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. 2010 Oct;203(4):408.e1-4.
doi: 10.1016/j.ajog.2010.05.030. Epub 2010 Jul 14.

Are second-trimester minor sonographic markers for Down syndrome useful in patients who have undergone first-trimester combined screening?

Monica Sood  1 , Burton Rochelson, David Krantz, Rachel Ravens, Hima Tam Tam, Nidhi Vohra, Dawnette Lewis, Bidisha Ray
Affiliations

Are second-trimester minor sonographic markers for Down syndrome useful in patients who have undergone first-trimester combined screening?

Monica Sood et al. Am J Obstet Gynecol. 2010 Oct.

Abstract

Objective: We sought to determine efficacy of minor markers for detection of Down syndrome (DS) in a population prescreened with first-trimester combined screening (FTS).

Study design: FTS was modified using established likelihood ratios to generate a new composite risk (NCR).

Results: Of 3845 women, 390 had ≥1 marker. There were 10/3845 cases of DS; 3 were among patients with low-risk FTS (n = 3727). In 55 patients, NCR adjusted the risk from low to high without increasing detection rate. NCR did not modify risk to allow for detection of the 3 DS among patients with low-risk FTS even though 2 of these fetuses had 1 minor marker each. There were 7 DS among patients with high-risk FTS (n = 118). Use of NCR increased positive predictive value from 7/118 (5.1%) to 7/53 (13.2%).

Conclusion: Screening for minor markers is useful in patients with high-risk FTS. It is of questionable benefit in patients with low-risk FTS.

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