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• W1973396768 abstract "low risk for Trisomy 21 on first trimester screening Alireza A. Shamshirsaz, Samadh Ravangard, Amirhoushang A. Shamshirsaz, James Egan, Winston A. Campbell, Peter Benn, Adam Borgida, Mary Beth Janicki, Anne-Marie Prabulos, Charles Ingardia, Debora Feldman, Gary Turner, Carolyn Zelop, Diane Timms, Padmalatha Gurram, Kisti Fuller, Yu Ming Victor Fang, Rachel Billstrom, Kevin Lenehan, Allison Sadowski University of Connecticut Health Center, Obstetrics and Gynecology, Farmington, CT, St. Francis Hospital, Obstetrics and Gynecology, Hartford, CT, University of Connecticut. Health Center, Department of Genetics and Developmental Biology, Farmington, CT, Hartford Hospital, Obstetrics and Gynecology, Hartford, CT, Beth Israel Deaconess Medical Center, Obstetrics and Gynecology, Boston, MA, Hartford Hospital, Maternal-Fetal Medicine, Hartford, CT OBJECTIVE: To determine the rate of utilization of second trimester serum [2nd TS] screening among women who are at very low risk after the first trimester [1stT] aneuploidy screen risk for trisomy 21 [T-21]. STUDY DESIGN: Records for all women with singleton pregnancies who received first trimester trisomy 21 screening (NT, PAPP-A, and hCG, the combined test) were retrospectively reviewed to determine which patients also received a sequential 2nd TS screening test (AFP, hCG, uE3, INH-A) and/or second trimester ultrasound exam (2nd US). Our screening policy was not to limit these follow-up tests to any particular sub-group of women. A very low trisomy 21 risk was defined as 1:270 in the second trimester. We excluded all the women with an increased trisomy 18 risk 1:100. RESULTS: A total of 12,218 women underwent 1stT screening, 9,332 (76.4%) were classified as very low risk for a trisomy 21 fetus. Of these 9, 332 women, 3,329 (35.6%, group A) had both 2nd TS markers and 2nd US, 1,825 (19.5%, group B) had only 2nd US, 2,343 (25.1%, group C) had only 2nd TS markers and 1,835 (19.8%, group D) had no more screening. Of the women who had 2nd TS markers (group A and C) (n 5,672, 60.7%), 56 women (1.0%) became screen-positive. The net number of women who had invasive testing (amnio) was 50 (0.5%) of which 14 women had invasive testing (amnio) after becoming screen positive in the 2nd TS markers. Within the 5,672women (group A and C) who had 2nd TS markers there was one case of trisomy 21 that remained at screen-negative after the 2nd TS markers. CONCLUSION: Women, who are at very low risk after the first trimester screening, are very unlikely to have a trisomy 21 affected pregnancy. The use of a full set of second trimester serum markers is not indicated for women who are at very low risk after first trimester screening and who have no other indications for further screening." @default.
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• W1973396768 date "2012-01-01" @default.
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• W1973396768 title "722: Follow-up frequency of testing in patients at very low risk for Trisomy 21 on first trimester screening" @default.
• W1973396768 doi "https://doi.org/10.1016/j.ajog.2011.10.740" @default.
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