Document Detail

First trimester screening for Down syndrome using free beta hCG, total hCG and PAPP-A: an exploratory study.
MedLine Citation:
PMID:  17960785     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate the potential utility of first trimester screening for Down syndrome using Free beta-hCG, total hCG and PAPP-A. MATERIALS AND METHODS: Using estimates from the literature, a simulation study was undertaken to estimate the performance of tests incorporating, Free beta-hCG, total hCG and PAPP-A at gestations of 8-12 weeks. We used sensitivity analysis to assess the effect of departures from the assumed model. RESULTS: We estimate that detection rates in excess of 75% for a false positive rate (FPR) of 3% can be achieved with first trimester measures of PAPP-A, total hCG and Free beta-hCG at 8 weeks-the addition of total hCG adding 11%. Detection rates of around 90% for a FPR of 3% can be achieved through the inclusion of nuchal translucency (NT) at 12 weeks to these early first trimester biochemical markers. Our analysis indicates that the marginal benefit of adding total hCG diminishes rapidly with gestational age and that there is little benefit from adding total hCG later than 10 weeks of gestation. CONCLUSION: The performance of first trimester screening using early combinations of total hCG, Free beta-hCG and PAPP-A should be assessed in further studies.
Dave Wright; Kevin Spencer; Barry Nix
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  27     ISSN:  0197-3851     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-28     Completed Date:  2008-03-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  1118-22     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2007 John Wiley & Sons, Ltd.
University of Plymouth, Plymouth, UK.
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MeSH Terms
Chorionic Gonadotropin / analysis
Chorionic Gonadotropin, beta Subunit, Human / analysis*,  blood
Computer Simulation
Down Syndrome / diagnosis*
False Positive Reactions
Monte Carlo Method
Pilot Projects
Pregnancy Trimester, First
Pregnancy-Associated Plasma Protein-A / analysis*
Prenatal Diagnosis / methods*
Reg. No./Substance:
0/Chorionic Gonadotropin; 0/Chorionic Gonadotropin, beta Subunit, Human; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A

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