Antenatal screening policies for Down's syndrome

doi:10.1136/bmj.325.7371.1034

BMJ 2002;325:1034 ( 2 November )

Letters

Antenatal screening policies for Down's syndrome

Audit of Down's syndrome screening is not valid

Serum screening for Down's syndrome is better than age screening

Authors' reply

Audit of Down's syndrome screening is not valid

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

EDITOR $---$ Wellesley et al are unjustified in their view that serum screening for Down's syndrome is not worth while.¹ Theyignore evidence from previous studies that shows the substantialadvantage of serum screening over screening based on maternalage alone.^2-4 Their view is based on the results from two districts,the only two out of the eight where serum screening was routinelyoffered (using the Doubletest).

In these two districts only 24% of affected pregnancies (22 of the 91) were detected antenatally by using serum screening,though the Double test has a detection rate of 58% for a falsepositive rate of 5%.² This could, at least in part, be dueto a low screening uptake (in which case the focus should be onwhy this was so), but the uptake of screening cannot be determinedfrom the paper. It could also be due to affected pregnancies thatwere . . . [Full text of this article]

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