Screening for Down's syndrome by fetal nuchal translucency measurement in a general obstetric population

E. Pajkrt, J. M M Van Lith, B. W J Mol, O. P. Bleker, C. M. Bilardo

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

Objective. To examine the effectiveness of nuchal translucency measurement in the detection of trisomy 21 in a low-risk population. Design. Prospective cohort study. Subjects. A total of 1473 women with viable singleton pregnancies between 10 and 14 weeks' gestation attending an antenatal clinic for routine obstetric care. Methods. The fetal nuchal translucency was measured in all women. Fetal karyotyping was performed for the usual indications and in cases of a nuchal translucency measurement ≥ 3 mm. Results. Down's syndrome was found in nine fetuses (0.6%). Screening by maternal age would have diagnosed six out of nine fetuses (67%) with trisomy 21 for an invasive testing rate of 24%. Because the actual uptake of prenatal diagnosis for maternal age was 79%, only 44% of the Down's syndrome fetuses would have been detected prenatally by this screening method. A nuchal translucency of 3 mm or more identified 67% of the fetuses with trisomy 21, for an invasive testing rate of 2.2%. The combination of nuchal translucency thickness, corrected for the influence of gestation by 'delta-value', and maternal age performs differently according to the chosen cut-off point for adjusted risk. A minimum risk of 1:100 would detect 78% of the Down's syndrome fetuses for a testing rate of 8.1%. By offering karyotyping to all women with a post-test risk of 1:300, the detection rate would increase to 100% with an invasive testing rate of 19.8%. This is lower than the invasive testing rate of maternal age screening. Conclusions. These data suggest that nuchal translucency measurement is an effective screening method for trisomy 21 in an unselected obstetric population.

LanguageEnglish
Pages163-169
Number of pages7
JournalUltrasound in Obstetrics and Gynecology
Volume12
Issue number3
DOIs
Publication statusPublished - 28 Oct 1998

Keywords

  • Down's syndrome
  • Fetal aneuploidies
  • Nuchal translucency
  • Ultrasound screening

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Reproductive Medicine
  • Radiology Nuclear Medicine and imaging
  • Obstetrics and Gynaecology

Cite this

Pajkrt, E. ; Van Lith, J. M M ; Mol, B. W J ; Bleker, O. P. ; Bilardo, C. M. / Screening for Down's syndrome by fetal nuchal translucency measurement in a general obstetric population. In: Ultrasound in Obstetrics and Gynecology. 1998 ; Vol. 12, No. 3. pp. 163-169.
@article{a58c952583504b5f85b3d19030b21a5e,
title = "Screening for Down's syndrome by fetal nuchal translucency measurement in a general obstetric population",
abstract = "Objective. To examine the effectiveness of nuchal translucency measurement in the detection of trisomy 21 in a low-risk population. Design. Prospective cohort study. Subjects. A total of 1473 women with viable singleton pregnancies between 10 and 14 weeks' gestation attending an antenatal clinic for routine obstetric care. Methods. The fetal nuchal translucency was measured in all women. Fetal karyotyping was performed for the usual indications and in cases of a nuchal translucency measurement ≥ 3 mm. Results. Down's syndrome was found in nine fetuses (0.6{\%}). Screening by maternal age would have diagnosed six out of nine fetuses (67{\%}) with trisomy 21 for an invasive testing rate of 24{\%}. Because the actual uptake of prenatal diagnosis for maternal age was 79{\%}, only 44{\%} of the Down's syndrome fetuses would have been detected prenatally by this screening method. A nuchal translucency of 3 mm or more identified 67{\%} of the fetuses with trisomy 21, for an invasive testing rate of 2.2{\%}. The combination of nuchal translucency thickness, corrected for the influence of gestation by 'delta-value', and maternal age performs differently according to the chosen cut-off point for adjusted risk. A minimum risk of 1:100 would detect 78{\%} of the Down's syndrome fetuses for a testing rate of 8.1{\%}. By offering karyotyping to all women with a post-test risk of 1:300, the detection rate would increase to 100{\%} with an invasive testing rate of 19.8{\%}. This is lower than the invasive testing rate of maternal age screening. Conclusions. These data suggest that nuchal translucency measurement is an effective screening method for trisomy 21 in an unselected obstetric population.",
keywords = "Down's syndrome, Fetal aneuploidies, Nuchal translucency, Ultrasound screening",
author = "E. Pajkrt and {Van Lith}, {J. M M} and Mol, {B. W J} and Bleker, {O. P.} and Bilardo, {C. M.}",
year = "1998",
month = "10",
day = "28",
doi = "10.1046/j.1469-0705.1998.12030163.x",
language = "English",
volume = "12",
pages = "163--169",
journal = "Ultrasound in Obstetrics and Gynecology",
issn = "0960-7692",
publisher = "John Wiley and Sons Ltd",
number = "3",

}

Screening for Down's syndrome by fetal nuchal translucency measurement in a general obstetric population. / Pajkrt, E.; Van Lith, J. M M; Mol, B. W J; Bleker, O. P.; Bilardo, C. M.

In: Ultrasound in Obstetrics and Gynecology, Vol. 12, No. 3, 28.10.1998, p. 163-169.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Screening for Down's syndrome by fetal nuchal translucency measurement in a general obstetric population

AU - Pajkrt, E.

AU - Van Lith, J. M M

AU - Mol, B. W J

AU - Bleker, O. P.

AU - Bilardo, C. M.

PY - 1998/10/28

Y1 - 1998/10/28

N2 - Objective. To examine the effectiveness of nuchal translucency measurement in the detection of trisomy 21 in a low-risk population. Design. Prospective cohort study. Subjects. A total of 1473 women with viable singleton pregnancies between 10 and 14 weeks' gestation attending an antenatal clinic for routine obstetric care. Methods. The fetal nuchal translucency was measured in all women. Fetal karyotyping was performed for the usual indications and in cases of a nuchal translucency measurement ≥ 3 mm. Results. Down's syndrome was found in nine fetuses (0.6%). Screening by maternal age would have diagnosed six out of nine fetuses (67%) with trisomy 21 for an invasive testing rate of 24%. Because the actual uptake of prenatal diagnosis for maternal age was 79%, only 44% of the Down's syndrome fetuses would have been detected prenatally by this screening method. A nuchal translucency of 3 mm or more identified 67% of the fetuses with trisomy 21, for an invasive testing rate of 2.2%. The combination of nuchal translucency thickness, corrected for the influence of gestation by 'delta-value', and maternal age performs differently according to the chosen cut-off point for adjusted risk. A minimum risk of 1:100 would detect 78% of the Down's syndrome fetuses for a testing rate of 8.1%. By offering karyotyping to all women with a post-test risk of 1:300, the detection rate would increase to 100% with an invasive testing rate of 19.8%. This is lower than the invasive testing rate of maternal age screening. Conclusions. These data suggest that nuchal translucency measurement is an effective screening method for trisomy 21 in an unselected obstetric population.

AB - Objective. To examine the effectiveness of nuchal translucency measurement in the detection of trisomy 21 in a low-risk population. Design. Prospective cohort study. Subjects. A total of 1473 women with viable singleton pregnancies between 10 and 14 weeks' gestation attending an antenatal clinic for routine obstetric care. Methods. The fetal nuchal translucency was measured in all women. Fetal karyotyping was performed for the usual indications and in cases of a nuchal translucency measurement ≥ 3 mm. Results. Down's syndrome was found in nine fetuses (0.6%). Screening by maternal age would have diagnosed six out of nine fetuses (67%) with trisomy 21 for an invasive testing rate of 24%. Because the actual uptake of prenatal diagnosis for maternal age was 79%, only 44% of the Down's syndrome fetuses would have been detected prenatally by this screening method. A nuchal translucency of 3 mm or more identified 67% of the fetuses with trisomy 21, for an invasive testing rate of 2.2%. The combination of nuchal translucency thickness, corrected for the influence of gestation by 'delta-value', and maternal age performs differently according to the chosen cut-off point for adjusted risk. A minimum risk of 1:100 would detect 78% of the Down's syndrome fetuses for a testing rate of 8.1%. By offering karyotyping to all women with a post-test risk of 1:300, the detection rate would increase to 100% with an invasive testing rate of 19.8%. This is lower than the invasive testing rate of maternal age screening. Conclusions. These data suggest that nuchal translucency measurement is an effective screening method for trisomy 21 in an unselected obstetric population.

KW - Down's syndrome

KW - Fetal aneuploidies

KW - Nuchal translucency

KW - Ultrasound screening

UR - http://www.scopus.com/inward/record.url?scp=0031669166&partnerID=8YFLogxK

U2 - 10.1046/j.1469-0705.1998.12030163.x

DO - 10.1046/j.1469-0705.1998.12030163.x

M3 - Article

VL - 12

SP - 163

EP - 169

JO - Ultrasound in Obstetrics and Gynecology

T2 - Ultrasound in Obstetrics and Gynecology

JF - Ultrasound in Obstetrics and Gynecology

SN - 0960-7692

IS - 3

ER -