Second-Trimester Ultrasound Markers for Detection of Trisomy 21: Which Markers Are Best?
Publication/Presentation Date
6-1-1997
Abstract
OBJECTIVE: To investigate which second-trimester ultrasound markers for aneuploidy are the most diagnostically efficient in detecting fetal trisomy 21.
METHODS: All second-trimester genetic sonograms performed since November 1, 1992 for women at increased risk for fetal trisomy 21 were analyzed retrospectively. Statistical analysis included descriptive statistics, the test of proportions, and univariate and multivariable logistic regression analysis using trisomy 21 as the dependent variable and ten aneuploidy ultrasound markers as independent variables.
RESULTS: There were 581 normal fetuses, 23 with trisomy 21 and four with other chromosomal abnormalities. When one or more abnormal ultrasound markers were present, the sensitivity and false-positive rate for trisomy 21 were 87% and 13.4%, respectively. After adjusting for confounders, multivariate logistic regression analysis showed the best combination of ultrasound markers for detecting trisomy 21 to be nuchal fold thickening (relative risk [RR] 85.5; 95% confidence interval [CI] 20.4, 357.7), pyelectasis (RR 25.2; 95% CI 6.7, 95.0), and short humerus (RR 20.4; 95% CI 4.5, 92.1). The model combining these three ultrasound markers yielded a sensitivity of 87% and a false-positive rate of 6.7%.
CONCLUSION: By using only three ultrasound markers (combination of nuchal fold thickening, pyelectasis, and short humerus) the false-positive rate is decreased from 13.4% to 6.7% without any compromise in the sensitivity (87%). The clinical usefulness of evaluating the various second-trimester ultrasound markers needs to be evaluated in prospective studies.
Volume
89
Issue
6
First Page
941
Last Page
944
ISSN
0029-7844
Published In/Presented At
Vintzileos, A. M., Campbell, W. A., Guzman, E. R., Smulian, J. C., McLean, D. A., & Ananth, C. V. (1997). Second-trimester ultrasound markers for detection of trisomy 21: which markers are best?. Obstetrics And Gynecology, 89(6), 941-944.
Disciplines
Diseases | Maternal, Child Health and Neonatal Nursing | Medical Sciences | Medical Specialties | Medicine and Health Sciences | Obstetrics and Gynecology
PubMedID
9170470
LVHN link
http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=9170470&site=ehost-live&scope=site
Department(s)
Department of Obstetrics and Gynecology, Department of Obstetrics and Gynecology Faculty
Document Type
Article