{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T13:36:01Z","timestamp":1777037761308,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2002,5,28]],"date-time":"2002-05-28T00:00:00Z","timestamp":1022544000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2002,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Trisomy 21 maternal serum marker screening has led to screening for other anomalies, including trisomy 18. Trisomy 18 is generally prenatally diagnosed because of major morphological defects. However, in up to 30% of cases ultrasound signs are unclear, and in most cases diagnosis is performed late in pregnancy. Of the different maternal serum markers, PAPP\u2010A is now considered as the best for trisomy 18 screening. However, pregnancy\u2010associated plasma protein A (PAPP\u2010A) is of value in first trimester screening for trisomy 21, but not in the second trimester. We therefore propose a two\u2010step screening strategy. Based on 45 trisomy 18 cases, we confirm the values of alpha\u2010fetoprotein (AFP) (median 0.61\u2009MoM), free \u03b2\u2010human chorionic gonadotrophin (\u03b2\u2010hCG) (median 0.24\u2009MoM) and of PAPP\u2010A (median 0.08\u2009MoM). In the first step, a 0.5\u2009MoM cut\u2010off for AFP or for free \u03b2\u2010hCG resulted in detection of 37\/45 trisomy 18 cases (82%) with a 10% false\u2010positive rate. The second step consisted of the measurement of PAPP\u2010A for all these false\u2010positive cases. Using a PAPP\u2010A cut\u2010off of 0.5\u2009MoM, all the 37 trisomy 18 cases were detected, but now with a 0.1\u20130.2% false\u2010positive rate. Amniocentesis was only offered to these few patients. This two\u2010step second trimester screening will be of value for patients who have not been included in first trimester screening based on nuchal translucency (NT) measurement combined with the first trimester markers, PAPP\u2010A and free \u03b2\u2010hCG. Copyright \u00a9 2002 John Wiley &amp; Sons, Ltd.<\/jats:p>","DOI":"10.1002\/pd.345","type":"journal-article","created":{"date-parts":[[2002,9,11]],"date-time":"2002-09-11T02:05:28Z","timestamp":1031709928000},"page":"605-608","source":"Crossref","is-referenced-by-count":21,"title":["Second trimester two\u2010step trisomy 18 screening using maternal serum markers"],"prefix":"10.1002","volume":"22","author":[{"given":"Fran\u00e7oise","family":"Muller","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corinne","family":"Sault","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Lemay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathalie","family":"Roussel\u2010Mizon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Forestier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean\u2010Louis","family":"Frendo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2002,5,28]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.193.1.8090881"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(98)00554-7"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0223(199906)19:6<537::AID-PD573>3.0.CO;2-T"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0223(199905)19:5<405::AID-PD552>3.0.CO;2-D"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(99)00461-5"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1970100813"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0223(200004)20:4<293::AID-PD801>3.0.CO;2-O"},{"key":"e_1_2_1_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1998.tb08934.x"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)70096-0"},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(95)90088-8"},{"key":"e_1_2_1_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0223(200008)20:8<676::AID-PD884>3.0.CO;2-R"},{"key":"e_1_2_1_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)70247-8"},{"key":"e_1_2_1_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1970150806"},{"key":"e_1_2_1_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0223(199910)19:10<947::AID-PD674>3.0.CO;2-M"},{"key":"e_1_2_1_16_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.1998.17.5.327"},{"key":"e_1_2_1_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.307.6917.1455"},{"key":"e_1_2_1_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0223(199912)19:12<1127::AID-PD718>3.0.CO;2-Q"},{"key":"e_1_2_1_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(99)70545-4"},{"key":"e_1_2_1_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0223(199911)19:11<1035::AID-PD694>3.0.CO;2-2"},{"key":"e_1_2_1_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(98)70135-8"},{"key":"e_1_2_1_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.297.6653.883"}],"container-title":["Prenatal Diagnosis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpd.345","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pd.345","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,18]],"date-time":"2023-11-18T12:37:48Z","timestamp":1700311068000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/pd.345"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,5,28]]},"references-count":21,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2002,7]]}},"alternative-id":["10.1002\/pd.345"],"URL":"https:\/\/doi.org\/10.1002\/pd.345","archive":["Portico"],"relation":{},"ISSN":["0197-3851","1097-0223"],"issn-type":[{"value":"0197-3851","type":"print"},{"value":"1097-0223","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,5,28]]}}}