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Prenatal screening for Down's syndrome.British Medical Journal, 303
- Publisher
- SAGE
- Copyright
- © 1992 Association for Clinical Biochemistry
- ISSN
- 0004-5632
- eISSN
- 1758-1001
- DOI
- 10.1177/000456329202900504
- pmid
- 1280026
- Publisher site
- See Article on Publisher Site
Abstract
To ascertain the value of maternal serum free β-human choriogonadotropin subunit measurement in Down's syndrome screening and to compare its effectiveness when screening with a variety of biochemical markers, we have evaluated maternal serum free β-human choriogonadotropin, total human choriogonadotropin, α-fetoprotein and unconjugated oestriol in a large multicentre study of over 2800 unaffected cases and 90 affected cases, the largest collection of Down's cases ever reported.Of all the markers identified to date, free β-human choriogonadotropin is the marker of choice for use in Down's syndrome screening. When used in early gestation (14–16 weeks) in combination with α-fetoprotein and maternal age, it will allow the detection of 77% of Down's cases. A side-by-side comparison with the performance of total human choriogonadotropin shows the superior detection efficiency of free β-human choriogonadotropin. Unconjugated oestriol adds nothing further to the detection rate compared with the use of α-fetoprotein and free β-human choriogonadotropin alone, and its use results in a 1% increase in false positive rate. We conclude that unconjugated oestriol has no value in Down's screening.The superior detection rate obtained using free β-human choriogonadotropin is a result of superior detection of Down's cases in women under 30 years old, where the free β-human choriogonadotropin combination detects 100% more cases than does the total human choriogonadotropin combination.
Journal
Annals of Clinical Biochemistry: An International Journal of Biochemistry and Laboratory Medicine – SAGE
Published: Sep 1, 1992