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Vol. 47. Núm. 1.
Páginas 5-19 (enero 2004)
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Vol. 47. Núm. 1.
Páginas 5-19 (enero 2004)
Acceso a texto completo
Cribado bioquímico-ecográfico de las aneuploidías en el primer trimestre. Metodología y resultados
First-trimester biochemical-ultrasound aneuploidy screening. Methodology and results
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11888
C. Bacha, S. Torrenta, D. Cabrerob, J. Sabriàa,
Autor para correspondencia
jsabria@arrakis.es

Correspondencia: Servicio de Obstetricia y Ginecología. Hospital Universitario de Girona Doctor Josep Trueta. Ctra. de Francia, s/n. 17007 Girona. España
a Servicio de Obstetricia y Ginecología. Hospital Universitario de Girona Doctor Josep Trueta. Girona. España
b Laboratorio de Análisis Clínicos. Hospital Universitario de Girona Doctor Josep Trueta. Girona. España
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Resumen
Objetivo

Valorar la eficacia del cribado bioquímico-ecográfico de las aneuploidías en el primer trimestre de la gestación así como describir detalladamente la metodología utilizada.

Sujetos y métodos

Estudio prospectivo en 3.492 gestantes, portadoras de un feto único, en las que se realiza el cribado bioquímico mediante la fracción beta libre de la gonadotropina coriónica humana y la proteína plasmática A asociada al embarazo, entre las 8 y las 13 semanas de gestación, y el cribado ecográfico, entre las 11 y las 13 semanas, con la medición de la longitud cefalocaudal y del grosor de la translucencia nucal. Se exponen los procedimientos epidemiológico-matemáticos utilizados para estimar el riesgo de que una gestante sea portadora de un feto afectado de aneuploidía.

Resultados

El cribado bioquímico ecográfico del primer trimestre ha permitido detectar, en esta serie, el 83% (10 de 12) de las trisomías 21, el 86% (18 de 21) de las trisomías autosómicas y el 82% (23 de 28) de todas las aneuploidías, para una tasa de falsos positivos del 5,4%.

Conclusiones

Este tipo de cribado presenta una alta efectividad pero precisa una metodología adecuada para la obtención de resultados óptimos.

Palabras clave:
Cribado prenatal
Cribado bioquímico
Cribado ecográfico
Síndrome de Down
Primer trimestre
Abstract
Objective

To evaluate the effectiveness of first-trimester biochemical-ultrasound screening for aneuploidy and to describe the methodology used in detail.

Subjects and methods

We performed a prospective study of 3492 single pregnancies screened by means of two biochemical markers (free β subunit of human chorionic gonadotropin and pregnancy-associated plasma protein-A) between weeks 8 and 13 of gestation. Ultrasound screening was performed with measurement of nuchal translucency thickness and fetal crown-rump length between weeks 11 and 13. We describe the mathematical and epidemiological methods used to estimate the risk of aneuploidy in individual pregnancies.

Results

In our series, the detection rate of first-trimester biochemical-ultrasound screening was 83% (10 of 12) for trisomy 21, 86% (18 of 21) for autosomal trisomies and 82% (23 of 28) for all aneuploidies, with a false-positive rate of 5.4%.

Conclusions

This type of screening is highly effective but requires appropriate methodology to obtain optimal results.

Keywords:
Prenatal screening
Biochemical screening
Ultrasound screening
Down’s syndrome
First trimester
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Copyright © 2004. Sociedad Española de Ginecología y Obstetricia
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