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Federación Mexicana de Ginecología y Obstetricia, A.C.

2015, Number 05

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Ginecol Obstet Mex 2015; 83 (05)

Prenatal screening for anueploidies in the first trimester: Audit to a Fetal Medicine Centre with specialized Laboratory in Mexico

Oviedo-Cruz H, Hernández-Paredes J, Vanessa Ruíz-Ramírez A

Language: Spanish
References: 40
Page: 259-276
PDF size: 800.49 Kb.


ABSTRACT

Background: Screening for aneuploidies using ultrasound and biochemical first trimester markers has an expected performance if the qualification requirements are fulfilled.
Objective: To describe the first trimester markers in Mexico through the audit to a Fetal Medicine Centre and Laboratory.
Material and method: Descriptive study conducted with the audit method of ultrasound and biochemical markers in pregnancies that prenatal screening tests in the first quarter were made between 11 + 1 and 14 + 1 weeks pregnant patients who came to the Laboratorio del Centro Médico para Atención Fetal Especializada.
Results: In 17 months n=1020 pregnancies, 962 (94.3%) single, 55 (5.4%) doubles, and 3 (0.3%) triplets. Median maternal age of 33.8 years (16-52), 413 (40.5%) ≥ 35 years. 1080 foetuses with 1009 valid measurements of nuchal translucency (29.8% at external cabinets), 54% ›p50; 7.3% ›p95, and 1.6% › p99. Out of 1555 sera processed at the Laboratory (f-β-hCG and PAPP-A, Roche®), 641 (41.2%) were interpreted at external centres. In 914 sera the f-β-hCG MoM were p50 = 0.72, 3.2% ›p95; for PAPP-A, p50 = 0.89, 9.0% ‹p5. There were 850 combined tests, and in 745 an additional marker was added; the IP ductus venosus median was 0.99 MoM. A risk ≥ 1 in 100 resulted in 50 foetuses (4.6%); 27 underwent invasive procedure at our Centre, 19 normal karyotypes, and 8 abnormal as: 3 trisomy 21 and 5 diverse aneuploidies.
Conclusions: The qualification requirements are fulfilled for nuchal translucency, ductus venosus, and the combined test; 1 out of 3 invasive procedures resulted an aneuploidy; the estimated false positive rate is 3.9%. The Laboratory will adjust the median values of the biochemical markers. A cohort study has begun.


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