Quad Screen as a Predictor of Adverse Pregnancy Outcome

Abstract

These data suggest that components of the quad screen may prove useful in predicting adverse obstetric outcomes. We also showed that the total number and specific combinations of abnormal markers are most useful in predicting the risk of adverse perinatal outcome.

RETIRED: Diagnosis, Evaluation, and Management of the Hypertensive Disorders of Pregnancy

“…** Subfertility and its treatment (especially the use of donor eggs, sperm and/or gametes), after correction for multiple gestations. *** Decreased first trimester PAPP-A (pregnancy-associated plasma protein A) 65th centile [141], decreased first or second trimester PlGF (placental growth factor) [154][155][156], unexplained increased second trimester AFP (alphafetoprotein) [142][143][144][145][146][147], increased second trimester hCG [145][146][147][148], increased first or second trimester inhibin A [144,[149][150][151][152], increased second trimester activin. [153].…”

First Trimester Maternal Serum Screening Using Biochemical Markers PAPP-A and Free β-hCG for Down Syndrome, Patau Syndrome and Edward Syndrome

“…Some of the advantages of first-trimester biochemical screening over second trimester biochemical screening include providing clinicians and patients with the substantial advantage of an earlier diagnosis, higher detection rates for fetal Down syndrome i.e; 90 % [4] or even higher, compared to 80 % for the second trimester quadruple test [5,6] and 70 % for the older triple screening test [7], and detection of most major chromosome abnormalities other than trisomy 21. It also acts as a nonspecific marker for other birth defects including some major cardiac defects and syndromic conditions.…”

The relationship between second trimester alpha fetoprotein levels and adverse pregnancy outcome

“…A significant association was found between elevated MSAFP and pre-eclampsia, adjusted risk ratio (ARR) being 3.8. Several other studies have also confirmed these finding [2,3,11]. However Kang, Wald and Davidson did not find any significant increase in AFP in those that developed pre-eclampsia compared to controls [15][16][17].…”

“…In the first and second trimester evaluation of risk (FASTER) study involving 33,000 women, MSAFP > 2 MoM was associated with placental abnormalities as well as IUGR (odds ratio 2.7), miscarriage (OR 4.4) and intrauterine fetal death (OR 5.8) [2].…”