Cited by 1,572Prenatal Screening and DiagnosticsDown syndrome and intellectual disability researchFetal and Pediatric Neurological Disorders

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UK multicentre project on assessment of risk of trisomy 21 by maternal age and fetal nuchal-translucency thickness at 10–14 weeks of gestation

Snijders, RJM, Noble, P, Sebire, N, Souka, A, Nicolaides, KH·1998·The Lancet

DOI 10.1016/s0140-6736(97)11280-6

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Abstract

Background Prenatal diagnosis of trisomy 21 currently relies on assessment of risk followed by invasive testing in the 5% of pregnancies at the highest estimated risk. Selection of the high-risk group by a combination of maternal age and second-trimester maternal serum biochemistry gives a detection rate of about 60%. We investigated assessment of risk by a combination of maternal age and fetal nuchal-translucency thickness, measured by ultrasonography at 10-14 weeks of gestation.Methods The risk of trisomy 21 was estimated for 96127 women of median age 31 years (range 14-49) with singleton pregnancies. Ultrasonography was done by 306 appropriately trained sonographers in 22 centres. Risk of trisomy 21 was calculated from the maternal age and gestational-age-related prevalence, multiplied by a likelihood ratio depending on the deviation from normal in nuchal-translucency thickness for crown-rump length. The distribution of risks was investigated and the sensitivity of a cut-off risk of 1 in 300 was calculated. Phenotype was assessed by fetal karyotyping or clinical examination of liveborn infants.Findings The estimated trisomy-21 risk, from maternal age and fetal nuchal-translucency thickness, was 1 in 300 or higher in 7907 (8.3%) of 95476 normal pregnancies, 268 (82-2%) of 326 with trisomy 21, and 253 (77.9%) of 325 with other chromosomal defects. The 5% of the study population with the highest estimated risk included 77% of trisomy-21 cases.Interpretation Selection of the high-risk group for invasive testing by this method allows the detection of about 80% of affected pregnancies. However, even this method of risk assessment requires about 30 invasive tests for identification of one affected fetus.

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Fetal nuchal translucency: ultrasound screening for chromosomal defects in first trimester of pregnancy.
Nicolaides, K. H., Azar, G. B., Byrne, D. L., Mansur, C. A., & Marks, K. (1992) · BMJ · doi:10.1136/bmj.304.6831.867 · Cited by 1,051
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Maternal Age and Gestational Age-Specific Risk for Chromosomal Defects
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“…age, maternal serum free β-hCG and pregnancy-associated plasma protein A (PAPP-A), ultrasonographic measurement of fetal NT thickness and Doppler assessment of the flow pattern in the ductus venosus and across the tricuspid valve (Snijders et al., 1998; Kagan et al., 2008, 2009; Maiz et al., 2009).”
Method
Hyperclarté nucale à caryotype normal
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“Evidence from Snijders et al (15) suggests that with a false positive rate of 5 per cent, the sensitivity of NTS for trisomy 21 was 77 per cent (95% CI=72%, 82%).”
Background
Quality control of prenatal ultrasound
Salomon, L. J., & Ville, Y. G. (2005) · The ultrasound review of obstetrics & gynecology/Ultrasound review of obstetrics and gynecology · doi:10.3109/14722240500415419 · Cited by 11
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Screening for Fetal Chromosomal Abnormalities with Nuchal Translucency Measurement in the First Trimester
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“An increased nuchal translucency on ultrasound (Snijders et al., 1998) has been shown as an early indicator of DS.”
Background
Jugular vein and carotid artery blood flow in fetuses with increased nuchal translucency at 10–14 weeks' gestation
Martínez, J. M., Echevarría, M., Gómez, O., del Río, M., BORRELL, A., Puerto, B., & Fortuny, A. (2003) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.898 · Cited by 11
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“found that TRAP can be diagnosed at 11–14 weeks of gestation, supporting the need for the early clinical management of TRAP [6].”
Background
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“The nuchal translucency was measured on a directly obtained 2D midsagittal image of the fetus in the standard fashion as described by Snijders et al.(4) All firsttrimester fetuses in our center routinely undergo at least 2 volume acquisitions, which are saved for later review.”
Method
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“Measurement of nuchal translucency (NT) in the first trimester of pregnancy has become an established method for identifying fetuses at risk for aneuploidy, especially in Down syndrome screening (Pandya et al., 1995; Snijders et al., 1998).”
Method
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“The use of different serological markers in combination with maternal age and ultrasound markers such as nuchal translucency (NT) in the first trimester (Snijders et al., 1998) has been shown to increase the detection rate (DR) markedly for a reduced screen-positive rate (SPR).”
BackgroundMethod
Are nuchal translucency, pregnancy associated plasma protein-A or free-β-human chorionic gonadotropin depending on maternal age? A multicenter study of 8,116 pregnancies
Schmidt, P. M., Pruggmayer, M., Steinborn, A., Schippert, C., STABOULIDOU, I., Hillemanns, P., & Scharf, A. (2007) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-007-0342-4 · Cited by 10
“This is important as the fundamental studies on the likelihood ratios disregard the age [12].”
Screening for Down syndrome
Khalil, A. A., & Pandya, P. P. (2006) · Cited by 10
Clinical value of color doppler ultrasound in prenatal diagnosis of umbilical cord entry abnormity
Sun, J., Wang, L., & Li, Y. (2016) · Pakistan Journal of Medical Sciences · doi:10.12669/pjms.325.10518 · Cited by 10
Can biparietal diameter-to-femur length ratio be a useful sonographic marker for screening thanatophoric dysplasia since the first trimester? A literature review of case reports and a retrospective study based on 10,293 routine fetal biometry measurements
Wang, L., Takai, Y., Baba, K., Mikami, Y., Saito, M., Horiuchi, I., Konno, R., Takagi, K., & Seki, H. (2017) · Taiwanese Journal of Obstetrics and Gynecology · doi:10.1016/j.tjog.2017.04.021 · Cited by 10
First-Trimester Sonographic Screening for Down Syndrome
Malone, F. D., & D’Alton, M. E. (2003) · Obstetrics and Gynecology · doi:10.1097/00006250-200311000-00033 · Cited by 10
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Öztekin, Ö. (2009) · Journal of Medical Ultrasonics · doi:10.1007/s10396-009-0226-2 · Cited by 10
“Table 2 summarizes the technical and practical requirements for NT measurements [36].”
BackgroundMethod
First‐trimester prenatal diagnosis of a familial subtelomeric translocation
Kilby, M. D., Brackley, K. J., Walters, J. J., Morton, J. E. V., Roberts, E. T., & Davison, E. V. (2001) · Ultrasound in Obstetrics and Gynecology · doi:10.1046/j.1469-0705.2001.00363.x · Cited by 10
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Preliminary normal reference values of nuchal translucency thickness in Taiwanese fetuses at 11-14 weeks of gestation.
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Contribution of chromosomal microarray analysis and next‐generation sequencing to genetic diagnosis in fetuses with normal karyotype
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Distribution of nuchal translucency thickness in J apanese fetuses
Hasegawa, J., Nakamura, M., Hamada, S., Matsuoka, R., Ichizuka, K., Sekizawa, A., & Okai, T. (2012) · Journal of obstetrics and gynaecology research · doi:10.1111/j.1447-0756.2012.02037.x · Cited by 9
Fetal nuchal translucency scan in Nigeria
Oloyede, O. A., Abbey, M., Oloyede, A. A., & Nwachukwu, O. (2014) · Pan African Medical Journal · doi:10.11604/pamj.2014.18.62.3291 · Cited by 9
“As a routine, it provides a first trimester detection rate of about 80% for Down syndrome pregnancies for a false positive rate of about 5%, and even superior detection rates for trisomy 13 and 18 [2-4].”
Influential
Validation of First Trimester Screening for Trisomy 21 in Singapore with Reference to Performance of Nasal Bone
Yeo, G. S. H., Lai, F. M., Wei, X., Lata, P., Tan, D. T. H., Yong, M. H., Tan, E. T. H., & Kwek, K. (2012) · Fetal Diagnosis and Therapy · doi:10.1159/000338656 · Cited by 9
Fetal tricuspid valve Doppler at 11–13 weeks and 6 days: reference values and reproducibility
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“For NT thickness, a sagital section of the fetal neck was used and maximum subcutaneous hypoechogenic space was measured, as previously described by Snijders et al. (1998).”
Method
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Diagnosis of Fetal Abnormalities during the First Trimester
Yoshizato, T., Kozuma, Y., Horinouchi, T., Shinagawa, T., Yokomine, M., & Ushijima, K. (2019) · The Kurume Medical Journal · doi:10.2739/kurumemedj.ms662002 · Cited by 9
Abnormal Ductus Venosus Flow in First-Trimester Fetuses With Increased Nuchal Translucency
de Mooij, Y. M., Haak, M. C., Bartelings, M. M., Twisk, J. W. R., Groot, A. C. G., van Vugt, J. M. G., & Bekker, M. N. (2010) · Journal of Ultrasound in Medicine · doi:10.7863/jum.2010.29.7.1051 · Cited by 9
Clinical first-trimester routine screening for Down syndrome in singleton pregnancies in northern Finland
Valinen, Y., Rapakko, K., Kokkonen, H., Laitinen, P. H., Tekay, A., Ahola, T., & Ryynänen, M. (2007) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2006.11.040 · Cited by 9
Ver�nderte Anforderungen an die Beratung zur pr�natalen Diagnostik von fetalen Chromosomenanomalien
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“In der Multicenterstudie der Fetal Medicine Foundation [14,22] hatten nur 3,9% der chromosomal normalen Feten mit einer NT >95.”
Background
Comparison of the New PRC Software with the Established Algorithm of the FMF UK for the Detection of Trisomy 21 and 18/13
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“First-trimester screening using nuchal translucency (NT) measurement together with PAPP-A and free beta-hCG has become the foremost detection method for an evaluation of the risk for trisomy 21 in Germany and many other European countries. In many large studies, it was proven that this method is able to detect about 8…”
Method
Performance adjusted risks: a method to improve the quality of algorithm performance while allowing all to play
Evans, M. I., & Cuckle, H. (2011) · Prenatal Diagnosis · doi:10.1002/pd.2769 · Cited by 9
“The Fetal Medicine Foundation (FMF) in London established training and certification programs to monitor and credential new providers in NT measurements (Snijders et al., 1998, 2002).”
Background
Aneuploidy screening: ultrasound versus biochemistry
Sabrià, J., Cabrero, D., & Bach, C. (2002) · The ultrasound review of obstetrics & gynecology/Ultrasound review of obstetrics and gynecology · doi:10.1080/14722240208500490 · Cited by 9
Are Serum Protein Biomarkers Derived from Proteomic Analysis Useful in Screening for Trisomy 21 at 11–13 Weeks?
Mastricci, A. L., Akolekar, R., Kuppusamy, R., Ahmed, M. S., & Nicolaides, K. H. (2011) · Fetal Diagnosis and Therapy · doi:10.1159/000324310 · Cited by 9
The Role of Second-Trimester Serum Screening in the Post–First-Trimester Screening Era
Shamshirsaz, A. A., BENN, P. A., & EGAN, J. F. X. (2010) · Clinics in Laboratory Medicine · doi:10.1016/j.cll.2010.04.013 · Cited by 9
Estimating the effect of gestational age on test performance of combined first-trimester screening for Down syndrome: a preliminary study
van Heesch, P. N. A. C. M., Struijk, P. C., Laudy, J. A. M., Steegers, E. A. P., & Wildschut, H. I. J. (2010) · Journal of Perinatal Medicine · doi:10.1515/jpm.2010.033 · Cited by 9
First- and midtrimester Down syndrome screening and detection
Bahado-Singh, R. O., Choi, S., & Cheng, C. (2004) · Clinics in Perinatology · doi:10.1016/j.clp.2004.06.002 · Cited by 9
Dépistage de la trisomie 21 par le test combiné du premier trimestre suivi par l'échographie du second trimestre en population générale
Rozenberg, P., Bussières, L., Chevret, S., Bernard, J. P., Malagrida, L., Cuckle, H., Chabry, C., Durand‐Zaleski, I., Bidat, L., Lacroix, I., et al. (2007) · Gynécologie Obstétrique & Fertilité · doi:10.1016/j.gyobfe.2007.02.004 · Cited by 9
First-Trimester Screening for Trisomy 21 with Adjustment for Biochemical Results of Previous Pregnancies
Wright, D. E., Syngelaki, A., Birdir, C., Bedei, I. A., & Nicolaides, K. H. (2011) · Fetal Diagnosis and Therapy · doi:10.1159/000328710 · Cited by 9
Correlations between first and second trimester markers for Down's syndrome screening
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Elevated levels of total (maternal and fetal) β-globin DNA in maternal blood from first trimester pregnancies with trisomy 21
Jorgez, C. J., Dang, D., Wapner, R. J., Farina, A., Simpson, J. L., & Bischoff, F. Z. (2007) · Human Reproduction · doi:10.1093/humrep/dem154 · Cited by 9
Nuchal translucency screening: how do women actually utilize the results?
Caughey, A. B., Musci, T. J., Belluomini, J., Main, D. M., Otto, C., & Goldberg, J. (2006) · Prenatal Diagnosis · doi:10.1002/pd.1617 · Cited by 9
“…with first-trimester serum screens (Bewley et al., 1995; Hafner et al., 1998; Kornman et al., 1996; Orlandi et al., 1997; Pajkrt et al., 1998; Snijders et al., 1998; Taipale *Correspondence to: Aaron B. Caughey, Department of Obstetrics and Gynecology, University of California, San…”
A Review on Techniques for Computer Aided Diagnosis of Soft Markers for Detection of Down Syndrome in Ultrasound Fetal Images
Shiney, O. J., Singh, O. J. A. P., & Shan, B. P. (2017) · Biomedical & Pharmacology Journal · doi:10.13005/bpj/1266 · Cited by 9
First-Trimester Risk Assessment: Twin Gestations
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Medida da Translucência Nucal no Rastreamento de Anomalias Cromossômicas
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“24, no 3, 2002 Trabalhos Originais 24 (3): 167-173, 2002 RBGO”
Brachycephaly and frontal lobe hypoplasia in fetuses with trisomy 21 at 11 + 0 to 13 + 6 weeks
Borenstein, M., Dagklis, T., Csapó, B., Sotiriadis, A., & Nicolaides, K. H. (2006) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.3858 · Cited by 9
First trimester screening for fetal abnormalities
Hyett, J. A., & Thilaganathan, B. (1999) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/00001703-199912000-00005 · Cited by 9
Point-of-care screening for chromosomal anomalies in the first trimester of pregnancy.
Spencer, K. (2002) · PubMed · Cited by 9
Maternal Serum Screening for Chromosomal Abnormalities and Neural Tube Defects
Cuckle, H., Pergament, E., & BENN, P. A. (2015) · doi:10.1002/9781118981559.ch12 · Cited by 9
Clinical Audit and Reform of the UK Research Ethics Review System
Cave, E., & Nichols, C. (2007) · Metamedicine · doi:10.1007/s11017-007-9034-0 · Cited by 8
A significant linear association exists between nuchal translucency thickness and adverse perinatal outcome in euploid fetuses
Sheizaf, B., Sheiner, E., Fink, M., Hershkovitz, R., Mazor, M., & Wiznitzer, A. (2009) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767050802676717 · Cited by 8
“The overall rate of increased NT in our population (2%) with NT 2 mm, is lower than the expected 5% reported in other studies [2].”
BackgroundMethodResultInfluential
Preliminary analysis of the new ‘Prenatal Risk Calculation (PRC)’ software
Hörmansdörfer, C., Scharf, A., Golatta, M., Vaske, B., Hillemanns, P., & Schmidt, P. (2008) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-008-0743-z · Cited by 8
“Likelihood ratios for NT are calculated on the data of the British multicentre study [1].”
United States' experience in nuchal translucency measurement: variation according to provider characteristics in over five million ultrasound examinations
Thornburg, L. L., Bromley, B., Dugoff, L., Platt, L. D., Fuchs, K. M., Norton, M. E., McIntosh, J. J., Toland, G. J., & Cuckle, H. (2021) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.23621 · Cited by 8
Postpartum Hemorrhage
Decesare, J. Z. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.029 · Cited by 8
Application of chromosome microarray analysis and karyotyping in diagnostic assessment of abnormal Down syndrome screening results
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Audit of fetal biometry: understanding sources of error to improve our practice
Papastefanou, I., Nicolaides, K. H., & Salomon, L. J. (2023) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.26156 · Cited by 8
The role of ultrasound in first-trimester screening after the introduction of NIPT as a service of public health insurance – a consensus statement of the Fetal Medicine Foundation (FMF) Germany
Merz, E., Eiben, B., Thode, C., Hackelöer, B.-J., Faber, R., Tercanli, S., & Alkier, R. (2023) · Ultraschall in der Medizin - European Journal of Ultrasound · doi:10.1055/a-2104-2689 · Cited by 8
“For two decades, combined first-trimester screening (FTS), including data on maternal age, ultrasound markers, and biochemical parameters, had been the most reliable noninvasive procedure to calculate the risk of chromosomal abnormalities between 11 + 0 and 13 + 6 weeks of gestation [1, 2, 3, 4, 5].”
Background
Fetal upper limb amelia with increased nuchal translucency
Bianca, S., Bartoloni, G., Libertini, C., Boemi, G., Barrano, B., Cataliotti, A., Barone, C., Indaco, L., Vallone, A., & Ettore, G. (2009) · Congenital Anomalies · doi:10.1111/j.1741-4520.2009.00238.x · Cited by 8
“Increased NT is associated with an increased risk of chromosomal abnormality and is a marker for major cardiac defects, noncardiac structural defects, and rare genetic syndromes, including skeletal dysplasias in chromosomally normal fetuses (Snijders et al. 1998; Hyett et al. 1999).”
Background
Increased nuchal translucency origins from abnormal lymphatic development and is independent of the presence of a cardiac defect
Burger, N. B., Bekker, M. N., Kok, E., de Groot, C. J. M., Martin, J. F., Shou, W., Scambler, P. J., Lee, Y., Christoffels, V. M., & Haak, M. C. (2015) · Prenatal Diagnosis · doi:10.1002/pd.4687 · Cited by 8
Monochorionic diamniotic twin gestations discordant for markedly enlarged nuchal translucency
Edlow, A. G., Reiss, R. E., Benson, C. B., Gerrol, P., & Wilkins-Haug, L. E. (2011) · Prenatal Diagnosis · doi:10.1002/pd.2691 · Cited by 8
“5 mm was chosen because it corresponds to the 99th percentile for NT thickness (Snijders et al., 1998).”
BackgroundMethodInfluential
The relationship between maternal body mass, smoking status and ethnicity and first trimester nuchal translucency thickness
Cowans, N. J., & Spencer, K. (2011) · Prenatal Diagnosis · doi:10.1002/pd.2713 · Cited by 8
“Increased NT thickness is associated with an increased risk of trisomy 21 or other chromosomal anomalies (Nicolaides et al., 1992; Snijders et al., 1998), and NT thickness measurement is the principal contributor to the high detection rates achieved with the first trimester combined test (NT…”
Background
First trimester ultrasound screening for fetal aneuploidy and middle cerebral artery Doppler assessment for fetal alloimmunization
Biggio, J. (2005) · Current Opinion in Pediatrics · doi:10.1097/01.mop.0000181470.65000.eb · Cited by 8
The nuchal translucency examination leading to early diagnosis of structural fetal anomalies
Goldstein, I., Weizman, B., Khatib, N., & Weiner, Z. (2014) · Early Human Development · doi:10.1016/j.earlhumdev.2013.12.008 · Cited by 8
Nuchal translucency as a method of first-trimester screening for aneuploidy.
Naidoo, P., Erasmus, I., Jeebodh, J., Nicolaou, E., & Gelderen, C. J. V. (2008) · PubMed · Cited by 8
Prenatal Diagnosis of Double Trisomy 48,XXX,+18 in the First Trimester
Víctor Dezerega, P., Cecilia Be, R., Wong, A. E., Silva, R., & Sepúlveda, W. (2005) · Journal of Ultrasound in Medicine · doi:10.7863/jum.2005.24.5.717 · Cited by 8
Maternal serum human placental growth hormone at 11 to 13 weeks in trisomy 21 and trisomy 18 pregnancies
Sifakis, S., Akolekar, R., Syngelaki, A., Cruz, J. D. J., & Nicolaides, K. H. (2010) · Prenatal Diagnosis · doi:10.1002/pd.2438 · Cited by 8
“Methods The maternal serum concentration of hPGH at 11 to 13 weeks was measured in a case–control study from 28 pregnancies with fetal trisomy 21, 28 with trisomy 18 and 112 pregnancies with euploid fetuses.”
Method
Genetic Causes of Congenital Malformation in India
Talukder, G., & Sharma, A. K. (2006) · International Journal of Human Genetics · doi:10.1080/09723757.2006.11885942 · Cited by 8
“Women above 34 years should be advised after ultrasonography to avoid amniocetensis with 80% success (Snijders et al. 1998).”
Prenatal Genetic Diagnosis
Simpson, J. L., & Otaño, L. (2007) · Elsevier eBooks · doi:10.1016/b978-0-443-06930-7.50009-8 · Cited by 8
A four-year retrospective study of amniocentesis: one centre experience.
Daniilidis, A., Karydas, H., Zournatzi, V., Tantanasis, T., GIANNOULIS, C., & Tzafettas, J. M. (2008) · PubMed Central · Cited by 8
Value of increased nuchal translucency in the era of noninvasive prenatal testing with cell‐free DNA
Holzer, I., Husslein, P. W., Bettelheim, D., Scheidl, J., Kiss, H., & Farr, A. (2019) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.12808 · Cited by 8
Impact of preimplantation genetic testing for aneuploidies (PGT-A) on first trimester biochemical markers – PAPP-A (placenta-associated plasma protein) and free β-hCG (human chorionic gonadotropin)
Markova, D. M., Kagan, O., Hoopmann, M., Abele, H., Coughlan, C., Abecia, E. I., Fatemi, H. M., & Lawrenz, B. (2021) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2021.1906857 · Cited by 8

Authors: Snijders, R., Noble, P., Sebire, N., Souka, A., & Nicolaides, K.
Affiliations: King's College London (GB)
ORCID: Snijders, RJM
Sebire, N
Souka, A
Venue: The Lancet
Publisher: Elsevier BV
Published: 1998-08
Volume: 352
Issue: 9125
Pages: 343-346
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(97)11280-6
OpenAlex: W2148260008
Cited by: 1,572
References: 20
Citations by year: 2026: 10 · 2025: 14 · 2024: 21 · 2023: 20 · 2022: 24 · 2021: 36 · 2020: 21 · 2019: 36 · 2018: 26 · 2017: 85 · 2016: 34 · 2015: 42 · 2014: 47 · 2013: 60 · 2012: 58
FWCI: 73.54
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet (publishedVersion)
PubMed (publishedVersion)
UCL Discovery (University College London) (submittedVersion)
DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Topics: Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Screening and Diagnostics
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
Keywords: Down syndrome, prenatal diagnosis, nuchal translucency, maternal age, first-trimester screening, risk assessment, invasive prenatal diagnosis, sensitivity, chromosomal abnormalities, fetal karyotyping
MeSH terms: Adolescent, Adult, Chromosome Aberrations, Down Syndrome, Female, Fetus, Follow-Up Studies, Gestational Age, United Kingdom, Humans, Karyotyping, Maternal Age, Middle Aged, Neck, Phenotype, Predictive Value of Tests, Pregnancy, Pregnancy Outcome, Sensitivity and Specificity, Prevalence, Likelihood Functions, Ultrasonography, Prenatal, Crown-Rump Length, Risk Assessment, Chromosome Disorders, Pregnant People

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UK multicentre project on assessment of risk of trisomy 21 by maternal age and fetal nuchal-translucency thickness at 10–14 weeks of gestation

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