Antenatal down syndrome screening in the united states in 2001: A survey of maternal-fetal medicine specialists

Objective: Our objectives were to determine patterns of antenatal Down syndrome screening and risk adjustment by maternal-fetal medicine specialists in the United States in 2001. Study Design: A survey to investigate Down syndrome screening practice patterns was mailed to the 1638 members of the Society of Maternal-Fetal Medicine in the United States. Practice demographics, screening patterns, and the numeric risks quoted in counseling were analyzed. Results: Five hundred forty-three specialists (33.2%) responded; 530 of these specialists (97.6%) performed antenatal Down syndrome screening; all of them offered second-trimester screening, and 247 of them (45.5%) offered first-trimester screening. With the use of second-trimester ultrasonography, risk was increased by 69.4% of respondents and decreased by 33.1%. Amniocentesis was the most frequently used diagnostic test (83.2%), with loss rates quoted at 1:100 to 1:1000. Conclusion: Maternal-fetal medicine specialists show a wide in variation practices used for Down syndrome screening, modification of risk, and quoted procedure-related loss rates. This information calls for a consensus regarding risks that are quoted in Down syndrome counseling. (Am J Obstet Gynecol 2002;187:1230-4.)