Document Detail

Combining ultrasound and biochemistry in first-trimester screening for Down's syndrome.
MedLine Citation:
PMID:  9316126     Owner:  NLM     Status:  MEDLINE    
Data on pregnancies with and without Down's syndrome between 10 and 14 weeks of pregnancy were used to determine the performance of combined ultrasound and biochemical markers in prenatal screening for Down's syndrome. We used three datasets: one published by Pandya et al. (1995) on nuchal translucency measurement in 86 Down's syndrome pregnancies; one published by Wald et al. (1996a) on free beta human chorionic gonadotrophin (hCG) and pregnancy-associated plasma protein A (PAPP-A) in 77 affected pregnancies and 385 unaffected pregnancies; and the third from Schuchter et al. on 561 unaffected pregnancies with nuchal translucency measurement. Combining the data from these three datasets showed that screening between 10 and 14 weeks by combining the serum markers with nuchal translucency measurement had a detection rate of 80 per cent for a 5 per cent false-positive rate, better than maternal age with two serum markers (62 per cent for 5 per cent) or maternal age with nuchal translucency measurement (63 per cent for 5 per cent). At this time in pregnancy, it appears that screening using the combined test is better than second-trimester serum screening (76 per cent for 5 per cent), though these estimates do not allow for any association between the markers and spontaneous fetal loss, an issue that needs to be clarified by further research. Meanwhile, these results provide a reasonable working estimate of screening performance using different combinations of these markers.
N J Wald; A K Hackshaw
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  17     ISSN:  0197-3851     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  1997 Sep 
Date Detail:
Created Date:  1998-01-02     Completed Date:  1998-01-02     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  821-9     Citation Subset:  IM    
Department of Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, St Bartholomew's, London, U.K.
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MeSH Terms
Chorionic Gonadotropin / blood
Down Syndrome / blood*,  epidemiology,  ultrasonography*
False Positive Reactions
Fetal Diseases / blood*,  epidemiology,  ultrasonography*
Genetic Testing / methods*
Maternal Age
Neck / embryology,  ultrasonography
Pregnancy / blood*
Pregnancy Trimester, First
Pregnancy-Associated Plasma Protein-A / analysis
Prenatal Diagnosis / methods
Risk Factors
Statistics as Topic
Ultrasonography, Prenatal / methods
Reg. No./Substance:
0/Chorionic Gonadotropin; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A
Comment In:
Prenat Diagn. 1998 May;18(5):511-9   [PMID:  9621388 ]

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