Clinical analysis of triple marker screening test for fetal Down syndrome in midtrimester of pregnancy-Low sensitivity of triple marker screening test / 대한산부인과학회잡지

OBJECTIVE: To assess the reliability of triple marker screening test in midtrimester pregnancy for fetal Down syndrome. METHODS: From October 1, 1996 to May 31, 1998 at Nowon Eulji Hospital, 3700 Pregnant women underwent serum tiple marker screening for Down syndrome during 15-20weeks of gestational age. The results of serum triple marker screenig tests for Down syndrome and the outcomes of pregnancies were retrospectively assesed. RESULTS: Sixty seven of 3700 cases(1.81%) were positive in screening test, and 3633(98.18%) cases were negative. Among 67 cases of positive screening test, 1 case(1.49%) was diagnosed as Down syndrome. Among 3633 cases of negative screening test, 4 cases(0.1%) were diagnosed as chromosomal abnormalies postnatally. Two of these 4 cases of chromosomal abnormalies were Down syndrome. CONCLUSION: With this results, sensitivity of triple marker screeing test for Down syndrome is very low as 33.3%. In order to increase the sensitivity, some compensatory adjustment is required in triple marker screening test.

Adverse Pregnancy Outcomes after a False-PositiveScreen for Down Syndrome using Triple Serum Markers / 대한산부인과학회잡지

OBJECT: To assess the relative risk of an adverse pregnancy outcome in women with a false-positive riskfor Down syndrome by prenatal screeen using triple markers(maternal serum alpha-fetoprotein[AFP], unconjugated estrio[uE3], and human chorionic gpna dotropin[hGC] levels) and age. METHODE: Case-Control study including sixity four women with false-positive screens for Down sydromeand a matched control group of 128 women whose screen indicated a risk for Down syndrome of less than1 :270. The risk for adverse pregnancy outcome was compared for the two groups,and the roles of maternal serum AFP, uE3, and hCG as predictors of adverse pregnancy outcome weredetermined. RESULT: Women with false-positive screen for Down syndrome were not significantly different from theirmatched controls in the incidence of preterm delivery (5% versus 2%), pretermpremature rupture of membrane(3% versus 0%), placental abruption(0% versus 1%),preeclampsia(3% versus 1%), small for gestational age newborns(5% versus 6%), and fetal demise after20 week's gestation(2% versus 0%). The occurrence of an adverse outcome in 7 of 64(11%) pregnancieswith a flase positive screen for Down syndrome was not different from that in 12 of 128(9%) matchedcontrol pregnancies.Only maternal age (odds ratio 1.19,95% cofidence interval 1.05~1.34, p < 0.005) was siginificantly associatedwith adverse outcome after controlling for the effects of maternal serum AFP, hCG and uF3. CONCLUSION: Althought the sample on this study, women with a false-positive screen for Down syndromedo not seem to be at increased risk for a adverse pregnancy outcome when compared to those with a negativescreen result. Among maternal age, maternal serum AFP, hCG, and uE3level, only maternal age seemed tobe a predictorof an adverse pregnancy outcome.

Adverse Pregnancy Outcomes after a False-PositiveScreen for Down Syndrome using Triple Serum Markers / 대한산부인과학회잡지

OBJECT: To assess the relative risk of an adverse pregnancy outcome in women with a false-positive riskfor Down syndrome by prenatal screeen using triple markers(maternal serum alpha-fetoprotein[AFP], unconjugated estrio[uE3], and human chorionic gpna dotropin[hGC] levels) and age. METHODE: Case-Control study including sixity four women with false-positive screens for Down sydromeand a matched control group of 128 women whose screen indicated a risk for Down syndrome of less than1 :270. The risk for adverse pregnancy outcome was compared for the two groups,and the roles of maternal serum AFP, uE3, and hCG as predictors of adverse pregnancy outcome weredetermined. RESULT: Women with false-positive screen for Down syndrome were not significantly different from theirmatched controls in the incidence of preterm delivery (5% versus 2%), pretermpremature rupture of membrane(3% versus 0%), placental abruption(0% versus 1%),preeclampsia(3% versus 1%), small for gestational age newborns(5% versus 6%), and fetal demise after20 week's gestation(2% versus 0%). The occurrence of an adverse outcome in 7 of 64(11%) pregnancieswith a flase positive screen for Down syndrome was not different from that in 12 of 128(9%) matchedcontrol pregnancies.Only maternal age (odds ratio 1.19,95% cofidence interval 1.05~1.34, p < 0.005) was siginificantly associatedwith adverse outcome after controlling for the effects of maternal serum AFP, hCG and uF3. CONCLUSION: Althought the sample on this study, women with a false-positive screen for Down syndromedo not seem to be at increased risk for a adverse pregnancy outcome when compared to those with a negativescreen result. Among maternal age, maternal serum AFP, hCG, and uE3level, only maternal age seemed tobe a predictorof an adverse pregnancy outcome.