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Effecitive screening for major aneuploidies can be provided in the firest trimester of pregnancy. Screening by a combinatioβn of fetal nuchal translucency and maternal serum free-β-human chorionci gonadotrophin and pregnancy-associated plasma protein-A can identify about 90% of fetuses with trisomy 21 and other major aneupolidies for a false-positive rate 5%. Improvement in the performance of first-trimester screening can be achieve b firstly, inclusion in the ultrasound examination assessment of the nasal bone and flow in the ductus venosus, hepatic arter and across the tricuspid valve, and secondly, carrying out the biochemical test at 9 to 1o weeks and the ultrasound scan at 12 weeks.
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