1) The ACOG Guidelines  and Guidelines for Perinatal Care published
by a joint committee of ACOG and the American Academy of Pediatrics 
are very out of date.
2) The triple screen, in capable hands, should detect 60% of antenatal
Down's Syndrome births, 70% of chromosome 18 trisomies, significant
proportions of Turner's and all patent Open Neural Tube Defects.
3) Newer versions of the Screening Test  will detect 72% of Down's
Syndrome gestations with a 2-5% false positive rate.
4) For these reasons, an international collaboration has strongly
endorsed the policy of offering testing to ALL women .
Bert Gold, Ph.D.
University of California, San Francisco
School of Medicine
Board Active Status - (Eligible) - Medical Molecular Genetics
American Board of Medical Genetics
 American College of Obstetricians and Gynecologists, Standards for
Obstetric-Gynecologic Services, 7th Edition, 1989.
 American Academy of Pediatrics and American College of Obstetricians
and Gynecologists, Guidelines for Perinatal Care, 2nd Edition, 1988.
 Prenatal Diagnosis (1994) 14: 707-716 and 14: 717-719.
 Wald, NJ; Kennard, A.; Watt, H.; Haddow, J.E.; Palomaki, G.E.; Knight,
G. and Canick, J.A. (1995) Decision Analysis and Screening for Down's
Syndrome. Testing Should be in All Women. BMJ 311, 1372-1373