| An 8-center study to evaluate the utility of mid-term genetic sonograms among high-risk pregnancies. | |
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MedLine Citation:
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PMID: 12523608 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: A multicenter study was undertaken to evaluate the diagnostic efficacy of a genetic sonogram. METHODS: Eight centers provided data on 176 pregnancies complicated by fetal Down syndrome. One hundred thirty-four pregnancies were considered high risk because of advanced maternal age (> 35 years), and 42 were considered high risk for having "abnormal" triple-screen results (risk > 1:250). Each center provided fetal biometric data, information regarding the presence or absence of major structural abnormalities, and between 3 and 6 additional ultrasonographic markers for trisomy 21. The heterogeneity of our 8 independent "sensitivity estimates" was evaluated by Poisson regression, and a single combined estimate of the sensitivity was calculated. RESULTS: Of the total 176 cases of trisomy 21, 125 fetuses (71.0%) had either an abnormal long bone length (femur length, humerus length, or both), a major structural abnormality, or a Down syndrome marker. The combined diagnostic sensitivity was 71.6%, with a range of 63.6% (7 of 11) to 80% (8 of 10). Five centers had sensitivity estimates falling between 64% and 76%. The sensitivity of individual markers varied between 3% (sandal gap) and 46.5% (nuchal skin fold thickness). A condensed regimen of nuchal skin fold thickness, femur length, and a standard anatomic survey would screen in 56.8% of fetuses with Down syndrome. CONCLUSIONS: This 8-center study that included many fetuses with Down syndrome validates the concept that the genetic sonogram can be used to better adjust the Down syndrome risk for high-risk patients. |
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Authors:
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John C Hobbins; Dennis C Lezotte; Wayne H Persutte; Greggory R DeVore; Beryl R Benacerraf; David A Nyberg; Anthony M Vintzileos; Lawrence D Platt; Dru E Carlson; Raymond O Bahado-Singh; Alfred Z Abuhamad |
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Publication Detail:
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Type: Journal Article; Multicenter Study |
Journal Detail:
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Title: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine Volume: 22 ISSN: 0278-4297 ISO Abbreviation: J Ultrasound Med Publication Date: 2003 Jan |
Date Detail:
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Created Date: 2003-01-13 Completed Date: 2003-04-15 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8211547 Medline TA: J Ultrasound Med Country: United States |
Other Details:
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Languages: eng Pagination: 33-8 Citation Subset: IM |
Affiliation:
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Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Denver, CO 80262, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Biometry Down Syndrome / ultrasonography* Female Fetus / anatomy & histology Humans Maternal Age Poisson Distribution Pregnancy Pregnancy Trimester, Second Pregnancy, High-Risk* Sensitivity and Specificity Ultrasonography, Prenatal* |
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