Bert Gold bgold at itsa.ucsf.edu
Sat Feb 10 20:04:05 EST 1996

Dear Netters,

1) The ACOG Guidelines [1] and Guidelines for Perinatal Care published
   by a joint committee of ACOG and the American Academy of Pediatrics [2]
   are very out of date.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 [3] 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 [4].

Bert Gold, Ph.D.
University of California, San Francisco
School of Medicine
Board Active Status - (Eligible) - Medical Molecular Genetics
American Board of Medical Genetics


[1] American College of Obstetricians and Gynecologists, Standards for
    Obstetric-Gynecologic Services, 7th Edition, 1989.

[2] American Academy of Pediatrics and American College of Obstetricians
    and Gynecologists, Guidelines for Perinatal Care, 2nd Edition, 1988.

[3] Prenatal Diagnosis (1994) 14: 707-716 and 14: 717-719.

[4] 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

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