A 28-year old woman with one previous pregnancy termination presented with delayed menstrual periods for about 7 weeks, left-sided lower abdominal pain, mild vaginal bleeding and vomiting. A transvaginal scan revealed an intrauterine pregnancy of 6 weeks' gestation with fetal heart activity and a suspected cervical ectopic pregnancy. She requested termination of the pregnancy. Suction evacuation of the cervical ectopic pregnancy followed by cervical dilatation and suction evacuation of the intrauterine pregnancy was performed with ultrasound scan guidance. Cervical haemostatic sutures were inserted prior to suction evacuation and estimated blood loss was 200 ml. Separate tissue specimens from the two pregnancy sites confirmed pregnancy tissue on histology.
In October 2003, The National Institute for Clinical Excellence recommended screening tests for Down's syndrome (DS) to come into effect from April 2007. These tests were recommended based on studies performed in research centres. Some of the recommended tests have a fetal nuchal translucency scan component. In this retrospective study at the Basildon and Thurrock University Hospital we have evaluated nuchal translucency (NT) scans performed between July 1998 and January 2004 on 18,965 fetuses with a view to comparing our findings with research centres. In spite of our high standards, our detection rate for DS was 72.0% (95% CI 56.0-83.8%) for a 5% false positive rate. This was much lower than the 85% reported from the seminal paper in 1994. We believe that the advice given to women should be based on data from working programmes and not research units.
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