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Screening for Down's syndrome: the first two years experience in Bristol
D J Goldie1, J P Astley, J M Beaman
1Department of Clinical Chemistry, Southmead Hospital, Bristol.
Journal of Medical Screening
|January 1, 1995
Summary
This study shows antenatal screening for Down's syndrome using maternal serum markers is effective. Early screening before 17 weeks gestation significantly improves detection rates for Down's syndrome pregnancies.
Area of Science:
- Maternal serum screening
- Prenatal diagnostics
- Down's syndrome screening
Background:
- Antenatal screening for Down's syndrome is crucial for early detection and management.
- Maternal serum markers, including alpha fetoprotein and human chorionic gonadotrophin, are utilized in screening protocols.
Purpose of the Study:
- To evaluate the effectiveness of a Down's syndrome antenatal screening program.
- To assess the utility of alpha fetoprotein and total human chorionic gonadotrophin as maternal serum markers.
Main Methods:
- A prospective screening program was implemented in a district general hospital.
- Maternal serum markers were analyzed between 15 and 20 weeks gestation.
- Risk estimates for Down's syndrome were calculated using marker results and maternal age.
Main Results:
- Over two years, 22,816 women were screened, with an 84% population uptake.
- 32 Down's syndrome pregnancies were identified.
- Screening before 17 weeks gestation yielded significantly higher detection rates (80% > or = 1:300 risk) compared to later screening (33% > or = 1:300 risk).
Conclusions:
- The antenatal screening program for Down's syndrome demonstrated overall effectiveness.
- Screening performed before 17 weeks of gestation is substantially more effective than screening performed later.