Document Detail

The NTplus method of screening for Down syndrome: achieving the 2010 targets?
MedLine Citation:
PMID:  20440731     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: The performance of pregnancy-associated plasma protein-A (PAPP-A) as a first trimester trisomy 21 marker is hypothesized to improve below 11 weeks, whereas beta-human chorionic gonadotrophin (hCG) is better after 14 weeks. We audited a model combining early PAPP-A (9-10 weeks) with NT (11-13 weeks and 6 days) and early triple test (>14 weeks). METHODS: A total of 1507 women with viable ongoing pregnancies were screened during 2007-2008. First-stage 'screen-positive' risk was based on combined PAPP-A and NT cut-off >or=1 : 100. Where first-stage risk was <1 : 100 or invasive testing declined, triple test was performed and a combined second-stage risk given with cut-off >or=1 : 250 being screen positive. RESULTS: Median age of women was 35.4 years. Sixty-four (4.2%) were 'screen positive'. Of these, 11 had a fetus with trisomy 21. Twelve pregnancies were affected with trisomy 21, giving a detection rate of 11/12 (92%) with a false-positive rate (FPR) of 3.2%. The screen-positive rate (SPR) and FPR were 1.93 and 1.44%, respectively, standardized to median maternal age 29. CONCLUSIONS: Early PAPP-A, NT and later triple testing offers comparable detection for trisomy 21 to published data for first trimester combined testing but feasibly achieve the national target for 2010 of 90% detection of trisomy 21 for < 2% SPR.
Osama Habayeb; Sandy Goodburn; Trish Chudleigh; Jeremy Brockelsby; Hannah Missfelder-Lobos; Gerald Hackett; Christoph Lees
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  30     ISSN:  1097-0223     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-04     Completed Date:  2010-09-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  434-7     Citation Subset:  IM    
Department of Fetal Medicine, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom.
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MeSH Terms
Chorionic Gonadotropin, beta Subunit, Human / blood*
Down Syndrome / blood*,  ultrasonography*
Middle Aged
Nuchal Translucency Measurement*
Predictive Value of Tests
Pregnancy Trimester, First
Pregnancy-Associated Plasma Protein-A / analysis*
Young Adult
Reg. No./Substance:
0/Chorionic Gonadotropin, beta Subunit, Human; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A

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