title: Ultrasound findings after screening for Down syndrome using the integrated test.
abstract: OBJECTIVE
  To evaluate the incidence and significance of fetal anomalies and "soft markers" after screening for Down syndrome using the integrated test.
  
  
  METHODS
  This study is a retrospective study of 2,332 women at University College London Hospitals, United Kingdom. All women were screened for Down syndrome by the integrated test. Subsequently, a detailed anomaly scan was performed. All scan reports and screening results were analyzed statistically using SPSS 11.0 software.
  
  
  RESULTS
  Sixty-eight (2.9%) patients were categorized as high risk. There were 12 cases affected by Down syndrome, 10 (10 of 68) in the high-risk group and two (two of 2,264) in the low-risk group. Soft markers or structural anomalies were found in 13.0% of the low-risk group, in 29.4% of the high-risk group, and in 50% of the fetuses affected by Down syndrome. Multiplying the likelihood ratio of each marker with the risk of Down syndrome from the integrated test reduced the false-positive rate of the integrated test from 2.5% to 1.8%, but was accompanied by a reduction in the detection rate from 83% to 75%.
  
  
  CONCLUSIONS
  Absence of structural anomalies or markers should not prevent offering karyotyping to women in the high-risk group, because this would result in a significant reduction in the detection rate of Down syndrome. Women screened as low risk by the integrated test who have isolated soft markers should not be offered an amniocentesis.
authors.affiliation: Department of Obstetrics and Gynaecology, University College London and Wolfson Institute of Preventive Medicine, St. Bartholomew's and Royal London School of Medicine and Dentistry, London, United Kingdom.boazmd@zahav.net.il
authors.forename: Boaz
authors.initials: B
authors.lastname: Weisz
authors.forename: Pranav P
authors.initials: PP
authors.lastname: Pandya
authors.forename: Anna L
authors.initials: AL
authors.lastname: David
authors.forename: Wayne
authors.initials: W
authors.lastname: Huttly
authors.forename: Patricia
authors.initials: P
authors.lastname: Jones
authors.forename: Charles H
authors.initials: CH
authors.lastname: Rodeck
mesh_terms: D000293:Adolescent; D000328:Adult; D004314:Down Syndrome / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008875:Middle Aged; D048208:Nuchal Translucency Measurement; D011247:Pregnancy; D012189:Retrospective Studies; D018570:Risk Assessment; D016216:Ultrasonography, Prenatal