Document Detail


Screening for chromosomal abnormalities in the first trimester using ultrasound and maternal serum biochemistry in a one-stop clinic: a review of three years prospective experience.
MedLine Citation:
PMID:  12628268     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the performance of a one-stop multidisciplinary clinic of screening for fetal chromosomal anomalies in the first trimester of pregnancy by a combination of maternal serum biochemistry and ultrasonography. DESIGN: Retrospective review of screening performance. SETTING: District General Hospital maternity unit. POPULATION: All women booked for routine antenatal care at Harold Wood Hospital between 1 June 1998 and 31 May 2001. The population included 12,339 women with singleton pregnancies presenting at 10-14 weeks of gestation. METHODS: Women were offered screening using a combination of maternal serum free beta-hCG and pregnancy associated plasma protein-A (PAPP-A) and fetal nuchal translucency thickness. Those with an estimated risk of >/=1 in 300 of carrying a fetus with trisomy 21 or trisomy 18 or trisomy 13 were offered the option of an invasive diagnostic test. Follow up of the outcome of all pregnancies was carried out. MAIN OUTCOME MEASURES: Uptake of screening and invasive testing, detection rate for fetal chromosomal abnormalities and false positive rate. RESULTS: The uptake of first trimester screening was 97.5% and the uptake of invasive testing in the increased risk group was 77%. The rate of detection of trisomy 21 was 92% (23 of 25), of trisomy 13 or 18 was 100% (all 15) and of all aneuploidies was 96% (49 of 51). The false positive rate was 5.2%. CONCLUSIONS: First trimester screening for trisomy 21 and other aneuploidies can be delivered in an efficient manner in a one-stop multidisciplinary clinic. The detection rates are far better than can be achieved by second trimester serum screening.
Authors:
Kevin Spencer; Christine E Spencer; Maureen Power; Carolynne Dawson; Kypros H Nicolaides
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  110     ISSN:  1470-0328     ISO Abbreviation:  BJOG     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-11     Completed Date:  2003-04-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  281-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Clinical Biochemistry, Harold Wood Hospital, Essex, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Distribution
Chorionic Gonadotropin, beta Subunit, Human / blood
Chromosome Disorders / blood,  diagnosis*,  ultrasonography
Down Syndrome / blood,  diagnosis,  ultrasonography
Female
Humans
Maternal Age
Patient Acceptance of Health Care / statistics & numerical data
Pregnancy
Pregnancy Outcome
Pregnancy Trimester, First
Pregnancy-Associated Plasma Protein-A / analysis
Prenatal Diagnosis / methods*
Prospective Studies
Retrospective Studies
Risk Factors
Ultrasonography, Prenatal / methods
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin, beta Subunit, Human; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A

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