Biochemical screening for Down syndrome: patients' perception of risk.
OBJECTIVE
To determine the utility of the triple test in routine clinical practice and in addition to the document, the acceptability of a cut-off of 1:250 for invasive testing.


METHODS
Retrospective analysis of data from screening and invasive testing for Down syndrome over a 5-year period in Hull Maternity Hospital. Computer-based records were accessed and individual data drawn from case notes were analyzed.


RESULTS
14827 (78%) of all patients opted for the triple test. A positive result (1:250 or greater) was found in 586 (4%). Fifteen percent of this group refused further testing with amniocentesis. 0.08% requested amniocentesis despite a negative triple test result. Of the screened pregnancies the triple test and selective invasive testing identified nine out of 15 (60%) of Down syndrome cases.


CONCLUSIONS
Sixty percent of Down syndrome pregnancies were identified with a 4% invasive testing rate. Fifteen percent of women who had a positive test did not agree with the cut-off of 1:250 and therefore declined invasive testing. Invasive procedure complication rates do not equate with patients' perception of Down syndrome.
O'Connell
M P
MP
Hull Maternity Hospital, Hedon Road, Hull, UK.
Holding
S
S
Morgan
R J
RJ
Lindow
S W
SW
D000649:Amniocentesis; D006063:Chorionic Gonadotropin / Q000097:blood*; D004314:Down Syndrome / Q000175:diagnosis*; D004964:Estriol / Q000097:blood*; D005260:Female; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D000509:alpha-Fetoproteins / Q000032:analysis*
D006063:Chorionic Gonadotropin; D000509:alpha-Fetoproteins; D004964:Estriol