| The NTplus method of screening for Down syndrome: achieving the 2010 targets? | |
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MedLine Citation:
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PMID: 20440731 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Osama Habayeb; Sandy Goodburn; Trish Chudleigh; Jeremy Brockelsby; Hannah Missfelder-Lobos; Gerald Hackett; Christoph Lees |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Prenatal diagnosis Volume: 30 ISSN: 1097-0223 ISO Abbreviation: Prenat. Diagn. Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-04 Completed Date: 2010-09-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8106540 Medline TA: Prenat Diagn Country: England |
Other Details:
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Languages: eng Pagination: 434-7 Citation Subset: IM |
Affiliation:
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Department of Fetal Medicine, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Chorionic Gonadotropin, beta Subunit, Human / blood* Down Syndrome / blood*, ultrasonography* Female Humans Middle Aged Nuchal Translucency Measurement* Predictive Value of Tests Pregnancy Pregnancy Trimester, First Pregnancy-Associated Plasma Protein-A / analysis* Young Adult |
| 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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