Free Beta Human Choriogonadotropin in Down's Syndrome Screening: A Multicentre Study of its Role Compared with other Biochemical Markers

Spencer, Kevin; Ej, Coombes; As, Mallard; Am, Ward

doi:10.1177/000456329202900504

Cited by 180 publications

(129 citation statements)

References 29 publications

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“…(Fifty eight samples from the Romford centre and 27 samples from the Portsmouth centre were reported on as part of a previous study.) 6 To obtain information on gestational age-related reference ranges, each centre provided gestational age-matched control samples from unaffected singleton pregnancies across the gestational age range 15-21 weeks. Table 1 summarizes the study populations.…”

Section: Methodsmentioning

confidence: 99%

Dual Analyte Immunoassay in Neural Tube Defect and Down's Syndrome Screening: Results of a Multicentre Clinical Trial

et al. 1993

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SUMMARY. We report a multicentre clinical field trial of a novel dual analyte enzyme immunoassay method for the simultaneous measurement of alpha-fetoprotein (AFP) and free (j-human choriogonadotropin (hCG) in the same micro titre well. The assay was shown to have good technical performance in the hands of all trial centres, with between assay coefficients of variation better than 10% for both analytes across the whole of the assay ranges. The method compared well with single analyte measuring procedures and produced acceptable performance as judged by external quality assurance criteria. Recovery of added analyte and analyte dilution curves also showed acceptable performance.In clinical evaluation of a large set of neural tube defect cases, good clinical discrimination from unaffected cases was observed using AFP. With over 150 Down's syndrome cases, the combination of AFP and free (3 hCG confirmed the high detection rates achievable using this marker combination, with detection rates in excess of 70% in early gestation.We conclude that the combination of clinically superior markers coupled with technologically innovative assay design will lead to more efficient Down's screening programmes. Additional key phrases: alpha-fetoprotein; free beta-human choriogonadotropinIn many parts of the developed world, second trimester screening for neural tube defects using the biochemical marker maternal serum crfetoprotein (AFP) has been a routine part of obstetric practice since the publication of the UK Collaborative studies in the mid 1970s.1 The observation by one of US,2 that lowered levels of maternal serum AFP during the second trimester were associated with fetal chromosomal trisomies, added a further dimension to second trimester Correspondence: Mr K Spencer. 394 screening for birth defects. More recently, the use of new biochemical markers has been shown to improve screening efficiency, such that with the markers AFP and free (j-human choriogonadotropin (hCG) it is now possible to achieve detection rates of the order of 75-80010 as demonstrated in retrospective':" or prospective? studies. The recent observation that maternal serum free (j-hCG is also elevated in the first trimester of pregnancies affected by Down's syndrome and lowered in pregnancies affected by trisomy 18, provides further evidence of the value of this biochemical marker. 8

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Section: Methodsmentioning

confidence: 99%

Dual Analyte Immunoassay in Neural Tube Defect and Down's Syndrome Screening: Results of a Multicentre Clinical Trial

et al. 1993

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“…The major breakthrough of early screening was the identification (29,30) and implementation (31) of nuchal translucency measurements between the 11th and the 14th weeks ' of gestation. During the early 1990s, several studies reported the association between DS and low levels of the pregnancyassociated plasma protein A (PAPP-A) (7) with high levels of hCG (32) ; plus the use of these for screening in the fi rst trimester (33) . The combination of the NT measurement with these two serum biochemical markers in the fi rst trimester make up the combined test, with a signifi cant and important decrease in the false positivity rate (34,35) .…”

Section: First Trimester Screening Testsmentioning

confidence: 99%

Recommendations on prenatal screening and the connections to other diseases such as thyroid dysfunction

Springer

Potluková²,

Límanová³

et al. 2012

Clinical Chemistry and Laboratory Medicine (CCLM)

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The aim of general maternal-foetal care is to ensure an uncomplicated birth of a healthy baby to a healthy mother. There is a large range of screening tests used during pregnancy: for gestational diabetes, infection, rhesus-D status, thyroid dysfunction, as well as other tests. An important part of prenatal care is the screening of major aneuploidies, primarily for Down ' s syndrome. This screening is possible in either the fi rst or second trimester, or in both. Management of this type of screening is very similar around the world. Hypothyroidism can affect the psychomotor development of the child. Thyroidstimulating hormone (TSH), autoantibodies against thyroperoxidase (TPOAb), and free thyroxin (FT4) were determined within our group of 7530 pregnant women. Elevated concentrations of TSH were found in 5.1 % , suppression was found in 2.9 % and 11.5 % were TPOAb positive. Either a familial or personal history of thyroid or autoimmune diseases was present in 58.3 % of those women who tested positive on any thyroid test. At minimum, 40 % of women TPOAb positive during pregnancy have some kind of thyroid disorders after delivery. These results support the effi cacy of general thyroid function screening in early pregnancy, as well as the follow-up after delivery of those women who are positive.

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“…During the second trimester of pregnancy, fetal Down syndrome is associated with increased maternal serum levels of a variety of secretory products of the placenta, including progesterone, human placental lactogen, schwangerschaftsprotein 1, human chorionic gonadotropin (hCG), and the free a and b subunits of hCG (1). hCG and free b-hCG are now commonly used in screening serum for fetal Down syndrome and their levels in Down syndrome are, on average, about double those in unaffected pregnancies (2). Recently, the amounts of another placental protein, inhibin A were also shown to be about twice as great in maternal serum from Down syndrome than in serum from unaffected pregnancies (3)(4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Second trimester levels of maternal serum total activin A and placental inhibin/activin alpha and betaA subunit messenger ribonucleic acids in Down syndrome pregnancy

Lambert-Messerlian

Luisi²,

Florio³

et al. 1998

European Journal of Endocrinology

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Objectives: Previous data have shown that inhibin A (a/bA) is increased about twofold in maternal serum samples from Down syndrome pregnancy. Our objectives were to determine whether activin A (bA/bA) was similarly increased in maternal serum from pregnancies affected with fetal Down syndrome, and to investigate whether increased expression of each inhibin/activin subunit occurred in placental tissue from cases of fetal Down syndrome. Design and methods: Maternal serum total activin A levels were measured in 20 cases of fetal Down syndrome and 100 unaffected pregnancy samples. In addition, analysis of inhibin/activin a and bA subunit mRNA levels was performed in placental tissue extracts from six cases of fetal Down syndrome and six tissues with a normal karyotype. Results: The median total activin A level in the Down syndrome cases was 0·82 MoM (multiples of the median); values did not differ significantly (P ¼ 0.36, Mann-Whitney U analysis) from those in unaffected pregnancies. The inhibin a subunit/GAPDH mRNA ratio, but not that of bA subunit/ GAPDH mRNA, was significantly greater (P < 0.01, ANOVA) in placental tissue from Down syndrome than in control placental tissue. Conclusions: Unlike inhibin A, activin A is not significantly increased in Down syndrome relative to unaffected pregnancy. Furthermore, increased amounts of maternal serum inhibin A in Down syndrome pregnancy probably result from increased placental expression of inhibin a, but not bA, subunit. [425][426][427][428][429] European Journal of Endocrinology 138

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Free Beta Human Choriogonadotropin in Down's Syndrome Screening: A Multicentre Study of its Role Compared with other Biochemical Markers

Cited by 180 publications

References 29 publications

Dual Analyte Immunoassay in Neural Tube Defect and Down's Syndrome Screening: Results of a Multicentre Clinical Trial

Dual Analyte Immunoassay in Neural Tube Defect and Down's Syndrome Screening: Results of a Multicentre Clinical Trial

Recommendations on prenatal screening and the connections to other diseases such as thyroid dysfunction

Second trimester levels of maternal serum total activin A and placental inhibin/activin alpha and betaA subunit messenger ribonucleic acids in Down syndrome pregnancy

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