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Fetal Diagn Ther. 2012;31(4):221-9. doi: 10.1159/000337322. Epub 2012 May 17.

A mixture model of ductus venosus pulsatility index in screening for aneuploidies at 11-13 weeks' gestation.

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  • 1Fetal Medicine Unit, Obstetrics and Gynecology Department, Cruces University Hospital, Biscay, Spain.

Abstract

OBJECTIVE:

To assess the value of ductus venosus pulsatility index for veins (DV PIV) in screening for aneuploidies at 11-13 weeks' gestation.

METHODS:

Fetal DV PIV was measured in singleton pregnancies undergoing first-trimester screening for aneuploidies. In euploid (n = 44,756) and aneuploid (202 cases of trisomy 21, 72 cases of trisomy 18 and 30 cases of trisomy 13) fetuses, DV PIV was best described by a mixture model of distributions. Performance of screening for aneuploidies by DV PIV alone and in combination with fetal nuchal translucency (NT) thickness and serum free β-hCG and PAPP-A was estimated.

RESULTS:

In euploid pregnancies there was a bimodal distribution of DV PIV with a dominant crown-rump length (CRL)-dependent part, accounting for around 97% of cases in Caucasians and around 93% in Afro-Caribbeans, and a smaller CRL-independent distribution. In aneuploidies the dominant part was the CRL-independent distribution, which accounted for around 85% cases of trisomies 21 and 18 and 70% of cases of trisomy 13. In screening for trisomy 21 by maternal age, NT and biochemistry at a risk cutoff of 1 in 100, the detection rate was 89.7% and false positive rate was 2.74%; with addition of DV PIV, the values were 93.5 and 1.63%, respectively.

CONCLUSIONS:

Measurement of DV PIV improves the performance of first-trimester combined test for aneuploidies.

Copyright © 2012 S. Karger AG, Basel.

PMID:
22614037
[PubMed - indexed for MEDLINE]
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