Improved first-trimester Down syndrome screening performance by lowering the false-positive rate: a prospective study of 9941 low-risk women
| Autor: | V. Brocks, Karin Sundberg, A. C. Shalmi, J. Bang, Ann Tabor, Michael Christiansen, K. R. Wøjdemann, Bent Nørgaard-Pedersen, Severin Olesen Larsen |
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| Rok vydání: | 2005 |
| Předmět: |
Gynecology
education.field_of_study medicine.medical_specialty Down syndrome Radiological and Ultrasound Technology Pregnancy-associated plasma protein A business.industry Population Obstetrics and Gynecology Gestational age Prenatal diagnosis General Medicine medicine.disease Reproductive Medicine Predictive value of tests medicine Radiology Nuclear Medicine and imaging Trisomy Prospective cohort study business education |
| Zdroj: | Ultrasound in Obstetrics and Gynecology. 25:227-233 |
| ISSN: | 0960-7692 |
| Popis: | Objective To determine the performance of screening for Down syndrome (DS) and other major chromosomal abnormalities using nuchal translucency (NT), free β-human chorionic gonadotropin (β-hCG) and pregnancy-associated plasma protein-A (PAPP-A) in a prospective study of a non-selected population. Methods Of 9941 women with an early ultrasound examination, NT was measured in 8622 singleton pregnancies with a gestational age between 10 + 3 and 13 + 6 weeks. β-hCG and PAPP-A were analyzed in 6441 cases. Detection rates (DR) and false-positive rates (FPR) for the NT screening, the double test (β-hCG and PAPP-A) and the combined test (NT and the double test) were calculated using a 1 : 250 cut-off. Results NT could be measured in 97.5% of cases. The DR for DS with NT screening alone was 75% with a FPR of only 1.8%. The double test detected 73% and the combined test 91%, for FPRs of 8.8% and 2.1%, respectively. We detected 80% of fetuses with other major chromosomal abnormalities with a combination of NT screening and other ultrasound findings. Low β-hCG and PAPP-A values (below 0.4 MoM) were observed in 0.5% of the women including all cases of triploidy and trisomy 18 and 13. Conclusions The performance of a screening strategy for DS using a combination of NT and the double test was superior to that using either NT or the double test alone due to a very low FPR and a higher DR. Copyright © 2005 ISUOG. Published by John Wiley & Sons, Ltd. |
| Databáze: | OpenAIRE |
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