GeneCare Comments on ACOG Approval for First Trimester NT/freeBeta/ PAPP-A Prenatal Screening.CHAPEL HILL, N.C. -- On June 30, 2004 the American College of Obstetricians and Gynecologists The American College of Obstetricians and Gynecologists (ACOG) is a professional association of medical doctors specializing in obstetrics and gynecology in the United States. It has a membership of over 49,000[1] and represents 90 percent of U.S. (ACOG ACOG American College of Obstetricians and Gynecologists. ACOG American College of Obstetricians & Gynecologists ) approved First Trimester Prenatal Screening for genetic defects. For more information on the ACOG opinion please see: www.acog.com/from_home/publications/press_releases/nr06-30-04.cfm First Trimester Screening combines a Nuchal Translucency (NT) measurement of fluid at the back of the fetus' neck and free Beta hCG and PAPP-A PAPP-A Pregnancy-Associated Plasma Protein A dried maternal blood tests to generate a patient-specific risk for Down syndrome and trisomy trisomy /tri·so·my/ (tri´so-me) the presence of an additional (third) chromosome of one type in an otherwise diploid cell (2n + 1). See also entries under syndrome. triso´mic tri·so·my n. 18 chromosomal abnormalities. The ACOG Committee Opinion notes certain criteria need to be met for measuring Nuchal Translucency. To ensure consistent and accurate NT measurements, a national NT training, certificate, and on-going external audit program has been in place since 1999. NT measurements should be combined with freeBeta/PAPP-A serum biochemical screening to increase detection and reduce screen positives. The US and international literature have documented 90% detection of Down syndrome and 97% detection of trisomy 18 with First Trimester NT/free Beta/PAPPA screening. These studies show the screen positive rates are lower with dried blood screening than with liquid blood. Low screen positive rates reduce maternal anxiety and unnecessary follow up diagnostic testing. When a screening test shows an increased risk at 11-13 weeks, the patient has greater privacy, additional options, and safer alternatives than in the second trimester. Patients can have chorionic villi sampling Chorionic villi sampling A procedure to remove a small tissue sample of the placenta, the sac that surrounds the developing fetus. This test can be performed as early as week 10 of the pregnancy. The tissue can be tested for genetic defects. (CVS (1) (Concurrent Versions System) A version control system for Unix that was initially developed as a series of shell scripts in the mid-1980s. CVS maintains the changes between one source code version and another and stores all the changes in one file. ) at 10-12 weeks or an earlier amniocentesis. Equally important is the 11-13 week detailed fetal ultrasound exam performed to detect fetal anomalies including about 40% of heart defects, determine the chorionicity for multiple pregnancies, and to make other observations about fetal development. The exam improves patient risk assessment and provides earlier options for pregnancy management. At this time, it is appropriate to offer First Trimester Screening to all low risk patients as well as to increase risk patients who decline amniocentesis and CVS. Patients who decline amniocentesis should be aware that prenatal screening is not a substitute for a diagnostic test like amniocentesis or CVS. NT training is provided to physicians, sonographers, and other health care providers across the US through non-profit NT training courses listed at www.genecare.com/First_Trimester_Nuchal nuchal (nyōōˑ·k  l),adj pertaining to the posterior or nape of the neck. _Translucency_Courses.html To find NT Certificate health care providers of First Trimester Screening, call GeneCare or e-mail to info@genecare.com. Reference: ACOG Committee Opinion #296: First-Trimester Screening for Fetal Aneuploidy aneuploidy /an·eu·ploi·dy/ (an?u-ploi´de) any deviation from an exact multiple of the haploid number of chromosomes, whether fewer or more. an·eu·ploi·dy n. . Obstet Gynecol. 2004 Jul;104(1):215-217. |
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