Prenatal diagnosis versus first-trimester screening of trisomy 21 among pregnant women aged 35 or more
| Autor: | Gianluigi Pilu, Francesca Ravennati, Tullio Ghi, Elisa Maroni, Eva Pompilii, Maria Carla Pittalis, Elisa Montaguti, G. Pacella, T. Arcangeli, Nicola Rizzo, Ginevra Salsi |
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| Přispěvatelé: | T. Ghi, T. Arcangeli, F. Ravennati, G. Salsi, E. Montaguti, G. Pacella, E. Maroni, M. C. Pittali, E. Pompilii, G. Pilu, N. Rizzo |
| Rok vydání: | 2014 |
| Předmět: |
Adult
Prenatal Diagnosi medicine.medical_specialty Prenatal diagnosis Group B Miscarriage Pregnancy Retrospective Studie Prenatal Diagnosis Humans Mass Screening Medicine Sampling (medicine) Fetal Death Retrospective Studies Gynecology Fetus Invasive procedure medicine.diagnostic_test business.industry Infant Newborn Pregnancy Outcome Obstetrics and Gynecology Prenatal screening Retrospective cohort study medicine.disease Pregnancy Trimester First Chorionic Villi Sampling Aneuploidie Pediatrics Perinatology and Child Health Screening Amniocentesis Female Down Syndrome business Trisomy Abortion Eugenic Human Maternal Age |
| Zdroj: | The Journal of Maternal-Fetal & Neonatal Medicine. 28:674-678 |
| ISSN: | 1476-4954 1476-7058 |
| DOI: | 10.3109/14767058.2014.928852 |
| Popis: | Objective: To compare the policy of prenatal diagnosis versus first trimester screening of trisomy 21 among pregnant women of advanced age. Methods: A retrospective study was conducted on patients aged ≥35 divided in two groups: patients who requested first trimester combined test and only in case of screen-positive result underwent invasive testing (group A); patients undergoing chorionic villous sampling or amniocentesis as first investigation (group B). The following outcome variables were compared: antenatal detection of trisomy 21, occurrence of trisomy 21 at birth, miscarriage rate, hospitals' costs. Results: 4527 women were included. Of these, 534 (11.80\%) underwent T21 screening whereas 3993 (88.20\%) requested primary invasive testing. In group A, 64 combined test were positive (11.99\%) and 8 trisomy 21 cases were diagnosed (1.50\%); the loss of euploid fetuses after invasive procedure was 4.55\% (2/44). No false-negative case was observed. In group B 57 cases of trisomy 21 were diagnosed (1.43\%), and pregnancy loss rate of chromosomally normal fetuses was 0.45\% (17/3806). The estimated cost was, respectively, 67.720€ for the primary screening versus 1.996.500€ for direct prenatal diagnosis. Conclusion: First trimester screening of trisomy 21 is highly accurate and cost saving among women ≥35. |
| Databáze: | OpenAIRE |
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