At 17(+4) week, non-invasive prenatal testing (NIPT) results of a 24-years-old 
mother showed high risk of monosomy X (45, X). Abnormally shaped head and 
cardiac defects were observed in prenatal ultrasound scan at 19(+3) week. 
Amniocentesis conducted at 19(+3) week identified karyotype 47, XX, +18, which 
suggested that the NIPT failed to detect trisomy 18 (T18) in this case. With a 
further massively parallel sequencing (MPS) of maternal blood, fetal and 
placental tissues, we found a confined placental mosaicism (CPM) with non-mosaic 
T18 fetus and multiclonal placenta with high prevalence of 45, X and low level 
of T18 cells. FISH and SNP-array evidence from the placental tissue confirmed 
genetic discrepancy between the fetus and placenta. Because the primary source 
of the fetal cell-free DNA that NIPT assesses is mostly originated from 
trophoblast cells, the level of T18 placental mosaicism may cause false negative 
NIPT result in this rare case of double aneuploidy.