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  • Title: A prospective trial of prenatal screening for Down syndrome by means of maternal serum alpha-fetoprotein, human chorionic gonadotropin, and unconjugated estriol.
    Author: Burton BK, Prins GS, Verp MS.
    Journal: Am J Obstet Gynecol; 1993 Sep; 169(3):526-30. PubMed ID: 7690522.
    Abstract:
    OBJECTIVE: Our purpose was to prospectively evaluate the effectiveness of prenatal screening for Down syndrome by means of multiple serum markers. STUDY DESIGN: alpha-Fetoprotein, human chorionic gonadotropin, and unconjugated estriol were measured in 8233 midtrimester serum samples, including 7492 from women < 35 years old and 741 from women > or = 35 years old. Down syndrome risks were computed by means of age and all three markers. Further testing was recommended for patients with a risk > or = 1:270. Testing for trisomy 18 was recommended for patients with an alpha-fetoprotein < or = 0.70 multiples of the median, human chorionic gonadotropin < or = 0.50 multiples of the median, and unconjugated estriol < or = 0.55 multiples of the median. RESULTS: Of women screened initially 10.4% had a Down syndrome risk > or = 1:270; 10 of 12 known cases of Down syndrome were identified. One abnormality was detected for every 33 amniocenteses performed in this group. Of 0.4% of patients at increased risk for trisomy 18, two cases of trisomy 18 and one of triploidy were found. CONCLUSION: Multiple marker screening is effective in identifying the majority of fetal chromosome anomalies.
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