Abstract

Introduction

Materials & Methods

Results

Discussion & Conclusion

References

Discussion
Board

IMPACT OF SECOND TRIMESTER MATERNAL SERUM SCREENING IN SOUTH AUSTRALIA R Cocciolone, E Gjerde, E Ranieri, RG Ryall, and DW Thomas. The South Australian Maternal Serum Antenatal Screening Programme, Department of Chemical Pathology Women's and Children's Hospital, North Adelaide, South Australia, Australia. Maternal serum screening using four analytes (alphafetoprotein, free alpha and free beta chorionic gonadotrophin, unconjugated estriol) was introduced in South Australia in 1991. Over 85000 pregnancies have been screened. Detection of fetal neural tube defects has been consistently high (86.4%) with a recall rate of 3%. Almost all those undetected were closed lesions. Detection of fetal Down syndrome (trisomy 21) has increased steadily and has exceeded 80% of all affected pregnancies for the past two years. The recall rate has increased from 4.0% to 6.9%, this increase coincident with an increase from 9.2% to 13.5% of mothers more than 35 years at delivery. Increased use of early ultrasound, from 15.1% to 28.9% of all mothers, has seen the number of specimens submitted from pregnancies more than 3 weeks overstated in gestation falling from 1.2% to 0.4%. Uptake of amniocentesis following a result of increased risk of trisomy 21 has increased from 64.9% to 85.1% as confidence in the Programme has grown. Because of the accuracy with which the Programme detects affected pregnancies, maternity hospitals in South Australia now offer amniocentesis and karyotyping to older mothers only after maternal serum screening generates a result indicating increased risk of trisomy 21.

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Poster Number PAcocciolone0325
Keywords: maternal, screening, down syndrome, second trimester, serum