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Screening for Chromosomal Anomalies

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Perinatology

Abstract

Screening for chromosomal anomalies has evolved much since the 1970s. Methods include history, maternal biochemistry, ultrasonographic markers, and the detection of cell-free fetal DNA (cffDNA) on maternal serum. Best results are achieved by combining multiple methods. When providing screening for these conditions, importance should be given to correct counseling, as a screen-positive pregnancy does not mean an affected fetus, thereby indicating the need for a diagnostic procedure before decisions are made. Maternal age alone should not be used for screening because of the low detection rate. Services must choose the most appropriate method for screening based on the resources available.

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References

  1. United Nations: https://www.un.org/en/events/downsyndromeday/background.shtml

  2. Mai CT, et al. National population-based estimates for major birth defects, 2010–2014. Birth Defects Res. 2019:1–16.

    Google Scholar 

  3. Akolekar R, et al. Procedure-related risk of miscarriage following amniocentesis and chorionic villus sampling: a systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2015;45:16–26.

    Article  CAS  Google Scholar 

  4. Renshaw R, et al. Antenatal screening for Down syndrome: a quantitative demonstration of the improvements over the past 20 years. J Health Serv Res Policy. 2013;18(4):195–201.

    Article  Google Scholar 

  5. Nicolaides KH. Screening for aneuploidies at 11 to 13 weeks. Prenat Diagn. 2011;31:7–15.

    Article  Google Scholar 

  6. Evans MI, et al. Meta-analysis of first trimester Down syndrome screening studies: free β-human chorionic gonadotropin significantly outperforms intact human chorionic gonadotropin in a multimarker protocol. Am J Obstet Gynecol. 2007;196(3):198–205.

    Article  CAS  Google Scholar 

  7. Noble PL, et al. Maternal serum inhibin-A and free beta-hCG concentrations in trisomy 21 pregnancies at 10 to 14 weeks of gestation. Br J Obstet Gynaecol. 1997;104(3):367–71.

    Article  CAS  Google Scholar 

  8. Brizot ML, et al. First trimester maternal serum alpha-fetoprotein in fetal trisomies. Br J Obstet Gynaecol. 1995;102(1):31–4.

    Article  CAS  Google Scholar 

  9. Wright D, et al. First-trimester screening for trisomies 21, 18 and 13 by ultrasound and biochemical testing. Fetal Diagn Ther. 2014;35(2):118–26.

    Article  CAS  Google Scholar 

  10. Souka AP, et al. Assessment of fetal anatomy at the 11-13-week ultrasound examination. Ultrasound Obstet Gynecol. 2004;24:730–4.

    Article  CAS  Google Scholar 

  11. Nicolaides KH. The 11–13+6 weeks scan. London: Fetal Medicine Foundation; 2014.

    Google Scholar 

  12. Wald NJ, et al. SURUSS in perspective. BJOG. 2004;111:521.

    Article  CAS  Google Scholar 

  13. Wright D, et al. A mixture model of nuchal translucency thickness in screening for chromosomal defects. Ultrasound Obstet Gynecol. 2008;31:376–83.

    Article  CAS  Google Scholar 

  14. Sonek JD. Nasal bone evaluation with ultrasonography: a marker for fetal aneuploidy. Ultrasound Obstet Gynecol. 2003;22:11.

    Article  CAS  Google Scholar 

  15. Cicero S, et al. Learning curve for sonographic examination of the fetal nasal bone at 11-14 weeks. Ultrasound Obstet Gynecol. 2003;22:135.

    Article  CAS  Google Scholar 

  16. Cicero S, et al. Likelihood ratio for trisomy 21 in fetuses with absent nasal bone at the 11-14-week scan. Ultrasound Obstet Gynecol. 2004;23:218.

    Article  CAS  Google Scholar 

  17. Mavrides E, et al. Screening for aneuploidy in the first trimester by assessment of blood flow in the ductus venosus. BJOG. 2002;109:1015.

    Article  Google Scholar 

  18. Maiz N, et al. Ductus venosus Doppler in screening for trisomies 21, 18 and 13 and Turner syndrome at 11-13 weeks of gestation. Ultrasound Obstet Gynecol. 2009;33:512.

    Article  CAS  Google Scholar 

  19. Maiz N, Plasencia W, Dagklis T, et al. Ductus venosus Doppler in fetuses with cardiac defects and increased nuchal translucency thickness. Ultrasound Obstet Gynecol. 2008;31:256.

    Article  CAS  Google Scholar 

  20. Kagan KO, et al. Tricuspid regurgitation in screening for trisomies 21, 18 and 13 and Turner syndrome at 11 + 0 to 13 + 6 weeks of gestation. Ultrasound Obstet Gynecol. 2009;33:18–22.

    Article  CAS  Google Scholar 

  21. Scala C, et al. Fetal tricuspid regurgitation in the first trimester as a screening marker for congenital heart defects: systematic review and meta-analysis. Fetal Diagn Ther. 2017;42:1–8.

    Article  Google Scholar 

  22. Breathnach FM, et al. The second trimester genetic sonogram. Am J Med Genet Part C Semin Med Genet. 2006;145C:62–72.

    Article  Google Scholar 

  23. Agathokleous M, et al. Meta-analysis of second-trimester markers for trisomy 21. Ultrasound Obstet Gynecol. 2013;41:247–61.

    Article  CAS  Google Scholar 

  24. The American College of Obstetricians and Gynecologists. Practice Bulletin number 163 - screening for fetal aneuploidy. Obstet Gynecol. 2016;127:e123–37.

    Article  Google Scholar 

  25. Mackie FL, et al. The accuracy of cell-free fetal DNA-based non-invasive prenatal testing in singleton pregnancies: a systematic review and bivariate meta-analysis. BJOG. 2017;124(1):32–46.

    Article  CAS  Google Scholar 

  26. Gil MM, et al. Analysis of cell-free DNA in maternal blood in screening for aneuploidies: updated meta-analysis. Ultrasound Obstet Gynecol. 2017;50:302–14.

    Article  CAS  Google Scholar 

  27. Taylor-Phillips S, et al. Accuracy of non-invasive prenatal testing using cell-free DNA for detection of Down, Edwards and Patau syndromes: a systematic review and meta-analysis. BMJ Open. 2016;6(1):e010002.

    Article  Google Scholar 

  28. Nicolaides KH. Nuchal translucency and other first-trimester sonographic markers of chromosomal abnormalities. Am J Obstet Gynecol. 2004;191:45e67.

    Article  Google Scholar 

  29. Veduta A, et al. The first trimester combined test for aneuploidies – a single center experience. J Matern Fetal Neonatal Med. 2017;31(16):2091–6.

    Article  Google Scholar 

  30. Johnson J, et al. First-trimester Down syndrome screening using additional serum markers with and without nuchal translucency and cell-free DNA. Prenat Diagn. 2013;33:1044–9.

    Article  CAS  Google Scholar 

  31. Wald NJ, et al. Antenatal screening for Down’s syndrome. J Med Screen. 1997;4:181–246.

    Article  CAS  Google Scholar 

  32. Wald NJ, et al. First and second trimester antenatal screening for Down’s syndrome: the results of the Serum, Urine and Ultrasound Screening Study (SURUSS). Health Technol Assess. 2003;7(11):1.

    Article  CAS  Google Scholar 

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da Silva Costa, F., Ragazini, C.S. (2022). Screening for Chromosomal Anomalies. In: Moreira de Sá, R.A., Fonseca, E.B.d. (eds) Perinatology. Springer, Cham. https://doi.org/10.1007/978-3-030-83434-0_5

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  • DOI: https://doi.org/10.1007/978-3-030-83434-0_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-83433-3

  • Online ISBN: 978-3-030-83434-0

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