8,9) Currently, the best second-trimester test is the quadruple test (AFP, unconjugated estriol, hCG [total or free [beta]-hCG], and inhibin-A) with an 80% detection rate at a 5% false-positive rate.
14) The combined test (maternal age in combination with pregnancy-associated plasma protein A, free [beta]-hCG, and nuchal translucency measurements), which is the highest-performing first-trimester test, is roughly equivalent in performance to the second-trimester quadruple test.
If more than one specific test was included in the questionnaire (eg, triple test, quadruple test under second trimester), those subtotals are also presented.
The tests included were the combined test, triple test, quadruple test
, integrated test, serum integrated test, sequential screening test, contingent screening test, and amniocentesis for women aged 35 years and older (Am.
The performance estimates for the triple test (AFP, uE3, and hCG) and the quadruple test
(triple test plus DIA) differed slightly from those published previously because the distribution of maternal ages in the United States was different in 2000 from that available for the earlier calculations.
Antenatal screening for Down's syndrome with the quadruple test
Bartholomew's and The London School of Medicine and Dentistry assessed prenatal serum screening for Down syndrome with the quadruple test
among 46,193 pregnancies in 14 hospitals over a five-year period.
Professor Nicholas Wald of the Wolfson Institute of Preventive Medicine added: "The quadruple test
is a better method of screening for Down's syndrome.
a) Detection rate (%) at a false positive rate of 3% 5% 7% Quadruple test
75 81 85 Quadruple test
+ fetal DNA 80 86 90 Detection rates for the quadruple test
were calculated using multivariate Gaussian distribution analysis from coefficients in Wald et al.
The studies consisted of approximately 120 000 women screened, including 153 cases of Down syndrome screened with the triple test and 86 cases of Down syndrome screened with the quadruple test.
Validation of risk estimation using the quadruple test in prenatal screening for Down syndrome.