Document Detail


Current concepts of Down syndrome screening tests in assisted reproduction twin pregnancies: another double trouble.
MedLine Citation:
PMID:  16170837     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Assisted reproductive technologies (ART) have increased both the number of pregnancies in women beyond the age of 35 and the incidence of multiple pregnancies. Various methods of screening for Down syndrome (DS) were introduced in clinical practice during the last two decades, and specific problems were encountered when they were applied for twin pregnancies. The current review aims to explore the problematic issue of prenatal DS screening in ART twins. Overall, more women with twin pregnancies (mainly those who conceived via assisted reproduction) are found to be false positive for DS. This is because mid-trimester maternal serum screening is associated with a higher false-positive rate secondary to changes in the feto-placental endocrinologic metabolism, reflected mainly in high human chorionic gonadotrophin (hCG) levels in the ART pregnancies. First-trimester nuchal translucency (NT) measurement in twin pregnancies is not affected by the problems encountered in serum screening. This sonographic screening approach enables a fetus-specific identification of those fetuses at high risk of DS and is associated with a lower false-positive rate than mid-trimester serum screening. DS screening in ART twins presents several challenges in determining the most appropriate screening test modality. Whether there is any significant benefit of adding first-trimester biochemistry or nasal bone scanning in screening ART-conceived twins awaits further investigation.
Authors:
Ron Maymon; Ortal Neeman; Adrian Shulman; Hadar Rosen; Arie Herman
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  25     ISSN:  0197-3851     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-09-28     Completed Date:  2005-12-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  746-50     Citation Subset:  IM    
Copyright Information:
2005 John Wiley & Sons, Ltd.
Affiliation:
Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, Israel. intposgr@post.tau.ac.il
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MeSH Terms
Descriptor/Qualifier:
Chorionic Gonadotropin, beta Subunit, Human / blood
Down Syndrome / blood,  diagnosis*
Female
Fertilization in Vitro*
Humans
Neck / embryology,  ultrasonography
Pregnancy
Pregnancy Trimesters
Pregnancy-Associated Plasma Protein-A / metabolism
Prenatal Diagnosis*
Twins*
Ultrasonography, Prenatal
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin, beta Subunit, Human; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A

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