The assessment of nuchal translucency and serum markers for down syndrome screening with ductus venosus Doppler measurements in the first trimester

Abstract

Objective:The aim of the study was to improve nuchal translucency (NT) and serum marker Down syndrome (Tri21) screening methods by including fetal ductus venosus (DV) Doppler measurements. Material and Methods:A total of 213 pregnant women were screened consecutively by combining maternal age, fetal NT and maternal serum pregnancy associated plasma protein A (PAPP-A) and free β-human chorionic gonadotropin (f β-HCG) values at 11-14 weeks of gestation. Also, a DV Doppler analysis was performed for the contribution to the screening for Tri21 and other fetal anomalies or adverse pregnancy outcomes. Results:Twelve fetuses had DV PI measurements above the 95th percentile and two (17%) developed intrauterine growth retardation. DV PI values negatively correlated with birth weight (p=0.013, r=0.171). Two patients had T 21 among the study group (0.9%) with abnormal biochemical screening results. In these with Tri21, the combined test risk was above the suggested limit (>1/250). PAPP-A was <0.4 MoM in 23, and f β-HCG was >1.91 MoM in 49 patients. The rates of false positivity were 10% for PAPP-A and 22% for f β-HCG. The sensitivity, specificity, positive and negative predictive values of the combined test was 100%, 95%, 20% and 100%, respectively. Conclusion:The combined test has high sensitivity and specificity for Tri21 detection. The addition of DV Doppler ultrasound in the first trimester might have the advantage of predicting some adverse pregnancy outcomes. However, in the Turkish population, further studies with larger numbers of patients will be needed to establish the usefulness of DV for the detection of Tri21 or the prediction of some major cardiac anomalies. (J Turkish-German Gynecol Assoc 2010; 11: 194-8) Abstract ÖzetOriginal Investigation 194

Results of routine first trimester screening tests and following invasive procedures during pregnancy

“…Also, in pregnant women recommended first trimester combined screening test by adding combined test into the clinical use, it is seen that the rate of pregnant women accepting procedure increases significantly. [4] In the studies carried out in Turkey, [5,6] mean f-βhCG values were reported between 0.82 and 1.07 MoM and mean PAPP-A values were reported between 1.06 and 1.61 MoM. In our study group, we found these values as 1.25 and 1.16 MoM, respectively.…”

Relationship Between Body Mass Index And Ductus Venosus Doppler Measurements at 11-14 Gestational Weeks

“…In addition, impaired endothelial development and differentiation and lymphatic abnormalities have been reported to play a role in the disorder. In a study by Özlem et al, [16] maternal age, nuchal translucency, DV Doppler findings were examined in 213 pregnant women between 11-14 gestational weeks. DV PI was >95 p in 12 of 213 patients and in fetuses of two of these pregnants IUGR was detected.…”

Importancia clínica de la evaluación ecográfica de la translucencia nucal fetal

“…Por otro lado, cuando el aumento del valor de la TN está asociado a pérdida o inversión de la onda A en la ecografía doppler venosa, el riesgo de CC aumenta aún más (60,61). Por tanto, en estos fetos, la suma de la evaluación doppler venosa, puede mejorar la precisión de la predicción de CC (62).…”