Le dépistage des aneuploïdies en Tunisie: à quand la généralisation du calcul de risque intégré au premier trimestre ?

In Tunisia, we don't have a national aneuploidy screening program. We intend to compare two methods of screening for aneuploidies in the same population and discuss the importance of quality of nuchal translucency measurements during ultrasound examination in the first trimester. This is a prospective study over a period of 18 months. We compared the results of the risk calculation carried out using two methods. The first method took into account only maternal age and serum markers while the second method additionally integrated nuchal translucency. 19% of 221 women in labor were older than 38 years. The first screening method was sensitive to the single case of aneuploidy registered. The power of this test was 60%. The analysis of serum markers in the second trimester enabled the detection of neural tube closure defects with a statistically significant value in terms of specificity (98.6%) and negative predictive value (100%). The median values of the NT measurements was 0,75 MoM for gestational age. Only 17.6% of measures were within the range [0.9 -1.1] MoM. We didn't objectify significant difference between the two screening methods with regard to power. However, in terms of false positives, combined test was more interesting, its use could have prevented 18 invasive specimens. In the immediate future Tunisia will have to move towards combined first-trimester screening. This strategy can only be realized after establishing a quality control of biological and ultrasound measures. [ABSTRACT FROM AUTHOR]