First-trimester combined screening: experience with an instant results approach.
OBJECTIVE
This study was undertaken to assess an instant results protocol for first-trimester combined screening.


METHODS
Retrospective analysis of patients having first-trimester combined screening between Nov. 1, 2003 and Oct. 31, 2005. We evaluated the feasibility of patient self-collection and mail-in of blood samples before nuchal translucency ultrasound. Primary outcome was success with providing in-office, immediate screening results after the ultrasound. Predictor variables included age, ethnicity, insurance, and provider. The chi2 analysis was performed.


RESULTS
Two thousand three hundred ten women completed first-trimester combined screening, and 60.6% received instant results. When the biochemistry sample was collected at home, 80% received instant results. Age 35 years or older predicted instant results (P = .001), whereas ethnicity, insurance, and referring provider did not. Comparing the prior 24 months, clinic volume increased by 18%. Diagnostic procedure volume was unchanged, although chorionic villus sampling increased by 12% (P = .02) and amniocentesis decreased by 6% (P = .049).


CONCLUSIONS
Patients were able to obtain instant results in 60.6% of cases, which appeared to increase the use of chorionic villus sampling.
Norton
Mary E
ME
Division of Perinatal Medicine and Genetics, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, CA, USA.
Hopkins
Linda M
LM
Pena
Sherri
S
Krantz
David
D
Caughey
Aaron B
AB
D000328:Adult; D000649:Amniocentesis / Q000706:statistics & numerical data; D001800:Blood Specimen Collection / Q000379:methods*; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D015193:Chorionic Villi Sampling / Q000706:statistics & numerical data; D015331:Cohort Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008423:Maternal Age; D048208:Nuchal Translucency Measurement; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis; D012189:Retrospective Studies; D012648:Self Care; D016216:Ultrasonography, Prenatal
D018997:Chorionic Gonadotropin, beta Subunit, Human; D011266:Pregnancy-Associated Plasma Protein-A