www.erythron-lab.com

ACOGSOCGCCMGNICE

1 the American Congress of Obstetricians = ACOG 2 - The Society of Obstetricians and Gynecologists of Canada (= SOGC) 3 - Canadian College of Medical Genetics (=CCMG) 4 - the UK National Institute for Health and Clinical Excellence (=NICE)

5 - Open Neural Tube Defects (=ONTDs) 6 - efficient

NT

1 - cost effecitvie

ACOG

MoMsMoM

MoM

MoMs

AFP

AFPAFP

1 - Multiple of Median (=MoM) 2 - Median 3 - Radio Immuno Assay (=RIA) 4 - ELISA

MoMs

MoM

MoM

OAPR

OAPR

nOAPR

OAPR

OAPR

PAPP-AhCGFree(NT)

(11W+0D)(13W+6D)

12W+0D13W+3D

1 - Odds of being Affected given a Positive Result (=OAPR)

2 - Positive Predictive Value (=PPV)

3 - First Trimester Screening (=FTS)

PAPP-AhCGFree

(NT)

NT

OSCAR

4 - One Stop Clinic for Assessment of Risk (=OSCAR)

OAPR

(11W+0D)

MoMs

MoMs

CVS

NT

1 - Mahalanobis distance 2 - screen positive 3 - Chorionic Villus Sampling (=CVS) 4 - fetal transverse limb abnormality 5 - micrognathia 6 - microglossia

7 - exomphalos 8 - ossification

NT

CRL

(13W+6D)

NT

NT

NT

NTNT

NT

CRL

1 - nuchal edema 2 - Nuchal Translucency (=NT) 3 - transabdominal 4 - transvaginal 5 - Crown Rump Length (CRL)

NTNT

NT

NTCRL

CRL

NT

NT

NT

NT

NT

NT

6 - mid - sagital 7 - Neutral 8 - flexed position 9 - hyperextended position 10 - Calipers 11 - inner to inner

NT

NT

NT

NTNT

NT

BCPGSPNT

NT

NTNT

45.XOX

NT

NT

NTNT

CRLCRL

NT

NT

NT

NT

1 - BC Prenatal Genetic Screening Program (=BCPGSP)

2 - skeletal dysplasia

PAPP-A

PAPP-A

IGF

IGFIGF

hCGFreehCG

hCGFreehCG

hCG

(high risk)

(borderline risk)

1 - insulin growth factor (=IGF) 2 - Chorionic Villus Sampling (=CVS) 3 - sequential

(low risk)

AFPAFP MoMNTDs

NT

NT

NT

BCPGSP

4 - translocation 5 - deletion 6 - insertion 7 - inversion 8 - unbalanced chromosomal complement

PAPP-A MoM Free hCG MoMNT MoM

HIV

HIV

IVFICSI1

AFPhCGuE3Inhibin A

1 - Intra Cytoplasmic Sperm Injection(=ICSI)

(14W+0D)

(22W+6D)

15W+2D17W+0D

(AFP)AFP

AFP

(hCG)hCG

mIU/ml

mIU/mlhCG

(uE3)uE3

(DIA) Inhibin AInhibin A

AB

hCGInhibin AAFPuE3

NTPAPP-A

NT

NT

1 - integrated tests 2 - serum integrated 3 - non - discloser

NT hCG

Free PAPP-A

(high risk)

LMP

4 - independent 5 - stepwise 6 - contingent

AFP MoM hCG MoMuE3 MoMInhibin A MoM

IUGR

AFP)2.5(MoMhCG)3.0(MoM

Inhibin A)3.0(MoMuE3).40(MoM

(low risk)

(high risk)

IUGR1

LMP

(low risk)

1 - Intra Uterine Growth Restriction (= IUGR) 2 - choroids plexus

(NTDs)

AFP

NT

AFPhCGPAPP-A

Inhibin AAFP

1 - false positive rate 2 - ethnic origin

hCGPAPP-AuE3

NT

(IDDM)

AFPuE3

hCGFree

PAPP-A NT

IVFhCGuE3

AFPInhibin AIVFhCG

PAPP-ANThCGFree

BCPGSP

1 - prior risk 2 - likelihood ratio 3 - isolated echogenic cardiac focus 4 - echogenic bowel 5 - soft markers

CSF

NF

IUGR

6 - nuchal thickness 7 - renal calyceal dilation 8 - cystic hygroma 9 - clinodactyly 10 - duodenal atresia 11 - hypopastic or absent mid phalanx of the fifth digit 12 - sandal gap 13 - abnormal wave in ductus venosus 14 - cisterna magna 15 - Cerebro Spinal Fluid (=CSF) 16 - facial cleft 17 - single umbilical artery 18 - overlapping fingers 19 - rocker bottom feet

1 - holoprosencephaly 2 - syndactyly 3 - hithch hiker toe deformity

MoMNT

hCG MoM

NTDs

AFP

4 - hypetelorism 5 -hypotelorism 6 - anoophtalmia 7 - cleft lip / cleft palate 8 - open neural tube defects 9 - open spina bifida 10 - myelomeningocele 11 - encephalocele

Quad

Screen

First Trimester Combined

Screen

Serum Integrated

Screen Full Integrated

Screen Sequential

Screen

NTDs

AFP , HCG, UE3 , DIA

NT , PAPP-A , FBHCG

PAPP-A , AFP , HCG , UE3 , DIA

NT , PAPP-A , AFP HCG , UE3 ,

DIA

NT PAPP-A , FBHCG , AFP ,

HCG , UE3 , DIA

Quad Screen

First Trimester

Screen

Serum Integrated

Screen

Full Integrated

Screen Sequential

Screen

AFP

SLO

1 - closed NTDs 2 - lipomyelomeningocele 3 - lipomeningocele 4 - tethered cord 5 - Smith Lemli Opitz

SLO

uE3

MoMMoMs

SLOSLO

SLO

NTDs

NT

PAPP-A0.4MoM0.5MoMhCG

Free

1 - microphthalia 2 - anophthalmia 3 - Peter anomaly

IUGR

IUFD

IUGR

PAPP-A

hCGFree

hCGFree

XhCGFreePAPP-A

(MoM<0.25) PAPP-A

IUGR

PAPP-A

4 - Intra Uterine Fetal Death (= IUFD) 5 - abnormal maternal uterine artery Doppler 6 - impaired placental function 7 - small for gestational function 8 - Spencer

(MoM>2.0) PAPP-A

PAPP-AhCGFree

AFPAFP

NTDs

AFP

AFP MoMAFP MoM

AFP

AFP MoMuE3 MoM

1 - spontaneous reduction 2 - vanishing twin 3 - fetal structural anomalies 4 - ventral or abdominal wall defects 5 - gastroschisis 6 - omphalocele 7 - teratoma 8 - Cystic hygroma

AFPAFP

AFP MoM

AFP

AFP

AFP MoM

AFP MoM

AFPAFP

AFP

AFP MoM

hCG

(MoM>3.0)

IUGR

AFP

AFP

AFP

(IUGR)

AFPHCG

MoM>2.5MoM<0.5

AFP

IUGRAFP

IUFD

1 - choriocangioma 2 -choriocarcinoma 3 - Preterm Rupture of Membranes (=PROM) 4 - preterm delivery or labor or birth 5 - low birth weight 6 - Katz 7 - Haley 8 - abruption placenta 9 - oligohydroamnious

AFP

AFP

AFP

AFP

IUGR IUFD

AFP MoM

AFP

(MoM<0.25) AFP

AFP

10 - antepartum bleeding 11 - prematurity 12 - uterine artery Doppler 13 - transabdominal multifetal reduction 14 - macrosomia 15 - placenta previa 16 - placenta accrete 17 - placenta increta

AFP

AFP

AFP

AFP

AFP

hCG

hCG

hCG

hCG

(MoM=>3.0) hCG

IUGR

1 - placenta percreta 2 - morbidity 3 - asphyxia 4 - sudden infant death syndroma 5 - maternal hypertension or pregnancy induced hypertension

hCG MoM

hCG MOM

HELLP70 IU/L

hCG(MoM 2.0-4.0)

IUGRLBW

hCG

hCGIUGR

hCG

6 mole hydatiform 7 - Walton 8 - hemolysis , elevated liver enzymes and low platelets 9 - Fragmin

hCGAFP

hCG

hCG

B12

hCG

(MoM < 0.5) hCG

hCGAFP

AFPhCG

HIVCD4

uE3(MoM<0.3)

uE3(MoM<0.5)X

1 - non immune hydrops 2 - protease inhibitors intake 3 - X- linked Ichtyosis

Rh

IUGR

uE3LBW

uE3

Inhibin AInhibin A(MoM>2.5)

Inhibin AIUGRIUFD

Inhibin A

(MoM > 2.8) Inhibin A

Inhibin AHELLP

4 - congenital adrenal hyperplasia (=CAH) 5 - oligohydramnios 6 - steroid sulfatase deficiency 7 - placental aromatase deficiency 8 - uterine artery notching

AFP

(MoM>2.5)hCG(MoM>3.0)Inhibin-A (MoM>3.0)AFP

(MoM>0.25)uE3(MoM<0.5)

REFERENCES

1. Nicolaides KH. Am J. Obstet. Gynecol. 2004; 191 : 45-67. 2. Chitayat D, and et al. JOGC July 2011, 261: 736-50. 3.Buckley F and et al. Down Syndrome Research and Practice. Oct. 2008, 12 (Issue 2): 79-86. 4. Taheri Amin MM, et al. Gamete Scientific Bulletin. Vol 8, No.23 & 15, Summer 2010. 5. Taheri Amin MM, et al. Gamete Scientific Bulletin. Vol 4 , No. 12 , Spring 2007. 6. Taheri Amin MM, et al. Eighth International Congress of International Down s Syndrme Screening Group. (Oral Presentation), Vancouver, Canada, May 2008. 7. pandya PP, and et al. BJOG 1995; 102: 957-62. 8. Cuckle HS, et atl. Ultrasound Obstet. Gynecol. 2007: 19 (4): 323-6. 9. Taheri Amin MM, et al. Sixth International Congress of Fetal Medicine. (Oral Presentation), Cavtat, Croatia, July 2007. 10. Taheri Amin MM, et al. Seventh Internaltional Congerss of International Down s Syndrome Screening Group. (Oral presentation), Amsterdam, Netherlands, May 2006. 11. Spencer K, et al. Prenatal Diagnosis. 2000; 20, 91-5. 12. Hackshaw AK, and et al. Prenatal Diagnosis. 2001; 21, 58-61. 13. Snijders RJM, and et al. Lancel 1998 ; 351:343-6. 14.Dugoff L, et al. Obstet Gynecol, 2005 Aug. 106 (2): 260-7. 15. Gagnon A, et al. JOGC Oct. 2008; 217: 918-32. 16. Hasegawa J, et al . Taiwan J. Obstet. Gynecol, 2006 March; 45 (1) : 21-5. 17. Palomaki GE. Adv. Clin. Chem. 2007; 43: 177. 18. Spencer K. Prenat Diagn, 2008: 28: 7. 19. Karsidag AYK, et a.. JPMA, 2010; 10: 13-5. 20. Dugoff L, et al. Obstet. Gynecol. 2010 May; 115(5): 1052-61. 21. Gagnon A, et al. JOGC Oct. 2008; 217: 918-32. 22. Huang T, et al. Prenat. Diagn. 2010 May; 30 (5): 471-7.

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