Document Detail

Combined ultrasound biometry, serum markers and age for Down syndrome risk estimation.
MedLine Citation:
PMID:  10846774     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To compare Down syndrome screening efficiency of the standard serum triple analyte screen to that of a four-component screen consisting of ultrasound biometry and serum markers in the second trimester. METHODS: The Down syndrome screening efficiency of the triple screen, i.e. alpha-fetoprotein (AFP), unconjugated estriol (E3), hCG and maternal age, was compared with the four-marker algorithm, i.e. humerus length, nuchal thickness, AFP and hCG plus maternal age. A quadrivariate Gaussian algorithm was used to calculate individual Down syndrome odds. Receiver operating characteristic (ROC) curves plotting sensitivity against false-positive rate were constructed for each algorithm and the areas under the curves were compared to determine which was superior. Sensitivity and false-positive rates at different Down syndrome risk thresholds were also compared. RESULTS: There were 46 cases of Down syndrome (1.9%) with 2391 normal singleton pregnancies in a referral population in which triple screen, fetal biometry and karyotype had been done. The gestational age range for the study was 14-24 completed weeks. The median maternal age for the study group was 35.0 years (14.0-46.0 years). The areas (SE) under the ROC curves were 0.75(0.04) and 0.93(0.02) for the standard triple and the four-marker screen, respectively (P < 0.001). At a 10% false-positive rate, detection was 45.7% for the triple and 80.4% for the four-marker screen. CONCLUSIONS: A new algorithm combining humerus length and nuchal thickness measurement with serum AFP, hCG and maternal age substantially improved Down syndrome screening efficiency compared with the traditional triple screen. The model appears promising and should be evaluated in an independent data set.
R O Bahado-Singh; A U Oz; K Gomez; D Hunter; J Copel; A Baumgarten; M J Mahoney
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  15     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2000-09-26     Completed Date:  2000-09-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  199-204     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut, USA.
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MeSH Terms
Biological Markers / blood*
Down Syndrome / diagnosis*,  epidemiology
Evaluation Studies as Topic
Mass Screening / methods*
Maternal Age
Middle Aged
Pregnancy Trimester, Second
Prenatal Diagnosis / methods*
ROC Curve
Risk Assessment
Sensitivity and Specificity
Ultrasonography, Prenatal
Reg. No./Substance:
0/Biological Markers

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