First-trimester combined screening: experience with an instant results approach

Am J Obstet Gynecol. 2007 Jun;196(6):606.e1-5; discussion 606.e5. doi: 10.1016/j.ajog.2007.03.019.

Abstract

Objective: This study was undertaken to assess an instant results protocol for first-trimester combined screening.

Study design: Retrospective analysis of patients having first-trimester combined screening between Nov. 1, 2003 and Oct. 31, 2005. We evaluated the feasibility of patient self-collection and mail-in of blood samples before nuchal translucency ultrasound. Primary outcome was success with providing in-office, immediate screening results after the ultrasound. Predictor variables included age, ethnicity, insurance, and provider. The chi2 analysis was performed.

Results: Two thousand three hundred ten women completed first-trimester combined screening, and 60.6% received instant results. When the biochemistry sample was collected at home, 80% received instant results. Age 35 years or older predicted instant results (P = .001), whereas ethnicity, insurance, and referring provider did not. Comparing the prior 24 months, clinic volume increased by 18%. Diagnostic procedure volume was unchanged, although chorionic villus sampling increased by 12% (P = .02) and amniocentesis decreased by 6% (P = .049).

Conclusion: Patients were able to obtain instant results in 60.6% of cases, which appeared to increase the use of chorionic villus sampling.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Amniocentesis / statistics & numerical data
  • Blood Specimen Collection / methods*
  • Chorionic Gonadotropin, beta Subunit, Human / blood
  • Chorionic Villi Sampling / statistics & numerical data
  • Cohort Studies
  • Feasibility Studies
  • Female
  • Humans
  • Maternal Age
  • Nuchal Translucency Measurement*
  • Pregnancy
  • Pregnancy Trimester, First*
  • Pregnancy-Associated Plasma Protein-A / analysis
  • Retrospective Studies
  • Self Care
  • Ultrasonography, Prenatal*

Substances

  • Chorionic Gonadotropin, beta Subunit, Human
  • Pregnancy-Associated Plasma Protein-A