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. 2011 Oct;205(4):364.e1-5.
doi: 10.1016/j.ajog.2011.06.107. Epub 2011 Aug 27.

First-trimester screening in triplets

David A Krantz  1 , Terrence W Hallahan, Kuanglin He, John E Sherwin, Mark I Evans
Affiliations

First-trimester screening in triplets

David A Krantz et al. Am J Obstet Gynecol. 2011 Oct.

Abstract

Objective: The purpose of this study was to determine the performance of Down syndrome screening in triplet pregnancy.

Study design: Nuchal translucency (NT; n = 794), nasal bone (n = 219), and biochemistry (n = 198) were evaluated in triplet pregnancy. Screening performance was evaluated with the use of delta and Gaussian models.

Results: The median multiples of the median values for free beta human chorionic gonadotropin and pregnancy-associated plasma protein A were 2.86 and 3.48, respectively. A significant correlation in delta NT within pregnancy was observed (0.46-0.68). The modeled false-positive rates were 11.7%, 7.4%, and 8.9% with the delta model and 11.9%, 6.6%, and 12.0% with the Gaussian model for NT, NT + nasal bone, and NT + biochemistry. Based on simulation, the detection rate at 12 weeks' gestation was 78%, 93%, and 80% for NT, NT + nasal bone, and NT + biochemistry at a 10% false-positive rate using either the delta or Gaussian models.

Conclusion: In triplet pregnancy, the addition of nasal bone lowers the false-positive rate of nuchal translucency screening. More data are required on the effectiveness of biochemistry.

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