| Estimating the effect of gestational age on test performance of combined first-trimester screening for Down syndrome: a preliminary study. | |
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MedLine Citation:
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PMID: 20121529 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of perinatal medicine Volume: 38 ISSN: 1619-3997 ISO Abbreviation: J Perinat Med Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-06 Completed Date: 2010-06-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0361031 Medline TA: J Perinat Med Country: Germany |
Other Details:
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Languages: eng Pagination: 305-9 Citation Subset: IM |
Affiliation:
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Division of Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. p.vanheesch@erasmusmc.nl |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Chorionic Gonadotropin, beta Subunit, Human / blood Crown-Rump Length Down Syndrome / diagnosis* Female Gestational Age* Humans Menstruation Nuchal Translucency Measurement Pregnancy Pregnancy-Associated Plasma Protein-A / analysis Prenatal Diagnosis / methods* Retrospective Studies Sensitivity and Specificity Time Factors Ultrasonography, Prenatal |
| Chemical | |
Reg. No./Substance:
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0/Chorionic Gonadotropin, beta Subunit, Human; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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