Prenatal Screening Strategies for Down Syndrome: Many Options but Few Answers

1998 ◽  
Vol 4 (3) ◽  
pp. 229
Author(s):  
Euan M. Wallace
Keyword(s):  
Down Syndrome ◽  
Prenatal Screening ◽  
New South ◽  
South Australia ◽  
Nuchal Translucency ◽  
Second Trimester ◽  
Mental Handicap ◽  
South Wales ◽  
Screening Strategies ◽  
Serum Screening

Down syndrome is the single most common cause of severe mental handicap in Australia. Prenatal screening for Down syndrome is therefore an important component of modern antenatal care. However, while effective second trimester serum screening for Down syndrome has been available in Australia for almost a decade it appears that the majority of Australian women, particularly those outside South Australia and New South Wales, are still not offered it. Newer methods of screening have been recently described and are already being offered in routine clinical practice. These methods, including nuchal translucency, will afford results earlier in pregnancy than second trimester serum screening and so are attractive to women. However, available evidence suggests that nuchal translucency may not perform as well as second trimester serum screening and further evaluation of the newer screening strategies in an Australian population is urgently required. Alteration of practice prior to such an evaluation is simply not warranted at this time.

Prenatal Screening for Down Syndrome in Australia

Ultrasound ◽  
2009 ◽  
Vol 17 (3) ◽  
pp. 167-171
Author(s):  
Debbie L Nisbet ◽  
Andrew McLennan
Keyword(s):  
Down Syndrome ◽  
Prenatal Screening ◽  
False Positive Rate ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Maternal Serum ◽  
Screening Tests ◽  
Maternal Serum Screening ◽  
Serum Screening ◽  
Maternal Preference

Prenatal screening for Down syndrome should be offered to all pregnant women. The screening option chosen will be influenced by maternal preference, local availability of tests, and the gestation at which the pregnant woman presents. Screening tests take into account the effect of maternal age on Down syndrome risk. The combined first trimester screen using nuchal translucency and first trimester maternal serum screening can achieve a detection rate for Down syndrome of 90% with a 5% false positive rate, when performed by appropriately trained individuals. Midtrimester maternal serum screening is a good screening option for women unable to undergo the combined first trimester screen.

The cost effectiveness of prenatal ultrasound screening for trisomy 21

2004 ◽  
Vol 20 (4) ◽  
pp. 464-468 ◽  
Author(s):  
Anthony H. Harris
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Trisomy 21 ◽  
Nuchal Translucency ◽  
Decision Analytic Model ◽  
Ultrasound Screening ◽  
Second Trimester ◽  
Screening Strategies ◽  
Serum Screening ◽  
The Cost

Objectives: The cost-effectiveness of opportunistic nuchal translucency ultrasound screening in pregnancy was compared with alternative screening strategies for trisomy 21 in Australia.Methods: A decision analytic model was used of various pregnancy screening strategies based on a systematic review of the literature on the effectiveness of nuchal translucency ultrasound and serum screening and costs based on current reimbursement fees. The model included the likelihood and cost of terminations after diagnostic testing and the associated risk of fetal loss. All prices are in 2001 Australian dollars.Results: With a twenty percentage point difference in detection rate, the incremental cost for a combination of nuchal translucency and serum screening with age in the first trimester compared with maternal serum screening in the second trimester was $105,484 per extra case detected and $374,779 per live trisomy 21 birth avoided. Serum screening in the second trimester had an incremental cost per extra case detected of between $61,700 and $117,100 per extra live birth avoided when compared with no screening.Conclusions: The cost-effectiveness of ultrasound screening for trisomy 21 would appear to be more attractive if it were done at the same time as current dating ultrasound. Any funding mechanism for screening should take this strategy into account by incorporating, as far as possible, provision of nuchal translucency screening into existing services provided in early pregnancy.

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

In A Fix: Fixed-Term Parliaments in the Australian States

2013 ◽  
Vol 41 (2) ◽  
pp. 265-298
Author(s):  
Peter Congdon
Keyword(s):  
Western Australia ◽  
Prime Minister ◽  
New South ◽  
New South Wales ◽  
South Australia ◽  
Constitutional Amendments ◽  
South Wales

Constitutional systems of Westminster heritage are increasingly moving towards fixed-term parliaments to, amongst other things, prevent the Premier or Prime Minister opportunistically calling a ‘snap election’. Amongst the Australian states, qualified fixed-term parliaments currently exist in New South Wales, South Australia and Victoria. Queensland, Tasmania and Western Australia have also deliberated over whether to establish similar fixed-term parliaments. However, manner and form provisions in those states' constitutions entrench the Parliament's duration, Governor's Office and dissolution power. In Western Australia and Queensland, unlike Tasmania, such provisions are doubly entrenched. This article considers whether these entrenching provisions present legal obstacles to constitutional amendments establishing fixed-term parliaments in those two states. This involves examining whether laws fixing parliamentary terms fall within section 6 of the Australia Acts 1986 (Cth) & (UK). The article concludes by examining recent amendments to the Electoral Act 1907 (WA) designed to enable fixed election dates in Western Australia without requiring a successful referendum.

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

The Relation Between the Food of the Australian Barracouta, Thyrsites atun (Euphrasen), and Recent Fluctuations in the Fisheries

1957 ◽  
Vol 8 (1) ◽  
pp. 29 ◽  
Author(s):  
M Blackburn
Keyword(s):  
Population Distribution ◽  
New South ◽  
New South Wales ◽  
South Australia ◽  
Downward Trend ◽  
Small Fish ◽  
Fish Diet ◽  
Upward Trend ◽  
Independent Evidence ◽  
South Wales

The diet of surface-swimming Australian barracouta was studied from over 10,000 stomachs. The principal prey organisms in Bass Strait are the euphausiid Nyctiphanes australis Sars, the anchovy Engraulis australis (White), and young barracouta, in that order; and in eastern Tasmania Nyctiphanes, Engraulis, and the sprat Clupea bassensis McCulloch, in that order. The pilchard Sardinops neopilchardus (Steindachner) is not an important item of the diet in these regions although it is so in New South Wales, South Australia, and Western Australia. The jack mackerel Trachurus declivis Jenyns is a significant item in eastern Tasmania and New South Wales but not in Bass Strait. These and other features of the fish diet of the barracouta reflect actual availability of the various small fish species in the waters. Barracouta eat Nyctiphanes by herding them into dense masses (or finding them already concentrated) and swallowing them. The movements of the anchovy make it unavailable to Bass Strait and eastern Tasmanian barracouta for much of the summer and autumn period, when the barracouta are thus dependent upon Nyctiphanes for the bulk of their food. A close positive relationship between the availability of barracouta and Nyctiphanes might therefore be expected at those seasons. There is evidence of such a relationship between mean availability (catch per boat-month) of barracouta and mean percentage of barracouta stomachs containing Nyctiphanes, at those seasons, from year to year. For southern Victorian coastal waters both show a downward trend from 1948-49 to 1950-51 and then an upward trend to 1953-54; for eastern Tasmania both show a downward trend (for autumn only) from 1949-50 through 1952-53. The records of catch per boat-month furnish independent evidence that the main variations in this index were effects of availability (population distribution or behaviour) rather than abundance (population size), at least for southern Victoria. It is therefore considered that when scarcity of barracouta occurs in summer and autumn in the coastal fishing areas it may be due to scarcity of Nyctiphanes, forcing the fish to go offshore for this food which is known to be available there. This would take the fish out of range of the fishermen.

Mycosphaerella linicola. [Distribution map].

1996 ◽  
Author(s):  
Keyword(s):  
South Dakota ◽  
Linum Usitatissimum ◽  
New South ◽  
Russian Far East ◽  
Far East ◽  
South Australia ◽  
Rio Grande Do Sul ◽  
Distribution Map ◽  
South Wales ◽  
New Distribution

Abstract A new distribution map is provided for Mycosphaerella linicola Naumov. Hosts: Flax (Linum usitatissimum) and other (Linum) spp. Information is given on the geographical distribution in Argentina, Australia, New South Wales, Queensland, South Australia, Victoria, Western Australia, Austria, Belarus, Belgium, Brazil, Rio Grande do Sul, Bulgaria, Canada, Alberta, British Columbia, Manitoba, Ontario, Saskatchewan, China, Croatia, Czech Republic, Denmark, Ethiopia, France, Germany, Greece, Hungary, Ireland, Italy, Kazakhstan, Kenya, Mexico, Morocco, New Zealand, Peru, Poland, Portugal, Romania, Russia, Russia (European), Russian Far East, Slovakia, Slovenia, Sweden, Tanzania, Tunisia, Turkey, UK, Scotland, USA, Arizona, California, Iowa, Kansas, Michigan, Minnesota, Montana, North Dakota, South Dakota, Texas, Wisconsin, Ukraine, Uruguay, Yugoslavia (former).

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