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The history of the second‐trimester sonographic markers for detecting fetal Down syndrome, and their current role in obstetric practice
Author(s) -
Benacerraf Beryl R.
Publication year - 2010
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.2531
Subject(s) - fetus , medicine , down syndrome , obstetrics , first trimester , second trimester , pregnancy , prenatal diagnosis , ultrasound , biology , radiology , genetics , psychiatry
This review summarizes the development, history and use of second‐trimester sonographic markers for the detection of fetal Down syndrome over three decades. Starting with the nuchal fold thickening in 1985 and culminating in the genetic sonogram in the 1990s. The combination of second‐trimester serum screening with the ultrasound markers improved the detection rate of affected fetuses but also allowed patients to decrease their risk of carrying a fetus with Down syndrome if the genetic sonogram was normal. More recently the role of the genetic sonogram and its markers have changed with the wide spread use of first‐trimester screening. This prior screening ultimately decreases the prevalence of fetal Down syndrome in the second trimester to less than 85% of what it was in the first‐trimester as most fetuses with Down syndrome are now identified early. Current interpretation of the second‐trimester Down syndrome markers must be based on the result of the first trimester and combined screening to achieve the most accurate risk estimate of an affected fetus. Copyright © 2010 John Wiley & Sons, Ltd.