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LETTER TO THE EDITOR. ULTRASOUND DATING IN FIRST-TRIMESTER BIOCHEMICAL SCREENING FOR DOWN SYNDROME

✍ Scribed by A. BORRELL; M. T. FARRÉ; D. COSTA; A. FORTUNY

Publisher
John Wiley and Sons
Year
1996
Tongue
English
Weight
125 KB
Volume
16
Category
Article
ISSN
0197-3851

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✦ Synopsis

Ultrasound dating in first-trimester biochemical screening for Down syndrome

We have read with interest the article by Macintosh ef al. (1995) which describes the effects of ultrasound estimation of gestational age on the performance of first-trimester biochemical screening for fetal aneuploidy.

In this study, the crown-rump length (CRL) measurement had the effect of crediting aneuploid fetuses a mean of 2.5 days less in estimation of gestational age than expected by the last menstrual period (LMP). Consequently, the maternal serum PAPP-A (MS-PAPP-A) value expressed as multiples of the mean for euploid pregnancies resulted in a smaller reduction than the value derived from gestational age based on dates. Therefore, ultrasound dating would lead to a significant underdetection for aneuploidy. In relation specifically to Down syndrome, the detection rate by means of PAPP-A was not significantly reduced (3 per cent) when ultrasound rather than dates was used to estimate gestational age.

In our unit, we have studied 1637 consecutive first-trimester pregnancies (9-1 3 weeks) undergoing transcervical chorionic villus sampling,

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