Second-Trimester Dimeric Inhibin-a in Down's Syndrome Screening

Spencer, Kevin; Wallace, Euan M.; Ritoe, Savitri C.

doi:10.1002/(sici)1097-0223(199612)16:12<1101::aid-pd5>3.0.co;2-7

Cited by 58 publications

(18 citation statements)

References 32 publications

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“…In comparison, the median increase in risk with the addition of inhibin A to triple markers was 1·8-fold in a previous study of 20 cases of Down syndrome (Lambert-Messerlian et al, 1996). Also, several large studies have shown that the addition of inhibin A to double and triple-marker screening protocols results in a 7-22 per cent increase in detection of fetal Down syndrome (Aitken et al, 1996;Cuckle et al, 1996;Wald et al, 1996;Spencer et al, 1996;Wenstrom et al, 1997). Therefore, if inhibin A measurement were added to prenatal serum screening protocols to enhance Down syndrome detection, it would be likely to enhance detection of Turner syndrome with hydrops as well.…”

Section: Discussionmentioning

confidence: 81%

“…Measurement of maternal serum inhibin A appears to be a useful addition to second-trimester prenatal screening for Down syndrome (Canick et al, 1994;Aitken et al, 1996;Cuckle et al, 1996;Wallace et al, 1996;Wald et al, 1996;Lambert-Messerlian et al, 1996;Spencer et al, 1996;Wenstrom et al, 1997), adding a minimum of seven per cent to the detection rate achieved with multiple marker screening. In this study, we have examined levels of maternal serum inhibin A in trisomy 18 and Turner syndrome cases and have explored how the introduction of inhibin A to clinical screening might affect the detection of these aneuploidies.…”

Section: Introductionmentioning

confidence: 99%

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Second-trimester maternal serum inhibin A levels in fetal trisomy 18 and Turner syndrome with and without hydrops

et al. 1998

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The objective was to investigate whether cases of fetal trisomy 18 and Turner syndrome with and without hydrops were associated with alterations in the second‐trimester levels of maternal serum inhibin A. Twenty‐one cases of trisomy 18, 10 cases of Turner syndrome without hydrops and 12 cases of Turner syndrome with hydrops were identified. Five control samples were matched to each case for date of sample collection and completed week of gestation. Inhibin A levels were modestly, but significantly reduced in cases of trisomy 18 (median=0·88 MoM) and Turner syndrome without hydrops (median=0·64 MoM). In contrast, inhibin A levels were markedly increased in cases of Turner syndrome with hydrops (median=3·91 MoM). These data for Turner syndrome are similar to those for human chorionic gonadotropin (hCG). The addition of inhibin A to multiple marker screening (alpha‐fetoprotein, unconjugated oestriol and hCG) resulted in a median increase in the Down syndrome risk of 2·6‐fold in cases of Turner syndrome with hydrops. The addition of inhibin A to multiple marker Down syndrome screening programmes will be likely to enhance the detection of fetal Turner syndrome with hydrops, but will not contribute substantially to the detection of fetal trisomy 18. Copyright © 1998 John Wiley & Sons, Ltd.

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Section: Discussionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Second-trimester maternal serum inhibin A levels in fetal trisomy 18 and Turner syndrome with and without hydrops

et al. 1998

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“…Dimeric inhibin A has been reported to meet these criteria. [4][5][6][7][8][9][10][11] Inhibins are circulating dimeric glycoprotein hormones synthesised by the gonads and the placenta. The subunit can combine with one of two subunits ( A and B) to form inhibin A or inhibin B. Inhibin precursors are also present in maternal circulation.…”

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confidence: 99%

Second trimester screening for Down's syndrome using maternal serum dimeric inhibin A

et al. 1998

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“…It is also clear that adding a fourth marker, dimeric inhibin A, to the triple test (the "quad test") further increases the detection rate. [108][109][110][111][112] Second-trimester screening is further improved by correlating biochemical markers with sonographic findings, just as sonography and biochemical screening are better combined during the first trimester. Indeed, some reports indicate that second-trimester sonography and biochemistry might also be able to achieve detection rates of 90% or more with a low-false positive rate.…”

Section: Is First-trimester Screening More Effective Than Second-trimmentioning

confidence: 99%

Sonographic screening for fetal aneuploidy: first trimester.

Souter¹,

Nyberg²

2001

J of Ultrasound Medicine

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Objectives. Screening for fetal aneuploidy is now possible during the first trimester using sonographic and biochemical markers. The aim of this review was to summarize the efficacy and use of nuchal translucency in screening for fetal aneuploidy, especially fetal Down syndrome, and other anomalies. Methods. We reviewed available literature regarding first-trimester screening. This includes more than 16 studies of nuchal translucency as a marker for fetal aneuploidy published since 1995. Results. Although early studies showed wide variation in detection of fetal Down syndrome when using nuchal translucency, more recent studies showed sensitivities of approximately 70% to 80%, for a 5% false-positive rate. Increased nuchal translucency has also been found to be a marker for other aneuploidies, including trisomy 18, trisomy 13, and Turner syndrome. Maternal serum biochemical screening can be used as a test for aneuploidy during the first trimester. The 2 maternal serum markers that appear to be most useful in the late first trimester are the free β subunit of human chorionic gonadotropin and pregnancy-associated plasma protein A. Together with maternal age, these markers yield a detection rate for trisomy 21 of approximately 60%, for a 5% false-positive rate. Because sonographic and biochemical markers appear to be largely independent, their combined risk results in improved detection rates compared with either method alone. As a result, the combination of nuchal translucency, biochemical markers, and maternal age has achieved a detection rate of approximately 85%, for a 5% false-positive level for detection of trisomy 21. A newly proposed "integrated" approach using a panel of first-and second-trimester markers suggests that further improvement in the screening performance is possible. A number of questions regarding first-trimester screening remain. We address some of these questions: Is first-trimester screening more effective than second-trimester screening? How to account for intrauterine lethality? Is earlier diagnosis important, and will it be accepted by patients? Is first-trimester screening cost-effective? How should first-trimester screening be interpreted with second-trimester tests? Conclusions. Despite encouraging data and general enthusiasm for first-trimester screening for fetal Down syndrome and other aneuploidies, a number of questions remain about its implementation in the United States. Multicenter studies currently under way should help answer some of these questions.

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Second-Trimester Dimeric Inhibin-a in Down's Syndrome Screening

Cited by 58 publications

References 32 publications

Second-trimester maternal serum inhibin A levels in fetal trisomy 18 and Turner syndrome with and without hydrops

Second-trimester maternal serum inhibin A levels in fetal trisomy 18 and Turner syndrome with and without hydrops

Second trimester screening for Down's syndrome using maternal serum dimeric inhibin A

Sonographic screening for fetal aneuploidy: first trimester.

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