MSAFP vs triple screen

From: Danny Tucker (danny.tucker@dial.pipex.com)
Fri Jul 11 13:16:51 1997


Samir Saidi <sam@saidi.prestel.co.uk> said:

--
SO, what about fetal nuchal translucency? Current (last month) quoted
figures I believe, based on Kypros Nicholaides formulae, are a
sensitivity of 80% for Down's. No extra cost? - 12/40 scan for dating
often performed anyway. And I think more reassuring for the patient.
--

Have to disagree here, Sam. Kypros's data has not been reproduced in terms of general population screening yet [see below]. As others have said, I'm sure it is in part due to his group's expertise as well as the selective population he gets. We need to be careful not to introduce yet another inadequately studied screening test into general usage. Surely we've learnt from the electronic FHR monitoring fiasco!!

I have a real problem with the false positives. Also what you were saying about adequate counselling prior to the test, which of course often doesn't happen in the primary care setting.

--
First trimester fetal nuchal translucency: problems with screening the
general population. 1.
Article Source: Br J Obstet Gynaecol 1995 May;102(5):381-5
Author(s): Roberts LJ; Bewley S; Mackinson AM; Rodeck CH
--
First trimester fetal nuchal translucency: problems with screening the
general population. 2.
Article Source: Br J Obstet Gynaecol 1995 May;102(5):386-8
Author(s):  Bewley S; Roberts LJ; Mackinson AM; Rodeck CH
--
Nuchal translucency cannot be used as a screening test for chromosomal
abnormalities in the first trimester of pregnancy in a routine ultrasound
practice.
Article Source: Prenat Diagn 1996 Sep;16(9):797-805
Author(s): Kornman LH; Morssink LP; Beekhuis JR; De Wolf BT; Heringa MP;
Mantingh A
--

Best wishes,

Danny.

--
Danny Tucker
Nottingham, UK
http://ds.dial.pipex.com/danny.tucker/




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