Improving Methods of Screening for Down's Syndrome

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Abstract
To the Editor: Various screening procedures have been proposed to identify pregnant women at risk for having a baby with Down's syndrome. The goal has been to restrict amniocentesis, the definitive prenatal diagnostic procedure, to a minimum. The use of low values for maternal serum alpha-fetoprotein concentrations1 alone is hampered by the considerable overlap of levels between normal and abnormal pregnancies, although discrimination can be improved by also considering maternal age.2 To improve discrimination, we examined the predictive power of the serum concentration of maternal human chorionic gonadotropin (hCG) in relation to alpha-fetoprotein concentration. Levels of hCG and chromosomal abnormalities . . .