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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. n.j.wald@qmul.ac.uk

Seminars in Perinatology
|August 18, 2005
PubMed
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The Integrated test is the safest and most effective first-trimester screening for Down

Area of Science:

  • Prenatal diagnostics
  • Maternal-fetal medicine
  • Genetics screening

Background:

  • Antenatal screening for Down's Syndrome historically lacked standardized comparisons due to varied study designs.
  • The Serum Urine and Ultrasound Screening Study (SURUSS) aimed to provide a direct comparison of different screening methods.
  • Updated SURUSS results incorporate recent data on nuchal translucency 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 identify the optimal screening strategy based on gestational age at first attendance.
  • To evaluate the false-positive rates and procedure-related fetal losses associated with different screening tests.

Main Methods:

  • Prospective study of 47,053 singleton pregnancies, including 101 with Down's Syndrome.

Related Experiment Videos

  • Collection and storage of serum and urine samples between 9-13 and 14-20 weeks gestation.
  • Testing of stored samples for biochemical markers and nuchal translucency measurements at 11 weeks.

    • Main Results:

    • At an 85% Down's Syndrome detection rate, the Integrated test had a 0.9% false-positive rate.
    • The Combined test (4.3%), Quadruple test (6.2%), and nuchal translucency alone (15.2%) had significantly higher false-positive rates.
    • The Integrated test resulted in fewer procedure-related fetal losses (6 per 100,000) compared to the Combined (35) or Quadruple (45) 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 attending in the second trimester; older tests are not justified.