Impact of first-trimester aneuploidy screening in a high-risk population.

Objective: To determine the impact on maternal decision-making of offering first-trimester screening to women at increased risk for fetal aneuploidy.

Methods: A retrospective chart review of all patients > or = 35 years of age at delivery who registered to deliver at Massachusetts General Hospital before (2000-2002; n = 1,604) and after (2003-2005; n = 1,915) the introduction of first-trimester screening. Demographics, the choice of screening test and/or invasive procedure (chorionic villus sampling or amniocentesis), and the detection rate of fetal aneuploidy were compared between the two groups by chi(2) test.

Low or absent unconjugated estriol in pregnancy: an indicator for steroid sulfatase deficiency detectable by fluorescence in situ hybridization and biochemical analysis.

It has been previously reported that a low or absent maternal serum unconjugated estriol (uE3) level is associated with placental steroid sulfatase (STS) deficiency. Here we report a correlation between patients who present with a very low or absent maternal serum uE3 and a deletion of the STS gene as assessed by fluorescence in situ hybridization (FISH). We studied nine prenatal cases that presented to the clinical laboratory with an abnormal triple screen, specifically low or absent maternal serum uE3 and a 46,XY karyotype.