Screening for Down's syndrome

doi:10.1136/bmj.321.7263.762/a

BMJ 2000;321:762 ( 23 September )

Letters

Screening for Down's syndrome

Biochemical screening offers advantages

Serum screening shows a clear benefit across age groups

Data do not support study's claim

Statistical modelling is best tool for formulating screening policy

Serum screening programmes are effective and safe

A large independent trial would be useful

Authors' reply

Biochemical screening offers advantages

The first 150 words of the full text of this article appear below.

EDITOR $---$ We were interested in the findings of Howe et al on screening for Down's syndrome in Southampton and their suggestionthat the benefits of mid-trimester serum screening have been overrated.¹The Women's Centre at the John Radcliffe Hospital in Oxford hasa similar population in terms of the number of deliveries andthe percentage of women having prenatal karyotyping (7%) and hasa similar screening policy for Down's syndrome: amniocentesisoffered to women aged $>=$ 35 at expected date of delivery; no serumor nuchal translucency screening through the NHS (some women organisethis privately). The population at the Women's Centre has a higherdistribution in maternal age (16% aged $>=$ 35, compared with 10%inSouthampton).

We performed a similar analysis on 78 cases of Down's syndrome in 1993-8 in which the fetus was alive at the time of scan(table). Forty three (55%) cases were diagnosed prenatally before24 weeks' gestation; . . . [Full text of this article]

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Relevant Article

Six year survey of screening for Down's syndrome by maternal age and mid-trimester ultrasound scans: David T Howe, Robert Gornall, Diana Wellesley, Tracy Boyle, and John Barber
BMJ 2000 320: 606-610. [Abstract] [Full Text] [PDF]