Clinical significance of combining second trimester serum and ultrasound screening for Down syndrome / 临床儿科杂志

objectives To explore the clinical significance of the triple screening method and fetal sonographic markers in Down syndrome screening. Methods The retrospective study included maternal blood serum triple-marker screening per-formed in normal singleton pregnancies at 14+1 to 19+6 weeks and ultrasonography screening for fetal chromosomal trisomy at 18+1 to 23+6 weeks from 2010 to 2013. Results In 24 368 pregancies, Karyotype analysis reveal 35 Down syndromes, the incidence is 0.14%(35/24 368). 25/35 were pregnancies with an expected date of delivery lower than 35 years old and 10/35 were pregnan-cies with an expected date of delivery higher than 35 years old. In 1 215 pregnancies, second-trimester serum screening showed high risk (cutoff>1:380), 14 were confirmed as Down syndromes ( sensitivity 40%;specificity 95.06%). In 1 142 pregnant women showed ultrasonography abnormalities, of which 11 were found to have Down syndrome (sensitivity 60%;specificity 91.09%). In 112 pregnancies, second-trimester serum screening and ultrasonography showed high risk, 4 were conformed as Down syn-drome (sensitivity 11.43%;specificity 99.56). Conclusions The most effective method of screening for Down syndrome is by maternal serum biochemistry. Ultrasonography is important in screening fetal trisomy 21. combined screening methods can improve the detection rate of trisomy 21.

Analysis of Serum Triple-Marker Screening in In Vitro Fertilization and Naturally Conceived Pregnancy / 대한산부인과학회잡지

OBJECTIVE: To compare and analysis the result of second trimester maternal serum triple marker screening test for Down syndrome and open neural tube defects in singleton pregnancies conceived by conventional in vitro fertilization- embryo transfer (IVF-ET) with that of the naturally conceived pregnancies. METHODS: Maternal serum screening tests during the second trimester in 49 singleton pregnancies conceived by IVF-ET and 813 singleton pregnancies conceived naturally of whom delivery outcome was normal in each other were analyzed from April 1997 to June 2000. RESULTS: 4 (8.2%) out of 49 cases of IVF-ET singleton pregnancies compared with 62 (7.6%) out of 813 cases of naturally conceived pregnancies had a positive RESULTS: for Down syndrome or open neural tube defects. The median level of the triple markers were 1.03 0.47 multiples of the median (MoM) in IVF-ET pregnancies vs 1.05+/-0.39 MoM in natural pregnancies for alpha-fetoprotein (AFP), 1.11+/-0.64 vs 1.19+/-1.13 MoM for unconjugated estriol (uE3) and 1.21+/-0.56 vs 1.11+/-0.59 MoM for human chorionic gonadotropin (hCG). CONCLUSION: The positive rate of triple test and the median values of triple markers for Down syndrome and open neural tube defect between two groups were not different in terms of statistical significance. To provide an objective assessment of an individual patient's risk of fetal abnormality, the impact of IVF-ET on triple marker biochemistry should be studied further in larger samples and adjustments made if appropriate.

Analysis of Results of Serum Triple Marker Screening test between In Vitro Fertilization and Naturally Conceived Pregnancy / 대한산부인과학회잡지

OBJECTIVE: To evaluate the results of second-trimester maternal serum triple-marker screening test for Down syndrome and open neural tube defects in singleton pregnancies conceived from in vitro fertilization, the screen positive rates and triple-marker level of patients conceiving singleton pregnancies by IVF were compared to those of pregnancies conceived naturally. METHODS: Two hundred singleton pregnancies conceived by IVF and naturally conceived pregnancies who had done maternal serum screening test during the second trimester were analyzed from January 1995 to April 1998. RESULTS: One (0.5%) of the 200 cases of IVF singleton pregnancies had a positive result for Down syndrome compared with 1% of screen positive rate in the 200 cases of naturally conceived pregnancies. The median level of the triple markers were 0.92 multiples of the median(MoM) for alpha-fetoprotein(AFP), 1.44 MoM for unconjugated estriol(E3) and 0.87 MoM for human chorionic gonadotropin(hCG) respectively. CONCLUSION: The positive rate of triple test for Down syndrome and open neural tube defect in the two groups were significantly not different. As additional data are collected, corrected standards should be determined.