Obstetrical complications associated with first‐trimester screening markers in twin pregnancies

İskender, Cantekin; Tarım, Ebru; Çok, Tayfun; Yalçınkaya, Cem; Kalaycı, Hakan; Yanık, Filiz Bilgin

doi:10.1111/jog.12091

Cited by 9 publications

(9 citation statements)

References 17 publications

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“…We identified 4 studies that evaluated the second-trimester serum levels of hCG (2 studies; n = 1868) 85,86 or the first-trimester serum levels of free b-hCG (2 studies; n = 174) 87,88 for predicting preterm birth among women with twin gestations and normal fetuses. Overall, the predictive performance of high maternal serum levels of hCG (≥5.0 MoM 85 or >3 MoM 86 ) or free β-hCG (>75th percentile 87 or >90 th percentile 88 ) for preterm birth at <32, <34, and <37 weeks of gestation was low (sensitivities between 7–24%, specificities between 75–97%, and positive and negative likelihood ratios between 0.9–3.0 and between 0.9–1.0, respectively).…”

Section: Biochemical Testsmentioning

confidence: 99%

“…Overall, the predictive performance of high maternal serum levels of hCG (≥5.0 MoM 85 or >3 MoM 86 ) or free β-hCG (>75th percentile 87 or >90 th percentile 88 ) for preterm birth at <32, <34, and <37 weeks of gestation was low (sensitivities between 7–24%, specificities between 75–97%, and positive and negative likelihood ratios between 0.9–3.0 and between 0.9–1.0, respectively).…”

Section: Biochemical Testsmentioning

confidence: 99%

“…87–89 The overall predictive ability of low serum levels of PAPP-A (defined as ≤25th percentile, 87 <10th percentile, 88 or <5th percentile 89 ) for preterm birth at <32, <34, <35, and <37 weeks of gestation was minimal (sensitivities ranging from 5–56%, specificities from 78–95%, and positive and negative likelihood ratios from 1.0–2.9 and 0.6–1.0, respectively).…”

Section: Biochemical Testsmentioning

confidence: 99%

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Prediction of preterm birth in twin gestations using biophysical and biochemical tests

Conde-Agudelo

Romero

2014

American Journal of Obstetrics and Gynecology

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The objective of this study was to determine the performance of biophysical and biochemical tests for the prediction of preterm birth in both asymptomatic and symptomatic women with twin gestations. We identified a total of 19 tests proposed to predict preterm birth, mainly in asymptomatic women. In these women, a single measurement of cervical length with transvaginal ultrasound before 25 weeks of gestation appears to be a good test to predict preterm birth. Its clinical potential is enhanced by the evidence that vaginal progesterone administration in asymptomatic women with twin gestations and a short cervix reduces neonatal morbidity and mortality associated with spontaneous preterm delivery. Other tests proposed for the early identification of asymptomatic women at increased risk of preterm birth showed minimal to moderate predictive accuracy. None of the tests evaluated in this review meet the criteria to be considered clinically useful to predict preterm birth among patients with an episode of preterm labor. However, a negative cervicovaginal fetal fibronectin test could be useful in identifying women who are not at risk for delivering within the next week, which could avoid unnecessary hospitalization and treatment. This review underscores the need to develop accurate tests for predicting preterm birth in twin gestations. Moreover, the use of interventions in these patients based on test results should be associated with the improvement of perinatal outcomes.

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Section: Biochemical Testsmentioning

confidence: 99%

Section: Biochemical Testsmentioning

confidence: 99%

Section: Biochemical Testsmentioning

confidence: 99%

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Prediction of preterm birth in twin gestations using biophysical and biochemical tests

Conde-Agudelo

Romero

2014

American Journal of Obstetrics and Gynecology

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“…Data from current literature are still contradictory regarding the strength of association between pregnancy biochemical markers and twin pregnancy outcomes 12,13 . Biochemical markers are associated with a variety of external factors, such as patient's and partner's age, demographic data, course and outcome of previous pregnancies, especially premature births, spontaneous abortion, perinatal morbidity and mortality, type of performed ART (IVF, ICSI, DO), number of previous unsuccessful ART attempts, the course of current pregnancy and the presence of symptoms that indicate imminent abortion or premature delivery 12,13 . There is still an on going debate how could serum biomarkers be used in the prediction of pregnancy course and outcome.…”

Section: Discussionmentioning

confidence: 99%

Twin pregnancies concieved by assisted reproduction - early prediction of preterm birth

et al. 2020

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Background/Aim. Twins conceived by assisted reproduction techniques (ART) are the most susceptible for perinatal complications. The aim of this study was to examine the role of prenatal noninvasive fetal screening of the first and second trimester in prediction of delivery time of ART conceived twins. Methods. Prospective cohort study of all ART conceived twin pregnancies was conducted at the Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, during the period from January 1, 2016 to December 31, 2017. In the 12th gestational week (GW) twins crown-rump lenght (CRL) and thickness nuchal translucency (NT) were measured ultrasonographically. Moreover, serum levels of beta subunit of human chorionic gonadotropin (β hCG) and pregnancy-associated plasma protein A (PAPPA) were assessed. In the 17th GW twins biparietal diameter (BPD), abdominal circumference (AC) and femur length (FL) were determined ultrasonografically. Additionally, β hCG, alphafetoprotein (AFP), estriol (E3) and inhibin (INH) were measured in mothers serum. The GW of delivery was noted for each pregnancy. Results. Study included 100 pregnant women with mean age 35.44 ± 5.82. In the examined sample of ART conceived twins significantly more (51%) were delivered in term (≥ 35 GW) (p = 0.001). Delivery time correlated negatively with NT and first trimester β hCG serum levels, while it correlated positively with FL of the smaller twin, second trimester β hCG, AFP and E3 concentrations. According to obtained model for prediction of delivery time in ART conceived twin pregnancies based on first trimester diagnostic tests the significant predictors were PAPPA and β hCG in the 12th GW as well as NT of the first larger twin. Nevertheless, reliability (sensitivity 50%-75%, specificity 30%-40%) of these diagnostic tests was moderate. Conclusion. Prenatal noninvasive fetal screening of the first and second trimester (ultrasonography and laboratory testing) can be used for prediction of delivery time of ART conceived twins. ApstraktUvod/Cilj. Blizanci nastali tehnikama asistirane reprodukcije (ART) su najosetljiviji na pojavu perinatalnih komplikacija. Cilj rada bio je da se ispita uloga prenatalnog neinvazivnog fetalnog skrininga prvog i drugog trimestra u predviđanju vremena porođaja blizanaca nastalih metodama ART. Metode. Prospektivna kohortna studija kojom su obuhvaćene sve blizanačke trudnoće nastale ART metodama sprovedena je na Klinici za ginekologiju i akušerstvo Kliničkog centra Srbije u periodu od 01. 01.2016. do 31.12.2017. U 12. gestacionoj nedelji (GN) ultrasonografski su blizancima izmereni razmak teme-trtica (CRL) i nuhalno zadebljanje (NT). Takođe, određeni su serumski nivoi beta podjedinice humanog horionskog gonadotropina (β hCG) i plazma proteina A povezanog sa trudnocćom (PAPPA). U 17. GN ultrasonografski su blizancima izmereni biparietalni dijametar (BPD), obim abdomena (AC) i dužine femura (FL). Pored toga, β hCG, alfa fetoprotein (AFP), estriol (E3) i inhibin (INH) su izmereni u serumu majki. Za svaku trudnocú zabeležena je G...

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“…An elevated β-hCG level is associated with adverse pregnancy outcomes during different phases of pregnancy; for example, for triploidy risk in the first trimester, the screening result might be positive for trisomy 21 if the calculated risk is at least 1 in 270 pregnancies and positive for trisomy 18 if the risk is at least 1 in 150 [41]. Elevated β-hCG might also be correlated with maternal impaired renal function, preterm delivery and intrauterine growth retardation in the second trimester due to placental hypoxia [13,42,43]. The MoM of β-hCG is a concentration index representing the MoM of normal β-hCG levels found in healthy pregnant women [44].…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Free β-hCG Multiple of the Median for Women with Preeclampsia

Liu¹,

Wang²,

Wang³

et al. 2015

Gynecol Obstet Invest

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Background: Preeclampsia (PE) is relatively common and is unpredictable in its onset and progression. Aims: We investigated the clinical value of using the multiple of the median (MoM) of free β-human chorionic gonadotropin (β-hCG) concentrations in women with normal pregnancy and PE. Methods: This study was based on a dataset available from published studies, and the relevant studies were retrieved from multiple electronic databases. Data were extracted from case-control studies; a random-effects model was employed, and standardized mean difference and 95% confidence intervals were calculated. Twelve case-control studies (eleven English-based articles and one Chinese-based article) were analyzed in the current meta-analysis and included 702 patients with PE and 8,233 women with normal pregnancies. Results: Statistical analysis revealed a higher MoM of β-hCG serum levels in patients with PE. Ethnicity subgroup analysis showed that the MoM of serum β-hCG levels was significantly higher in women with PE in both Asian and Caucasian populations. Conclusion: The MoM of β-hCG serum levels was significantly increased in women with PE compared to women with normal pregnancies. Screening for serum β-hCG MoM levels will be helpful in the early identification of pregnancies at risk of developing PE.

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Obstetrical complications associated with first‐trimester screening markers in twin pregnancies

Abstract: Elevated first-trimester free β-hCG was related to adverse pregnancy outcomes in twin pregnancies, whereas low PAPP-A levels were not linked to adverse pregnancy outcomes.

Cited by 9 publications

References 17 publications

Prediction of preterm birth in twin gestations using biophysical and biochemical tests

Prediction of preterm birth in twin gestations using biophysical and biochemical tests

Twin pregnancies concieved by assisted reproduction - early prediction of preterm birth

Predictive Value of Free β-hCG Multiple of the Median for Women with Preeclampsia

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