British women do not get most effective or safest test for Down's syndrome

Few pregnant women in the United Kingdom get the most effective or safest antenatal screening tests for Down's syndrome. Most women are offered the double serum test in the second trimester. However, an analysis by Gilbert et al (p 423) shows that measurement of nuchal translucency with or without serum testing in the first trimester, or the quadruple test, would detect more fetuses affected by Down's syndrome and cost the same or less than the second trimester double test. The integrated test is the most effective and safest test currently available but it is also the most expensive. Choice of screening strategy depends on how much service providers are willing to pay, the total budget available, and values on safety.

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Relevant Article

Screening for Down's syndrome: effects, safety, and cost effectiveness of first and second trimester strategies • Commentary: Results may not be widely applicable • Authors' response

R E Gilbert, C Augood, R Gupta, A E Ades, S Logan, M Sculpher, J H P van der Meulen, Euan M Wallace, and Sheila Mulvey
BMJ 2001 323: 423. [Abstract] [Full Text] [PDF]