Integration of Antenatal Down SyndromeScreening at 1 st and 2 nd Trimester (Proposalof Screening Protocol)

Czech version

Authors: D. Stejskal ¹; P. Nedvěd ¹; M. Břešťák ²; L. Krofta ³
Authors‘ workplace: GENNET CZ, s. r. o., Praha, vedoucí MUDr. D. Stejskal 2 Gyncentrum Sanatorium, s. r. o. Praha, vedoucí MUDr. P. Pícha 3 Ústav pro péči o matku a dítě Praha 4 -Podolí, ředitel doc. MUDr. J. Feyereisl, CSc. ¹
Published in: Ceska Gynekol 2002; (3): 0
Category:

Overview

Objective:
Proposal of antenatal Down syndrome screening protocol using integration of first andsecond trimester results.Design:Review.Setting:Antenatal screening centre GENNET,Prague.Methods:Search of relevant articles,software analysis and pilot implementation.Results:Screening of Down syndrome (DS)is divided into two phases:at first phase combined DSrisk is calculated using pregnancy plasma protein –A (PAPP-A)at 9 th –11 th gestational week andultrasound fetal nuchal translucency (NT)at 11 th –13 th week with risk cut-off 1/100 (about 2 percent of screened).Positive mothers are counselled immediately after NT measurement:Firstphase negative mothers continue to second phase where PAPP-A and NT values are integratedwith second trimester screening results.Protocol is supported with special software (Obstetrician ’s Screening Guide-OSG).Conclusion:At proposed protocol the information on significant first trimester DS risk is notwithheld to second trimester and mother can choose early prenatal diagnosis.Expected detectionrate is near 90 per cent at 5 per cent false positive rate.

Key words:
integrated antenatal screening,Down ’s syndrome,screening protocol

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