An ultrasound test used in screening for chromosome abnormalities could lead women to undergo unnecessary invasive tests and risk miscarrying healthy babies, reported two newspapers (16 August 2007). The reports were based on a published lecture. A figure for the number of miscarriages appeared only in the accompanying press release.
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Two newspapers (1-2) reported on 16 August 2007 that ultrasound assessment of foetal 'nuchal thickness' (accumulation of fluid at the back of the neck) as a preliminary screening test for chromosome abnormalities is not supported by scientific data. As a result, pregnant women may be unnecessarily referred for invasive tests that carry a risk of miscarriage, leading to the loss of up to 3200 normal babies a year.
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The reports are based on part of a lecture by Dr Hylton B Meire published in the journal Ultrasound (3), and the accompanying press release (4).
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The newspaper reports accurately summarised Dr Meire's view of the limitations of ultrasound screening. The figure of 3200 miscarriages of healthy babies per year appeared only in the press release and was based on an extrapolation of Dr Meire's analysis of data from one clinical trial to the whole UK population of pregnant women.
Systematic reviews
Information staff at CRD searched for systematic reviews relevant to this topic. Systematic reviews are valuable sources of evidence as they locate, appraise and synthesize all available evidence on a particular topic.
There was one related systematic review identified on the Cochrane Database of Systematic Reviews (CDSR) (5) and four on the Database of Abstracts of Reviews of Effects (DARE) (6-9).
References and resources
1. The '3,000 needless miscarriages'. Daily Mail, 16 August 2007, p2.
2. Down's syndrome test 'risk to healthy babies'. The Daily Telegraph, 16 August 2007, p2.
3. Meire HB. Is Ultrasound as Useful as We Think?: The Donald, MacVicar and Brown Lecture 2006. Ultrasound 2007;15(3):177-184.
4. Maney Publishing. Is ultrasound as useful as we think? Press Release, 16 August 2007
5. Neilson JP. Ultrasound for fetal assessment in early pregnancy. Cochrane Database of Systematic Reviews 1998, Issue 4. Art. No.: CD000182. DOI: 10.1002/14651858.CD000182.
6. Framarin A. First-trimester prenatal screening for Down syndrome and other aneuploidies. Montreal, PQ, Canada: Agence d'Evaluation des Technologies et des Modes d'Intervention en Sante (AETMIS). AETMIS; 03-01, 2003. [DARE Abstract]
7. Pearson V. Antenatal ultrasound scanning. Bristol: University of Bristol, Department of Social Medicine, Health Care Evaluation Unit, 1994. [DARE Abstract]
8. Bricker L, Garcia J, Henderson J, Mugford M, Neilson J, Roberts T, et al. Ultrasound screening in pregnancy: a systematic review of the clinical effectiveness, cost-effectiveness and women's views. Health Technology Assessment 2000;4(16):1-193. [DARE Abstract]
9. Smith-Bindman R, Hosmer W, Feldstein VA, Deeks JJ, Goldberg JD. Second-trimester ultrasound to detect fetuses with Down syndrome: a meta-analysis. JAMA 2001;285(8);1044-1055. [DARE Abstract]
Consumer information
NHS Direct - Down's Syndrome
Down's Syndrome Association
The Down Syndrome Educational Trust
Previous Hitting the Headlines summaries on this topic
'Repeated ultrasound scans safe for foetus'. Hitting the Headlines archive, 6 December 2004.
NHS shuns best test for Down's. Hitting the Headlines archive, 24 August 2001.
Further information about Hitting the Headlines
Further information about Hitting the Headlines, together with selected relevant links, can be found at http://www.library.nhs.uk/hth/.
