How can we tell that the fetus would have severe handicap? -checksum="32047" ends

Objectives:

To examine the effectiveness of first-trimester fetal trisomy 21 screening using a combination of maternal age, nuchal translucency thickness (NT) and maternal serum free beta-human chorionic gonadotropin (beta-hCG) and pregnancy-associated plasma protein-A (PAPP-A) levels in a predominantly Chinese population in Hong Kong.

Methods:

This was a prospective study over a 1.5-year period of 2990 women who underwent combined screening for trisomy 21 between 11 + 0 and 13 + 6 weeks of gestation in a university fetal medicine unit. NT was measured according to the criteria set by The Fetal Medicine Foundation (FMF), maternal serum free beta-hCG and PAPP-A levels were measured, and the risk of trisomy 21 was calculated using The FMF's algorithm. Fetal karyotyping was advised when the risk was 1 : 300 or above. All subjects were followed up for pregnancy and fetal outcome.

Results:

Of the 2990 women who underwent the screening program, 99% were Chinese. There were 57 twin pregnancies, giving a total of 3047 fetuses. Thirty-one percent of the women were 35 years old or above. One hundred and eighty-five (6.1%) fetuses were screen-positive; this included 14 cases of trisomy 21 and 17 cases of other chromosomal abnormalities. The positive predictive value was 16.7%. Among the 2862 screen-negative fetuses, only 18 (0.6%) cases had an unknown fetal outcome. There were no cases in which trisomy 21 was missed and the infant was liveborn.

Conclusion:

First-trimester combined screening for fetal trisomy 21 is highly effective among Chinese subjects.

Please click on the required question.

• 1 What does the term abortion mean?
• 2 What are the legal criteria that permit doctors to terminate a pregnancy in the UK?
• 3 How could we tell if there is a substantial risk that if the child were born it would suffer from such physical abnormalities as to be seriously handicapped - e.g. Down Syndrome?
• 3A What is Tay Sachs and should we test for it?
• 4 How prevalent is pregnancy termination?
• 5 Why do unwanted pregnancies occur?
• 6 I think I may be pregnant and I do not want to have a baby now. What should I do?
• 7 Should I terminate my pregnancy for social reasons?
• 8 How can my pregnancy be terminated?
• 9 What does a suction (surgical) termination of pregnancy involve?
• 10 What is a medical abortion?
• 11 What will happen to me if I have a medical abortion?
• 12 How do medical and surgical pregnancy termination compare?
• 13 What are the chances of medical termination failing?
• 14 What are the risks of pregnancy termination?
• 15 Why is there debate about the ethics of pregnancy termination?
• 16 Support Groups.
• 17 Where can I obtain more information?
  

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

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