The diagnostic value of combined test for trilogy 21 and 18 screening in over 35 years old pregnant women in the gestational age of 9-14 weeks

Shahshahan, Z.; Azami, N.
June 2014
Iranian Journal of Reproductive Medicine;Jun2014 Supplement, Vol. 12, p76
Academic Journal
Introduction: Early diagnosis of congenital anomalies can prevent the birth of these children. The Step-wise sequential test has the most sensitivity in this regard; but because of the religious and legal rules in our country (the abortion must be done before 17 weeks of gestation or 19 weeks of LMP), it is better to use a test that is performed in first trimester and has high sensitivity rate. We aimed to estimate the diagnosis value of combined test (free beta-hCG, nuchal translucency, and pregnancy-associated protein A) for trisomy 21 and 18. Materials and Methods: In this cross sectional study, 380 pregnant women who were more than 35y, referred to Beheshti and Alzahra clinics at 9-14 weeks of gestation were enrolled. Combines test analysis was done with Alpha software, cases was divided to high and low-risk portions for trisomy 21 and 18. The high risks went on amniocentesis and the other group followed after birth for detecting if there were any signs of syndromes manifestation. Results: For trisomy 21, the sensitivity of combined test was 100%, and the specificity was 96.4%. For trisomy 18, it was 75% for the sensitivity and 100% for the specificity, with a false positive rate of 0%. Conclusion: Regarding to high sensitivity and specificity of the combined test in our population compared to other societies, we can use this test with more confidence. So, diagnosing the maternal anomalies in early first trimester could be done and we could terminate pregnancies with proven trisomy 21 and 18 legally.


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