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Alert: Down Syndrome Test Urged for Pregnant Women
Drs Neal Barry and Nicole Barry

There's a big change coming for pregnant women: Down syndrome testing no longer hinges on whether they're older or younger than 35. This week, the American College of Obstetricians and Gynecologists begins recommending that every pregnant woman, regardless of age, be offered a choice of tests for this common birth defect.

The main reason: Tests far less invasive than the long-used amniocentesis are now widely available, some that can tell in the first trimester the risk of a fetus having Down syndrome or other chromosomal defects.

It's a change that promises to decrease unnecessary amniocentesis — giving mothers-to-be peace of mind without the ordeal — while also detecting Down syndrome in moms who otherwise would have gone unchecked.

The new guideline is published in the January issue of the journal Obstetrics & Gynecology.

The newest method, topping ACOG's recommendation for everyone, is a first-trimester screening that combines blood tests with a simple ultrasound exam, called a "nuchal translucency test" to measure the thickness of the back of the fetal neck.

Studies from England, where the nuchal translucency combo has been used for about a decade, and the U.S. conclude that screening method is more than 80 percent accurate, with a very small risk of falsely indicating Down syndrome in a healthy fetus. It is performed between 11 and 13 weeks into pregnancy, and women are usually given numerical odds of carrying an affected fetus.
A woman determined to be high risk then still has time for an invasive test to tell for sure.

Women who don't seek prenatal care until the second trimester can still undergo blood tests known as the triple or quadruple screens.

The guideline also says women of any age can choose to skip the screening and go straight for invasive testing, an approach that might appeal to those with chromosomal defects in the family.

In This Issue:
Keep it Dark at Night
Down Syndrome Test Urged for Pregnant Women
Antibiotics Not Needed for Runny Nose
Recipe: Tomato Soup

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