Strategies for antenatal detection of Down's syndrome
Northern Regional
Congenital Abnormality Survey
Correspondence to: Dr Christopher Wren, Department of Paediatric Cardiology, Freeman Hospital, Newcastle upon Tyne NE7 7DN
Accepted 4 November 1996
AIM
To predict the effect of maternal serum
screening and fetal echocardiography on the birth prevalence of Down's syndrome.
METHODSThe outcome of all Down's syndrome
pregnancies in the Northern Health Region between 1985 and 1991 was
retrospectively ascertained. The number and outcome of all Down's
syndrome pregnancies were used to define a theoretical population which
would exist in the absence of screening. Published reports were used to
predict the effects of screening strategies.
RESULTSDown's syndrome was identified in 412 pregnancies of which 315 (76%) resulted in live birth. A theoretical
population with no antenatal screening would be expected to produce 31 stillbirths and 381 (92%) live births affected by Down's syndrome. In
the same population a programme of maternal serum screening and fetal echocardiography would lead to 155 and 14 terminations, respectively, and when combined, would reduce affected live births to 229 (56%).
CONCLUSIONSEven if maternal serum screening and
fetal echocardiography achieve their predicted potential, around half
of all pregnancies affected by Down's syndrome will result in live
born babies.
© 1997 by Archives of Disease in Childhood
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This article has been cited by other articles:
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Alderson, P.
(2001). Prenatal Screening, Ethics and Down's Syndrome: a literature review. Nurs Ethics
8: 360-374
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