The serum screening test for trisomy 21 was offered to all pregnant women in East Finland during 1993. The results and the women’s views on trisomy screening are reported here. A total of 9,343 (89%) of the pregnant women participated in the screening. A total of 615 women were eligible for amniocentesis or chorionic villus sampling; among them 22 pregnancies were affected by Down syndrome. Fifteen of them were detected by double screening; in 2 missed cases only maternal-serum alpha-fetoprotein had been determined. In all 5 cases missed by double screening the maternal age was less than 30 years. The women’s attitudes were studied by means of a questionnaire, which was mailed to 214 women. The response rate to our questionnaire was 74%. A total of 87% of respondents highly or very highly valued the opportunity to participate in the screening. Despite the existing problems caused by late testing, 87% of respondents want to be tested again in their future pregnancies.
It is concluded that up-regulation of tumor suppressor and growth regulatory genes may play an important role in the pathogenesis of severe early-onset preeclampsia.
In primiparous preeclamptic pregnancies, an elevated maternal serum hCG concentration is a marker of early-onset and severe disease with significant maternal and perinatal morbidity. This finding, in turn, reinforces the association between elevated hCG concentrations and placental damage in early pregnancy. Elevated maternal serum hCG levels identify a subgroup of preeclamptic patients who deserve more intensive observation.
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