Objectives: To determine the utility of the triple test in routine clinical
practice and in addition to the document, the acceptability of a cut-off o
f 1:250 for invasive testing. Design: Retrospective analysis of data from s
creening and invasive testing for Down syndrome over a 5-year period in Hul
l Maternity Hospital. Computer-based records were accessed and individual d
ata drawn from case notes were analyzed. Results: 14 827 (78%) of all patie
nts opted for the triple test. A positive result (1:250 or greater) was fou
nd in 586 (4%). Fifteen percent of this group refused further testing with
amniocentesis. 0.08% requested amniocentesis despite a negative triple test
result. Of the screened pregnancies the triple test and selective invasive
testing identified nine out of 15 (60%) of Down syndrome cases. Conclusion
: Sixty percent of Down syndrome pregnancies were identified with a 4% inva
sive testing rate. Fifteen percent of women who had a positive test did not
agree with the cut-off of 1:250 and therefore declined invasive testing. I
nvasive procedure complication rates do not equate with patients' perceptio
n of Down syndrome. (C) 2000 International Federation of Gynecology and Obs
tetrics.