Combined first-trimester versus second-trimester serum screening for Down syndrome: A cost analysis

2003 ◽  
Vol 188 (3) ◽  
pp. 745-751 ◽  
Author(s):  
William Cusick ◽  
Philip Buchanan ◽  
Terrence W. Hallahan ◽  
David A Krantz ◽  
John W. Larsen ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Cost Analysis ◽  
First Trimester ◽  
Second Trimester ◽  
Serum Screening

Prenatal serum screening for Down syndrome and neural tube defects in the United States: Changes in utilization patterns from 2012 to 2020

2021 ◽  
pp. 096914132110316
Author(s):  
Nathalie Lepage ◽  
Philip Wyatt ◽  
Edward R Ashwood ◽  
Robert G Best ◽  
Thomas Long ◽  
...  
Keyword(s):  
United States ◽  
Down Syndrome ◽  
First Trimester ◽  
The United States ◽  
Maternal Serum ◽  
Second Trimester ◽  
Maternal Serum Screening ◽  
Cell Free Dna ◽  
Free Dna ◽  
Serum Screening

Objective To compile current usage of serum-based prenatal screening for Down syndrome in the United States and compare it with results from a similar 2011/2012 survey. Setting The College of American Pathologists maternal screening proficiency testing survey includes a supplemental question on the first of three yearly distributions. Methods Information regarding tests offered and the monthly number of pregnancies tested for US-based laboratories were reviewed. Results were stratified by size of laboratory, tests offered, and pregnancies tested. Findings were compared to an earlier survey. Results Fifty-six laboratories reported they will have screened 1,131,336 pregnancies in 2020. Of these, 36% are screened by stand-alone first trimester testing, 48% by stand-alone second trimester testing, and 16% using tests that integrate results from both trimesters. Eighty percent of all serum screens were provided by the five laboratories that performed the most screens (at least 50,000). These five performed similar proportions of first or second trimester screens (42.2% and 41.8%, respectively). Compared to eight years earlier, there are now 54% fewer laboratories. Pregnancies screened using the first trimester, second trimester, and integrated protocols were lower by 27%, 69%, and 72%, respectively. The serum screening activity in the US showed a 62% decrease from 2012 levels. During 2012–2020, the number of cell-free DNA tests increased from negligible to 1,492,332. Conclusions Maternal serum screening for common aneuploidies has changed significantly in eight years with fewer laboratories, a shift toward larger laboratories and a 2.5-fold reduction in pregnancies tested, likely due to the introduction of cell-free DNA screening.

scholarly journals Fetal Down syndrome screening models for developing countries; Part I: Performance of Maternal Serum Screening

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Chanane Wanapirak ◽  
Wirawit Piyamongkol ◽  
Supatra Sirichotiyakul ◽  
Fuanglada Tongprasert ◽  
Kasemsri Srisupundit ◽  
...  
Keyword(s):  
Developing Countries ◽  
Down Syndrome ◽  
Reference Range ◽  
First Trimester ◽  
Maternal Serum ◽  
Second Trimester ◽  
First Trimester Screening ◽  
Maternal Serum Screening ◽  
Serum Screening ◽  
Trimester Screening

Abstract Background To identify the performance of fetal Down syndrome (DS) screening for developing countries. Methods A prospective study on MSS (maternal serum screening) with complete follow-ups (n = 41,924) was conducted in 32 network hospitals in the northern part of Thailand. Various models of MSS were tested for performance. Results MSS based on Caucasian reference range resulted in very high false positive rate (FPR; 13%) in our country, compared to the rate of 7.8% with our own (Thai) reference range, whereas the detection rate was comparable. As individual screening, C-S (contingent first trimester screening including PAPP-A, and free beta-hCG, classified as a) high risk [> 1:30], indicated for invasive diagnosis; b) intermediate risk [1:30–1500], indicated for STS; and c) low risk [< 1:1500], need no further tests.) was the most effective model (sensitivity 84.9%, FPR 7.7%) but nearly one-third needed the second trimester test (STS) because of intermediate results. Additionally, about one-third had their first visits in the second trimester and had no chance of FTS (first trimester screening). C-S plus STS had a sensitivity of 82.4% and FPR 8.1% whereas independent first and second trimester screening model (I-S) gave the sensitivity of 78.4% and FPR of 7.5% but was much more convenient and practical. Conclusion C-S plus STS was the most effective models while I-S model was also effective and may be better for developing countries because of its simplicity and feasibility.

Comparison and integration of first trimester fetal nuchal translucency and second trimester maternal serum screening for fetal Down syndrome

2002 ◽  
Vol 22 (8) ◽  
pp. 730-735 ◽  
Author(s):  
Yung Hang Lam ◽  
Chin Peng Lee ◽  
Sai Yuen Sin ◽  
Rebecca Tang ◽  
Hong Soo Wong ◽  
...  
Keyword(s):  
Down Syndrome ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Maternal Serum ◽  
Second Trimester ◽  
Maternal Serum Screening ◽  
Serum Screening

scholarly journals How women deal with the results of serum screening for Down syndrome in the second trimester of pregnancy

2000 ◽  
Vol 20 (9) ◽  
pp. 705-708 ◽  
Author(s):  
Martin J. N. Weinans ◽  
Annemarie M. G. Huijssoon ◽  
Tjeerd Tymstra ◽  
Mignon C. F. Gerrits ◽  
Johan R. Beekhuis ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Second Trimester ◽  
Serum Screening

Four Years' Experience With an Interlaboratory Comparison Program Involving First-Trimester Markers of Down Syndrome

2010 ◽  
Vol 134 (11) ◽  
pp. 1685-1691
Author(s):  
Glenn E. Palomaki ◽  
George J. Knight ◽  
Geralyn Lambert-Messerlian ◽  
Jacob A. Canick ◽  
James E. Haddow
Keyword(s):  
Down Syndrome ◽  
Chorionic Gonadotropin ◽  
Plasma Protein ◽  
Human Chorionic Gonadotropin ◽  
Interlaboratory Comparison ◽  
Protein A ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Second Trimester ◽  
Coefficients Of Variation

Abstract Context.—We initiated a voluntary, self-funded interlaboratory comparison program in the fall of 2005 because no proficiency testing program was available to laboratories in North America offering first-trimester, combined serum and ultrasound, Down syndrome screening. Objectives.—To evaluate the first 4 years of the interlaboratory comparison program against stated goals, to identify areas of concern, and to create new initiatives as indicated. Design.—Five serum samples are distributed 3 times a year to be tested for pregnancy-associated plasma protein A, human chorionic gonadotropin or its β subunit, and dimeric inhibin-A; participants convert these results into multiples of the median. Patient histories include nuchal translucency information that enables the calculation of the risk of Down syndrome. Also included are educational components linked to interlaboratory comparison program results. Assessment of integrated (first- and second-trimester markers) risks is accomplished by having participants combine interlaboratory comparison program results with their results from a second-trimester proficiency testing program administered by the College of American Pathologists. Results.—The precision profile for pregnancy-associated plasma protein A shows decreasing coefficients of variation with increasing pregnancy-associated plasma protein A concentrations and multiples of the median (25% to 11% and 30% to 15%, respectively). In contrast, coefficients of variation are a relatively constant 12% throughout the entire range of human chorionic gonadotropin results. On a logarithmic scale, the median coefficient of variation of the risk of Down syndrome is 9%. Conclusions.—Participants in the interlaboratory comparison program reliably measure analytes, compute multiples of the median, and calculate consistent Down syndrome risks. Assays for the measurement of pregnancy-associated plasma protein A are not standardized and are less precise than those for human chorionic gonadotropin. Participants calculate reliable median equations given sonographer-specific sets of paired crown-rump length and nuchal translucency measurements.

scholarly journals The Effect of Down Syndrome Biochemical Markers on Predicting Severity of Preeclampsia

2020 ◽  
Author(s):  
AYSE OZBAN
Keyword(s):  
Down Syndrome ◽  
Pregnant Women ◽  
Biochemical Markers ◽  
First Trimester ◽  
Maternal Serum ◽  
Screening Tests ◽  
Second Trimester ◽  
Study Results ◽  
Second Trimester Screening ◽  
Trimester Screening

Abstract Objective: This study aims to determine whether it is possible to predict preeclampsia by comparing postpartum results and test results of the pregnant women diagnosed with preeclampsia, whose first and/or second trimester screening tests were accessible, and to demonstrate the predictability of severity and week of onset.Background: 204 patients underwent renal transplantation in our center and 84 of them were female. Five of our patients (one of them had two births) gave birth to a total of 6 pregnancies.Method: 135 patients were diagnosed with preeclampsia and their first and/or second trimester screening tests were accessible, and 366 control participants gave birth to a healthy baby between 37-41 weeks after standard follow-up period for pregnancy and their screening tests were also accessible.Results: The study results show that the first trimester maternal serum PAPP-A level is significantly low in preeclamptic pregnant women, and that the second trimester maternal serum AFP and hCG levels are significantly high and uE3 levels are significantly low The results also suggest that the first and second trimester Down syndrome biochemical markers can be used in preeclampsia screening.Conclusion: Among these markers, uE3 is the parameter which affects the possibility of preeclampsia the most. However, the first and second trimester Down syndrome biochemical markers are not effective in predicting the severity and onset week of preeclampsia.

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