{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T10:12:17Z","timestamp":1774519937481,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,2,17]],"date-time":"2015-02-17T00:00:00Z","timestamp":1424131200000},"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":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the performance and cost efficacy of different first\u2010trimester contingent screening strategies based on an initial analysis of biochemical markers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Swedish National Quality Register for prenatal diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>35\u00a0780 women with singleton pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Serum values from first trimester biochemistry were re\u2010analyzed in a contingent approach. For risks between 1:40 and 1:1000, risk estimates from nuchal translucency measurements were added and outcomes were compared using either a final cut\u2010off risk of 1:200 to proceed with invasive testing or offering non\u2010invasive prenatal testing. In a subgroup of 12\u00a0836 women with regular menstrual cycles the same analyses were performed using data on the last menstrual period for determining gestational age. The costs of detecting one case of aneuploidy were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Comparison of screening strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The detection rate was the same (87%) in the contingent group as in complete combined screening, with only 41% requiring a nuchal translucency scan. As an alternative, offering non\u2010invasive prenatal testing to the intermediate risk group would result in a detection rate of 98%, but the cost to detect one case of trisomy 21 would be 83% higher than the cost associated with traditional combined screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>First trimester examination using a contingent approach will achieve similar results compared with full combined screening. Non\u2010invasive prenatal testing will not be cost\u2010effective when a high proportion of pregnancies need further testing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.12579","type":"journal-article","created":{"date-parts":[[2015,1,12]],"date-time":"2015-01-12T07:48:08Z","timestamp":1421048888000},"page":"368-375","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["First trimester contingent testing with either nuchal translucency or cell\u2010free DNA. 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