Document Detail


First-trimester screening for aneuploidy: research or standard of care?
MedLine Citation:
PMID:  10739496     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
First-trimester screening for Down syndrome has been proposed as a significant improvement with respect to second-trimester serum screening programs, the current standard of care, because of apparently higher detection rates and an earlier gestational age at diagnosis. First-trimester nuchal translucency on ultrasonography forms the basis of this new form of screening, although studies of its efficacy have yielded widely conflicting results, with detection rates ranging from 29% to 91%. Studies of first-trimester serum screening with measurements of pregnancy-associated plasma protein A and free beta-human chorionic gonadotropin serum concentrations have been much more consistent, with Down syndrome detection rates of 55% to 63% at a 5% false-positive rate. The combination of first-trimester ultrasonographic and serum screening has the potential to yield a Down syndrome detection rate of 80% at a 5% false-positive rate, although this approach has not been adequately studied. There have been no studies performed to date to directly compare the performance of first-trimester and second-trimester methods of screening. Two major trials are underway that will address this issue, one in the United Kingdom and one in the United States. Until the results of these trials are available, the current standard of care with respect to Down syndrome screening should not be changed, and first-trimester screening should remain investigational.
Authors:
F D Malone; R L Berkowitz; J A Canick; M E D'Alton
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  182     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2000-05-02     Completed Date:  2000-05-02     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  490-6     Citation Subset:  AIM; IM    
Affiliation:
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia-Presbyterian Medical Center, New York, NY 10032, USA.
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MeSH Terms
Descriptor/Qualifier:
Aneuploidy*
Chorionic Gonadotropin, beta Subunit, Human / blood
Clinical Trials as Topic
Down Syndrome / blood,  diagnosis,  genetics
Female
Fetal Death
Genetic Testing*
Humans
Multicenter Studies as Topic
Pregnancy
Pregnancy Trimester, First
Pregnancy Trimester, Second
Staphylococcal Protein A / blood
Ultrasonography, Prenatal / trends*
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin, beta Subunit, Human; 0/Staphylococcal Protein A
Comments/Corrections
Comment In:
Am J Obstet Gynecol. 2000 Dec;183(6):1591-2   [PMID:  11120540 ]
Am J Obstet Gynecol. 2000 Dec;183(6):1590-1   [PMID:  11120539 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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