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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Schlattmann, Peter / Tate, Jillian R. / Tsongalis, Gregory J.

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Comparison of First Trimester, Second Trimester and Integrated Downs Syndrome Screening Results in Unaffected Pregnancies

Silvana Canini / Federico Prefumo / Luciano Famularo / Pier Luigi Venturini / Valter Palazzese / Pierangela De Biasio

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 40, Issue 6, Pages 600–603, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2002.103, June 2005

Publication History

Published Online:
2005-06-01

Abstract

Our aim was to compare the results of first trimester combined test, second trimester triple test, and integrated test in the same pregnant population. We retrospectively studied 927 women, all giving birth to an unaffected baby except for two cases of Down's syndrome. The women underwent a nuchal translucency ultrasound measurement and a blood sampling for pregnancy-associated plasma protein A and free β-hCG subunit (free total chorionic gonadotropin subunit) assay in the first trimester of pregnancy. A second trimester biochemical screening (α-fetoprotein, unconjugated oestriol and total hCG) was performed later. The correlations between each pair of markers and between each marker level and maternal age were calculated. No marker showed significant correlation with any other or with maternal age, with the obvious exception of free β-hCG subunit and total hCG. The false-positive rate (cut-off level: 1 in 350 at term) was 1.5% for the first trimester test, 3.6% for the second trimester test and 0.54% for the integrated test. In 10/14 pregnancies, the increased risk in the first trimester was not confirmed neither in the second trimester nor by the integrated test. In 29/33 women with an increased risk in the second trimester, the first trimester and the integrated test results were discordant. The absence of correlation among different marker levels suggests that the information supplied by the first and second trimester tests is different. Integrating first and second trimester markers in a single test could pose the ethical problem of withholding first trimester results and thus denying the possible advantages of an earlier pregnancy termination.

Citing Articles

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[1]
J. Garriguet, S. Valverde, C. Chica, and J. Espejo
Clínica e Investigación en Ginecología y Obstetricia, 2004, Volume 31, Number 1, Page 17
[2]
Sheng-Wen Shaw, Jenn-Jeih Hsu, Chien-Nan Lee, Ching-Hua Hsiao, Chih-Ping Chen, T'sang-T'ang Hsieh, and Po-Jen Cheng
Taiwanese Journal of Obstetrics and Gynecology, 2008, Volume 47, Number 2, Page 157
[3]
Aleksandra Novakov-Mikic
Medicinski pregled, 2005, Volume 58, Number 1-2, Page 5
[4]
Howard Cuckle, Peter Benn, and Dave Wright
Seminars in Perinatology, 2005, Volume 29, Number 4, Page 252
[5]
Bob Heyman, Gillian Hundt, Jane Sandall, Kevin Spencer, Clare Williams, Rachel Grellier, and Laura Pitson
Social Science & Medicine, 2006, Volume 62, Number 10, Page 2360
[6]
Ron Maymon, Reuven Sharony, Julia Grinshpun-Cohen, Deganit Itzhaky, Arie Herman, and Orit Reish
Journal of Perinatal Medicine, 2005, Volume 33, Number 5
[7]
Prenatal Diagnosis, 2002, Volume 22, Number 10, Page 949

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