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Earlier 'Sneak Peek' Offers Peace of Mind for Moms to Be

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Posted: 6/6/2005

COLUMBUS, Ohio – Ohio State University maternal-fetal medicine specialists are among the first physicians in the United States to offer pregnant women a new first-trimester screening option that delivers the earliest and most accurate assessment available of risks for a range of fetal abnormalities and birth defects.

The benefit of earlier results, physicians say, is that the vast majority of women – at least 95 percent – are assured in the first trimester that the fetus is developing normally. And for those few found to be at risk for having a baby with abnormalities, additional prenatal testing becomes an even earlier option, says Dr. Mark Landon, director of the maternal-fetal medicine division and vice chair of the department of obstetrics and gynecology at The Ohio State University Medical Center.

The assessment combines special measurements obtained on an ultrasound exam between 11 and 13 weeks gestation with results from a blood test women can take at home. When results are analyzed together in a customized computer program, the findings are estimated to be nearly 90 percent accurate – with fewer false positive results than tests typically recommended during the second trimester.

“The principal benefit of obtaining these results earlier in the pregnancy is, in almost all cases, to reassure women the fetus is off to a good start,” Landon said. “In the past, women have relied on tests available closer to the middle of the pregnancy. We find the sensitivity of those tests is lower when compared to this first trimester test, especially in detecting chromosomal abnormalities. Additionally, fewer women screen positive, which creates the need for overall less invasive testing.”

The combined screen tests for about half a dozen chromosomal abnormalities, as well as structural and genetic abnormalities and even heart-related birth defects. The woman’s blood specimen is screened for two important markers in the serum – free Beta human chorionic gonadotropin and pregnancy associated plasma protein-A. During the ultrasound, specially certified physicians and sonographers measure the thickness of the skin at the back of the fetus’s neck – called the nuchal translucency – as an additional method to detect Down syndrome in particular.

Using a newly available at-home blood test kit, a woman can collect her own blood specimen with nothing more than a finger stick and send her dried blood card to the lab as early as just nine weeks into the pregnancy. Her results are entered into the lab’s database and accessed by Ohio State University maternal-fetal medicine specialists upon her visit for an 11-week ultrasound. The data are integrated to achieve the most accurate results possible.

“This represents a refinement of first trimester testing by offering the result as quickly as possible,” Landon said. Previously, the 11-week ultrasound would be followed by a blood test and a wait for the results.

A standard of care in Europe and increasing in prevalence in North American medical centers, this combined first-trimester screening approach has been endorsed for its safety, effectiveness and accuracy by the American College of Obstetricians and Gynecologists.

Though healthy women over age 35 typically have healthy pregnancies, they are at higher risk for some conditions, such as diabetes and miscarriage, as well as for having babies with genetic abnormalities. Landon said that although women initially identified as having a higher risk for problems during pregnancy might be the most likely to seek a first trimester screening, he expects the instant-risk assessment to be made available to any woman interested in the early reassurance about her pregnancy.

The Ultra-Screen Instant Risk Assessment at-home test used by OSU Medical Center is manufactured by NTD Labs based in Huntington Station, N.Y.

The lab fee for the blood test is $95.

Ohio State’s maternal-fetal medicine specialists constitute central Ohio’s only group of clinician-researchers and educators in high-risk obstetrics. The group’s comprehensive scope of services ranges from preconception counseling and prenatal screening to specialized programs in diabetes and cardiovascular disease and preterm birth prevention.

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Emily Caldwell
Medical Center Communications

Maternity; University Hospital; Women's Health