{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:58:46Z","timestamp":1792004326646,"version":"4.4.0"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T00:00:00Z","timestamp":1699401600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T00:00:00Z","timestamp":1699401600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Gynecol Obstet"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to investigate the performance, cost-effectiveness and additional findings of combined detailed ultrasound and biochemical screening for risks of major fetal trisomies in the first-trimester.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective analysis study, we estimated the risk of trisomies 21, 18 and 13 based on maternal age, fetal nuchal translucency thickness, nasal bone, ductus venosus pulsatility index velocity, tricuspid regurgitation, fetal heart rate, free beta-human chorionic gonadotropin, and pregnancy-associated plasma protein A in singleton pregnant women, and performed non-invasive prenatal testing for women with risks of trisomy 21 between 1:500 and 1:300. Invasive diagnostic testing was performed for women with positive or failed non-invasive prenatal testing result and in the high-risk group of this screening method. The direct costs were compared between this strategy and the non-invasive prenatal testing which alone used as first-line screening for all pregnant women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 25,155 singleton pregnant women who underwent screening, 24,361 were available for analysis, of these, 194 cases underwent non-invasive prenatal testing. Among the 24,361 women, 39, 19, and 7 had trisomies 21, 18 and 13, respectively. The use of this strategy could potentially detect approximately 94.87% of trisomy 21 cases, 100% of trisomy 18 cases, and 100% of trisomy 13 cases, with false-positive rates of 2.49%, 0.41%, and 0.49%, respectively. The overall detection rate and overall false-positive rates were 96.92% and 2.52%, respectively. The detection rate was 100% in the advanced age group and 94.12% in the general age group. Additionally, structural abnormalities were detected in 137 fetuses, and 44 fetuses had other chromosomal abnormalities. The total cost of this strategy was $3,730,843.30, and the cost per person tested was $153.15. The total cost of using non-invasive prenatal testing as the first-line strategy would be $6,813,387.04 and the cost per person tested was $279.68.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our strategy is an efficient and cost-effective approach for detecting major trisomies and identifying more fetuses with a potential abnormality. Therefore, this strategy is a valuable screening method and highly feasible in the clinical setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00404-023-07267-3","type":"journal-article","created":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T02:02:37Z","timestamp":1699408957000},"page":"843-853","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["The value of combined detailed first-trimester ultrasound\u2013biochemical analysis for screening fetal aneuploidy in the era of non-invasive prenatal testing"],"prefix":"10.1007","volume":"310","author":[{"given":"Caixia","family":"Ye","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyan","family":"Duan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengyuan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianqiang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingwen","family":"Xiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yizhen","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiong","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruiling","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruiman","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,11,8]]},"reference":[{"issue":"11","key":"7267_CR1","doi-asserted-by":"publisher","first-page":"CD011767","DOI":"10.1002\/14651858.CD011767.pub2","volume":"11","author":"M Badeau","year":"2017","unstructured":"Badeau M, Lindsay C, Blais J, Nshimyumukiza L, Takwoingi Y, Langlois S, L\u00e9gar\u00e9 F, Gigu\u00e8re Y, Turgeon AF, Witteman W, Rousseau F (2017) Genomics-based non-invasive prenatal testing for detection of fetal chromosomal aneuploidy in pregnant women. Cochrane Database Syst Rev 11(11):CD011767. https:\/\/doi.org\/10.1002\/14651858.CD011767.pub2","journal-title":"Cochrane Database Syst Rev"},{"key":"7267_CR2","unstructured":"Ministry of Health of the People\u2019s Republic of China (2012) Report on the prevention and control of birth defects in China [R]"},{"issue":"1","key":"7267_CR3","doi-asserted-by":"publisher","first-page":"11","DOI":"10.3760\/cma.j.cn511374-20210512-00404","volume":"39","author":"N Wang","year":"2022","unstructured":"Wang N, Zhou S, Wang S, Kuang Y, Zu Y, Xie R, Yang M, Peng H, Liu J, He J (2022) Economic burden of Down syndrome patients and psychological and social discrimination to female caregivers in Changsha, China. Zhonghua Yi Xue Yi Chuan Xue Za Zhi 39(1):11\u201315. https:\/\/doi.org\/10.3760\/cma.j.cn511374-20210512-00404","journal-title":"Zhonghua Yi Xue Yi Chuan Xue Za Zhi"},{"issue":"1","key":"7267_CR4","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1002\/uog.6412","volume":"34","author":"KO Kagan","year":"2009","unstructured":"Kagan KO, Etchegaray A, Zhou Y, Wright D, Nicolaides KH (2009) Prospective validation of first-trimester combined screening for trisomy 21. Ultrasound Obstet Gynecol 34(1):14\u201318. https:\/\/doi.org\/10.1002\/uog.6412","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"1","key":"7267_CR5","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1002\/pd.2637","volume":"31","author":"KH Nicolaides","year":"2011","unstructured":"Nicolaides KH (2011) Screening for fetal aneuploidies at 11 to 13 weeks. Prenat Diagn 31(1):7\u201315. https:\/\/doi.org\/10.1002\/pd.2637","journal-title":"Prenat Diagn"},{"key":"7267_CR6","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1007\/s11684-010-0100-z","volume":"4","author":"XM Bian","year":"2010","unstructured":"Bian XM, Guo Q, Qi QW (2010) Current situation and development of prenatal diagnosis in China. Front Med China 4:271\u2013274","journal-title":"Front Med China"},{"key":"7267_CR7","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1017\/S026646230400145X","volume":"20","author":"Y Chen","year":"2004","unstructured":"Chen Y, Qian X, Tang Z et al (2004) Situation analysis of prenatal diagnosis technology utilization in China: current situation, main issues, and policy implications. Int J Technol Assess Health Care 20:524\u2013530","journal-title":"Int J Technol Assess Health Care"},{"issue":"9","key":"7267_CR8","doi-asserted-by":"publisher","first-page":"1998","DOI":"10.1038\/s41436-019-0467-4","volume":"21","author":"D Liang","year":"2019","unstructured":"Liang D, Cram DS, Tan H, Linpeng S, Liu Y, Sun H, Zhang Y, Tian F, Zhu H, Xu M, Wang H, Yu F, Wu L (2019) Clinical utility of noninvasive prenatal screening for expanded chromosome disease syndromes. Genet Med 21(9):1998\u20132006. https:\/\/doi.org\/10.1038\/s41436-019-0467-4","journal-title":"Genet Med"},{"issue":"5","key":"7267_CR9","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1002\/uog.14792","volume":"45","author":"H Zhang","year":"2015","unstructured":"Zhang H, Gao Y, Jiang F, Fu M, Yuan Y, Guo Y, Zhu Z, Lin M, Liu Q, Tian Z, Zhang H, Chen F, Lau TK, Zhao L, Yi X, Yin Y, Wang W (2015) Non-invasive prenatal testing for trisomies 21, 18 and 13: clinical experience from 146,958 pregnancies. Ultrasound Obstet Gynecol 45(5):530\u2013538. https:\/\/doi.org\/10.1002\/uog.14792","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"1","key":"7267_CR10","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1002\/uog.14693","volume":"45","author":"MI Evans","year":"2015","unstructured":"Evans MI, Sonek JD, Hallahan TW, Krantz DA (2015) Cell-free fetal DNA screening in the USA: a cost analysis of screening strategies. Ultrasound Obstet Gynecol 45(1):74\u201383. https:\/\/doi.org\/10.1002\/uog.14693","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"3","key":"7267_CR11","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1002\/uog.17484","volume":"50","author":"MM Gil","year":"2017","unstructured":"Gil MM, Accurti V, Santacruz B, Plana MN, Nicolaides KH (2017) Analysis of cell-free DNA in maternal blood in screening for aneuploidies: updated meta-analysis. Ultrasound Obstet Gynecol 50(3):302\u2013314. https:\/\/doi.org\/10.1002\/uog.17484","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"6","key":"7267_CR12","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1002\/uog.17283","volume":"49","author":"M Santorum","year":"2017","unstructured":"Santorum M, Wright D, Syngelaki A, Karagioti N, Nicolaides KH (2017) Accuracy of first-trimester combined test in screening for trisomies 21, 18 and 13. Ultrasound Obstet Gynecol 49(6):714\u2013720. https:\/\/doi.org\/10.1002\/uog.17283","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"4","key":"7267_CR13","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1002\/uog.18905","volume":"51","author":"KO Kagan","year":"2018","unstructured":"Kagan KO, Sroka F, Sonek J, Abele H, L\u00fcthgens K, Schmid M, Wagner P, Brucker S, Wallwiener D, Hoopmann M (2018) First-trimester risk assessment based on ultrasound and cell-free DNA vs combined screening: a randomized controlled trial. Ultrasound Obstet Gynecol 51(4):437\u2013444. https:\/\/doi.org\/10.1002\/uog.18905","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"1","key":"7267_CR14","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1002\/uog.12511","volume":"42","author":"KH Nicolaides","year":"2013","unstructured":"Nicolaides KH, Wright D, Poon LC, Syngelaki A, Gil MM (2013) First-trimester contingent screening for trisomy 21 by biomarkers and maternal blood cell-free DNA testing. Ultrasound Obstet Gynecol 42(1):41\u201350. https:\/\/doi.org\/10.1002\/uog.12511","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"3","key":"7267_CR15","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1159\/000356066","volume":"35","author":"KH Nicolaides","year":"2014","unstructured":"Nicolaides KH, Syngelaki A, Poon LC, Gil MM, Wright D (2014) First-trimester contingent screening for trisomies 21, 18 and 13 by biomarkers and maternal blood cell-free DNA testing. Fetal Diagn Ther 35(3):185\u2013192. https:\/\/doi.org\/10.1159\/000356066","journal-title":"Fetal Diagn Ther"},{"issue":"7","key":"7267_CR16","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1002\/pd.4157","volume":"33","author":"H Cuckle","year":"2013","unstructured":"Cuckle H, Benn P, Pergament E (2013) Maternal cfDNA screening for Down syndrome\u2014a cost sensitivity analysis. Prenat Diagn 33(7):636\u2013642. https:\/\/doi.org\/10.1002\/pd.4157","journal-title":"Prenat Diagn"},{"issue":"6","key":"7267_CR17","first-page":"5","volume":"21","author":"Y Huang","year":"2021","unstructured":"Huang Y, Jiang B (2021) Fertility culture and medical risks: an analysis of pregnancy and birth experience in elderly triplets. J Nanjing Med Univ Soc Sci Ed 21(6):5","journal-title":"J Nanjing Med Univ Soc Sci Ed"},{"issue":"1","key":"7267_CR18","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1002\/uog.12342","volume":"41","author":"LJ Salomon","year":"2013","unstructured":"Salomon LJ, Alfirevic Z, Bilardo CM, Chalouhi GE, Ghi T, Kagan KO, Lau TK, Papageorghiou AT, Raine-Fenning NJ, Stirnemann J, Suresh S, Tabor A, Timor-Tritsch IE, Toi A, Yeo G (2013) ISUOG practice guidelines: performance of first-trimester fetal ultrasound scan. Ultrasound Obstet Gynecol 41(1):102\u2013113. https:\/\/doi.org\/10.1002\/uog.12342","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"3","key":"7267_CR19","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1159\/000358326","volume":"35","author":"MM Gil","year":"2014","unstructured":"Gil MM, Akolekar R, Quezada MS, Bregant B, Nicolaides KH (2014) Analysis of cell-free DNA in maternal blood in screening for aneuploidies: meta-analysis. Fetal Diagn Ther 35(3):156\u2013173. https:\/\/doi.org\/10.1159\/000358326","journal-title":"Fetal Diagn Ther"},{"issue":"4","key":"7267_CR20","doi-asserted-by":"publisher","first-page":"e27","DOI":"10.3346\/jkms.2021.36.e27","volume":"36","author":"SA Choe","year":"2021","unstructured":"Choe SA, Seol HJ, Kwon JY, Park CW, Kim M, Lee JY, Kim MA, Hwang HS, Na S, Shim JY, Kim K, Ryu HM (2021) Clinical practice guidelines for prenatal aneuploidy screening and diagnostic testing from Korean Society of Maternal-Fetal Medicine: (1) Prenatal Aneuploidy Screening. J Korean Med Sci 36(4):e27. https:\/\/doi.org\/10.3346\/jkms.2021.36.e27","journal-title":"J Korean Med Sci"},{"issue":"1","key":"7267_CR21","doi-asserted-by":"publisher","first-page":"e010002","DOI":"10.1136\/bmjopen-2015-010002","volume":"6","author":"S Taylor-Phillips","year":"2016","unstructured":"Taylor-Phillips S, Freeman K, Geppert J, Agbebiyi A, Uthman OA, Madan J, Clarke A, Quenby S, Clarke A (2016) Accuracy of non-invasive prenatal testing using cell-free DNA for detection of Down, Edwards and Patau syndromes: a systematic review and meta-analysis. BMJ Open 6(1):e010002. https:\/\/doi.org\/10.1136\/bmjopen-2015-010002","journal-title":"BMJ Open"},{"issue":"6","key":"7267_CR22","doi-asserted-by":"publisher","first-page":"691.e1","DOI":"10.1016\/j.ajog.2017.10.005","volume":"217","author":"AK Petersen","year":"2017","unstructured":"Petersen AK, Cheung SW, Smith JL, Bi W, Ward PA, Peacock S, Braxton A, Van Den Veyver IB, Breman AM (2017) Positive predictive value estimates for cell-free noninvasive prenatal screening from data of a large referral genetic diagnostic laboratory. Am J Obstet Gynecol 217(6):691.e1-691.e6. https:\/\/doi.org\/10.1016\/j.ajog.2017.10.005","journal-title":"Am J Obstet Gynecol"},{"issue":"1","key":"7267_CR23","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1002\/uog.14636","volume":"45","author":"R Akolekar","year":"2015","unstructured":"Akolekar R, Beta J, Picciarelli G, Ogilvie C, D\u2019Antonio F (2015) Procedure-related risk of miscarriage following amniocentesis and chorionic villus sampling: a systematic review and meta-analysis. Ultrasound Obstet Gynecol 45(1):16\u201326. https:\/\/doi.org\/10.1002\/uog.14636","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"1","key":"7267_CR24","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1002\/uog.15820","volume":"47","author":"CB Wulff","year":"2016","unstructured":"Wulff CB, Gerds TA, Rode L, Ekelund CK, Petersen OB, Tabor A, Danish Fetal Medicine Study Group (2016) Risk of fetal loss associated with invasive testing following combined first-trimester screening for Down syndrome: a national cohort of 147,987 singleton pregnancies. Ultrasound Obstet Gynecol 47(1):38\u201344. https:\/\/doi.org\/10.1002\/uog.15820","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"7","key":"7267_CR25","doi-asserted-by":"publisher","first-page":"e0132313","DOI":"10.1371\/journal.pone.0132313","volume":"10","author":"P Benn","year":"2015","unstructured":"Benn P, Curnow KJ, Chapman S, Michalopoulos SN, Hornberger J, Rabinowitz M (2015) An economic analysis of cell-free DNA non-invasive prenatal testing in the US general pregnancy population. PLoS ONE 10(7):e0132313. https:\/\/doi.org\/10.1371\/journal.pone.0132313","journal-title":"PLoS ONE"},{"issue":"1","key":"7267_CR26","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1002\/uog.17330","volume":"50","author":"FR Grati","year":"2017","unstructured":"Grati FR, Kagan KO (2017) Rate of no result in cell-free DNA testing and its influence on test performance metrics. Ultrasound Obstet Gynecol 50(1):134\u2013137. https:\/\/doi.org\/10.1002\/uog.17330","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"1","key":"7267_CR27","doi-asserted-by":"publisher","first-page":"9457","DOI":"10.1038\/s41598-020-66320-2","volume":"10","author":"W Luo","year":"2020","unstructured":"Luo W, He B, Han D, Yuan L, Chen X, Pang L, Tang J, Zou F, Zhao K, Du Y, Liu H (2020) A retrospective analysis of different contingent screening models for fetal down syndrome in Southwestern China. Sci Rep 10(1):9457. https:\/\/doi.org\/10.1038\/s41598-020-66320-2","journal-title":"Sci Rep"},{"issue":"22","key":"7267_CR28","doi-asserted-by":"publisher","first-page":"4258","DOI":"10.1080\/14767058.2020.1849102","volume":"35","author":"S Capriglione","year":"2022","unstructured":"Capriglione S, Latella S, De Felice G, Filippini M, Ettore C, Ettore G, Farinelli M, Gulino FA (2022) First trimester screening for aneuploidy: may combined test and fetal DNA work together? J Matern Fetal Neonatal Med 35(22):4258\u20134262. https:\/\/doi.org\/10.1080\/14767058.2020.1849102","journal-title":"J Matern Fetal Neonatal Med"},{"key":"7267_CR29","doi-asserted-by":"publisher","first-page":"82","DOI":"10.3760\/cma.j.issn.0366-6999.20122477","volume":"2","author":"WJ Li","year":"2013","unstructured":"Li WJ, Yan RL, Zhang YL, Zhou Q (2013) Ultrasound soft markers in screening for fetal chromosomal abnormality during first-trimester. Chin J Perinat Med 2:82\u201385","journal-title":"Chin J Perinat Med"},{"issue":"4","key":"7267_CR30","doi-asserted-by":"publisher","first-page":"396.e1","DOI":"10.1016\/j.ajog.2020.10.037","volume":"224","author":"Y Liao","year":"2021","unstructured":"Liao Y, Wen H, Ouyang S, Yuan Y, Bi J, Guan Y, Fu Q, Yang X, Guo W, Huang Y, Zeng Q, Qin Y, Xiang H, Li S (2021) Routine first-trimester ultrasound screening using a standardized anatomical protocol. Am J Obstet Gynecol 224(4):396.e1-396.e15. https:\/\/doi.org\/10.1016\/j.ajog.2020.10.037","journal-title":"Am J Obstet Gynecol"},{"issue":"1","key":"7267_CR31","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1002\/uog.26106","volume":"61","author":"CM Bilardo","year":"2023","unstructured":"International Society of Ultrasound in Obstetrics and Gynecology, Bilardo CM, Chaoui R, Hyett JA, Kagan KO, Karim JN, Papageorghiou AT, Poon LC, Salomon LJ, Syngelaki A, Nicolaides KH (2023) ISUOG Practice Guidelines (updated): performance of 11\u201314-week ultrasound scan. Ultrasound Obstet Gynecol 61(1):127\u2013143. https:\/\/doi.org\/10.1002\/uog.26106","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"1","key":"7267_CR32","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1186\/s12884-019-2434-0","volume":"19","author":"M\u00c1 S\u00e1nchez-Dur\u00e1n","year":"2019","unstructured":"S\u00e1nchez-Dur\u00e1n M\u00c1, Bernabeu GA, Calero I, Ramis FJ, Illescas T, Avil\u00e9s MT, Maiz N, Carreras E (2019) Clinical application of a contingent screening strategy for trisomies with cell-free DNA: a pilot study. BMC Pregnancy Childbirth 19(1):274. https:\/\/doi.org\/10.1186\/s12884-019-2434-0","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"7267_CR33","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1002\/uog.15783","volume":"47","author":"MM Gil","year":"2016","unstructured":"Gil MM, Revello R, Poon LC, Akolekar R, Nicolaides KH (2016) Clinical implementation of routine screening for fetal trisomies in the UK NHS: cell-free DNA test contingent on results from first-trimester combined test. Ultrasound Obstet Gynecol 47(1):45\u201352. https:\/\/doi.org\/10.1002\/uog.15783","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"1","key":"7267_CR34","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1002\/uog.14691","volume":"45","author":"KO Kagan","year":"2015","unstructured":"Kagan KO, Wright D, Nicolaides KH (2015) First-trimester contingent screening for trisomies 21, 18 and 13 by fetal nuchal translucency and ductus venosus flow and maternal blood cell-free DNA testing. Ultrasound Obstet Gynecol 45(1):42\u201347. https:\/\/doi.org\/10.1002\/uog.14691","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"24","key":"7267_CR35","doi-asserted-by":"publisher","first-page":"2905","DOI":"10.1080\/14767058.2016.1268593","volume":"30","author":"E Colosi","year":"2017","unstructured":"Colosi E, D\u2019Ambrosio V, Periti E (2017) First trimester contingent screening for trisomies 21,18,13: is this model cost efficient and feasible in public health system? J Matern Fetal Neonatal Med 30(24):2905\u20132910. https:\/\/doi.org\/10.1080\/14767058.2016.1268593","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"9","key":"7267_CR36","doi-asserted-by":"publisher","first-page":"1210","DOI":"10.1093\/clinchem\/hvab067","volume":"67","author":"MD Pertile","year":"2021","unstructured":"Pertile MD, Flowers N, Vavrek D, Andrews D, Kalista T, Craig A, Deciu C, Duenwald S, Meier K, Bhatt S (2021) Performance of a paired-end sequencing-based noninvasive prenatal screening test in the detection of genome-wide fetal chromosomal anomalies. Clin Chem 67(9):1210\u20131219. https:\/\/doi.org\/10.1093\/clinchem\/hvab067","journal-title":"Clin Chem"},{"issue":"4","key":"7267_CR37","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1002\/pd.5621","volume":"40","author":"J Geppert","year":"2020","unstructured":"Geppert J, Stinton C, Johnson S, Clarke A, Grammatopoulos D, Taylor-Phillips S (2020) Antenatal screening for fetal trisomies using microarray-based cell-free DNA testing: a systematic review and meta-analysis. Prenat Diagn 40(4):454\u2013462. https:\/\/doi.org\/10.1002\/pd.5621","journal-title":"Prenat Diagn"},{"issue":"1","key":"7267_CR38","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1111\/aogs.13047","volume":"96","author":"E Iwarsson","year":"2017","unstructured":"Iwarsson E, Jacobsson B, Dagerhamn J, Davidson T, Bernab\u00e9 E, Heibert AM (2017) Analysis of cell-free fetal DNA in maternal blood for detection of trisomy 21, 18 and 13 in a general pregnant population and in a high risk population\u2014a systematic review and meta-analysis. Acta Obstet Gynecol Scand 96(1):7\u201318. https:\/\/doi.org\/10.1111\/aogs.13047","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"4","key":"7267_CR39","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1016\/j.tjog.2018.06.011","volume":"57","author":"M Pan","year":"2018","unstructured":"Pan M, Huang L-Y, Zhen L, Li D-Z (2018) A cost-effectiveness analysis comparing two different strategies in advanced maternal age: combined first-trimester screening and maternal blood cell-free DNA testing. Taiwan J Obstet Gynecol 57(4):536\u2013540. https:\/\/doi.org\/10.1016\/j.tjog.2018.06.011","journal-title":"Taiwan J Obstet Gynecol"},{"issue":"9","key":"7267_CR40","doi-asserted-by":"publisher","first-page":"799","DOI":"10.1056\/NEJMoa1311037","volume":"370","author":"DW Bianchi","year":"2014","unstructured":"Bianchi DW, Parker RL, Wentworth J, Madankumar R, Saffer C, Das AF, Craig JA, Chudova DI, Devers PL, Jones KW, Oliver K, Rava RP, Sehnert AJ, CARE Study Group (2014) DNA sequencing versus standard prenatal aneuploidy screening. N Engl J Med 370(9):799\u2013808. https:\/\/doi.org\/10.1056\/NEJMoa1311037","journal-title":"N Engl J Med"},{"issue":"4","key":"7267_CR41","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1002\/uog.17562","volume":"51","author":"CB Miltoft","year":"2018","unstructured":"Miltoft CB, Rode L, Ekelund CK, Sundberg K, Kjaergaard S, Zingenberg H, Tabor A (2018) Contingent first-trimester screening for aneuploidies with cell-free DNA in a Danish clinical setting. Ultrasound Obstet Gynecol 51(4):470\u2013479. https:\/\/doi.org\/10.1002\/uog.17562","journal-title":"Ultrasound Obstet Gynecol"}],"container-title":["Archives of Gynecology and Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00404-023-07267-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00404-023-07267-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00404-023-07267-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T10:05:59Z","timestamp":1721297159000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00404-023-07267-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,8]]},"references-count":41,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["7267"],"URL":"https:\/\/doi.org\/10.1007\/s00404-023-07267-3","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3194989\/v1","asserted-by":"object"}]},"ISSN":["1432-0711"],"issn-type":[{"value":"1432-0711","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,8]]},"assertion":[{"value":"28 July 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 October 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 November 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declared that they have no conflicts of interest to this work. We declare that we do not have any commercial or associative interest that represents a conflict of interest in connection with the work submitted.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study received approval by the Scientific and Ethics Review Committees of The First Affiliate Hospital of Jinan University (SYJS 2022-07-04-28).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}]}}