{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T08:06:16Z","timestamp":1763366776834},"reference-count":14,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2006,5,19]],"date-time":"2006-05-19T00:00:00Z","timestamp":1147996800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2006,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To design a trisomy 21 screening protocol for sequential triage in the first trimester, and to evaluate whether it reduces the need for advanced ultrasound scanning to such an extent that this could be dealt with by a limited number of well\u2010trained sonographers only.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Screening results of 31 trisomy 21 affected pregnancies and 16 096 unaffected pregnancies from the first trimester screening program of Algemeen Medisch Laboratorium in Antwerp, Belgium, were used to define high\u2010risk, intermediate\u2010risk and low\u2010risk groups. A serum screening result (age, pregnancy\u2010associated plasma protein\u2010A (PAPP\u2010A) and free beta\u2010human chorionic gonadotropin (\u03b2\u2010hCG)) of \u22651 : 30 and\/or a nuchal translucency thickness (NT) measurement of \u2265 3.5 mm were classified as high risk. A serum screening result of &lt; 1 : 1000 together with an NT of &lt; 3.5 mm were classified as low risk. Other results were considered intermediate risk, for which further advanced ultrasound screening would be indicated. This protocol was then evaluated prospectively in another population of 13 493 first\u2010trimester pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the total population, 1.9% was identified as being high risk (14 trisomy 21 pregnancies and 222 unaffected pregnancies; prevalence, 1 : 17), 59.6% was identified as being low risk (three trisomy 21 pregnancies and 9615 unaffected pregnancies; prevalence, 1 : 3206) and 38.4% was identified as being intermediate risk (10 trisomy 21 pregnancies and 6190 unaffected pregnancies; prevalence, 1 : 620). A similar distribution was found in the prospective arm of the study. There was no reduction of overall screening performance compared with our current first\u2010trimester combined screening program. The number of intermediate\u2010risk pregnancies was sufficiently low as to enable advanced ultrasound scanning by well\u2010trained sonographers only.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In population screening for fetal trisomy 21, sequential triage in the first trimester can be achieved using very simple methods. Pregnancies at high or at low risk can be identified easily and the number of pregnancies at intermediate risk can be reduced sufficiently to enable advanced ultrasound scanning by well\u2010trained sonographers only. A prospective study is needed to evaluate the performance of this approach and to compare its results with current combined or integrated screening algorithms. Copyright \u00a9 2006 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.2780","type":"journal-article","created":{"date-parts":[[2006,5,19]],"date-time":"2006-05-19T12:26:28Z","timestamp":1148041588000},"page":"622-627","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Sequential triage in the first trimester may enhance advanced ultrasound scanning in population screening for trisomy 21"],"prefix":"10.1002","volume":"27","author":[{"given":"W. J. A.","family":"Gyselaers","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. R. A.","family":"Roets","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. D. Y. J.","family":"Van Holsbeke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. J.","family":"Vereecken","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. J. H.","family":"Van Herck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. P. L.","family":"Straetmans","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W. U. A. M.","family":"Ombelet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. G.","family":"Nijhuis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,5,19]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/pd.588"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1860"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0009-8981(02)00187-0"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1217"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1137"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1258\/096914103321824133"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043693"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/pd.358"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/pd.336"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/pd.974"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1215"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1732"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/pd.308"},{"key":"e_1_2_5_15_2","unstructured":"The Fetal Medicine Foundation.http:\/\/www.fetalmedicine.com\/f\u2010downs.htm[Accessed 1st August 2005]."}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.2780","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.2780","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T22:58:09Z","timestamp":1695941889000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.2780"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,5,19]]},"references-count":14,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2006,6]]}},"alternative-id":["10.1002\/uog.2780"],"URL":"https:\/\/doi.org\/10.1002\/uog.2780","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,5,19]]},"assertion":[{"value":"2005-12-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2006-05-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}