FASTER - First-trimester or Second-trimester Screening or Both, for Downs Syndrome Flashcards Preview

Landmark Trials > FASTER - First-trimester or Second-trimester Screening or Both, for Downs Syndrome > Flashcards

Flashcards in FASTER - First-trimester or Second-trimester Screening or Both, for Downs Syndrome Deck (10)
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1

Journal
Year

The New England Journal of Medicine 2005

2

Aims

To investigate the best way to screen women for fetal Down’s syndrome

3

Study Design

Observational study

4

Participants

38,167 women with singleton pregnancies

5

Inclusion Criteria:

● Maternal age of 16 years or older
● Singleton pregnancy with a live fetus and a fetal CRL of 36-79mm at study entry

6

Exclusion Criteria

● Prior measurement of nuchal translucency
● Previously diagnosed anencephaly of the fetus

7

Intervention

Women underwent first-trimester combined screening (NT + PAPP-A + B-HCG) and second trimester quadruple screening (AFP + B-HCG + estriol + inhibin A) comparing the results of step-wise screening, fully integrate screening, and serum integrated screening.

8

Primary end-points

● High risk was defined as:
○ 1 in 150 for 1st trimester screening
○ 1 in 300 for 2nd trimester screening

9

Summary of results

● With a 5% false positive rate, detection of Down’s Syndrome were as follows:
○ 1st trimester combined 87% at 11w, 85% at 12w, 82% at 13w
○ Second-trimester quadruple screening 81%
○ Stepwise sequential screening 95%
○ Serum integrated screening 88%
○ Fully integrated screening 96%

10

Conclusion

First trimester combined screening at 11w is better than second trimester quadruple screening but at 13 w has similar results. Both stepwise sequential screening and fully integrated screening have high rates of detection of Down’s syndrome, with low false positive rates.