Screening for Common Fetal Trisomies in Twin Pregnancies: First-Trimester Combined, Cell-Free DNA, or Both?
Fetal Diagn Ther
; 46(4): 217-222, 2019.
Article
en En
| MEDLINE
| ID: mdl-30466098
ABSTRACT
OBJECTIVE:
To examine the distribution of risks for fetal trisomies after first-trimester combined screening in twins and to investigate different strategies for clinical implementation of cell-free DNA (cfDNA) testing.METHODS:
We retrospectively analyzed all twin pregnancies undergoing first-trimester combined screening over a 10 years' period. The population was stratified according to various risk cut-offs, and we examined different screening strategies for implementation of cfDNA testing in terms of impact on invasive testing rate, cfDNA test failure rate, and economic costs.RESULTS:
We included 572 twin pregnancies 480 (83.92%) dichorionic and 92 (16.08%) monochorionic. Performing a first-line combined screening and offering cfDNA testing to the group with a risk between 1 in 10 and 1 in 1,000, would lead to an invasive testing rate of 2.45%, and cfDNA testing would be performed in 22.20% of the population. This strategy would be cost-neutral compared to universal combined screening alone.CONCLUSIONS:
First-trimester combined screening results can be used to stratify twin pregnancies into different risk categories and select those that could be offered cfDNA testing. A contingent screening strategy would substantially decrease the need for invasive testing in twins and it would be cost-neutral compared to combined testing alone.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Primer Trimestre del Embarazo
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Trisomía
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Embarazo Gemelar
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Pruebas de Detección del Suero Materno
/
Ácidos Nucleicos Libres de Células
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
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Risk_factors_studies
/
Screening_studies
Límite:
Adult
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Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Fetal Diagn Ther
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
/
OBSTETRICIA
/
PERINATOLOGIA
Año:
2019
Tipo del documento:
Article