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Correction to Wald et al., N Engl J Med 341(7):461-467 August 12, 1999.

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Volume 341:1935-1937 December 16, 1999 Number 25
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Integrated Screening for Down's Syndrome

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 by Copel, J. A.
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 by Wald, N.J.
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 by Wald, N.J.
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To the Editor: Wald et al. (Aug. 12 issue)1 describe a protocol for screening for Down's syndrome that is based on tests performed during both the first and second trimesters of pregnancy. However, their estimates are based on data from multiple studies, some rather small. Most important, they fail to consider the advantages of a diagnosis in the first trimester.

Chorionic-villus sampling in the first trimester and amniocentesis in the second trimester are equally effective and safe procedures with similar rates of procedure-induced loss at experienced centers.2,3 Total loss rates after chorionic-villus sampling are higher because of the higher rate . . . [Full Text of this Article]

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