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Рабочая группа по диагностике и лечению обмороков Европейского общества кардиологов (ESC) Подготовлены в сотрудничестве с Европейской ассоциацией сердечного ритма (EHRA) 1 , Ассоциацией сердечной недостаточности (HFA) 2 и Обществом сердечного ритма (HRS) 3 Одобрены Европейским обществом неотложной медицины (EuSEM) 4 , Европейской федерацией внутренней медицины (EFIM) 5 , Европейским обществом гериатрической медицины (EUGMS) 6 , Американским обществом гериатрии (AGS), Европейским неврологическим обществом (ENS) 7 , Европейской федерацией обществ вегетативной нервной системы (EFAS) 8 , Американским обществом вегетативной нервной системы (AAS) 9 Авторы (члены рабочей группы): Angel Moya (Председатель) (Испания)*, Richard Sutton (Сопредседатель) (Великобритания)*

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<b><i>Introduction:</i></b> Contingent cell-free (cf) DNA screening on the basis of the first-trimester combined test (FCT) results has emerged as a cost-effective strategy for screening of trisomy 21 (T21). <b><i>Objectives:</i></b> To assess performance, patients’ uptake, and cost of contingent cfDNA screening and to compare them with those of the established FCT. <b><i>Methods:</i></b> This is a prospective cohort study including all singleton pregnancies attending to their FCT for screening of T21 at 2 university hospitals in South Spain. When the FCT risk was ≥1:50, there were major fetal malformations, or the nuchal translucency was ≥3.5 mm, women were recommended invasive testing (IT); if the risk was between 1:50 and 1:270, women were recommended cfDNA testing; and for risks bellow 1:270, no further testing was recommended. Detection rate (DR), false-positive rate (FPR), patients’ uptake, and associated costs were evaluated. <b><i>Results:</i></b> We analyzed 10,541 women, including 46 T21 cases. DR of our contingent strategy was 89.1% (41/46) at 1.4% (146/10,541) FPR. Uptake of cfDNA testing was 91.2% (340/373), and overall IT rate was 2.0%. The total cost of our strategy was €1,462,895.7, similar to €1,446,525.7 had cfDNA testing not been available. <b><i>Conclusions:</i></b> Contingent cfDNA screening shows high DR, low IT rate, and high uptake at a similar cost than traditional screening.