PLACENTAL MOSAICISM IS ASSOCIATED WITH UNEXPLAINED SECOND-TRIMESTER ELEVATION OF MShCG LEVELS, BUT NOT WITH ELEVATION OF MSAFP LEVELS

Morssink, Leonard P.; Sikkema‐Raddatz, Birgit; Beekhuis, J. R.; Wolf, B. T. H. M. De; Mantingh, A.

doi:10.1002/(sici)1097-0223(199609)16:9<845::aid-pd958>3.0.co;2-0

Cited by 31 publications

(12 citation statements)

References 23 publications

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“…Since the number of CPM cases in the present study is small, the percentage of poor pregnancy outcome is more an indication than a precise risk ®gure. However, Morssink et al (1996) measured elevated levels of maternal serum human chorionic gonadotrophin (MShCG) in pregnancies with CPM. This resulted in a negative effect on placental function and fetal development.…”

Section: Discussionmentioning

confidence: 99%

Four years' cytogenetic experience with the culture of chorionic villi

Sikkema‐Raddatz

Bouman

Verschuuren‐Bemelmans

et al. 2000

Prenat. Diagn.

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Section: Discussionmentioning

confidence: 99%

Four years' cytogenetic experience with the culture of chorionic villi

Sikkema‐Raddatz

Bouman

Verschuuren‐Bemelmans

et al. 2000

Prenat. Diagn.

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“…Trophoblastic cells cultured in vitro showed that hypoxia increases hCG production (31). Placental pathology studies suggest that unexplained mid-trimester elevation of ms-hCG levels associated with villitis, placental vascular lesions (infarction, ischemic changes, intervillus thrombosis), velamentous cord insertion and placental mosaicism (26, 28-30, 32, 33). It is unknown whether elevated ms-hCG levels, are the cause or the result of villitis and placental vascular lesions.…”

Section: Evidence Acquisitionmentioning

confidence: 99%

Mid-Trimester Maternal Serum hCG and AFP Levels: Clinical Significance and Prediction of Adverse Pregnancy Outcome

Georgios

Panagiotis

Decavalas

2013

Int J Endocrinol Metab

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ContextMaternal serum human Chorionic Gonadotropin (hCG) and Alpha Fetal Protein (AFP) were originally introduced to detect trisomy 21 and neural tube defects. However, in the absence of aneuploidy or neural tube defects, mid-trimester maternal serum hCG and/or maternal serum AFP associated with adverse pregnancy outcomes. Pregnancies with unexplained mid-trimester elevation in maternal serum hCG and/or maternal serum AFP, are at increased risk for pregnancy complications resulting from placental insufficiency.Evidence AcquisitionMid-trimester maternal serum hCG>2.5 MoM associated with an increased risk for pregnancy complications including: late fetal loss, gestational hypertension, preeclampsia, intrauterine growth restriction (IUGR), preterm delivery and intrauterine fetal death(IUFD). Mid-trimester maternal serum AFP levels >2.5 MoM are thought to reflect a defect in placentation and associated with an increased risk for pregnancy complications including: late fetal loss, gestational hypertension, preeclampsia, IUGR, preterm delivery and IUFD.ResultsCombined mid-trimester elevation in maternal serum hCG and AFP levels suggest a more complex type of placental pathology. They have stronger association with pregnancy complications including: late fetal loss, gestational hypertension, preeclampsia, IUGR, preterm delivery and IUFD.ConclusionsMid-trimester maternal serum hCG or AFP levels alone cannot detect all pregnant women with increased risk to develop pregnancy complications. Multiparameter testing of placental function in mid-trimester (maternal serum hCG and AFP screening, uterine artery Doppler and placental morphology) may allow us to identify women with increased risk to develop severe placental insufficiency and pregnancy complications. However, future prospective studies are needed to confirm the prognostic significance of multiparameter testing of placental function in mid-trimester.

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“…Parmi les dix cas d'ACLP de type 3 homogènes décrites dans ce travail, six cas avaient été recrutés sur l'indication de facteurs sériques maternels du deuxième trimestre plaçant la femme dans la groupe à risque d'attendre un enfant à naître atteint de trisomie 21 [7]. Chez ces patientes, il est intéressant de noter que le taux de b-HCG était considérablement augmenté, avec des valeurs comprises entre 5,14 et 18,0 MdM dans notre étude.…”

Section: Discussionunclassified