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Prenatal Risk Calculation (PRC) 3.0: An Extended DoE-Based First-Trimester Screening Algorithm Allowing For Early
Ultrasound International Open
|October 1, 2016
Summary
This study extends the German PRC algorithm for first-trimester screening by enabling early blood sampling before 11 weeks. The enhanced method accurately detects trisomies 21, 13, and 18 with improved detection rates and manageable false positive rates.
Area of Science:
- Maternal-fetal medicine
- Prenatal screening
- Genetics
Background:
- Previous German PRC algorithm versions assumed synchronized maternal blood sampling and fetal ultrasonography.
- This limitation restricted screening to specific gestational windows.
Purpose of the Study:
- To extend the German PRC algorithm for first-trimester screening.
- To accommodate scenarios where maternal blood sampling precedes fetal ultrasonography (before 11 weeks gestation).
Main Methods:
- Logarithmic transformation of PAPP-A and free ß-hCG serum concentrations.
- Development of reference bands for early gestational ages.
- Calibration approach to eliminate maternal weight influence.
Main Results:
- The extended algorithm demonstrated satisfactory statistical characteristics despite sparse early-gestation data.
- For trisomy 21, a false positive rate (FPR) of 3.42% and a detection rate (DTR) of 86.8% were achieved.
- For trisomies 13 and 18, FPR was 1.60% and DTR was 86.4%.
Conclusions:
- Logarithmic transformation of serum markers enables extension of the DoE-based algorithm.
- The enhanced algorithm is applicable to first-trimester screening with pre-11-week blood sampling.
- This improves flexibility and accuracy in prenatal diagnosis of trisomies.
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