Counseling patients on screening for Down syndrome has long been a challenge. Findings from the FASTER trial provide solid evidence upon which to base recommendations for first- or second-trimester testing, or a combination of both.
But today in the United States, second-trimester quadruple screening remains the most popular way to test for Down syndrome.4 Assessment of maternal serum markers including alphafetoprotein (AFP), total hCG, unconjugated estriol (uE3), and inhibin-A is estimated to detect 67% to 81% of fetuses with Down syndrome, for a false-positive rate of 5%.5,6
How should ob/gyns and their patients decide amongst screening during the first trimester, the second trimester, or some combination of both? Until recently, little information has been available to guide this process, and the testing options have continued to evolve.
Who were the FASTER patients?
We excluded patients who had already had an NT measurement in the current pregnancy and/or had anencephaly or cystic hygroma detected on NT U/S. FASTER also included a separate study of karyotype and complete obstetric and pediatric outcome in patients who were diagnosed in the first trimester with a septated cystic hygroma. Those findings will be discussed later in this article.
What was the trial protocol?
The 102 sonographers in FASTER were uniformly trained to detect NT, following a standard U/S protocol. To demonstrate their proficiency with the screening, each of them submitted a minimum of 50 adequate images to a central reviewer.
Unlocking HPV prevention: Insights from 2022 data on vaccination trends
May 14th 2024Explore the latest findings revealing vaccination rates among children aged 9 to 17 years, uncovering demographic disparities and highlighting the crucial role of vaccination in combating human papillomavirus infections and related health risks.
Read More
Prenatal cannabis and nicotine use linked to adverse pregnancy outcomes
May 14th 2024A recent study highlights the heightened risks of maternal and neonatal morbidity and mortality associated with combined cannabis and nicotine use during pregnancy, urging further investigation into their impact on short- and long-term outcomes.
Read More
Understanding pediatric STIs: Trends, management, and more
May 10th 2024Dive into the rising prevalence of sexually transmitted infections among adolescents and young adults, exploring educational gaps, vaccination rates, and the imperative need for open conversations between patients and health care providers to combat stigma and enhance preventive care.
Read More
No link found between antenatal corticosteroids and child neurodevelopment
April 25th 2024A recent study found no link between antenatal corticosteroid administration and adverse neurodevelopmental outcomes in children aged 6 years or older, offering reassurance for late preterm delivery practices.
Read More