title: A negative second trimester triple test and absence of specific ultrasonographic markers may decrease the need for genetic amniocentesis in advanced maternal age by 60%.
abstract: OBJECTIVE
  A study was conducted to evaluate the sensitivity of combining a second trimester triple test and targeted ultrasound in order to detect Down syndrome in women undergoing amniocentesis over 35 years of age.
  
  
  METHODS
  Women over 35 years of age underwent a triple test and an ultrasound examination for chromosomal markers immediately prior to genetic amniocentesis.
  
  
  RESULTS
  One thousand and six women were examined. Four hundred and thirty seven were triple test-positive and in 195 cases ultrasonographic abnormalities were observed. Thirteen had Down syndrome and eight had other chromosomal abnormalities. All women with Down syndrome babies were triple test-positive and seven also had ultrasonographic markers. Three of eight women who had babies with chromosomal aberrations other then Down syndrome were also triple test-positive.
  
  
  CONCLUSIONS
  The use of the triple test as a screening tool in our population would reduce the number of amniocenteses by 60%, while no cases of Down syndrome would be missed. Ultrasonographic markers have added little to this population. Three non-Down syndrome chromosomal abnormalities and two Down syndrome mosaic cases would be missed by this approach.
authors.affiliation: Department of Obstetrics & Gynecology, Meir Hospital, Kfar-Saba, Israel. doron_rosen@hotmail.com
authors.forename: D J D
authors.initials: DJ
authors.lastname: Rosen
authors.forename: I
authors.initials: I
authors.lastname: Kedar
authors.forename: A
authors.initials: A
authors.lastname: Amiel
authors.forename: T
authors.initials: T
authors.lastname: Ben-Tovim
authors.forename: Y
authors.initials: Y
authors.lastname: Petel
authors.forename: H
authors.initials: H
authors.lastname: Kaneti
authors.forename: M
authors.initials: M
authors.lastname: Tohar
authors.forename: M D
authors.initials: MD
authors.lastname: Fejgin
mesh_terms: D000328:Adult; D000649:Amniocentesis; D006063:Chorionic Gonadotropin / Q000097:blood; D002869:Chromosome Aberrations; D004314:Down Syndrome / Q000175:diagnosis*; D004964:Estriol / Q000097:blood; D005260:Female; D005865:Gestational Age; D006801:Humans; D007621:Karyotyping; D008423:Maternal Age; D008875:Middle Aged; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D011296:Prenatal Diagnosis; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D006063:Chorionic Gonadotropin; D000509:alpha-Fetoproteins; D004964:Estriol