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  • 1
    Electronic Resource
    Electronic Resource
    Authors’ reply (1994)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 101 (1994), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1994.tb13092.x
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  • 2
    Electronic Resource
    Electronic Resource
    Detection of hydatidiform mole in maternal serum screening programmes for Down's syndrome (1992)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 99 (1992), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To determine how frequently hydatidiform mole will be detected in a maternal serum Down's syndrome screening programme.Design Affected pregnancies were identified using a national register. Unconjugated oestriol (μE3) and human chorionic gonadotrophin (hCG) were measured in stored serum samples and alphafetoprotein (AFP) levels were available from previous neural tube defect screening at 15–20 weeks gestation.Subjects Ten pregnancies with a complete mole (i.e., hydropic placenta without a fetus), nine with stored serum samples and one with an AFP level only.Results The median values were 0.08, 0.13 and 1–83 multiples of the normal median for AFP, uE3 and hCG respectively. Six out of nine (67%) tested for all three markers had a high risk of Down's syndrome given maternal age and the marker levels.Conclusion Many molar pregnancies that have not presented clinically before 15 weeks will be detected through Down's syndrome screening.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1992.tb13789.x
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  • 3
    Electronic Resource
    Electronic Resource
    Second trimester amniotic fluid oestriol, dehydroepiandrosterone sulphate, and human chorionic gonadotrophin levels in Down's syndrome (1991)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 98 (1991), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective— To investigatc the rcason for low matcrnal scrum unconjugated oestriol (uE3) and raised human chorionic gonadotrophin (hCG) levels in Down's syndrome pregnancies.Design— Mcasurement of uE3, total oestriol (tE3), dehydroepiandrosterone sulphate (DHEAS), a precursor of oestriol, and hCG in 15–20 week amniotic fluid samples from pregnancies with and without Down's syndrome.Setting— The retrieval and use of stored amniotic fluid samples collected from women who had had an amniocentesis for antenatal diagnosis.Subjects— 45 women with a Down's syndrome pregnancy and 224 unaffected controls of the same gestational age.Results— The median level of amniotic fluid in affected pregnancies was low for uE3, tE3 and DHEAS but high for hCG: 0.50,0.46,0.35 and 1–58 multiples of the normal median, respectively.Conclusion— These results suggest that the abnormal maternal serum levels of uE3 and hCG in affected pregnancies are due mainly to abnormal feto-placental synthesis, rather than feto-maternal transfer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1991.tb15370.x
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  • 4
    Electronic Resource
    Electronic Resource
    Maternal serum screening for Down's syndrome: the effect of routine ultrasound scan determination of gestational age and adjustment for maternal weight (1992)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 99 (1992), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To investigate the effect of using a routine ultrasound estimate of gestational age and maternal weight adjustment on maternal serum alpha-fetoprotein (AFP), unconjugated oestriol (uE3) and human chorionic gonadotrophin (hCG) levels in antenatal screening for Down's syndrome.Design Women with a singleton pregnancy without Down's syndrome were screened using the three serum markers and an estimate of gestational age based on ‘dates’ (time since first day of the last menstrual period) and one based on an ultrasound scan examination was recorded together with maternal weight.Setting Women attending the Homerton Hospital, Hackney, for their antenatal care between February 1989 and January 1990.Subjects 2113 women with a singleton pregnancy without Down's syndrome.Results The use of ultrasound to estimate gestational age (usually based on the biparietal diameter of the fetal skull) led to a significant reduction in the variance of each marker at a given week of pregnancy. The level of each marker was negatively associated with maternal weight, so that adjustment for weight also led to a reduction in variance. These data on gestational age and maternal weight, taken together with published data on pregnancies associated with Down's syndrome, indicate that the routine use of ultrasound to estimate gestational age will increase the detection rate from 58% to 67% while maintaining the false-positive rate at 5%, or reduce the false-positive rate from 5.7% to 3.1% while maintaining the detection rate at 60%. Routine maternal weight adjustment for the serum marker levels was much less useful, increasing the detection rate by about 0.5% for a given false-positive rate, or reducing the false-positive rate about 0.1% for a given detection rate.Conclusion An ultrasound gestational age estimate available at the time of Down's syndrome screening confers a substantial advantage to screening performance with a further small benefit resulting from maternal weight adjustment, which is worth adopting if it can be done without difficulty or extra cost.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1992.tb14474.x
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  • 5
    Electronic Resource
    Electronic Resource
    Maternal serum unconjugated oestriol as an antenatal screening test for Down's syndrome (1988)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 95 (1988), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. The median maternal serum unconjugated oestriol level between 13 and 27 weeks gestation in 77 pregnancies associated with Down's syndrome was lower than the median level in 385 unaffected control pregnancies matched for maternal age, gestational age, and duration of serum sample storage (P〈0·001). The median level for the affected pregnancies was 73% of that in the controls. Low unconjugated oestriol levels can be used to detect fetal Down's syndrome; at cut-off levels selected to detect at least 35% of affected pregnancies, unconjugated serum oestriol was a better screening test than either maternal age or serum alpha-fetoprotein (AFP). The use of all three variables in combination to select women with a 1:250 or greater risk of a Down's syndrome term pregnancy would yield a 45% detection rate with a falsepositive rate of 5.2%. The same detection rate using maternal age alone or using age and serum AFP in combination would yield higher falsepositive rates, 15% and 9.8% respectively. The addition of unconjugated oestriol to a Down's syndrome screening programme would therefore be more efficient than the use of age and AFP alone; for a given detection rate fewer women would need an amniocentesis or, for a given percentage of women having an amniocentesis, more pregnancies with Down's syndrome would be detected.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1988.tb06602.x
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  • 6
    Electronic Resource
    Electronic Resource
    The effect of smoking in pregnancy on maternal serum alpha-fetoprotein, unconjugated oestriol, human chorionic gonadotrophin, progesterone and dehydroepiandrosterone sulphate levels (1990)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 97 (1990), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1990.tb01794.x
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  • 7
    Electronic Resource
    Electronic Resource
    A comparison of some classification methods used to determine benthic macro-invertebrate species associations in river survey work based on data obtained from the River Ely, South Wales (1983)
    Oxford, UK : Blackwell Publishing Ltd
    Freshwater biology 13 (1983), S. 0 
    Details
    ISSN: 1365-2427
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Biology
    Notes: SUMMARY. The results of a survey of the macro-invertebrates of the polluted River Ely, South Wales, are used as a basis for comparing several classification methods which have been used previously in river survey work to determine species groupings. The methods compared are product-moment correlation (clustered by the nearest neighbour technique), Kendall's tau coefficient (clustered by the nearest neighbour and average linkage techniques), and Squared Euclidean-Distance coefficient (clustered by nearest neighbour and Ward's techniques). The species groupings determined by these methods were influenced both by the association coefficient and the technique used to cluster it. Some species were grouped together by all or most of the methods. The ecological validity of these robust groups is examined. A clear recommendation regarding the most appropriate method is frustrated by incomplete knowledge of the ecological requirements of most of the aquatic macro-invertebrates used in the data-set. However, Kendall's tau coefficient clustered by the average linkage technique appeared to produce ecologically meaningful species groups. Product-moment correlation was also reasonably successful and since it is based on absolute abundance data whereas Kendall's tau coefficient is based on relative abundance data, the use of the two together is recommended for determining robust groups.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2427.1983.tb00654.x
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  • 8
    Electronic Resource
    Electronic Resource
    Serum screening for Down's syndrome between 8 and 14 weeks of pregnancy (1996)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 103 (1996), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To determine the value of serum screening for Down's syndrome at 8–14 weeks of pregnancy using seven potential serum markers (alpha-fetoprotein, unconjugated oestriol, total human chorionic gonadotrophin (hCG), free α-hCG, free P-hCG, pregnancy associated plasma protein A (PAPP-A), and dimeric inhibin A).Design Stored blood samples collected from women at about 10 weeks of pregnancy, prior to having a chorionic villus sampling procedure on account of advanced maternal age, were retrieved from pregnancies associated with Down's syndrome and from matched unaffected pregnancies.Setting Twenty-one obstetric centres in nine countries.Subjects Seventy-seven pregnancies associated with Down's syndrome each matched with five controls (except in two cases that were matched with four controls) for maternal age (same five year age groups), duration of storage of the serum sample (same calendar year), and gestational age (usually same week of pregnancy).Results The levels of two potential markers differed between affected and unaffected pregnancies sufficiently to be of value in screening—free β-hCG and PAPP-A. The median free P-hCG level in affected pregnancies was 1.79 times the median level for unaffected pregnancies, and the median PAPP-A level was 0.43 times the normal median. These two markers were combined with maternal age to estimate a woman's risk of having a fetus with Down's syndrome. A screening programme that used a risk cutoff level of 1:300 would detect 63 % of affected pregnancies and also classify 5.5% of unaffected pregnancies as screen positive. None of the other five markers added more than 2 % detection for the same false-positive rate.Conclusion The performance of screening using maternal age and serum-free β-hCG and PAPP-A at 10 weeks of pregnancy was better than the double test (alpha-fetoprotein and hCG with maternal age) and similar to the triple test (alpha-fetoprotein, unconjugated oestriol and hCG with maternal age) at 15–22 weeks.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1996.tb09765.x
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