Document Detail

Estimating the effect of gestational age on test performance of combined first-trimester screening for Down syndrome: a preliminary study.
MedLine Citation:
PMID:  20121529     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To establish how different methods of estimating gestational age (GA) affect reliability of first-trimester screening for Down syndrome. METHODS: Retrospective single-center study of 100 women with a viable singleton pregnancy, who had first-trimester screening. We calculated multiples of the median (MoM) for maternal-serum free beta human chorionic gonadotropin (free beta-hCG) and pregnancy associated plasma protein-A (PAPP-A), derived from either last menstrual period (LMP) or ultrasound-dating scans. RESULTS: In women with a regular cycle, LMP-derived estimates of GA were two days longer (range -11 to 18), than crown-rump length (CRL)-derived estimates of GA whereas this discrepancy was more pronounced in women who reported to have an irregular cycle, i.e., six days (range -7 to 32). Except for PAPP-A in the regular-cycle group, all differences were significant. Consequently, risk estimates are affected by the mode of estimating GA. In fact, LMP-based estimates revealed ten "screen-positive" cases compared to five "screen-positive" cases where GA was derived from dating-scans. CONCLUSION: Provided fixed values for nuchal translucency are applied, dating-scans reduce the number of screen-positive findings on the basis of biochemical screening. We recommend implementation of guidelines for Down syndrome screening based on CRL-dependent rather than LMP-dependent parameters of GA.
Peter N van Heesch; Pieter C Struijk; Jaqueline A M Laudy; Eric A P Steegers; Hajo I J Wildschut
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of perinatal medicine     Volume:  38     ISSN:  1619-3997     ISO Abbreviation:  J Perinat Med     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-06     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0361031     Medline TA:  J Perinat Med     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  305-9     Citation Subset:  IM    
Division of Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
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MeSH Terms
Chorionic Gonadotropin, beta Subunit, Human / blood
Crown-Rump Length
Down Syndrome / diagnosis*
Gestational Age*
Nuchal Translucency Measurement
Pregnancy-Associated Plasma Protein-A / analysis
Prenatal Diagnosis / methods*
Retrospective Studies
Sensitivity and Specificity
Time Factors
Ultrasonography, Prenatal
Reg. No./Substance:
0/Chorionic Gonadotropin, beta Subunit, Human; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A

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