Inverted Pyramid of Care

Jiri D Sonek; Karl Oliver Kagan; Kypros H Nicolaides

doi:10.1016/j.cll.2016.01.009

Inverted Pyramid of Care

Clin Lab Med. 2016 Jun;36(2):305-17. doi: 10.1016/j.cll.2016.01.009. Epub 2016 Mar 14.

Authors

Jiri D Sonek¹, Karl Oliver Kagan², Kypros H Nicolaides³

Affiliations

¹ Center for Maternal-Fetal Medicine, Ultrasound, and Genetics, Fetal Medicine Foundation of USA, Wright State University, Berry Pavilion, 1 Wyoming Street, Dayton, OH 45409, USA. Electronic address: jdsonek@premierhealth.com.
² Department of Gynecology and Obstetrics, Universitäts-Frauenklinik, Calwerstrasse, Tübingen 772076, Germany.
³ Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, 16-20 Windsor Walk, London SE5 8BB, UK.

PMID: 27235914
DOI: 10.1016/j.cll.2016.01.009

Abstract

First-trimester pregnancy evaluation using fetal and maternal parameters not only allows for diagnoses to be made early in gestation but can also assess the risk of complications that become clinically evident later in pregnancy. This evaluation makes it possible for pregnancy care to be individualized. In select cases, treatment that reduces the risk of complications can be started early in pregnancy. Even though cell free DNA is a significant advance in diagnosing fetal aneuploidy, the combination of first-trimester ultrasound and maternal serum biochemistries casts a much wider diagnostic net; therefore, the 2 technologies are best used in combination.

Keywords: Anomalies; Diagnosis; First trimester; Maternal complications; Preeclampsia; Screening.

Publication types

Review

MeSH terms

Aneuploidy
Chromosome Disorders / diagnosis*
Cost-Benefit Analysis
Female
Fetal Development
Humans
Practice Guidelines as Topic
Pregnancy
Pregnancy Trimester, First*
Prenatal Care / methods*
Prenatal Care / trends
Prenatal Diagnosis / methods*
Prenatal Diagnosis / trends
Time Factors