First-trimester screening with nasal bone in twins

Jane Cleary-Goldman, Andrei Rebarber, David Krantz, Terrence Hallahan, Daniel Saltzman

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Objective: The purpose of this study was to evaluate the Down syndrome detection rate at a 5% screen positive rate in first-trimester screening for twins. Study Design: This was a retrospective study from August 2005 to July 2007 of twins who underwent first-trimester screening with nuchal translucency, nasal bone, pregnancy-associated plasma protein-A, and free β-hCG. Risks were calculated on the basis of the Fetal Medicine Foundation twin algorithm. The model simulated distributions of unaffected and affected cases at 12 weeks of gestation. Results: Two thousand ninety-four twin pregnancies (4188 fetuses) met the inclusion criteria. The addition of nasal bone to nuchal translucency, pregnancy-associated plasma protein-A, and free β-hCG increased the Down syndrome detection rate from 79-89% at a 5% screen-positive rate. Conclusion: In twins, first-trimester screening with nasal bone is valuable. The improved Down syndrome detection rate can help these high-risk patients with the decision-making process of whether to pursue invasive testing with its associated pregnancy loss risk.

Original languageEnglish
Pages (from-to)283.e1-283.e3
JournalAmerican Journal of Obstetrics and Gynecology
Issue number3
StatePublished - Sep 2008


  • Down syndrome screening
  • nasal bone
  • twin pregnancy


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