Document Detail


Adverse perinatal outcome in patients screen-positive for neural tube defects and fetal Down syndrome.
MedLine Citation:
PMID:  7526367     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
An association between various abnormal mid-trimester maternal serum analyte values and adverse perinatal outcome has been reported. From an original sample of 14,857 women, we observed five women who were 'screen-positive' for both neural tube defects [maternal serum alpha-fetoprotein (MSAFP) > or = 2.5 multiples of the median] and Down syndrome [risk > or = 1/274 using MSAFP, maternal serum unconjugated oestriol (MSuE3), maternal serum human chorionic gonadotropin (MShCG), and maternal age]. The four patients who elected to undergo amniocentesis all demonstrated both normal karyotype and normal amniotic fluid AFP levels. All five cases were associated with intrauterine growth retardation (IUGR) and abnormal pregnancy outcomes. Two cases exhibiting severe IUGR on ultrasound examination were terminated at 19.1 and 21.2 weeks, respectively; the former also exhibited fetal calcifications and positive maternal serology for toxoplasmosis. In another case, fetal demise occurred at 36 weeks' gestation in a patient who had been treated for syphilis in the second trimester. Neither infection was confirmed in fetal tissue studies. Though resulting in live births, the remaining two cases required operative deliveries; emergency Caesarean sections for fetal distress were performed at 38 and 32 weeks, respectively, the latter case being associated with severe pre-eclampsia. We conclude that elevated mid-trimester MSAFP levels concurrent with maternal serum analyte values associated with increased risk for fetal Down syndrome may presage a poor perinatal outcome, particularly IUGR and possibly congenital infection.
Authors:
S J Gross; O P Phillips; L P Shulman; N L Bright; J S Dungan; J L Simpson; S Elias
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  14     ISSN:  0197-3851     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  1994 Jul 
Date Detail:
Created Date:  1994-12-16     Completed Date:  1994-12-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  609-13     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, University of Tennessee, Memphis 38103-2896.
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MeSH Terms
Descriptor/Qualifier:
Adult
Amniocentesis
Chorionic Gonadotropin / blood
Down Syndrome / diagnosis*
Estriol / blood
Female
Fetal Death
Fetal Diseases / diagnosis
Fetal Growth Retardation
Humans
Karyotyping
Neural Tube Defects / diagnosis*
Pregnancy
Pregnancy Outcome*
Prenatal Diagnosis*
Risk Factors
Ultrasonography, Prenatal
alpha-Fetoproteins / analysis
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin; 0/alpha-Fetoproteins; 50-27-1/Estriol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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