Ductus venosus Doppler in screening for trisomies 21, 18 and 13 and Turner syndrome at 11–13 weeks of gestation
Abstract
Objectives: To investigate the performance of first‐trimester screening for aneuploidies by including assessment of ductus venosus flow in the combined test of maternal age, fetal nuchal translucency thickness, fetal heart rate, and serum free β‐human chorionic gonadotropin and pregnancy‐associated plasma protein‐A. Methods: Screening by the combined test was performed in singleton pregnancies, including 19 614 with euploid fetuses, 122 with trisomy 21, 36 with trisomy 18, 20 with trisomy 13 and eight with Turner syndrome. In all cases the a‐wave in the fetal ductus venosus flow was assessed. We examined the performance of two screening strategies: first, assessment of the a‐wave in all patients and, second, first‐stage screening using the combined test in all patients followed by second‐stage assessment of the a‐wave only in those with an intermediate risk of one in 51 to one in 1000 after the first stage Results: Reversed a‐wave was observed in 3.2% of the euploid fetuses, and in 66.4%, 58.3%, 55.0% and 75.0% of fetuses with trisomies 21, 18 and 13 and Turner syndrome, respectively. Inclusion of ductus venosus flow in all pregnancies would detect 96%, 92%, 100% and 100% of trisomies 21, 18 and 13 and Turner syndrome, respectively, at a false‐positive rate of 3%. The same detection rates were achieved with the two‐stage strategy at a false‐positive rate of 2.6%, in which it was necessary to assess the ductus venosus in only 15% of the total population. Conclusions: Assessment of ductus venosus flow improves the performance of first‐trimester screening for aneuploidies. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.
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A reversed a-wave on the ductus venosus was observed in 66.4% of fetuses with trisomy 21 and 75% of those with Turner syndrome.
“According to a study, a reversed a-wave on the ductus venosus was observed in 66.4% of fetuses with trisomy 21 and 75% of those with Turner syndrome [74].”
From First-Trimester Ultrasound: A Comparative Review of Guidelines (2026) · cites this paper as [74]
Co-evaluation of ductus venosus flow along with maternal age, NT, maternal free h-CG, PAPP-A and fetal heart rate increases the detection rates of trisomy 21, 18, 13 and Turner syndrome to 96%, 92%, 100% and 100%, respectively.
“Additionally, co-evaluation of this parameter along with maternal age, NT, maternal free h-CG, PAPP-A and fetal heart rate increases the detection rates of trisomy 21, 18, 13 and Turner syndrome to 96%, 92%, 100% and 100%, respectively [74].”
From First-Trimester Ultrasound: A Comparative Review of Guidelines (2026) · cites this paper as [74]
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- Authors
- Maiz, N., Valencia, C., Kagan, K. O., Wright, D., & Nicolaides, K. H.
- Affiliations
- Harris Birthright Research Centre for Fetal Medicine (GB)
- University of Plymouth (GB)
- Corresponding author
- Nicolaides, K. H.
- Venue
- Ultrasound in Obstetrics & Gynecology
- Publisher
- Wiley
- Published
- 2009-03-31
- Volume
- 33
- Issue
- 5
- Pages
- 512-517
- ISSN
- 0960-7692 (ISSN-L)
- 1469-0705
- OpenAlex
- W2104910044
- Cited by
- 206
- References
- 22
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 8 · 2023: 10 · 2022: 10 · 2021: 10 · 2020: 6 · 2019: 7 · 2018: 12 · 2017: 14 · 2016: 15 · 2015: 13 · 2014: 10 · 2013: 12 · 2012: 21
- FWCI
- 19.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Ultrasound in Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Screening and Diagnostics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
- Keywords
- ductus venosus flow, a-wave, first-trimester screening, aneuploidy, Down syndrome, trisomy 18, trisomy 13, Turner syndrome, nuchal translucency, combined test, false positive rate, fetal heart rate
- MeSH terms
- Adolescent, Adult, Algorithms, Chromosomes, Human, Pair 13, Chromosomes, Human, Pair 18, Down Syndrome, False Positive Reactions, Female, Humans, Maternal Age, Middle Aged, Pregnancy, Pregnancy Trimester, First, Pregnancy-Associated Plasma Protein-A, Prospective Studies, Regional Blood Flow, Trisomy, Turner Syndrome, Umbilical Veins, Vena Cava, Inferior, Biomarkers, Ultrasonography, Prenatal, Chorionic Gonadotropin, beta Subunit, Human, Young Adult
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