antenatal testing

Question 1

NICE issued guidelines on antenatal care in March 2008 including advice on screening for Down’s syndrome
the combined test is now standard
nuchal translucency measurement + serum B-HCG + pregnancy-associated plasma protein A (PAPP-A)

what would downs suggest

Answer 1

Down’s syndrome is suggested by ↑ HCG, ↓ PAPP-A, thickened nuchal translucency

trisomy 18 (Edward syndrome) and 13 (Patau syndrome) give similar results but the PAPP-A tends to be lower

Question 2

if women book later in pregnancy either what tests in what week

Answer 2

the triple or quadruple test should be offered between 15 - 20 weeks

triple test: alpha-fetoprotein, unconjugated oestriol, human chorionic gonadotrophin
quadruple test: alpha-fetoprotein, unconjugated oestriol, human chorionic gonadotrophin and inhibin-A