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d detected fetal structural anomalies. Tracking and real-time updating of fetal phenotype and consideration of re-classification of variants based upon postnatal findings is vital if one is to optimise the clinical impact already evident from this emergent genomic technology. This article is protected by copyright. All rights reserved. Prenatal exome sequencing using the NHS England r21 pathway shows great promise when applied to our initial cohort, with a genetic diagnosis obtained in over half of pre-selected ultrasound detected fetal