Authors:
Saridogan E. Djahanbakhch O. Naftalin AA.
Institution:
Newham General Hospital, Glen Road,Plaistow, London E13 8RU; United Kingdom.
Title:
Screening for Down Syndrome: Experience in an inner city health district.
Source:
British Journal of Obstetrics and Gynaecology. Vol 103(12) (pp205-1211),
1996.
Abstract:
Objectives:
To review the experience of Down Syndrome screening in an inner city health district.
Design:
In this retrospective study the names of the women were obtained from the Regional Cytogenetic Laboratory and District Down Syndrome Register. Antenatal notes of the mothers were studied. Maternal age during the affected pregnancy, screening test performed if any, gestational age at booking and at screening, screening test results, and pregnancy outcome were reviewed.
Setting:
An inner city health district.
Population:
Down Syndrome cases diagnosed prenatally and postnatally. Interventions None.
Results:
Antenatal diagnosis of Down Syndrome was made in 15/45 women (33.3%); Edwards' syndrome was diagnosed antenatally in 215 women. Screening was not performed in eight women (17.8%) whose infants were affected by Down Syndrome; it was also not performed in one woman whose baby was affected by Edwards' syndrome due to late presentation to the antenatal clinic or loss of the blood sample. Nineteen women (42.2%) with a Down Syndrome pregnancy and two women with a Edwards' syndrome pregnancy had had a negative screening test. Three women had had a positive screening test but declined amniocentesis. Among those who had a screening test, the overall detection rate of screening was 48.6% (18/37) for Down Syndrome and 50% (2/4) for Edwards' syndrome. The detection rates in different ethnic groups did not show significant difference. Four women chose not to have termination following diagnosis of Down Syndrome, giving a total reduction rate of 21%.
Conclusion:
Screening programmes for Down Syndrome have not yet resulted in a substantial reduction in the number of affected babies. In addition to trials at developing screening programmes with better detection rates, efforts should be made to improve the provision of the screening service and the quality of antenatal care in general with emphasis on early presentation and optimal understanding of the implications of the tests.
Please click on the required question.
- 1 What does the term abortion mean?
- 2 What are the legal criteria that permit doctors to terminate a pregnancy in the UK?
- 3 How could we tell if there is a substantial risk that if the child were born it would suffer from such physical abnormalities as to be seriously handicapped - e.g. Down Syndrome?
- 3A What is Tay Sachs and should we test for it?
- 4 How prevalent is pregnancy termination?
- 5 Why do unwanted pregnancies occur?
- 6 I think I may be pregnant and I do not want to have a baby now. What should I do?
- 7 Should I terminate my pregnancy for social reasons?
- 8 How can my pregnancy be terminated?
- 9 What does a suction (surgical) termination of pregnancy involve?
- 10 What is a medical abortion?
- 11 What will happen to me if I have a medical abortion?
- 12 How do medical and surgical pregnancy termination compare?
- 13 What are the chances of medical termination failing?
- 14 What are the risks of pregnancy termination?
- 15 Why is there debate about the ethics of pregnancy termination?
- 16 Support Groups.
- 17 Where can I obtain more information?
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