title: Community-based screening for Down's Syndrome in the first trimester using ultrasound and maternal serum biochemistry.
abstract: Two years of community-based first trimester screening (FTS) were audited. All women with singleton pregnancy in a defined health region who completed FTS (ultrasound and biochemistry) were included (n= 10,436) and outcomes obtained for 98.4%. All scans were performed or supervised by experienced sonologists with Fetal Medicine Foundation (FMF) accreditation. FMF software generated all risk assessments based on nuchal translucency (NT), maternal serum-free beta human chorionic gonadotropin (beta-hCG) and pregnancy-associated plasma protein A (PAPP-A). The detection rate for Trisomy 21 was 90.6% with a screen-positive rate of 3.9%. These findings indicate that where FTS is accessible within routine antenatal care, a detection rate of 90% and low screen-positive rate can be achieved using the FMF programme.
authors.affiliation: Western Diagnostic Pathology, Mayne Health, Western Australia, Australia.
authors.forename: Narelle C
authors.initials: NC
authors.lastname: Hadlow
authors.forename: Beverley G
authors.initials: BG
authors.lastname: Hewitt
authors.forename: Jan E
authors.initials: JE
authors.lastname: Dickinson
authors.forename: Peter
authors.initials: P
authors.lastname: Jacoby
authors.forename: Carol
authors.initials: C
authors.lastname: Bower
mesh_terms: D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D003127:Colposcopy / Q000379:methods; D003153:Community Health Services; D004314:Down Syndrome / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007621:Karyotyping; D048208:Nuchal Translucency Measurement; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D011296:Prenatal Diagnosis / Q000379:methods*; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014626:Vaginal Smears / Q000379:methods
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human; D011266:Pregnancy-Associated Plasma Protein-A