Document Detail


Comparison and integration of first trimester fetal nuchal translucency and second trimester maternal serum screening for fetal Down syndrome.
MedLine Citation:
PMID:  12210586     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is uncertain whether first trimester nuchal translucency (NT) is more effective than the well-established second trimester serum screening for fetal Down syndrome or whether their combination works best. We report data from a large multicentre non-interventional trial in which all subjects underwent both first and second trimester screening. METHODS: All women who attended the obstetric clinic before 15 weeks' gestation were recruited. An ultrasound examination was performed at 10 to 14 weeks to measure the NT. The nuchal measurements were not acted upon unless the fetus showed gross features of hydrops fetalis. All women had serum alpha-fetoprotein (AFP) and human chorionic gonadotrophin (hCG) assay at 15 to 20 weeks. The Down syndrome risk assigned by serum screening was disclosed and amniocentesis was offered if this assigned risk was >or=1:250 or if the women were 35 years and older. The efficacy of different combinations of screening markers was compared. RESULTS: Between January 1997 and August 2000, 17 590 women were recruited (19% >or=35 years old). After excluding subjects who miscarried, defaulted the serum test and other reasons, 16 237 pregnancies were analysed. Of these, 35 pregnancies were affected by Down syndrome (2.2 cases per 1000 pregnancies). At a false-positive rate of 5%, the detection rate of Down syndrome by NT alone, NT and age, serum hCG, AFP and age, and NT, hCG, AFP and age were 61%, 69%, 73% and 86%, respectively. CONCLUSION: Integration of NT and second trimester serum AFP and hCG assay yielded the best screening efficacy for Down syndrome.
Authors:
Yung Hang Lam; Chin Peng Lee; Sai Yuen Sin; Rebecca Tang; Hong Soo Wong; Sai Fun Wong; Danial Yee Tak Fong; Mary Hoi Yin Tang; Hennie Hai Nin Woo
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  22     ISSN:  0197-3851     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-09-04     Completed Date:  2003-02-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  730-5     Citation Subset:  IM    
Copyright Information:
Copyright 2002 John Wiley & Sons, Ltd.
Affiliation:
Department of Obstetrics and Gynaecology, The University of Hong Kong, Tsan Yuk Hospital, Hong Kong, China. yhlamobgyn@yahoo.com.hk
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MeSH Terms
Descriptor/Qualifier:
Amniocentesis
Biological Markers / blood*
Chorionic Gonadotropin / blood
Down Syndrome / blood,  diagnosis*,  ultrasonography
False Positive Reactions
Gestational Age*
Hydrops Fetalis / ultrasonography
Maternal Age
Neck / embryology*,  ultrasonography*
Pregnancy, High-Risk
Prenatal Diagnosis
ROC Curve
Risk Factors
Ultrasonography, Prenatal
alpha-Fetoproteins / analysis
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Chorionic Gonadotropin; 0/alpha-Fetoproteins

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