{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T07:52:20Z","timestamp":1718092340236},"reference-count":21,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2015,8,1]],"date-time":"2015-08-01T00:00:00Z","timestamp":1438387200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To report changes in the use of the combined first\u2010trimester screen (FTS) in patients classified as high and low risk for fetal aneuploidy, including after introduction of noninvasive prenatal testing (NIPT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospectively collected database was reviewed to investigate changes in FTS use before and after American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin No. 77 (<jats:italic>Obstet Gynecol<\/jats:italic> 2007; 109:217\u2013227), which recommended that all patients be offered aneuploidy screening, and after NIPT introduction. High\u2010risk patients were classified as 35 years or older at the estimated time of delivery or those with an abnormal prior screen, abnormal ultrasound findings, or family history of aneuploidy. Data were normalized per 100 morphologic ultrasound examinations to account for changes in patient number over time. Statistical significance was defined as <jats:italic>P<\/jats:italic> &lt; .05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 10,125 FTSs were recorded during the 88\u2010month study period, including 2962 in high\u2010risk patients and 7163 in low\u2010risk patients. The total number of FTSs performed per 100 morphologic ultrasound examinations significantly increased after ACOG Practice Bulletin No. 77 and significantly decreased after NIPT introduction. In high\u2010risk patients, the total number of FTSs performed per 100 morphologic ultrasound examinations significantly increased after ACOG Practice Bulletin No. 77 but significantly decreased after NIPT introduction. In contrast, in low\u2010risk patients, the total number of FTSs performed per 100 morphologic ultrasound examinations significantly increased after ACOG Practice Bulletin No.77 but was not statistically different after NIPT introduction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>American College of Obstetricians and Gynecologists Practice Bulletin No. 77 significantly increased patient use of FTS. The introduction of NIPT significantly decreased FTS use in the high\u2010risk population but not in the low\u2010risk population.<\/jats:p><\/jats:sec>","DOI":"10.7863\/ultra.34.8.1423","type":"journal-article","created":{"date-parts":[[2015,7,23]],"date-time":"2015-07-23T21:43:37Z","timestamp":1437687817000},"page":"1423-1428","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Use of the Combined First\u2010Trimester Screen in High\u2010 and Low\u2010Risk Patient Populations After Introduction of Noninvasive Prenatal Testing"],"prefix":"10.1002","volume":"34","author":[{"given":"Sebastian","family":"Larion","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven 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