Clinical article : screening for trisomy 13 using traditional combined screening versus an ultrasound-based protocol
| Autor: | Anna Matyszkiewicz, Bartosz Rajs, Damian Zietek, Sebastian Zalewski, Marcin Pasternok, Agnieszka Nocun, Michał Migda, Wioletta Rozmus-Warcholinska, Marcin Wiecheć, Judene Mavrikis |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Trisomy 13 Syndrome Screening test Trisomy 030105 genetics & heredity 03 medical and health sciences 0302 clinical medicine Pregnancy Prenatal Diagnosis Free β hcg Humans Multicenter Studies as Topic Pregnancy-Associated Plasma Protein-A Medicine Chorionic Gonadotropin beta Subunit Human Prospective Studies Ultrasonography Protocol (science) 030219 obstetrics & reproductive medicine business.industry Ultrasound Obstetrics and Gynecology medicine.disease Pregnancy Trimester First First trimester Pediatrics Perinatology and Child Health Female Radiology Down Syndrome Nuchal Translucency Measurement business human activities |
| Popis: | To compare the screening capability of ultrasonography in detecting trisomy 13 (T13) using a multiparameter sonographic protocol (NT+) with a classical combined screening test (CST) protocol.The project was a prospective, multicenter study based on a nonselected mixed-risk population of women referred for a first-trimester screening examination. Each subject was offered a choice between either the gold standard, traditional combined screening test (CSG arm) or the ultrasound-based screening protocol (USG arm). General and MA-based screening performances were checked.The study population comprised 20,887 pregnancies: 12,933 in the CSG arm, including 27 cases of T13, and 7954 in the USG arm, including 30 cases of T13. The DR for T13 was higher in the CSG arm than in the USG arm for all tested cutoff points: 1/50 (88.5 versus 63.3%, respectively), 1/100 (88.5 versus 70%, respectively) and 1/300 (92.3 versus 83.3%, respectively). Using the ROC curves for fixed FPRs of 3 and 5%, the T13 detection rate in our study reached 90 and 93%, respectively, in the USG arm and 92 and 96%, respectively, in the CSG arm. MA influenced the T13 screening performance in the USG arm and reduced the DR in patients31 years. Such influence was not detected in the CSG arm.Classic CST was more effective in detecting T13 than the ultrasound-only approach. However, the recommended cutoff of 1/50 showed unsatisfactory results for both traditional CST and the multiparameter sonographic test we proposed. |
| Databáze: | OpenAIRE |
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