| First trimester aneuploidy screening in the presence of a vanishing twin: implications for maternal serum markers. | |
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MedLine Citation:
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PMID: 20066674 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To assess the impact of a vanishing twin on the levels of the biochemical markers used in the first trimester aneuploidy screening. METHODS: A retrospective analysis of free beta-hCG and PAPP-A levels in 270 women with a normal singleton fetus with ultrasound evidence of a vanishing twin pregnancy. Marker levels (as MoM) were compared in three groups-76 women with a second empty gestational sac, 194 women with a second gestational sac containing a dead fetus with a measurable crown rump length (CRL), and 1360 matched singleton pregnancies. RESULTS: In women with a second empty gestational sac, the median free beta-hCG and PAPP-A MoMs (0.968 and 1.040, respectively) were not significantly different from the 1.0 MoM in singleton pregnancies. In the group with a vanished twin with a measurable-CRL-there was a significantly increased median PAPP-A MoM (1.317) but the median free beta-hCG MoM was not changed (1.024). Modelling this bias in PAPP-A MoM the detection rate for trisomy 21 would fall from 85 to 75%. CONCLUSION: First trimester screening in the presence of a vanishing twin may lead to errors in risk estimation. In such circumstances it may be advisable to restrict screening to the use of nuchal translucency (NT) alone. |
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Authors:
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K Spencer; I Staboulidou; K H Nicolaides |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Prenatal diagnosis Volume: 30 ISSN: 1097-0223 ISO Abbreviation: Prenat. Diagn. Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-01 Completed Date: 2010-06-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8106540 Medline TA: Prenat Diagn Country: England |
Other Details:
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Languages: eng Pagination: 235-40 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2009 John Wiley & Sons, Ltd. |
Affiliation:
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Prenatal Screening Unit, Clinical Biochemistry Department, King George Hospital, Goodmayes, UK. KevinSpencer1@aol.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abortion, Missed
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blood*,
ultrasonography Adult Aneuploidy* Biological Markers / blood* Chorionic Gonadotropin, beta Subunit, Human / blood* Diseases in Twins / blood*, ultrasonography Female Fetal Death / blood*, ultrasonography Humans Pregnancy Pregnancy Trimester, First / blood* Pregnancy-Associated Plasma Protein-A / analysis* Retrospective Studies Twins, Dizygotic Twins, Monozygotic |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Chorionic Gonadotropin, beta Subunit, Human; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A |
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