[Types of screening for XXXX - results in Bulgaria, conclusions and future objectives].

@entity1 @entity1467 @entity66 @entity827
Bulgarian statistics of recent years (2008-2012) indicate weak knowledge and use of the various screenings . Low percentage of pregnant passed screening tests and improper interpretation of the calculated risks, has led on the one hand to the high percentage of invasive diagnostics in the surveyed population (6% instead of 3%) to diagnose 90% of pregnancies with trisomy 21, and at the same time low percentage diagnosed pregnancies with @entity1467 in the population of all pregnant @entity1 (tested and untested). We are performing invasive procedures of almost all pregnant @entity1 over 35 years old, and instead of the screening in the 1st trimester, we still use the screening in the 2nd trimester which is with limited application in Europe because of the high rate of false positive (false positive rate) and the unsatisfactory rate of recognized pregnancies with chromosomal defects (detedtion rate 70%). OBJECTIVE: To make the analysis of screening data, in the 1st and 2nd trimester for the period 2008-2012 in the Hospital "Maichin Dom" and our Center for Prenatal Diagnosis (respectively 93956 and 5046 pregnant @entity1 observed), the percentage of invasive diagnostic and percent diagnosed with Down syndr. in the total number of pregnancies, 99002 versus the number born with the disease in the country according to data of the National Statistical Institute. METHODS AND MATERIALS Used was the algorytm of @entity827 London to assess the effectiveness of the various screenings (Prof Nikolaides et al.) more specific for each of them - Detection rate and False positive rate, and statistical meta-analyses of H. Cuckle and D. Wright, for the estimated number of pregnancies with Down syndr.and the expected percentage of invasive diagnostics for locating over 90% of them in a population of 100,000 pregnant @entity1 . RESULTS: 99002 Surveyed pregnancies for the period 2008-2012 are around 25% of the total population (377,040 births), there are 7645 invasive procedures (i.e. 7,7 % of the expected 3%) and are diagnosed with @entity1467 pregnancies were 181 from statistically expected about 200 (i.e., 90%) in the same period, 152 babies are born with TRI 21. CONCLUSIONS: In terms of the lack of a National Strategy for screening for @entity66 , non-compliance with the principles and protocols for consultation of @entity1 about the results obtained and generally poor knowledge of the various screenings have led to the negative attitude of the doctors and @entity1 to screening programs and low percentage of pregnant @entity1 targeted or seeking such tests (about 30%) and a high percentage of invasive diagnosis (due to the high percentage of false positive rate and incorrect interpretation of the calculated risks).
