Prenatal diagnosis of chromosomal abnormalities in a resource-poor setting |
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Authors: | Lut Geerts |
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Affiliation: | Department of Obstetrics and Gynecology, Tygerberg Hospital, University of Stellenbosch, Cape Town, South Africa |
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Abstract: | ObjectiveTo compare the efficacy and efficiency of systematic, ultrasound-based risk adjustment using a published algorithm with that of a maternal age cutoff of 37 years for the prenatal detection of chromosomal abnormalities (especially autosomal trisomies).MethodsThese approaches were compared in a retrospective study of 136 chromosomal abnormalities confirmed by karyotyping prenatally (n = 46) or postnatally (n = 90). There were 114 autosomal trisomies.ResultsMaternal age was known for 103 fetuses with confirmed abnormalities. The ultrasound-based risk adjustment approach was more sensitive for autosomal trisomy (93.9% vs 44.1%), and karyotyping for younger women with abnormalities on ultrasound was more effective than routine karyotyping in older women (1 trisomy detected in 13.5 vs 42.8 samples, P < 0.001). A lack of screening was the main reason for the postnatal diagnosis.ConclusionUltrasound-based risk adjustment was the more effective approach. |
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Keywords: | Aneuploidy Prenatal diagnosis Ultrasound Low-income country |
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