Adverse obstetric outcome in low- and high-risk pregnancies: predictive value of maternal serum screening

Rijn, Michiel van; Schouw, Yvonne T. van der; Hagenaars, A. M.; Visser, Gerard H.A.; Christiaens, G. C. M. L.

doi:10.1016/s0029-7844(99)00467-6

Cited by 47 publications

(34 citation statements)

References 25 publications

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“…Elevated ß-hCG is associated with Down syndrome (DS), and is therefore used in most second trimester maternal serum biochemical screening tests. Abnormally elevated second trimester ßhCG has also been linked, in a several studies, with an increased risk of adverse pregnancy outcomes such as proteinuric and non-proteinuric pregnancy-induced hypertension (PIH), preterm delivery, low birth weight, fetal growth restriction (FGR), fetal and neonatal deaths [1][2][3][4][5][6][7]. It was postulated that placental vascular changes in the second trimester result in these adverse outcomes.…”

Section: Introductionmentioning

confidence: 99%

First Trimester Maternal Serum Free Human Chorionic Gonadotropin as a Predictor of Adverse Pregnancy Outcome

Yaron¹,

Ochshorn

Heifetz

et al. 2002

Fetal Diagn Ther

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Objective: The purpose of this study was to evaluate whether abnormal levels of first trimester maternal serum free human chorionic gonadotropin (β-hCG) are predictive of adverse pregnancy outcomes. Methods: The study included 1,622 consecutive patients with singleton pregnancies who underwent first trimester Down syndrome screening using nuchal translucency, and maternal serum free β-hCG and pregnancy-associated plasma protein-A. Patients with fetal anomalies or chromosome aberrations were excluded from the study. The incidences of various adverse pregnancy outcomes were evaluated according to maternal serum free β-hCG levels. Outcome variables included spontaneous miscarriage, proteinuric and non-proteinuric pregnancy-induced hypertension, fetal growth restriction, intrauterine fetal demise, spontaneous preterm delivery, oligohydramnios and placental abruption. Results: No significant differences were noted between groups for any of the demographic variables. The only statistically significant result was an increase in the relative risk for spontaneous miscarriage (RR = 6.33) at free β-hCG <0.2 multiples of the medians. No other statistically significant result was noted for the other adverse outcomes or for the overall complication rate. Conclusion: Low free β-hCG is associated with a higher incidence of spontaneous miscarriage but is a poor predictor of other pregnancy complications.

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Section: Introductionmentioning

confidence: 99%

First Trimester Maternal Serum Free Human Chorionic Gonadotropin as a Predictor of Adverse Pregnancy Outcome

Yaron¹,

Ochshorn

Heifetz

et al. 2002

Fetal Diagn Ther

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“…Furthermore, unexplained elevated ␣ -FP values are predictive of fetal death, imminent [6] , or until term [15,16] . Increased ␣ -FP levels in the maternal serum and amniotic fluid are associated with loss of cutaneous integrity, as it occurs in uncovered neural tube defects [17] , omphalocele or gastroschisis, Meckel syndrome and trisomy 13 with scalp defects [18] .…”

Section: Discussionmentioning

confidence: 99%

“…The risk of adverse outcome seems to be significantly greater when both ␣ -FP and hCG are abnormally increased than when elevation of either analyte alone occurs [7,8] . The specific pathophysiologic mechanism for this association is unknown [6,8] , but most probably appears to be related to placental dysfunction [6,28] . To the best of our knowledge, this is the first report of second trimester abnormal levels of biochemical markers associated with ABS.…”

Section: Discussionmentioning

confidence: 99%

A Stillborn Fetus with Amniotic Band Syndrome and Elevated Levels of α-Fetoprotein plus β-Human Chorionic Gonadotropin: A Case Report

et al. 2008

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Amniotic band syndrome is an uncommon, congenital fetal abnormality with multiple disfiguring and disabling manifestations. A wide spectrum of clinical deformities are encountered and range from simple ring constrictions to major craniofacial and visceral defects. We report a case of constriction amniotic bands involving upper extremities and intrauterine fetal death due to strangulation of umbilical cord. Abnormally elevated levels of α-fetoprotein and β-chorionic gonadotropin were detected at 17 weeks’ gestation. They were probably caused by the loss of cutaneous integrity of the fetus (α-fetoprotein), and by the placental attempt to counteract the fetal growth restriction and hypoxia, due to the strangulation of umbilical cord by the amniotic bands (β-chorionic gonadotropin).

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“…Unexplained elevations of MSAFP are associated with an increased risk of intrauterine growth restriction, oligohydramnios, fetal demise and maternal pre-eclampsia (11)(12)(13)(14).…”

Section: Screening For Open Neural Tube Defectsmentioning

confidence: 99%

Prenatal diagnosis for paediatricians

Summers

2003

Paediatrics &Amp; Child Health

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Adverse obstetric outcome in low- and high-risk pregnancies: predictive value of maternal serum screening

Abstract: In women at low risk, elevated MSAFP and/or maternal serum hCG values are predictive of adverse pregnancy outcome. In women with a priori elevated risk, abnormal serum values do not increase this risk.

Cited by 47 publications

References 25 publications

First Trimester Maternal Serum Free Human Chorionic Gonadotropin as a Predictor of Adverse Pregnancy Outcome

First Trimester Maternal Serum Free Human Chorionic Gonadotropin as a Predictor of Adverse Pregnancy Outcome

A Stillborn Fetus with Amniotic Band Syndrome and Elevated Levels of α-Fetoprotein plus β-Human Chorionic Gonadotropin: A Case Report

Prenatal diagnosis for paediatricians

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