings that the genome-wide platform rarely affected pregnancy management, we saw that this screen may provide insight into the underlying cause of an early pregnancy loss which may help grieving patients have closure and reassurance for future pregnancies.