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Related Experiment Videos

SURUSS in perspective.

N J Wald1, C Rodeck, A K Hackshaw

  • 1Department of Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, UK.

BJOG : an International Journal of Obstetrics and Gynaecology
|June 17, 2004
PubMed
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The Integrated test is the most effective first-trimester screening for Down's Syndrome, offering the lowest false-positive rate and fewest procedure-related fetal losses. The Quadruple test is best for second-trimester screening.

Area of Science:

  • Prenatal diagnostics
  • Genetics
  • Obstetrics

Background:

  • Antenatal screening for Down's Syndrome lacked standardized comparisons due to varied study designs.
  • The Serum Urine and Ultrasound Screening Study (SURUSS) aimed to provide such a comparison.
  • Updated SURUSS results incorporate recent nuchal translucency data for Down's Syndrome pregnancies.

Purpose of the Study:

  • To compare the effectiveness and safety of various antenatal screening tests for Down's Syndrome.
  • To update and present the main findings from the SURUSS report.
  • To discuss the implications of these findings for clinical practice.

Main Methods:

  • Prospective study of 47,053 singleton pregnancies, including 101 with Down's Syndrome.
  • Nuchal translucency measurements and serum/urine sample collection at 9-13 and 14-20 weeks.

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  • Biochemical markers tested on samples from affected pregnancies and controls; follow-up for Down's Syndrome diagnosis.

    • Main Results:

    • At an 85% Down's Syndrome detection rate, the Integrated test had a 0.9% false-positive rate.
    • The Combined test had a 4.3% false-positive rate, and the Quadruple test had a 6.2% false-positive rate.
    • Integrated test resulted in significantly fewer procedure-related fetal losses (6/100,000) compared to Combined (35/100,000) or Quadruple (45/100,000) tests.

    Conclusions:

    • The Integrated test is the most effective and safest first-trimester screening method for Down's Syndrome.
    • The Serum integrated test is the second-best option for first-trimester screening.
    • The Quadruple test is recommended for women first attending in the second trimester; older tests are not justified.